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General discussion

Munchausen Syndrome by Proxy discredited?

Feb 7, 2004 9:45PM PST
Did a False Condition Lead to False Abuse Charges?

Munchausen Syndrome by Proxy (MSBP) is the psychiatric diagnosis by which a parent -- almost always a mother -- is believed to intentionally harm or kill a child in order to garner attention.

Diagnosing a mother as having MSBP is a tool often used by the state to remove children from the care of the parent, terminate parental rights or in the case of a child's death, charge the parent with murder. Now, due to a raging scandal in Britain, that diagnosis is being discredited.

According to British newspapers, over the last decade, thousands of British women who sought medical treatment for their children were in fact risking being diagnosed with MSBP -- a diagnosis that could lead to the termination of parental rights but also to imprisonment. Perhaps as many as tens of thousands of children have been taken by the state from their parents on the basis of "expert" testimony that the parent had MSBP.

But with MSBP's originator -- pediatrician Sir Roy Meadow -- under government investigation, British authorities are being forced to re-examine cases dating back to 1996. The Guardian comments: "The fallout from the Meadow affair is set to go global. Thousands of families around the world who have had their children taken into care are to demand their cases be re-examined."...


This is eerie to say the least! And what really TO do for those kids who have been in stable adoptive homes since being ripped from their parents.

Evie Happy

Discussion is locked

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Oh well, another psychological boondoggle. All hail psychology! </sarcasm>(nt)
Feb 8, 2004 1:21AM PST

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Re:Oh well, another psychological boondoggle. All hail psychology! </sarcasm>(nt)
Feb 8, 2004 9:20PM PST

You are so right James. Some of these newly created mental defects are just plain bunk.

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Re: Munchausen Syndrome by Proxy discredited?
Feb 8, 2004 6:14AM PST

Hi, Evie.

I think the article is misleading. IS MSbP over-diagnosed? Almost certainly. But that doesn't mean that it's not real -- the problem is that the threshhold for diagnosing it has been slid too low. People want a black/white, yes/no line, and as usual, reality is a shade of gray.

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Re:Re: Munchausen Syndrome by Proxy discredited?
Feb 8, 2004 8:29PM PST

That's the reason for the ? in my subject line. In a way, over-diagnosing any affliction (mis-diagnosing actually) does tend to delegitimate any diagnosis.

I think the ? in the article title is also appropriate. Misleading? Based on the evidence coming forward, there is reason to doubt if MSBP does even really exist hence a "false condition" fabricated by this Meadows fellow for whatever motivation?

It is not merely Meadow's credibility but also the research upon which MSBP rests -- research inexplicably shredded by Meadow -- which is under attack.

Seems the doubt IS extending to the very condition itself.

Evie Happy

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Re: Munchausen Syndrome by Proxy discredited?
Feb 8, 2004 9:36PM PST

Hi, Evie.

If you read further in the article, it basically says that the diagnosis is way overused, but doesn't really question the syndrome's existence, even if that name may be falling into disfavor. BTW, Munchausen itself sounds to me (who doesn't claim to be an expert in psychology) as an extreme form of hypochondria.

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Re:Re: Munchausen Syndrome by Proxy discredited?
Feb 8, 2004 9:45PM PST

What's your point then? You stated the article was misleading ... in what way? If the research that is the basis for this disorder is questioned, what more do you need to make a charge that the diagnosis/disease itself may be false.

The title was phrased in the form of a question, and I don't see where the article ever directly states it is a false condition. Confused as to what you found misleading about presenting some facts about some of the key players and what appears to be a rising trend of legitimate parties who question it's very existence.

Evie Happy

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It sounds to me like;
Feb 9, 2004 2:44AM PST
Munchausen itself sounds to me (who doesn't claim to be an expert in psychology) as an extreme form of hypochondria.

