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Dissertations / Theses on the topic 'Munchausen syndrome'
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Rakay, Chrisitine Alese. "Conquering the chimaera: an insight into the need to redefine the complex form of child abuse, Munchausen's Syndrome by Proxy." Thesis, Boston University, 2012. https://hdl.handle.net/2144/12595.
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Thesis (M.S.)--Boston UniversityMunchausen 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.
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Fallis, Mitchell Kent. "Munchausen by proxy syndrome : a comparative case study." Thesis, McGill University, 2000. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=33460.
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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.
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Baldwin, Paul Clive. "Munchausen syndrome by proxy : telling tales of illness." Thesis, University of Sheffield, 2000. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.422363.
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Tough, Essie Mary Bridget. "Understanding Munchausen Syndrome by Proxy as child abuse." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/29403.
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This thesis will demonstrate how Munchausen Syndrome and, by derivation Munchausen Syndrome by Proxy, grew out of historical themes of assigning disease labels to anomalous or problematic behaviour, replicating issues of gender, particularly in respect of illness and madness and power biases, in society. The literature review will demonstrate how the early case notifications provided 'a Munchausen narrative', which came both to construct and to pathologise, first patients and later women, as mothers. It is argued that psychiatric models account for few cases of child abuse. A more coherent theory allows child abuse and, therefore, Msbp to be understood within a framework, which takes account of past and present ecological influences on the development of individual experience, characteristics and competency, and importantly, the meaning of a child within the life-cycle of that individual. The research, in this thesis, was designed to provide an estimate of the incidence of Msbp in Scotland. While it confirmed die findings of earlier studies diat illness induction and fabrication are rare events, it demonstrated a range of manifestations of abnormal behaviour among parents, in presenting their children to doctors, which were recognisable as being abusive and which often overlapped other forms of child maltreatment and neglect. It became apparent that the connotations of the title Msbp, particularly in relation to its psychodynamic formulations and evidencing actual or a risk ofsignificant harm, makes this a professionally fraught and ill-defined area of child protection work for Paediatricians, irrespective of recent Guidance (RCPCH 2002). The concluding sections of the thesis will consider inherent difficulties in working in this difficult area of child abuse and will provide recommendations for facilitating professional and child protection practices.
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Korpershoek, Monica Jane. "Munchausen syndrome by proxy : a form of pathological play?" Master's thesis, University of Cape Town, 2002. http://hdl.handle.net/11427/8782.
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Bibliography: leaves 106-112.The primary aim of this dissertation was to gain an understanding of the psychopathology present in the perpetrator of Munchausen Syndrome by Proxy (MSP), exploring Jureidini's (1999) notion that this behaviour can be explained as the perpetrator engaging in a form of pathological play. A systematic literature review regarding MSP, with particular foci on psychopathology in perpetrators of MSP and the notion of pathological play was conducted. The notion that MSP is a form of pathological play was critically evaluated through the use of clinical case material. Two cases were selected, both of which met the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) diagnostic criteria for MSP, based on the assessment of a child psychiatrist with expertise in this area. The case material was analysed through the generation of common themes and identification of repetitive patterns which were then systematically analysed and compared with the findings cited in the literature review, with particular reference to MSP as a form of pathological play. Jureidini's (1999) theoretical statement was analysed in the light of the available evidence and the theoretical basis was then revised. Aspects explained by the theory were presented. Aspects not explained by the theory were rejected. Object Relations Theory was proposed as an alternative to understanding the psychopathology present in a perpetrator of MSP.
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MENEGAULT, CAROLE. "Syndrome de munchausen par procuration ou syndrome de meadow : a propos d'une observation." Reims, 1990. http://www.theses.fr/1990REIMM044.
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Gomes, Gonçalves Thomas, Motta Maria Eduarda Germano, Paula Kegler, and Macedo Mônica Medeiros Kother. "Munchausen Syndrome by proxy: Definition, context, and psychological factors involved." Pontificia Universidad Católica del Perú, 2014. http://repositorio.pucp.edu.pe/index/handle/123456789/99822.
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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.
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LE, GOAS GUY. "Le syndrome de munchausen : revue generale a propos de trois observations." Reims, 1990. http://www.theses.fr/1990REIMM050.
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Sonnois, Véronique. "Le syndrome de Munchausen par procuration : à propos de 2 observations." Montpellier 1, 1993. http://www.theses.fr/1993MON11039.
