ABSTRACT
Munchausen by proxy refers to an individual who abusively and compulsively falsifies physical, psychiatric or developmental disorders in a child or adult victim in order to satisfy a psychological need. Factitious disorder imposed on another refers to the psychopathology in the abuser. Psychologists in medical settings may: (1) identify patients they come to suspect as being victims or perpetrators of MBP, (2) conduct or assist in clinical or forensic evaluations; (3) offer recommendations for clinical case management, and/or (4) provide treatment or referrals. The purpose of this paper is to provide guidance to psychologists and other mental health professionals in medical settings who may encounter individuals with this potentially lethal form of psychopathology.
Subject(s)
Factitious Disorders , Munchausen Syndrome by Proxy , Adult , Child , Factitious Disorders/diagnosis , Factitious Disorders/therapy , Family , HumansABSTRACT
The purpose of this article is to propose management and treatment protocols for family members impacted by MBP abuse. A brief review of psychopathology, co-morbidities, MBP risk level, treatment outcomes, and rationale for treatment is presented, followed by detailed guidance regarding psychological treatment and management. We propose five components of psychotherapy for abusers, best remembered by using the acronym of ACCEPTS: ACknowledgement, Coping, Empathy, Parenting, Taking charge, and Support. Guidance for the treatment of spouses/partners of the abuser, other involved family members/friends, and child victims are also provided.
Subject(s)
Family Therapy/methods , Munchausen Syndrome by Proxy/therapy , Psychoanalytic Therapy/methods , Adaptation, Psychological , Adult , Child , Empathy , Family/psychology , Female , Humans , Male , Munchausen Syndrome by Proxy/psychology , Parenting/psychology , Social Support , Spouses/psychologySubject(s)
Motivation , Munchausen Syndrome by Proxy/diagnosis , Parents/psychology , Child , Humans , Pediatrics , Physician's RoleABSTRACT
BACKGROUND: Eating disorders in children and adolescents remain a serious cause of morbidity and mortality in children, adolescents, and young adults. The working knowledge of pathophysiology, recognition, and management of eating disorders continues to evolve as research in this field continues. OBJECTIVES: This article builds on previous background and position papers outlining issues relevant to the care of the adolescent patient with an eating disorder. METHODS: The eating disorder special interest group from the Society for Adolescent Medicine recognized the need to update the state of the art published guidelines for the care of the adolescent patient with an eating disorder. This article was a multidisciplinary, group effort to summarize the current knowledge of best practice in the field. RESULTS: This article summarizes newer findings on pathogenesis and etiology, prevention and screening, risk factors, nutritional issues, care from the primary care clinician's perspective, appropriate use of a multidisciplinary team, and issues of managed care and reimbursement. CONCLUSIONS: Primary prevention combined with early recognition and treatment helps decrease morbidity and mortality in adolescents with eating disorders.
Subject(s)
Adolescent/physiology , Feeding and Eating Disorders/diagnosis , Feeding and Eating Disorders/prevention & control , Child , Critical Pathways , Feeding and Eating Disorders/etiology , Female , Guidelines as Topic , Humans , Insurance, Health, Reimbursement/legislation & jurisprudence , Male , Mass Screening/methods , Nutrition Disorders/prevention & control , Nutritional Requirements , Patient Care Team/organization & administration , Risk Factors , Treatment Outcome , United StatesABSTRACT
The purpose of this article is to propose guidelines for the evaluation of possible Munchausen by proxy child abuse for the court systems. These assessments require the evaluator to have an understanding of the complexity involved when this type of abuse is alleged. The evaluator should have an appreciation of how falsification of illness may or may not occur, recognize the need for careful analysis of medical records, and understand the problems associated with the use of a profile in determining the validity of an abuse allegation. This article presents guidelines for gathering pertinent data, analyzing records, and evaluating psychological testing for forensic evaluations when the questions for the evaluation are the following: (a) Is there evidence that child abuse did occur? (b) Does the alleged perpetrator meet criteria forfactitious disorder, NOS (or factitious disorder by proxy)? and (c) What management and treatment recommendations should be made?
