Munchausen By Proxy Syndrome is a form of child abuse whereby parents induce symptoms of real illness, or falsely report symptoms, to initiate medical treatment for their children. Following a review of the literature with respect to case management, the author presents for study a case followed from initial suspicion to resolution two years later. The management of this case is compared to what the literature would suggest is the ideal practice. Areas of weakness are found to be the average social worker's lack of knowledge about the syndrome, due to its rarity, agency unpreparedness to deal with a case, over-reliance upon medical opinion and a lack of advice as to the long term likelihood of family reunification. Recommendations are made for the field of social work, child protection in particular.

Thesis (M.S.)--Boston University / Munchausen Syndrome by Proxy (MSBP) is a term given to a situation which presents criteria for both Pediatric Condition Falsification (PCF) and factitious disorder by proxy (FDP). According to the Diagnostic and Statistical Manual of Mental Disorders-IV text revision (DSM-IV-TR), in child abuse cases where FDP is a result of PCF, then the nomenclature, MSBP, can be used interchangeably to describe such an event. Currently, in a situation that is diagnosed as Factitious Disorder by Proxy, the perpetrator of such an event is diagnosed as having Factitious Disorder Not Otherwise Specified (FD-NOS). An obvious issue stemming from this is the confusion over what should be diagnosed and remedied, i.e., the situation, the perpetrator, and/or the victim. Due to the convoluted and often controversial definition of such an event, as well as the criteria for diagnosis, it is proposed here that a new definition be adopted to explain this form of child abuse. With this novel definition, the symptoms of this psychological disorder of the perpetrator are observed in the victim. Under this new definition, the psychiatric term "Factitious Disorder by Proxy" would be used as a mental diagnosis of the caregiver, wherein the symptoms manifest in that of the victim. Additionally, an addendum to the type of symptoms exhibited in the child is proposed to include that of the exacerbation of symptoms in children with valid pre-existing conditions. An extensive literature review was performed to support the proposal for changing the criteria and diagnosis of FDP in the DSM. The implications of this change would greatly benefit not only the psychiatric, medical, and legal realm, but the forensic community as well.

No description available.

The Munchausen syndrome by proxy refers to a pathology characterized by physical and emotional abuse in which the simulation or production of symptoms is directed towards a child, which involves taking him or her to health treatments and unnecessary surgeries. The difficulties in the diagnosis of this form of abuse and the emotional aspects involved highlight the destructive effects in the infancy subjectivity due to the lack of loving capacity protecting and prioritizing the child demands. Psychoanalysis offers a differentiated view, comprehending that the mother attempts to elaborate her own psychic conflicts by the repetition of traumatic experience. There is a necessity of comprehension of the instinct destructivity presented in the maternal unconscious dynamics revealed in the modality of caring which is reflected in violence. / El Síndrome de Munchausen by proxy se refiere a una patología caracterizada por el abuso físico o emocional, en donde la simulación o producción de síntomas es direccionada al hijo, llevando a tratamientos de salud y cirugías innecesarios. Las dificultades diagnósticas de este tipo de abuso y los aspectos emocionales implicados llaman atención por los efectos destructivos en la subjetividad infantil, fruto de una falla en la capacidad de amar, proteger y priorizar las demandas del hijo. El Psicoanálisis ofrece una mirada que retrata un intento de elaboración de los propios conflictos psíquicos por la vía de la repetición de vivencias traumáticas. Así, se percibe la necesidad de una comprensión de la destrucción pulsional presente en la dinámica inconsciente materna revelada por esta modalidad de cuidado que se traduce en violencia.