Investigators should certainly consider the possibility of MSBP if they believe there to be some secondary gain, in the form of attention or notoriety, afforded the offender at the expense of the victim. If investigators find no warning signs associated with MSBP cases or no secondary gain in the form of attention, then they should consider the possibility of homicide without the association of the MSBP factor. Are often upper class, well-educated persons. Remain uncharacteristically calm in view of the victim's perplexing medical symptoms. Praise medical staffs excessively.
Most offenders crave the attention gleaned from hospital staffs, doctors, and family members.
Mothers who have an unusually close relationship with the hospital's medical staff. Appear to be very knowledgeable about the victim's illness. Some offenders might receive gratification as they fool the doctors. They derive enjoyment from knowing what is wrong with the child while medical experts remain baffled. Have some medical education, either formal or through self-initiated study or experience.