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An explanatory model for Munchausen by proxy abuse.

D C Rand¹, M D Feldman

¹Marin Psychological Services, Mill Valley, California, USA.

International Journal of Psychiatry in Medicine

|January 5, 2002

Summary

Munchausen by proxy (MBP) abuse involves a caretaker fabricating illness in another to gain gratification. Understanding this behavior requires examining perpetrator drives, inhibitions, and learned patterns.

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Area of Science:

Psychiatry
Psychology
Criminology

Background:

Munchausen by proxy (MBP) is a form of abuse where a caretaker fabricates or induces illness in another person, typically a child, to seek attention or emotional gratification.
Traditional explanatory models for MBP have limitations in fully understanding this complex and counterintuitive behavior.

Observation:

This study analyzes personal accounts from MBP perpetrators, physicians, and family members, alongside a review of published literature and dedicated books on the subject.
Factors contributing to MBP include perpetrator drives like anger or frustration, and the overcoming of internal and external inhibitions.

Findings:

MBP perpetrators experience emotional release and a sense of control, with the behavior strengthening over time through "habit strength."
A behavioral perspective explains MBP as a learned behavior, its prevalence among mothers, and the difficulty perpetrators face in ceasing the abuse.

Implications:

Broadening explanations beyond psychodynamic theories to include observable behaviors and verifiable factors is crucial for a comprehensive understanding of MBP.
This behavioral approach offers insights into the learned nature of MBP, its gendered prevalence, and the challenges in intervention and treatment.

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