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Davis, Paul. "Munchausen syndrome by proxy, non-accidental poisoning and non-accidental suffocation of children." Thesis, Cardiff University, 1999. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.313580.
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Eriksson, Jessica. "Möjligheter läkare har att kunna identifiera och behandla patienter med Münchhausens syndrom." Thesis, Mälardalens högskola, Akademin för hållbar samhälls- och teknikutveckling, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-11568.
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Patienter som lider av Münchhausens syndrom hittar på symtom och/eller skadar sig själva i syfte att få uppmärksamhet från sjukvårdspersonal. Det är en svårdiagnostiserad störning som är till skada för individen och hela sjukvårdssystemet. Det har gjorts få undersökningar om Münchhausens syndrom och därför intervjuades fem läkare för att öka kunskapen om Münchhausens syndrom och få svar på vilka möjligheter läkare har att kunna identifiera denna störning, samt vilka åtgärder som då kan bli aktuella. Resultatet visade att läkarna ansåg sig vara för lite insatta om Münchhausens syndrom och att de inte kunde vara helt säkra på att patienten inte hade de besvär som patienten påstod sig lida av. Det fanns heller ingen handlingsplan ifall läkarna misstänkte att en patient inte talade sanning om sitt hälsotillstånd. Kunskap och medvetenhet var två viktiga faktorer för att kunna identifiera och behandla patienter med Münchhausens syndrom. Urvalet kan ha påverkat studiens giltighet.
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Hurst, Dawn R. "Munchausen Syndrome by Proxy : Gender, Sexism, and Just World Beliefs as Predictors of Juror Decisions." UNF Digital Commons, 2005. http://digitalcommons.unf.edu/etd/370.
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Mock jurors (N = 200) read descriptions of a mock civil case involving an adult survivor of Munchausen Syndrome by Proxy who is suing his/her abuser for monetary/psychological damages. Jurors individually decided perceived percent of responsibility of defendant, award to plaintiff pre- and post-group deliberations, and as a mock jury, in groups of 5 to 10. Jurors and juries assigned greater percent of culpability to female defendants than male defendants. Individual jurors awarded more n1oney to plaintiffs abused by female defendants than male defendants. Low Modem Sexism Scale (MSS) scorers attributed greater percentage of responsibility to defendants and awarded plaintiff more money than high scorers. There was no significant difference in award to male or female plaintiffs; however, greater percent of culpability was assigned to defendants who abused plaintiff longer (i.e., 19 years vs. 10 years). Low Belief in Just World (BJW) scorers individually attributed greater percent of responsibility to defendant and awarded more money to plaintiff than high scorers. Gender of defendant, just world, and sexist attitudes appeared to play important roles in jurors' decisions in cases involving adults who were child victims.
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Bools, Chriistopher N. "Fabricated and induced illness ('Munchausen syndrome by proxy') : a psychiatric study of parents and children." Thesis, University of Manchester, 2008. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.499915.
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Binet, Éric. "Psychopathologie du trauma et syndrome de Münchhausen par procuration : de la notion de clivage à celle de dissociation, de l’approche psychanalytique aux psychothérapies EMDR et ICV Un cas de maltraitance étrange : cyanose d’origine exogène d’un orteil chez un bébé de 13 mois et deuil pathologique au cours de la petite enfance Les pleurs de la petite enfance : une question d’attachement 1/2 Les pleurs de la petite enfance : une question d’attachement 2/2 Difficultés rencontrées dans les prises en charge thérapeutiques et/ou sociales de situations familiales caractérisées par un Syndrome de Münchhausen Par Procuration. Syndrome de Munchausen Par Procuration (SMPP) en périnatalité Recourir à la loi dans les cas de syndrome de Münchhausen par procuration : une solution face à des parents à l’abri de tout soupçon Le syndrome de Münchhausen, une maltraitance par excès de soins Le syndrome de Münchhausen par procuration : une nouvelle forme de dysparentalité transgénérationnelle Le syndrome de Münchhausen Par Procuration : mères et médecins au-dessus de tout soupçon Le syndrome de Münchhausen Par Procuration, Essai de compréhension psychologique Syndrome de Munchausen Par Procuration (SMPP) et EMDR (chapitre 41) Qu’est-ce que l’Intégration du Cycle de la Vie ? Principaux protocoles en ICV Intérêt et limites de l’Intégration du Cycle de la Vie (Lifespan Integration) auprès d’adultes victimes du Syndrome de Munchausen Par Procuration pendant leur enfance Spécificités du thérapeute ICV Aménagements de processus défensifs et mobilisation des affects en crèche, étude clinique et analyse psychodynamique Le syndrome de Münchhausen L’accompagnement du deuil du conjoint chez le sujet âgé par l’Intégration du Cycle de la Vie." Thesis, Université de Lorraine, 2018. http://www.theses.fr/2018LORR0332.
