Harry Stack Sullivan's interpersonal theory emphasized the role of interpersonal relationships, social development and culture in the formation of personality. His social psychologically based theory was among the earliest and most cogent critiques of Sigmund Freud's psychoanalytic drive theory and his psychosexual developmental theory. Sullivan posited that the human development arose out of a need for interpersonal relatedness more than satisfaction of drives, well before Bowlby's important discoveries regarding attachment. Sullivan's stages of human development involved meeting important psychosocial tasks, which in turn characterized the individual's personality.
Practitioners look to experts in a particular area to formulate and solidify diagnoses, dynamics, and other phenomena. Despite 30 years of literature, clarity and clinical direction are lacking in the case of Munchausen syndrome by proxy (MSBP), factitious disorder by proxy (FDBP), and fabricated and/or induced illness in children (FII). These diagnoses are rare, complex, and controversial, and their underlying dynamics and etiology are at best poorly understood by health professionals. Situations arise, nonetheless, requiring professionals to address these diagnoses under forensic scrutiny without solid scientific footing. This is the nature of the complaint addressed in this article, and the authors propose that these categories be reexamined using diagnostic conventions that already exist in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; DSM-IV-TR; American Psychiatric Association, 2000) and applying the most recognized markers of FDBP for an acceptable individual and dynamic diagnostic description.
Once central to the identity and practice of clinical psychology, psychological assessment (PA) is currently more limited in professional practice and generally less emphasized in graduate training programs than in the past. Performance-based personality tests especially are taught and used less, even though scientific evidence of their utility and validity has never been stronger. We review research on training in PA and discuss challenges that contributed to its decreased popularity. We then review continuing education requirements for ethical practice in PA and recommend that PA should be reconceptualized as a specialty best practiced by psychologists who have the resources and time to maintain competency. We offer recommendations about how professional organizations concerned with PA can promote its practice and how individual expert clinicians can assist. We conclude by describing a collaborative model for providing group consultation in PA to practicing psychologists. If implemented widely, this model could help promote PA and raise its standard of practice.
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