NCJ Number
208775
Journal
Child Abuse & Neglect: The International Journal Volume: 26 Issue: 5 Dated: May 2002 Pages: 525-536
Date Published
May 2002
Length
12 pages
Annotation
This study examined the relationship between factitious (induced) disorder by proxy (induced by someone other than the person with the disorder) and the genesis of factitious disorder (self-induced) in juveniles.
Abstract
Through a literature review and personal familiarity with unpublished cases, the author documents cases in which children and youth have induced or falsified an illness for presentation to medical personnel, as was the case with an 11-year-old boy who was hospitalized for bleeding in the mouth, which was found to be self-induced by stabbing his mouth with a ruler. Most self-induced symptoms of illness, such as fever created with a heating pad, or self-inflicted injury require at least a minimum level of medical sophistication to be persuasive to medical personnel. This suggests that most younger children require at least parental compliance, if not encouragement, to bring them to the doctor's office or hospital for treatment. The less easily classified cases of falsified or self-induced illness/injury in children and youth contain elements of both independent falsification by the subjects with an earlier history of collusion with a parent's Munchausen by Proxy disorder. This suggests a learning process for the child initiated by the parent. The literature on illness falsification in adults suggests the possibility that this behavior may be rooted in adolescence or earlier. Certain elements of the child victim's experience, including efforts to overcome feelings of powerlessness, chronic lack of control, and disappointment in the physician are suggested as possible dynamics in the eventual development of independent illness falsification. Further research on this issue should lead to a speedier, reliable identification of such patients and the development of more effective family interventions that will prevent long-term illness falsification. 3 tables and 28 references