...making an excuse to allow a guardian to harm a child and go unpunished for it. I don't think there should be any legal difference between this and child sexual abuse. They both harm the child and they both are crimes. I don't see it as hypochondria. I see it as a selfish parent who has so much disregard for their child they are willing to use them as a pawn to get the attention THEY crave for THEMSELVES. It is an ultimate act of SELFISHNESS without regard to the consequences to the one they are harming to achieve it.
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Re: It sounds to me like -- You misread me, James.
Feb 9, 2004 1:07PM PST

Muchausen is about people hurting themselves, and that's what I was comparing to hypochodria. MBP is about hurting someone else, and there we agree. Evie's trying to take things further than the article ans say there's no such thing as MBPO ("the diagnosis itself is in doubt"), which the article never says -- it's asking whther it's over-used, and I'm sure it is. Just like the "satanic cults" were a while back...

-- Dave K, Speakeasy Moderator
click here to email semods4@yahoo.com

The opinions expressed above are my own,
and do not necessarily reflect those of CNET!

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Psychiatric and Psychological information on MSBP
Feb 9, 2004 4:06AM PST

Some additional information on this supposed disorder might be of interest to you; and it might even be educational for people like James who apparently are not aware of the differences in the fields of psychiatry and psychology Wink

In the United States, psychiatric disorders are diagnosed on the basis of criteria in a book published by the American Psychiatric Association called "Diagnostic and Statistical Manual of Mental Disorders." The latest edition of this book is the 4th, and thus the book is often referred to as the "DSM-IV", spoken as DSM-four. (To be completely accurate and technical, there is a newer revision called "DSM-IV-TR" for "Text Revision"; but no matter).

In the DSM-IV there is no diagnosis called "Munchausen Syndrome by Proxy"; there is, however, a disorder that was proposed for inclusion in the DSM-IV, but was not because "there was insufficient information to warrant inclusion of these proposals as official categories or axes in DSM-IV." (quoted from DSM-IV) This proposed disorder is called "Factitious Disorder by Proxy" in DSM-IV. Research continues on this proposed disorder.

Finally, psychiatrists go to medical school and are medical doctors who specialize in mental disorders. Psychologists do not go to medical school, but receive advanced degrees in psychology and work in a variety of specialties, including work with those with mental disorders.

There is overlap between the fields of psychiatry and psychology, and psychologists are often trained in the diagnosis of mental illness. The official diagnostic system used in the U.S., however, should be credited to(or blamed on) the American Psychiatric Association.

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Mark, you sound like you're in the field.
Feb 9, 2004 4:52AM PST

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(NT) Yes, Psychologist ...
Feb 9, 2004 5:13AM PST

and to add to my previous post, there is often disagreement in the field regarding diagnoses, criminal responsibility, etc. As a matter of fact, some psychologists have pointed out the danger in over-diagnosing this and other "illnesses."

I would characterize myself as rather conservative in diagnosing a psychiatric illness in someone, particularly in those situations in which criminal charges might be brought.

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(nt) LOL, previous post should not be "NT"
Feb 9, 2004 5:14AM PST

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Re:Yes, Psychologist ...
Feb 9, 2004 5:20AM PST

I've got friends and family on that side of the couch. It's tough work.

Surely you base you client diagnoses on the clinical evaluation and the best interest of the client and not on any possible prosecutorial outcomes.

Dan

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Re:Re:Yes, Psychologist ...
Feb 9, 2004 5:36AM PST

Of course. In my particular situation, the issue rarely arises. But in a case in which criminal charges are possible, a clinician might take more time, review more records, do more tests, etc., as the stakes are higher. One always wants to be accurate in diagnosis, but the reality is that there is a cost/benefit ratio to consider, as there often is with medical diagnosis. If my son complains of a headache, there is a very small but real chance he has a brain tumor. But I don't immediately take him in for an MRI. Likewise, diagnostic certainty is rarely 100%. We strive to be as accurate as possible using a reasonable diagnostic approach.