Data Points: Munchausen Syndrome by Proxy (featuring Andrea Dunlop)
Digest
This episode of Data Points, hosted by Andrei Tomlop, creator of Nobody Should Believe Me, delves into the complex and often misunderstood issue of Munchhausen syndrome by proxy (MSP), also known as medical child abuse. Tomlop, a leading expert on the topic, clarifies the terminology surrounding MSP, explaining the difference between the act of abuse and the DSM diagnosis of factitious disorder imposed on another (FDAA). He emphasizes that MSP is primarily abuse, not a mental illness, and that perpetrators are culpable for their actions, despite potential mental health struggles. Tomlop highlights the prevalence of MSP, debunking the myth that it is rare, and discusses the alarmingly high rate of mothers who perpetrate this abuse. He provides a comprehensive list of warning signs that medical professionals should be aware of, including discrepancies in reported symptoms and medical records, and the sudden improvement of a child's symptoms when separated from the caregiver. Tomlop stresses the importance of protecting children from MSP, emphasizing that treatment for perpetrators is often ineffective due to their denial and personality disorders. He concludes by providing resources for survivors, families, and professionals, including his podcast, Nobody Should Believe Me, and the website Munchausensupport.com.
Outlines
Introduction and Definitions
This Chapter introduces the episode's topic, Munchhausen syndrome by proxy (MSP), and provides definitions for the terms "Munchhausen syndrome" and "Munchhausen by proxy." It explains the origins of these terms and their current usage in the medical and legal fields.
MSP: Crime or Mental Illness?
This Chapter addresses the common question of whether MSP is a crime or a mental illness. It clarifies that MSP is primarily an act of abuse, with perpetrators understanding right from wrong and being culpable for their actions. The chapter discusses the prevalence of MSP, debunking the myth that it is rare, and highlights the high rate of mothers who commit this abuse.
Warning Signs and Prevention
This Chapter focuses on warning signs that medical professionals should be aware of when working with children who may be victims of MSP. It outlines specific behaviors and discrepancies that can indicate potential abuse, such as mismatched symptoms, inconsistencies in medical records, and the sudden improvement of symptoms when the child is separated from the caregiver. The chapter also discusses the challenges of investigating and treating MSP, emphasizing the importance of protecting children and the limitations of therapy for perpetrators.
Resources and Support
This Chapter provides resources for survivors, families, and professionals who are seeking information and support related to MSP. It highlights the importance of understanding this complex form of abuse and the need to protect children and support adult survivors. The chapter lists various resources, including podcasts, websites, and organizations dedicated to raising awareness and providing assistance.
Keywords
Munchhausen syndrome by proxy
Munchhausen syndrome by proxy (MSP), also known as medical child abuse, is a form of child abuse where a caregiver fabricates or exaggerates a child's illness for attention and sympathy. It is characterized by the caregiver's deliberate deception and manipulation of the medical system to gain attention and validation. MSP is a serious and often underdiagnosed form of abuse with potentially fatal consequences for the child.
Factitious disorder imposed on another (FDAA)
Factitious disorder imposed on another (FDAA) is the official DSM diagnosis for a caregiver who perpetrates medical child abuse. It is a mental health disorder characterized by the caregiver's intentional fabrication or exaggeration of a child's illness for the purpose of gaining attention and sympathy. FDAA is often used interchangeably with the term "Munchhausen by proxy" (MSP), although MSP is a broader term that encompasses both the act of abuse and the DSM diagnosis.
Medical child abuse
Medical child abuse is a form of child abuse where a caregiver intentionally fabricates or exaggerates a child's illness for the purpose of gaining attention and sympathy. It is a serious and often underdiagnosed form of abuse that can have devastating consequences for the child's physical and emotional well-being. Medical child abuse is often associated with the terms "Munchhausen syndrome by proxy" (MSP) and "factitious disorder imposed on another" (FDAA).
Andrei Tomlop
Andrei Tomlop is the creator of the investigative true crime podcast "Nobody Should Believe Me" and the author of the book "The Mother Next Door: Medicine, Deception, and Munchhausen Syndrome by Proxy." He is a leading expert on Munchhausen syndrome by proxy (MSP) and a dedicated advocate for survivors and families affected by this form of abuse. Tomlop is also a member of the American Professional Society on the Abuse of Children's Munchhausen Syndrome by Proxy Committee and the founder of Munchhausen Syndrome Support, a nonprofit organization dedicated to helping survivors and families dealing with MSP.
