Reply to Schreier and Libow

Kelly, Ciaran; Loader, Peter

doi:10.1017/s136064179822154x

Cited by 2 publications

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“…The lack of clarity and ambiguity about what constitutes MSP complicates the identification, management and treatment of MSP and may result in many cases going undetected. The development of a continuum of Factitious Disorder Spectrum Diagnoses as suggested by Kelly and Loader (1998) may allow for more specific psychopathological formulations for each of the disorders on the spectrum and ensure the adoption of more appropriate strategies for intervention.…”

Section: Discussionmentioning

confidence: 99%

“…Furthermore, the specificity of diagnosis is essential in that treatment of an overanxious parent would certainly differ from a parent who has specifically induced an illness in her child. Kelly and Loader (1998) responded to the criticisms made by Schreier and Libow (1998). They argue for subcategories of Factitious Disorder by Proxy, of which MSP could be one.…”

Section: Definitions Of Mspmentioning

confidence: 99%

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Diagnosis and management of Munchausen's Syndrome by Proxy

Korpershoek

Flisher

2004

Journal of Child & Adolescent Mental Health

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A systematic literature review was conducted to identify and synthesise the relevant literature on the epidemiology, presentation, assessment and management of Munchausen's Syndrome by Proxy (MSP). This included collating information from published and unpublished sources. The purpose of the review was to provide an overview of the status of research into MSP. The results indicated that there are common areas of research and theorising on MSP. These areas were divided up into the following categories: definitions of MSP, diagnosis and recognition of MSP and management of MSP. The results of the literature review were summarised using the above-mentioned categories. The most widely accepted definitions of MSP included the International Classification of Diseases (10th edition) (ICD-10), (1994), Rosenberg (1987), The Diagnostic and Statistical Manual (4th edition) (1994) and Kelly and Loader (1997). The most common presentations of MSP identified included seizures, diarhhea, apnea and fevers. The most common forms of assault identified included suffocation, giving of drugs and poisoning. Mother-perpetrator features, child-victim features and family features were identified as categories used to help with the identification of MSP. Appropriate management of MSP included careful consideration of child protection factors with the emphasis on comprehensive assessment and management.

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Section: Discussionmentioning

confidence: 99%

Section: Definitions Of Mspmentioning

confidence: 99%

Diagnosis and management of Munchausen's Syndrome by Proxy

Korpershoek

Flisher

2004

Journal of Child & Adolescent Mental Health

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Book Reviews

Kelly

2000

Clin Child Psychol Psychiatry

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superficial and polarized views of this increasingly recognized and potentially serious form of child abuse. Allison and Roberts provide a provocative and at times limited reevaluation that challenges our constructs of this putative syndrome. For the authors the diagnosis of Munchausen by Proxy syndrome (MBPS) conjures up a sinister image: a severely personality disordered mother, while ostensibly seeking medical treatment, surreptitiously induces illness in her defenceless child in order to gain attention from a caring, powerful, perhaps even loving, physician. The authors question the generally accepted research usually quoted to support the diagnostic validity of MBPS, claiming it is insubstantial and logically flawed. Allison and Roberts selectively review an idiosyncratic selection of the literature to conclude that the diagnosis of MBPS depends on weak diagnostic criteria, and wholly circular and self-justifying arguments that further disempower disadvantaged mothers and chronically ill children. The authors are academic philosophers at Stony Brook, New York. Their writings scrutinize aspects of the world of medicine, including the concept of disease and what may or may not constitute appropriate illness and healthcare-seeking behaviour. They have adopted a social-constructionist and at times feminist perspective of the apparent power imbalances between patients and physicians. This book emphasizes the plight of well-intentioned mothers, who may face unreasonable accusations of fabrication and falsification from doctors, who feel deskilled when they encounter chronic paediatric conditions that do not respond well to medical management. Allison and Roberts maintain that the medical and legal professions collude in their allegations against mothers who are being persecuted in a manner analogous to the witch-hunts of medieval Europe. They draw detailed comparisons with the medical misperception and mismanagement of 19th century 'hysterics' and argue coherently against early psychodynamic models of understanding abnormal illness behaviour which is supposedly motivated by secondary gains. The authors critically review the writings of Cheyne, Gavin, Brodie, Charcot and Freud. They elaborate on how the constructs of abnormal illness behaviour and particularly MSPB have evolved in response to dominant discourses that have developed within the principally male and to some extent self-serving culture of medicine. At times Allison and Roberts can appear to be engaged in a personal crusade against Schreier and Libow and their textbook about MBPS, 'Hurting for love'. There may well be some validity in their criticism of Schreier and Libow's definition of MBPS, which specifies that the mother's motivation is to engage in an ambivalent relationship with the physician, or any other powerful societal figure (Schreier, 1996). Unfortunately, Allison and Roberts present their views as original and fail to give reference to many other

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Reply to Schreier and Libow

Cited by 2 publications

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Diagnosis and management of Munchausen's Syndrome by Proxy

Diagnosis and management of Munchausen's Syndrome by Proxy

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