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Cette thèse sur travaux retrace une activité clinique et rassemble des écrits (corpus de 15 articles, monographies et un livre) sur une vingtaine d’années portant sur une forme de maltraitance intrafamiliale qui instrumentalise la sphère médicale : le Syndrome de Munchausen Par Procuration. Depuis notre première rencontre avec un cas SMPP en 1996, nous avons appris à penser les traumatismes de la petite enfance avec différents modèles psychopathologiques et des approches cliniques distinctes (psychodynamique, EMDR, Intégration du Cycle de la Vie). Dans une perspective trans- et interdisciplinaire, nous nous sommes engagés au fil du temps dans une compréhension des phénomènes traumatiques se fondant sur des hypothèses psychodynamiques, cognitives ou neurophysiologiques à la recherche d’espaces de dialectisations féconds. De là l’intérêt d’étudier ce cheminement à travers ces champs épistémologiques a priori opposés, reflet d’une évolution de la clinique actuelle, en décrivant comment des patients auteurs ou victimes du SMPP ont pu bénéficier de cette dynamique. Composée en trois parties, la première partie de cette thèse est dédiée à une présentation générale de la psychopathologie du trauma et des détresses précoces en prenant en compte les développements conceptuels traités dans nos écrits. La deuxième partie centrée sur le SMPP porte sur sa sémiologie et son étiologie, les terminologies médicales et psychopathologiques comme sur les conduites multidimensionnelles nécessaires à sa prise en charge. La troisième partie est consacrée aux différentes approches psychothérapiques que nous avons utilisées dans le traitement de patients, adultes ou enfants, concernés par le SMPP. Cette dernière partie est l’occasion de comprendre comment les notions de clivage et de dissociation peuvent être revisitées, intégrées dans une perspective neuropsychologique développementale. Caractérisé par une réflexion épistémologique basée sur un pluralisme théorique et thérapeutique, ce partage d’expérience souhaite permettre une approche psychopathologique laissant place à la complémentarité, à l’intersubjectivité et à la phénoménologieThis thesis based on previous publications retraces clinical interventions and brings together written materials (15 articles, monographs and a book) spanning a period of 20 years on a form of intrafamilial abuse exploiting the medical field: the Munchausen Syndrome by proxy.Since our first encounter with a case of MSbP in 1996, we have learned to think about early childhood trauma using different psychopathological models and distinct clinical approaches (psychodynamic, EMDR, Lifespan Integration) in search of a fertile dialectisation and, over time, have committed to a trans- and inter-disciplinary perspective based on psychodynamic, cognitive and neurophysiological hypotheses to understand traumatic phenomena. From there interest in studying the line of thought involving epistemological fields assumed at first glance to be opposites reflects an evolution of clinical practice in describing how patients – authors or victims of MSbP have benefited from this dynamic. Composed of three parts, the first part of this thesis is devoted to a general presentation of the psychopathology of trauma and early distress taking into consideration the conceptual developments treated throughout our writings. The second part, centered on MSbP focuses on its semiology and etiology, medical and psychopathological terminology as well as the multidimensional interventions necessary for its treatment. The third part is dedicated to different psychotherapeutic approaches that we have used in treating patients, adults or children involved with MSbP. This last part gives rise to an understanding of how the concepts of splitting and dissociation can be revisited and integrated into a neuropsychological developmental perspective. Characterized by an epistemological framework based on a theoretic and therapeutic pluralism, this experience is shared with the desire of encouraging a psychopathological approach including complementarity, intersubjectivity and phenomenology
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Kessaci, Lyasmine. ""On tue un enfant " : de la clinique de la maltraitance infantile à la structure du fantasme." Thesis, Rennes 2, 2013. http://www.theses.fr/2013REN20053.
