HD_300 1st Edition Lecture 9 Outline of Last Lecture I. Neglecta. General definitionb. Legal definitionc. SESd. Selective Neglecte. Fatal Neglectf. Parental Investmentg. Maternal Deprivationh. Features of Maternal Deprivationi. Profound Neglectj. Non-Organic Failure to Thrivek. Psychosocial DwarfismOutline of Current Lecture I. Negative Effects of Neglecta. Emotional neglectII. Jennifer Bush DocumentaryIII. Introduction to MSbPIV. Munchausen SyndromeV. Munchausen Syndrome by Proxy (MSbP)VI. Diagnostic Criteria (APA)VII. Features of MSbPa. Perpetrators are almost exclusively mothersVIII. Types of MSbP PerpetratorsThese 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.a. Help-Seekersb. Active Inducersc. Doctor AddictsIX. Warning SignsX. Parental BehaviorCurrent LectureNegative effects of neglect- Emotional Neglecto Emotional behavior problems Excessive anger Acting out Bullying o Internal behavior problems Socially withdrawn Depression  Suicidal ideation Neglect (in one word)- If we were to describe neglect in a single word, it would be “indifference”Jennifer Bush Documentary- At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 Munchauseno 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 historieso May fake or even cause their own illness o Often go from doctor to doctor and hospital to hospital o It’s a bid to get attention and nurturance o May be a means to get drugsMunchausen 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 illnessesDiagnostic 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 absento Only seeking attention- The behavior is not better accounted for by any other mental disorderFeatures 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 thechild - The motivation is to gain attention and credibility- Prevalence- not known for sure, but appears to be more common than once thoughtTypes of MSbP Perpetrators- Help-Seekerso Seek medical attention for child in order to communicate their own anxiety or needso History of marital discord or violence o Unwanted pregnancyo Single parents ** Treatment is most successful with this group of perpetrators**- Active Inducerso Use dramatic means to induce illness in their childreno Psychological dysfunction  Anxious and depressed High level of denial  Dissociation of affect - Affect= emotion/expression Paranoid tendencieso Controlling relationship with physician and medical community o Resistant to treatmentNo psychological help - Doctor Addictso Obsessed with obtaining medical treatment for non-existent illnesses in their childreno 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 antagonistico Resistant to treatmentWarning 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-protectionParental 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