I. Primary Diagnosis—Munchausen Syndrome by Proxy
I propose Donna Roberts be diagnosed with Munchausen Syndrome by Proxy (MSP). The criteria for MSP, according to the Diagnostic and Statistical Manual of Mental Disorders V (DSM-5), include: falsification of “psychological or physical signs or symptoms or causing injury or disease in another person with the intention to deceive, presenting another person to others as sick, injured, or having problems functioning, and continuation of deception even without receiving any benefit or reward” (“Tests and Diagnosis,” 2014). MSP often occurs in mothers who create or exaggerate their child’s symptoms by ways of falsifying medical records, altering diagnostic tests, or physically inducing the
…show more content…
At present, no diagnosis has been determined and past diagnoses were ruled out for not accounting for her various symptoms.
b. Caretakers’ warning signs
Caretakers with MSP tend to have an attention-seeking behavior and strive to appear self-sacrificing and devoted to their child (Pietrangelo, 2016). Donna, throughout the case report, enjoyed displaying her knowledge on Mandy’s various health problems and the mass amount of medications she was taking. Donna stressed the fact that she quit her job as a nurse’s aid to care for Mandy full-time since she is the only one to understand her daughter’s health condition. Furthermore, Donna may be using Mandy’s alleged health problems as a way to get her husbands attention. Donna stated that Jim and her “haven’t had anytime together since Mandy was born” since he is working 60-80 hours per week. Throughout the case report, Jim expressed his gratitude for Donna and her willingness to care for Mandy. Donna may see Mandy as the only method of obtaining this praise/attention from her husband.
c. Caretakers’ past history
Theorists have proposed that past abuse, physically and/or sexually, can play a role in the development of MSP in individuals. Donna reported having a traumatic upbringing: her father sexually abused her at a young age. Individuals with MSP may create an illness within their child because they grew up believing “being sick was a way to get love” from their family members (Lyness, 2015).
My opinion on Munchausen/Munchausen by proxy syndrome is divided. It seems to me that this would be a very hard disorder to diagnose. I feel this way because there are most definitely people out there who are sick or that have sick children and must do all that is necessary to provide and take care of themselves or their children. So I feel that multiple doctor’s visits are necessary in this case. With that being said, I think it makes it hard for doctors to actually diagnose the initial cause of the symptoms. I also feel that someone who is constantly seeking medical attention from various doctors and hospitals would add to the difficulty in diagnosing this disorder.
Six year old Eric is continuously brought to a local clinic by his mother Monica for treatment of abdominal cramps or according to the mother, appendicitis. Eric is the only son and lives with his mother. With each appointment, Eric symptoms become more progressive, resulting in his hospitalization. As his length of stay increases, Eric’s doctor, Dr. Spencer begins to suspect that something is wrong and suspects Munchausen’s syndrome by proxy, however, none of the other hospital staff members believes Dr. Spencer. As Eric remains hospitalized, his hospital roommate, Ben, begins to develop similar symptoms Eric has been presenting. Dr. Spencer would like to monitor Eric’s mother without her knowledge, but the
Munchausen syndrome and MSBP are included in the DSM-III R category of factitious disorders and therefore are elusive syndromes that are difficult to diagnose and recognize (2). "Because symptoms in factitious disorders are not connected with obvious gain, the absence of external gain suggests that factitious disorders like Munchausen syndrome serve some psychological need, but do so by maladaptive methods (2)." The syndrome is not recognized by the American Medical Association or the American Psychiatric Association (10). Lack of official recognition from the medical community has created an air of confusion around MSBP. Munchausen syndrome is decidedly a psychiatric disorder involving the patient assuming a role, but the reason for skepticism concerning MSBP is that is clearly a form of child abuse, as
MSBP is a psychological disorder characterized by a pattern of behavior in which someone, usually a mother, induces physical ailments upon another person, usually on her child. (Heffner, 2004). This disorder is inflicted from one person onto another in the hopes of seeking
In the psychological thriller, The Devil’s Waltz by Jonathan Kellerman, a child psychologist detective, Alex Delaware is pitted against a personality disorder, Munchausen Syndrome by Proxy. This is a variant of classic Munchausen's Syndrome, which is characterized by Mr. Kellerman as "hypochondriasis gone mad." The disease is named after Baron von Munchausen who was a legendary liar. The syndrome refers to patients who fabricate diseases by mutilating and poisoning others. Dr. Alex Delaware was challenged throughout the novel to prove that a child's own mother or father is making her sick. The novel follows twenty-one-month-old Cassie Jones. She is bright, energetic, and the picture of health, except her parents rush her to the emergency room night after night with medical symptoms no doctor can explain. Cassie's parents seem sympathetic and deeply concerned and her
Currently, Suzette has been unemployed for over 5 months and collecting disability for her mental health issues while living in subsidized housing. She has no interest in finding a job and exhibits no concern about providing for her two children, a 6 year old daughter and 8 year old son. Suzette angrily reports for the past 2 years every time she talks to her step-mother, Lucille, “she yells at me that I am a neglectful mother. I really hate her.” Clinician observes Suzette as showing no interest in daily activities, seems fatigued and diminished interest in activities and relationships, the most concerning is her lack of interest in her children.
