When the lie is the truth: Grounded theory analysis of an online support group for factitious disorder

Factitious disorder (FD) is poorly understood because of the elusiveness of sufferers. What is known is based on speculation from observational case studies and this is evident by the manifold diagnostic and treatment issues associated with FD. This study sought to fill the gap in the literature and overcome the elusiveness of FD sufferers by analysing their text communications in two online communities. One hundred twenty four posts by 57 members amounting to approximately 38,000 words were analysed using grounded theory. The analysis showed that contrary to current theories of FD, motivation is conscious and not unconscious, members did experience symptoms associated with the disorder, and they were also upset by their behaviour and wanted to recover but were deterred by fear. Furthermore, using the excessive appetitive model by Orford (2001) it is hypothesised that the characteristics of FD described by the members were congruent with those associated with addiction.