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« On bat un enfant » ; « on tue un enfant » : pour la plupart de nos contemporains, c’est là l’horreur même — la transgression de ce qui reste encore de sacré dans notre culture dite moderne. Pour quelques autres, c’est une réalité clinique : celle que l’on saisit à travers ce que l’on appelle d’ordinaire « maltraitance infantile » et « infanticides ». Et pour tous (pour tout sujet), il s’agit également de la présentification d’un fantasme — le plus fondamental qui soit, encela qu’il convoque d’un côté le rapport au père et le masochisme primordial, d’un autre le rapport à l’idéal et le narcissisme primaire. Le plus fondamental des fantasmes, au point de pouvoir être considéré comme une écriture de sa « formule », le texte en exprimant au mieux la logique.C’est à nouer ces registres — structure du fantasme et réel clinique de la maltraitance infantile — et à en explorer les tenants et aboutissants, que se consacre cette thèse. Qui s’emploie à montrer d’abord comment la féminité peut porter à la maternité, et ce qui se joue dans le « désir d’enfant », voire dans le désir de mort de l’enfant (c’est-à-dire dans le ravage quand il aboutit à l’acte). Puis quels extrêmes peut atteindre la clinique avec le « syndrome de Münchhausen par procuration », d’une part, et les « néonaticides » avec conservation des corps des nouveau-nés, d’autre part (c’est-à-direavec ces situations où l’horreur se montre pour mieux se dissimuler, et se cache pour mieux s’exhiber).Ce qui permet donc, en dépliant ainsi ces figures de la mère, de l’enfant, et du mal, d’éclairer la logique du fantasme par le réel clinique — et réciproquement. C’est-à-dire d’éclairer la structure subjective, saisie au « coeur de l’être »« A child is being beaten » ; « a child is being killed » : for most of our contemporaries, this is an epitome of horror — a transgression of what is still considered as sacred in our socalled modern culture.For some others, it is a clinical reality : the one we observe through what is usually called « child abuse » and infanticides.And for everybody (for every subject), it is also the presentification of a phantasy — the most basic of all, as it concerns on one hand the relationship with the father and the primordial masochism, and on the other one the relation with the ideal and the primary narcissism. It is the most fondamental of phantasies so much that it can be considered as an account of its « formula », the text expressing its logic at best.Intertwining these two matrixes — structure of the phantasy and clinical reality of child abuse — and exploring the ins and outs ; this is the issue analyzed in the thesis. First, what is shown here is how feminity can lead to maternity and what is at stake in « desiring a child », even in the desire for the child’s death (i.e. in the « ravage » when it leads to the acting out). Then which extreme can the clinical approach get close to with « The Munchausen syndrom by proxy » on one hand, and « neonaticides » with the keeping of the bodies of the new borns on the other one (i.e. where horror can be shown to hide all the better and to hide to be better exhibited).Hence the possibility, by unfolding the figures of the mother, of the child, and of the evil, to shed light on the logic of the phantasy thanks to the clinical reality — and vice versa.In other words, to throw light on the subjective structure, seized in the « heart of being »
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Abdurrachid, Nuzhat. "Munchausen Syndrome By Proxy (MSBP) : a systematic review regarding Factitious Disorder Imposed on Another (FDIA)." Master's thesis, 2020. http://hdl.handle.net/10451/47281.
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2020A Síndrome de Munchausen por Procuração é uma forma rara de abuso devido a falsificação de doença. É atribuído ao perpetrador o diagnóstico de Perturbação Factícia Imposta em Outra Pessoa. As vítimas são frequentemente crianças. Os perpetradores são frequentemente mulheres num papel materno, e poderão ter associados conflitos familiares, perturbações da personalidade, ou outras perturbações psiquiátricas. Este estudo pretende rever os casos clínicos publicados na literatura nos últimos 15 anos. Extraímos dados relevantes de 108 artigos, incluindo 54 artigos com 81 casos clínicos. A distribuição de sexo entre vítimas foi equitativa (51% masculino, 43% feminino, 6% não reportado), consistindo na maioria em crianças com média de idades de 5 anos. Os perpetradores foram quase sempre do sexo feminino (91% feminino, 1% feminino e masculino, 8% não reportado). Vinte e três casos (28%) tinham um perpetrador com diagnóstico psiquiátrico conhecido: Perturbação Factícia Imposta no Próprio (10%), Depressão (9%), e Perturbações da Personalidade (7%). Mais de um terço (36%) referiu conflito familiar/marital ou abuso. Catorze casos (17%) tinham perpetradores que trabalhavam na área da saúde. A forma mais comum de falsificação foi Indução (74%), contudo 15% dos casos apresentava mais do que um tipo de falsificação. Na evolução encontrámos: separação do perpetrador e vítima (37%); sem acompanhamento reportado (22%); prisão do perpetrador (14%); morte da vítima (12%); tratamento psicológico ou psiquiátrico (10%); reunificação de perpetrador com vítima (4%); suicídio do perpetrador (1%). Mais de três quartos dos casos revelaram-se recorrentes. Os resultados reiteram que o reconhecimento das formas mais comuns da Síndrome de Munchausen por Procuração permitem aos médicos identificá-las em contexto clínico.
