Munchausen By Proxy Syndrome Essayscorer
Munchausen syndrome by proxy is the most common term used to describe a type of child abuse in which a caregiver exaggerates, fabricates, or induces symptoms of a medical condition in a child that lead to unnecessary and potentially harmful medical care. Other terms for this rare type of child abuse include: Pediatric symptom falsification, factitious disorder by proxy, fabricated or induced illness by carers, child abuse in a medical setting, or simply medical child abuse.
Use the following resources to learn more about perpetrators of Munchausen syndrome by proxy.
Early Recognition and Management of Fabricated or Induced Illness in Children
Bass & Glaser (2014)
The Lancet, 383(9,926)
Provides an explanation of what constitutes fabricated or induced illnesses in children, possible motivations of perpetrators, characters of perpetrators, and the effects on the child. The report includes information on the child protection process and further therapeutic needs of the child and perpetrator.
Munchausen by Proxy Syndrome
Rady Children’s Hospital
Provides an overview of Munchausen by proxy syndrome, symptoms exhibited by the child and caregiver, causes of the psychiatric condition, and treatment for the child and perpetrator.
Munchausen by Proxy Syndrome (MBPS)
Provides an overview of MBPS, symptoms of MBPS in children and the perpetrators, and causes of MBPS. The page includes information on treatment options for children and the perpetrator.
Munchausen Syndrome by Proxy
Presents the warning signs of Munchausen by Proxy in a child and caregiver, as well as the information on the causes, diagnosis, and treatment of the disorder. The page includes information on the outlook for people with Munchausen Syndrome by Proxy and ways to prevent the disorder from escalating.
The Perpetrators of Medical Child Abuse (Munchausen Syndrome by Proxy) - A Systematic Review of 796 Cases
Bass & Yates (2017)
Child Abuse & Neglect, 72
Presents findings from a case and literature review of perpetrators of Munchausen Syndrome by Proxy. The study concludes with recommendations for practice improvement and further research.
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Munchausen by proxy syndrome (MBPS) is a relatively rare form of child abuse that involves the exaggeration or fabrication of illnesses or symptoms by a primary caretaker.
Also known as "medical child abuse," MBPS was named after Baron von Munchausen, an 18th-century German dignitary known for making up stories about his travels and experiences in order to get attention. "By proxy" indicates that a parent or other adult is making up or exaggerating symptoms in a child, not in himself or herself.
Munchausen by proxy syndrome is a mental illness and requires treatment.
In MBPS, an individual — usually a parent or caregiver— causes or fabricates symptoms in a child. The adult deliberately misleads others (particularly medical professionals), and may go as far as to actually cause symptoms in the child through poisoning, medication, or even suffocation. In most cases (85%), the mother is responsible for causing the illness or symptoms.
Usually, the cause of MBPS is a need for attention and sympathy from doctors, nurses, and other professionals. Some experts believe that it isn't just the attention that's gained from the "illness" of the child that drives this behavior, but also the satisfaction in deceiving individuals whom they consider to be more important and powerful than themselves.
Because the parent or caregiver appears to be so caring and attentive, often no one suspects any wrongdoing. Diagnosis is made extremely difficult due to the the ability of the parent or caregiver to manipulate doctors and induce symptoms in the child.
Often, the perpetrator is familiar with the medical profession and knowledgeable about how to bring on illness or impairment in the child. Medical personnel often overlook the possibility of MBPS because it goes against the belief that parents and caregivers would never deliberately hurt their child.
Most victims of MBPS are preschoolers (although there have been cases in kids up to 16 years old), and there are equal numbers of boys and girls.
Diagnosis is very difficult, but could involve some of the following:
- a child who has multiple medical problems that don't respond to treatment or that follow a persistent and puzzling course
- physical or laboratory findings that are highly unusual, don't correspond with the child's medical history, or are physically or clinically impossible
- short-term symptoms that tend to stop or improve when the victim is not with the perpetrator (for example, when the child is hospitalized)
- a parent or caregiver who isn't reassured by "good news" when test results find no medical problems, but continues to insist that the child is ill and may "doctor shop" to find a professional who believes that
- a parent or caregiver who appears to be medically knowledgeable or fascinated with medical details or seems to enjoy the hospital environment and attention the sick child receives
- a parent or caregiver who's overly supportive and encouraging of the doctor, or one who is angry and demands further intervention, more procedures, second opinions, or transfers to more sophisticated facilities
If you have any concerns about a child you know, it is important to speak to someone at your local child protective services agency — even if you prefer to call in anonymously.
Causes of MBPS
MBPS is a psychiatric condition. In some cases, the perpetrators were themselves abused, physically and/or and sexually, as children. They may have come from families in which being sick was a way to get love.
The parent's or caregiver's own personal needs overcome his or her ability to see the child as a person with feelings and rights, possibly because the parent or caregiver may have grown up being treated like he or she wasn't a person with rights or feelings.
In rare cases, MBPS is not caused by a parent or family member, but by a medical professional (such as a nurse or doctor), who induces illness in a child who is hospitalized for other reasons.
What Happens to the Child?
In the most severe instances, parents or caregivers with MBPS may go to great lengths to make their children sick. When cameras were placed in some children's hospital rooms, some perpetrators were filmed switching medicines, injecting kids with urine to cause an infection, or placing drops of blood in urine specimens.
In most cases, victims of MBPS need hospitalization. And because they may be deemed a "medical mystery," hospital stays tend to be longer than usual. Whatever the cause, the child's symptoms — whether created or fabricated — ease or completely disappear when the perpetrator isn't present.
According to experts, common conditions and symptoms that are created or fabricated by parents or caregivers with MBPS can include: failure to thrive, allergies, asthma, vomiting, diarrhea, seizures, and infections.
The long-term prognosis for these children depends on the degree of damage done by the illness or impairment and the amount of time it takes to recognize and diagnose MBPS. Some extreme cases have been reported in which children developed destructive skeletal changes, limps, mental retardation, brain damage, and blindness from symptoms caused by the parent or caregiver. Often, these children need multiple surgeries, each with the risk for future medical problems.
For a child who is old enough to understand what's happening, the psychological damage can be significant. The child may come to feel that he or she will only be loved when ill and may, therefore, help the parent try to deceive doctors, using self-abuse to avoid being abandoned. And so, some victims of MBPS are at risk of repeating the cycle of abuse.
Getting Help for the Child
If MBPS is suspected, health care providers are required by law to report their concerns. However, after a parent or caregiver is charged, the child's symptoms may increase as the person who is accused attempts to prove the presence of the illness. If the parent or caregiver repeatedly denies the charges, the child would likely be removed from the home and legal action would be taken on the child's behalf.
In some cases, the parent or caregiver may deny the charges and move to another location, only to continue the behavior. If the child is returned to the perpetrator's custody while protective services are involved, the child may continue to be a victim of abuse while the perpetrator avoids treatment and interventions.
Getting Help for the Parent or Caregiver
To get help, the parent or caregiver must admit to the abuse and seek psychological treatment.
But if the perpetrator doesn't admit to the wrongdoing, psychological treatment has little chance of helping the situation. Recognizing MBPS as an illness that has the potential for treatment is one way to give hope to the family in these rare situations.