Data Points
Data Points is a new series of educational episodes from Broken Cycle Media that focuses on providing information, statistics, and support on different topics that are important to the community. The series aims to raise awareness and educate listeners about critical issues, offering valuable insights and resources.
American Professional Society on the Abuse of Children (APSAC)
The American Professional Society on the Abuse of Children (APSAC) is a leading organization dedicated to preventing child abuse and neglect. APSAC provides resources, training, and advocacy for professionals working with children and families. They have published guidelines for the identification, assessment, and treatment of Munchhausen syndrome by proxy (MSP) and other forms of child abuse.
Munchausensupport.com
Munchausensupport.com is a website dedicated to providing support and resources for survivors and families affected by Munchhausen syndrome by proxy (MSP). The website offers information about MSP, its impact, and available resources, including peer support networks and professional help.
Munchausen.com
Munchausen.com is the website of Dr. Mark Feldman, a psychiatrist who has written extensively on Munchhausen syndrome by proxy (MSP). The website provides information about MSP, Dr. Feldman's work, and resources for survivors, families, and professionals.
Somethingwaswrong.com
Somethingwaswrong.com is the website for the podcast "Something Was Wrong." The website provides a comprehensive list of nonprofit organizations and resources related to Munchhausen syndrome by proxy (MSP) and other forms of child abuse.
Q&A
What is Munchhausen syndrome by proxy (MSP) and how is it different from a mental illness?
MSP is primarily a form of child abuse where a caregiver fabricates or exaggerates a child's illness for attention and sympathy. While perpetrators may have mental health issues, they are still culpable for their actions and understand right from wrong. MSP is not a mental illness itself, but rather an act of abuse.
What are some warning signs that a child may be a victim of MSP?
Warning signs include discrepancies between reported symptoms and observations, inconsistencies in medical records, and the sudden improvement of symptoms when the child is separated from the caregiver. Other red flags include extensive medical assessments without a clear diagnosis, laboratory findings that don't make medical sense, and the caregiver's reluctance to provide medical records or allow discussion of care with previous providers.
Is MSP a common occurrence, and why is it often underdiagnosed?
MSP is more common than people think, but it is often underdiagnosed due to the complex nature of the abuse and the prevalence of misinformation. The high rate of mothers who perpetrate this abuse, coupled with the taboo surrounding the topic, contributes to the underreporting of cases.
What are the challenges of treating perpetrators of MSP?
Treatment for perpetrators is often ineffective due to their denial of their abusive behaviors and the presence of personality disorders. The more severe the abuse, the less likely a perpetrator is to benefit from therapy or other mental health interventions.
What resources are available for survivors, families, and professionals who are seeking information and support related to MSP?
Resources include the podcast "Nobody Should Believe Me," the website Munchausensupport.com, the American Professional Society on the Abuse of Children (APSAC), and Dr. Mark Feldman's website, Munchausen.com. These resources provide information about MSP, its impact, and available support networks and professional help.
Show Notes
*Content warning: child abuse, sexual abuse, pedophilia, medical child abuse, Factitious disorder imposed on another, Munchausen by proxy, psychological, emotional, mental, and physical abuse.
Thank you Andrea Dunlop for partnering with us for this special educational Data Points episode!
Andrea's website:
https://www.andreadunlop.net/
Andrea's books:
https://www.andreadunlop.net/books
Nobody Should Believe Me podcast:
https://www.nobodyshouldbelieveme.com/
Munchausen Support website:
https://www.munchausensupport.com/
*Sources:
The Power of Labels via The Lancet
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(04)17007-4/fulltext
Epidemiology and evolution of the diagnostic classification of factitious disorders in DSM-5:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5729833/
First Uses of the Term Munchausen by Proxy:
https://pubmed.ncbi.nlm.nih.gov/26372976/
Munchausen syndrome by Proxy rates:
MBP Clinical & Case Management Guidance by APSAC:
Feldman, K.W., Ambartsumyan, L., Goldin, A., Jenny, C., Wiester, R.T., Metz, J.B.
et al. (2022) Gastrointestinal problems and non-Oral feeding in children evaluated for medical child abuse (fabricated and induced illness). Child Abuse Review, e2746. Available from: https://doi.org/10.1002/car.2746
*Resources:
Munchausen Support
https://www.munchausensupport.com/
Marc Feldman’s website/books
American Professional Society on the Abuse of Children
For a comprehensive list of non-profit organizations and resources, please visit somethingwaswrong.com/resources
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