Munchausen Syndrome by Proxy

Definition

Munchausen syndrome is a type of psychological disorder that leads an individual with a deep need of being noticed to fake injury or sickness. Munchausen syndrome by proxy (MSBP) is a rare factitious disorder that is forced by a certain person to the other. It generally affects a caretaker, frequently the mother.


Munchausen Syndrome by Proxy


The individual with MSBP obtains attention by asking for medical help due to some make-up or exaggerated symptoms of the child he or she is taking care of. People with MSBP have several ways of exaggerating or creating a child’s symptoms; which may include lying about the symptoms, changing tests, faking medical records, or prevail upon symptoms through various ways such as suffocating, causing infection, poisoning, and starving.

Symptoms of Munchausen Syndrome by Proxy

Check for any warning signs with both the abused child and the caregiver suffering from MSBP. Possible warning signs of MSBP include:

  • A history of numerous repeated hospitalizations, illnesses, or injuries often with an odd set of symptoms
  • There could be one or more strange death or illness of children within the family
  • Chemicals may be present in the child’s urine, stool, or blood
  • Child’s worsening of symptoms is often reported by the mother and is not observed by the hospital staff
  • Child gets better in the hospital but have recurring symptoms at home
  • Reported symptoms and condition of the child do not match with the test results

Genetics

There is no genetic basis that is known for Munchausen Syndrome by Proxy. The cause of the disorder is not specified, although it is comprehended to be the outcome of a combination of social stressors, biological vulnerabilities, and ways of thinking. Little information is known regarding the specific biological vulnerabilities from which people with the condition are more likely to bear.

A lot of individuals who are diagnosed with MSBP had experienced the following:

  • Victims of child abuse when they were younger
  • Suffering a serious condition as a child
  • Had lost a parent at an early age
  • Had been neglected as a child
  • Suffered from trauma

People with MSBP also have problems on managing their frustration or anger. A few evidences suggest that heightened stressors like marital problems could trigger MSBP.

Case stories

  • The case of Lisa Hayden-Johnson

The son of Lisa Hayden-Johnson is a premature-born child which is why he required medical attention, such as a feeding tube. Lisa Johnson loved all the sympathy and attention for her child that when her son starts to get better, she falsified a statement that he was very ill. As she appeared on television; she told everyone that her son had several life-threatening conditions, which were so believable, that her son himself even thought he was sick.


The doctors were also convinced, leading to unnecessary operations. The case earned a lot of attention and donations from the public. This lasted for six years. In the year 2007, a pediatrician became suspicious and conducted more specific diagnosis. Later on, the schemes of Lisa Johnson were unraveled and she was arrested and punished by the law.

  • The case of Kathy Bush

An eight year daughter of Kathy Bush whose name is Jennifer Bush had been hospitalized for more than 200 times and had gone through over 40 medical procedures. She had seizures, weakened immune system, and digestive problems. In return, her gallbladder, appendix, and a part of her small intestine had been surgically removed.

Some nurses became doubtful of Jennifer since she seemed to get worse after every visit with her mother. Kathy Bush was even seen by a nurse while she injected her daughter with a syringe in the mouth. Officials started an investigation of Kathy, but there was not enough gathered evidence. Eventually in 1996, Kathy got arrested after another nurse issued a complaint. Jennifer was treated and fostered before she started getting better.

In 1999, Kathy was imprisoned and also forbidden from contacting her daughter, but later in 2005, when Jennifer turned 18, she lifted the ban and saw her mother once again. Jennifer stated that she does not believe that Kathy abused her. The family of Jennifer also supported that her health had already started improving before the officials took her from their care.

Treatment

Treatment for Munchausen Syndrome must include both for the adult and the child, and the entire family for most cases.

Treatment for the Parent

The parent that had been charged with child abuse will most-likely face criminal charges. If the disorder is being suspected, counseling sessions with the psychiatrist will be recommended. Treatment will be more difficult especially if the parent does not admit that there is a problem. Family or individual therapy could help all parties manage with the situation.

Treatment for the Child

Once it is fully confirmed that the child is a sufferer of abuse, he or she should be protected immediately.  This commonly means an involvement of child protective services and taking all the children away from the care of the parent with MSBP. Physical injury and illness should also be treated correspondingly. Psychological counseling might be necessary as well.


References:

  1. http://www.healthline.com/health/munchausen-syndrome-by-proxy#Overview1
  2. http://www.webmd.com/mental-health/munchausen-by-proxy?page=1#1
  3. http://www.medicinenet.com/munchausen_syndrome_by_proxy/article.htm#munchausen_syndrome_by_proxy_facts
  4. McCoy, Monica L.; Keen, Stefanie M. (2013). Child Abuse and Neglect: Second Edition. Psychology Press. p. 210.
  5. Stirling J; American Academy of Pediatrics Committee on Child Abuse Neglect (May 2007). “Beyond Munchausen syndrome by proxy: identification and treatment of child abuse in a medical setting”. PEDIATRICS 119 (5): 1026–30.
  6. Vennemann B, Bajanowski T, Karger B, Pfeiffer H, Köhler H, Brinkmann B (March 2005). “Suffocation and poisoning: The hard-hitting side of Munchausen syndrome by proxy”. Int. J. Legal Med. 119 (2): 98–102.

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