Munchausen Syndrome by Proxy is a rare form of abuse due to illness falsification. The perpetrator of this abuse suffers from a psychiatric illness called Factitious Disorder Imposed on Another. Victims are usually children. Perpetrators are usually women in a maternal role, and may have associated family conflict, personality disorder, or other comorbid psychiatric illnesses. This study aims to determine the most common patterns of presentation in cases published in the literature in the past 15 years. We extracted relevant data from 108 articles, including 54 papers presenting 81 case-reports. There was a mostly even distribution of sex among the victims (51% male, 43% female, 6% unreported), who were mostly children (mean age of child victims was approximately 5 years). Most perpetrators were female (91% female, 1% female and male, 8% unreported). Twenty-three cases (28%) had a perpetrator with a known psychiatric diagnosis, the most common being Factitious Disorder Imposed on Self (10%), Depression (9%), and Personality Disorders (7%). More than one third (36%) stated family/marital conflict or abuse. Fourteen cases (17%) had perpetrators who worked in healthcare. The most common type of falsification was Induction (74%) however 15% of cases had more than one type of falsification. The most common outcomes were: separation of perpetrator and victim (37%); no follow-up was reported (22%); imprisonment of the perpetrator (14%); death of the victim (12%); psychological or psychiatric treatment of the perpetrator (10%); continued living together (4%); suicide of the perpetrator (1%). Recurrence was present in more than three quarters of cases. Our results reiterate that awareness of the most common findings in Munchausen Syndrome by Proxy allows physicians to identify them in a clinical context.
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Oliveira, Vanessa Sofia Marques. "Síndrome de Munchausen por procuração na perspectiva dos profissionais de saúde." Master's thesis, 2016. http://hdl.handle.net/10400.14/20733.
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O Síndrome de Munchausen por Procuração é uma forma relativamente rara, mas grave, de maus-tratos infantis causados pelo(a) cuidador(a) que induz sinais e sintomas de doença numa criança. Consequentemente, os esforços dos profissionais de saúde para realizar o diagnóstico leva a que as intervenções realizadas sejam desnecessárias e potencialmente prejudiciais para a criança. Assim, é necessário que exista por parte dos profissionais de saúde um alto índice de alerta para a possibilidade de estarem presentes sinais e sintomas que não se enquadram numa doença em particular, quando estes são resistentes ao tratamento ou quando evoluem para outra(s) doença(s).
Assim, na formulação diagnóstica é fundamental a integração dos vários registos médicos do(s) menor(es) envolvido(s), uma comunicação consistente entre os profissionais de saúde bem como, uma abordagem multidisciplinar com as várias instâncias de proteção à criança, uma vez que o diagnóstico poderá ser controverso, difícil e acarretar repercussões legais e familiares.
Neste sentido, o presente estudo pretende aceder à perspetiva dos profissionais de saúde, nomeadamente acerca de que critérios é que os mesmos avaliam como sendo determinantes para a sinalização num caso em que existe a suspeita de Síndrome de Munchausen por Procuração.The Munchausen Syndrome by Proxy (MPBS) is one of the most serious, yet relatively rare, forms of child abuse, where the caretaker of a child fakes or induces real symptoms to make it look like the child is sick. Consequently, the efforts for Healthcare Providers to diagnose and provide treatment for a nonexistent condition often lead to unnecessary and potentially harmful interventions to the child. It is therefore essential that Healthcare Providers have a high degree of clinical suspicion and awareness for possible signs and symptoms that do not fit into a specific illness, when these signs or symptoms resist treatment or when they escalate into other diseases. When making a diagnosis, the combination of the different clinical data on the child is of the essence, as it is also crucial a consistent communication among Healthcare Providers, as well as a multidisciplinary approach with the various entities of child protection and safeguarding, since the final diagnosis may be not only controversial, but also difficult and lead to legal or family consequences. In this sense, this study intends to look into the Healthcare Providers' approach, namely to understand which are the key factors in the diagnosis of a potential condition of Munchausen Syndrome by Proxy.
