Garnett Spears lived 5 years, and was in the hospital more than 20 times for a variety of illnesses, including ear infections, seizures, fevers and digestive problems. On Monday a jury convicted his mother, Lacey Spears, of causing those illnesses and, eventually, her son’s death by poisoning him with salt, administering heavy concentrations of sodium through his stomach tube. Just before Garnett died, doctors noticed lethal amounts of sodium in his system, levels which one doctor said were “metabolically impossible.”

Spears constantly posted on her blog and social media pages about how much she loved her son, leading to the image portrayed by defense attorneys as that of a dutiful mothers struggling to care for a very ill child. Prosecutors considered her motives to be to make the child sick, calling her actions “nothing short of torture.”

Assistant District Attorney Patricia Murphy said in her closing argument that Spears apparently craved attention from “her family, her friends, her co-workers and most particularly the medical profession.” Experts are suggesting that she may have a rare psychological syndrome known as Munchausen by proxy, a disorder that causes a parent or other guardian to purposely harm a child in order to attract attention and sympathy.

Munchausen by proxy is considered a new branch of the disorder known as Munchausen syndrome, in which someone fabricates illnesses to gain sympathy from the medical community. Munchausen by proxy was introduced in 1977 in a British medical journal paper that called it the “hinterland of child abuse.” The article described parents who through falsification cause their children to undergo multiple harmful hospital procedures.

Children’s Hospital Oakland psychiatrist Herbert Schreier once told Psychology Today that the purpose of the abuse is not to kill, but just to keep the child sick enough that he or she would require medical care, so that the mother can maintain a relationship with the doctor, “who would recognize her devotion, knowledge and sacrifice.”

Spears’ attorneys did not use the syndrome as a defense during the trial. It has only come up in expert commentary in media reports about the case. The syndrome itself has come under criticism as being too outlandish to be real, but anecdotal evidence keeps appearing, such as the 1999 case in which a Florida woman intentionally sickened her child, causing her to go through 40 pointless surgeries. She was convicted of aggravated child abuse.