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Induced Illness - Munchausen syndrome by proxy
What is Munchausen syndrome by proxy? How does the caregiver typically act? Clues that a person may have Munchausen syndrome by proxy The caregiver with MSBP may: Falsely claim a child has experienced serious symptoms, such as seizures. Contaminate test results to make a child appear ill. Physically harm the child to produce symptoms. Victims of MSBP, typically small children, often undergo needless and painful medical tests. They may become seriously ill or injured or may die as a result of the actions of the offending caregiver. Many children affected by MSBP develop emotional problems that can last all through life. In Munchausen syndrome by proxy, a mother may abuse more than one of her children at different times. Children subjected to MSBP are usually younger than 6 years old but may be older. Older children may become convinced that they have an illness. They may passively or actively participate with the caregiver in deceiving health professionals.
This condition is related to
Munchausen syndrome,
a similar disorder in which a person causes or reports
symptoms in himself or herself. Children who are victims of
MSBP may later develop Munchausen syndrome as adults.
Also, parents may be motivated by the social rewards they
feel they achieve. They may get attention from not only
doctors and nurses, but others in their community. Sometimes
the parents who deceive others about the health of their
child are rewarded with money. People may help out in small
or big ways-such as by doing chores, bringing meals, or
donating money or services.
A
person who has MSBP does not seem to perceive her behavior
as harmful. She may lack empathy-the capacity to understand
what another person is feeling. Although she may appear
doting (showing extreme fondness or love), she may actually
be emotionally removed from her child. A child has a recurring or unusual illness for which no adequate explanation can be found. The parent makes the child have many different tests and evaluations, and the child continually fails to respond to or tolerate medical treatments that should improve symptoms. Symptoms occur or begin only when the caregiver is with or has recently been with the child. Symptoms improve or do not occur when the caregiver is absent or in a setting that is closely monitored. For example, symptoms usually improve when the child is in the hospital. But a caregiver sometimes can still cause her child to develop symptoms or make it appear that way. The other parent (usually the father) is noticeably absent. He is uninvolved even though a child's condition may be or appears to be serious. Evidence proves that the parent has given false information to health professionals or has contaminated lab samples. Often a caregiver abruptly switches doctors and provides misleading information about prior testing and treatment. Normal test results do not reassure the parent. She is inappropriately calm or euphoric when her child's condition is most severe. The caregiver makes an exceptional effort to become friendly and close to medical staff. A caregiver is seen or videotaped directly harming the child or causing symptoms.
Also, it may be discovered that the caregiver has a history
of Munchausen syndrome. There is more cause for suspicion of
MSBP if another child in the family has had unexplained
illness or death.
If
MSBP or another form of child abuse is diagnosed by health
professionals, then local children's protective services,
police, and other authorities are notified. Usually, further
investigation is not needed, and legal authorities and
medical personnel develop a plan to confront the caregiver
and ensure the child's safety. Treatment for the caregiver usually is coordinated through the legal system. Long-term psychotherapy is used to help the caregiver acknowledge and express her need for support, respect, and connection. Dealing with these emotional needs more directly may help prevent her from projecting them onto her child. Therapy also focuses on helping her to develop empathy, so she understands the effect her behavior has had on her child. Medications are used as treatment only if another diagnosed condition, such as anxiety disorder, exists along with MSBP. Caregivers with MSBP very often resist treatment. Typically, they experience extreme denial about the problem and diagnosis. Also, these caregivers often try to manipulate health professionals involved in their treatment. MSBP behavior has a high recurrence rate, and close monitoring and continuous counseling are usually needed.
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