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Brilhante, Ana Catarina Sousa. "Um caso particular de vitimização infantil : Munchausen’s by proxy syndrome : uma revisão." Master's thesis, 2015. http://hdl.handle.net/10451/24777.
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Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015Os maus tratos infantis assumem dimensão de epidemia global na saúde pública. No caso particular de vitimização infantil de Munchaunsen’s by proxy Syndrome (MbPS), o agressor – geralmente, a mãe - induz o aparecimento de sintomas compatíveis com patologias noutro indivíduo, neste caso o próprio filho, a fim de que seja alvo de procedimentos médicos injustificados. Estima-se que atinja cerca de 2,5 em 100 000 crianças no primeiro ano de vida. O epónimo Munchausen foi utilizado por Richard Asher (1951) para descrever pacientes que se submetiam a procedimentos médicos desnecessários. Roy Meadow (1977) ampliou o conceito ao reportar casos de mães que simulavam doença nos filhos. No MbPS a tipologia do agressor difere da de outros casos de mau trato: são sobretudo mulheres, cuidadoras das vítimas, e com conhecimentos médicos. A literatura aponta no sentido da evolução da vítima para um diagnóstico de Perturbação Factícia na idade adulta e, nalguns casos, para uma replicação do padrão de abuso. A gratificação obtida através do «papel de doente» (o próprio ou «by proxy») parece estar na base de uma perturbação crónica e transgeracional. Concluímos ser a detecção precoce e a articulação de equipas multidisciplinares fundamentais na tentativa de cessar a dinâmica vítima-agressor e interromper ciclo de violência.
Child abuse has become a global public health epidemic. In the particular case of Child Victimization caused by Munchausen’s by Proxy Syndrome (MbPS), the aggressor, usually the mother, fabricates symptoms consistent with different pathologies on another person, her own son, resulting in unnecessary medical procedures. MbPS is estimated to afflict 2.5 children for each 100 000 children in their first year of life. The eponymous Munchausen was first used by Richard Asher (1951) to describe patients who underwent unnecessary medical procedures. Roy Meadow (1977) introduced the concept "by proxy", when he reported cases of mothers simulating disease in their children. In MbPS cases, the perpetrator does not follow the usual profile: mainly female guardians with medical knowledge. Studies show that MbPS victims may suffer, as adults, from Factitious Disorder or continue the pattern of MbPS abuse. The gratification obtained through the "sick role" (one's own or "by proxy") appears to be the basis of a transgenerational and chronic disturbance. We conclude that early detection and the work of a multidisciplinary team are critical in the attempt to stop the victim-aggressor dynamics and therefore to end the violence cycle.
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Bosch, Adrian Frans. "A patient with the diagnosis of a "factituous disorder": a phenomenological investigation." Diss., 2003. http://hdl.handle.net/2263/25750.
Full textAbstract:
In this dissertation, the author provides an account of his therapeutic interaction and experience, as an intern clinical psychologist, in working with a patient in psychotherapy who was eventually diagnosed with a “factitious disorder”. This study descriptively addresses how the therapeutic interaction impacted upon the therapist’s thinking of the process both diagnostically and in terms of therapeutic goals. This study consists of a single case, qualitative research design. It concerns the interactions and experiences of the therapist with a specific patient (diagnosed with a factitious disorder) in the context of a multidisciplinary academic hospital setting. The study aims to be predominantly descriptive of this therapy, and as such employs the psychological phenomenological method of Giorgi (1985) in order to provide a specific description of the situated structure of the therapy. As such, this study is able to contribute to the sparse psychological and therapeutic information available on factitious disorders. There are few detailed accounts of actual therapeutic interactions – specifically from a psychological perspective – for patients diagnosed with factitious disorders. The specific description of the situated structure of the therapy is also compared to the available literature on factitious disorders. Although the aim of this study was not evaluative in nature, the author does provide some tentative comments on the aetiology and therapeutic considerations for factitious disorders – with regards to this particular case. The author suggests a strong link to personality and character deficits underlying factitious behaviour. The author further suggests the importance of acknowledging the “sick role”; allowing for “face-saving” strategies; providing consistency (on behalf of the therapist); and the setting of rigid, overt, therapeutic boundaries in the psychotherapeutic treatment of factitious disorders.Dissertation (MA (Clinical Psychology))--University of Pretoria, 2005.
Psychology
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