Circumstance: Ms. Smalls (MHP) attend and provide support to Richard and Ms. Cordova (caregiver) during onsite assessment.
No history of skin disease. Skin is pink, dry, and void of bruising, rashes, or lesions. No recent hair loss; head is normocephalic. Pupils equally reactive to light; no history of glaucoma or cataracts. Ears are in normal alignment; no history of chronic infections, hearing loss, tinnitus, or discharge. Nose and sinus history includes clear nasal discharge “since last October”, and occasional nose bleeds; states she use to get nose bleeds often as a child. Mouth and throat are absent of lesions; no bleeding gums, sore throat, dysphagia, hoarseness, or altered taste. Neck is void of pain, swelling,
MSbP is a mental disorder that causes parents to falsify their child’s symptoms and predetermined diagnosis. This is normally done by mothers who are seeking attention from the preferred environment of the medical field. The offenders themselves do not suffer from MSbP, they inflict it onto their children and therefore are the indirect patient, using their children as the one who actually undergoes all of the treatments.
The reason why I choose this psychological disorder was because it was brand new topic to me. I was very interested in the fact of not knowing anything about this topic previously so I was able to go into this research with a blank slate. After researching what this syndrome was, my main topic of interest was that Munchausen Syndrome is a largely unexplained phenomena, as it is both quite rare and difficult to diagnose. It is also practically impossible to treat, as most people will emerge with negative results. Most of the
The term Munchausen Syndrome by proxy was named in 1951 by Asher after a well-known German Baron story teller (Campbell V, McDougall, Justice G., 2015). Munchausen Syndrome by Proxy was defined as an acute illness which is supported by dramatic and plausible history by Asher (Campbell V, McDougall, Justice G., 2015). Asher characterized Munchausen Syndrome’s condition as an intense desire to deceive people as much as they can in order to be the center of attention (Campbell V, McDougall, Justice G., 2015). Asher believes that medical reports of Munchausen Syndrome by Proxy are usually made of fantasies and falsehoods and that the most interesting thing about it is that it is senseless (Campbell V,
A review of her medical records indicates that she has increased back pain and increased restless leg syndrome. She continues to suffer from chronic insomnia and chronic anxiety which is manage with Xanax. She suffers from chronic anemia and chronic depression.
Sandra was a 26 year old mother of four children who had been married for eight years. She had given birth to her fourth child two months ago, with the help of a midwife. Due to her husband’s recent pay cut, and already difficult financial situation, Sandra did not receive any antenatal or postnatal care. About a month after birth she felt normal. However, she soon began to exhibit unusual behavior including losing interest in her daily activities, spending most of the day alone without speaking to anyone, and ceasing to care for her
When investigating a case of Munchausen syndrome by proxy it is important for the child’s safety that the parent is unaware of the investigation or viewed as a suspect to avoid further harm to the child. Law enforcement would require multiple help of a physician to verify that there is no other possible causes of the Childs ailments. The physician can have access to all medical records to help further the investigation. Then help from the nurses to keep track of who had access to child to narrow down suspects. Once officers have suspects they can conduct interviews and search warrants to find evidence of the abuse. Hospitals can also place the child in a private room with surveillance camera’s to monitor any suspicious activities in tampering with the child’s recovery. When evidence exists of such abuse, child protective services can issue a court order to relocate the child to a safe location to avoid the risk of any more
Personality disorders generally reflect a disruptive childhood from which the child learns to rely on maladaptive defense mechanisms. Parental criticism and ridicule are central themes underlying these disorders. Additional research supports claims of childhood sexual or physical abuse, although this is not always characteristic in these disorders (Hansell & Damour, 2008).