HD 300 1st Edition Lecture 9 Outline of Last Lecture I Neglect a General definition b Legal definition c SES d Selective Neglect e Fatal Neglect f Parental Investment g Maternal Deprivation h Features of Maternal Deprivation i Profound Neglect j Non Organic Failure to Thrive k Psychosocial Dwarfism Outline of Current Lecture I Negative Effects of Neglect a Emotional neglect II Jennifer Bush Documentary III Introduction to MSbP IV Munchausen Syndrome V Munchausen Syndrome by Proxy MSbP VI Diagnostic Criteria APA VII Features of MSbP a Perpetrators are almost exclusively mothers VIII Types of MSbP Perpetrators These notes represent a detailed interpretation of the professor s lecture GradeBuddy is best used as a supplement to your own notes not as a substitute IX X a Help Seekers b Active Inducers c Doctor Addicts Warning Signs Parental Behavior Current Lecture Negative effects of neglect Emotional Neglect o Emotional behavior problems Excessive anger Acting out Bullying o Internal behavior problems Socially withdrawn Depression Suicidal ideation Neglect in one word If we were to describe neglect in a single word it would be indifference Jennifer Bush Documentary At beginning of the show 30 operations hospitalized more than 200 times Kathleen Kathy Bush is her mom and accused abuser She did get better Mother placed in prison Mother is now released Google to find out more about this famous case Unit 9 Introduction to MSbP MSbP falls under the umbrella of facetious disorders Also termed illness induction syndrome Munchausen Syndrome Named for Baron Karl von Munchausen o 18th century figure who gained fame for his tall tales about his adventures 1951 Dr Richard Asher coined the term Munchausen Syndrome to describe patients who fabricate illness or make themselves ill Features o Give plausible but fictitious medical histories o o o o May fake or even cause their own illness Often go from doctor to doctor and hospital to hospital It s a bid to get attention and nurturance May be a means to get drugs Munchausen Syndrome by Proxy MSbP 1977 English pediatrician Meadows coined the term after finding that mothers of some of his patients had fabricated the children s illnesses Diagnostic Criteria APA MSbP is the intentional production of physical or psychological signs and symptoms in a person under the individual s care Motivation for the perpetrator s behavior is to assume the sick role by proxy External incentives for the behavior are absent o Only seeking attention The behavior is not better accounted for by any other mental disorder Features of MSbP The perpetrator assumes the sick role indirectly by producing or feigning falsifying illness in another Perpetrators are almost exclusively mothers or female caregiver Victims are usually children under age six Perpetrators often have training experience or work in health related situations MSbP ranges from diseases that are completely imagined to diseases that are fully induced in the child The motivation is to gain attention and credibility Prevalence not known for sure but appears to be more common than once thought Types of MSbP Perpetrators Help Seekers o Seek medical attention for child in order to communicate their own anxiety or needs o History of marital discord or violence o Unwanted pregnancy o Single parents Treatment is most successful with this group of perpetrators Active Inducers o Use dramatic means to induce illness in their children o Psychological dysfunction Anxious and depressed High level of denial Dissociation of affect Affect emotion expression Paranoid tendencies o o Controlling relationship with physician and medical community Resistant to treatment No psychological help Doctor Addicts o Obsessed with obtaining medical treatment for non existent illnesses in their children o Inaccurate reporting of history and symptoms o May really believe their children are ill More like hypochondriac really believe Won t accept medical evidence that the child is well o Paranoid angry suspicious and antagonistic o Resistant to treatment Warning Signs Prolonged unusual multi system illness with incongruent symptoms Signs and symptoms disappear when the parent is absent One parent usually the father is absent when the child is hospitalized Lab results do not match the health of the patient History of SIDS in siblings The victim is under six years of age Evidence of separation and anxiety and maternal over protection Parental Behavior Pleasant cooperative concerned and supportive of the medical staff Thrives in the medical environment Becomes an expert on the child s illness Assists with the health of the child Denies deception Lacks the usual parental concern May have suicidal ideation and threatens or attempts suicide