Talk:Factitious disorder imposed on self

Official call for vote on MS/MSbP split

Since the subject has already been brought up informally a couple times, and the reasons for making the split are arguably even more valid now, I thought it was time to bring the idea of splitting this article up for an offical discussion and vote. The article itself has gotten more than a bit confusing, sometimes jumping between the two topics without warning, and at no point drawing a clear and consistant line between the two. Unless valid objections to the split come up, I will likely attempt the split myself in the near future. - Pacula 13:34, 30 October 2006 (UTC)

Split. There is a major difference between these two, both in terms of the psychological makeup of the people who have it and in terms of what the world around them experiences. Also, MSbP gets a pretty heavy emotional response, and the people who "just" have MS are not being done any favours by being associated with the killing of children in the court of public opinion. The article will be cleaner too. Discussion will take ages. Just make it a vote, and put it on the top of the page. Zuiram 20:29, 30 October 2006 (UTC)

Question:

ARTICLE: Many experts now doubt even the existence of MSbP

But I have seen documentaries where parents killed their babies in the hospital. How can some experts doubt the existence of this disorder?

wildt 17:27 11. May 2004 (UTC)

hmm i also saw on tv, hospital surveillance cams and all --62.251.90.73 00:27, 7 Jul 2004 (UTC)

The fact that these events occur is not in dispute. What is in dispute is the rationale for them and whether they are all part of the same associative grouping, and whether generalisations can be drawn. Sjc 08:45, 2 Nov 2004 (UTC)

I think the article could use a bit more detail on that; what are the alternate theories to explain the evidence (if there are alternates), etc... Is the alternate theory simply that, when that evidence for which we were trusting Meadow is discounted, the remaining evidence is not enough to support the theory of a syndrome? -- Antaeus Feldspar 17:06, 2 Nov 2004 (UTC)

The some articles did not use the capitalised form of "Munchausen Syndrome by Proxy", and it is causing a little bit of problem...
should I just go and make correct those articles? or make a new redirection page? --Zephirum 08:34, 2 Nov 2004 (UTC)

If I understand what you're saying, then the way I look at it is this: we have "legitimate" redirects, and "practical" redirects. (Not official terminology, just mine...) "Legitimate" redirects are names under which the article might legitimately be found, even if it's not there (for instance, it's reasonable to expect "Munchausen Syndrome by Proxy" to be the page where MBsP is discussed, even though it's actually a redirect page.) A "practical" redirect is one where the name is incorrect, but it's fairly predictable that someone will at some point use that incorrect name anyways (for instance, the James Joyce novel A Portrait of the Artist as a Young Man is so frequently referred to incorrectly as just A Portrait of the Artist that it might be for the best to have that page redirect to the correct article.)

Given that distinction, I think that if a page points to a legitimate redirect, it's functioning as appropriate and can be left as it is. If it's pointing to a practical redirect, it's better in the long run to fix the link to be pointing to a legitimate redirect, or to the article directly. Out of the two redirects we have for MSbP, Munchausen by proxy and Munchausen syndrome by proxy, I really don't have the subject-specific knowledge to know whether these should be considered legitimate or practical. I do, however, suggest that this should be the question we try to answer. -- Antaeus Feldspar 17:06, 2 Nov 2004 (UTC)

does msbp exist?

just like to add my voice to monsignor feldspar.. as regards more detail on alternate theories.. and some links to relevant papers would be nice.

There are far too many documented cases for it not to exist; although most paediatricians (pediatricians) today would not recognise the description in the article, which represents the state of knowledge of approximately 10 to 15 years ago.

The idea that there is "something wrong" with perpetrators of MSbP came from early, largely anecdotal, descriptions of families in the 70's and 80's. The Leeds-Cardiff study (?1998-ish) largely dismissed that idea. Perpetrators of this form of abuse are no more "suffering" from it than, say, a paedophile suffers from the abuse of his victims. Countless psychiatrists have verified that abusers do not have any identifiable psychiatric disorder.

Diagnosis is indeed difficult and controversial; paediatricians are used to believing and supporting parents and find it hard to switch into a accusatory and oppositional role. In addition, successful abusers are by their nature accomplished liars, if only because the poor ones are detected early on. The medical signs and symptoms can be confusing, inconsistent and misleading; excessive investigation is probably a greater cause of suffering than the fabrication itself, but many children have been injected, infused and even operated on unneccessarily.

Suggestive signs and symptoms centre on the child, not the adults. Poisoning with bizarre substances such salt levels way beyond even pathological levels; convulsions and respiratory arrest that only occur in the presence of one particular carer; a strong association with other forms of abuse such as fractures and neglect in the same child or a sibling.

refs (I'll check these fully when I have a moment)

1. Fabricated and Induced Illness. 2003 Royal College of Paediatricians and Child Health http://www.rcpch.ac.uk/publications/recent_publications/FII.pdf

1. Davis PM, Sibert JR. Munchausen syndrome by proxy or factitious illness spectrum disorder of childhood. Arch Dis Child. 1996 Mar;74(3):274-5.

Fearghus 23:28, 30 October 2005 (UTC)

Points for discussion, January 3 2005

These points were removed from the article on the above date but they may represent some information we do not currently have in the article, so I'm listing them here as points for further research and discussion. -- Antaeus Feldspar 20:52, 3 Jan 2005 (UTC)

• Observations on hospital surveillance cameras have caught MSbP abusers in the act of poisening and smothering their children and many confessed.
  • Not in dispute, except for whether MSbP is the correct classification. -- Antaeus Feldspar

• MsbP is often a highly recidivistic type of abuse like sexual abuse.
  • I do not doubt that some experts express this opinion but who are they and how do they fit in on the general spectrum of experts? -- Antaeus Feldspar 20:52, 3 Jan 2005 (UTC)

• Many people alarmed at the heinousness of the abusive acts mischaracterize MSbP as a psyhiatric illness which it is not.
  • Somehow I doubt that the question has been completely settled that MSbP is not a psychiatric illness. -- Antaeus Feldspar 20:52, 3 Jan 2005 (UTC)

• Experts more recently have coined the term "Pediatric condition fabrication" to define the abuse acts more precisely
  • It seems to be "pediatric condition falsification" but it also seems to be a descriptor of one half of the characteristic behavior of MBsP. What's the other half, and where is the line drawn? -- Antaeus Feldspar 20:52, 3 Jan 2005 (UTC)

Question: Should the MSbP info be split into a seperate page?

This article seems to be on two different topics that, while related, seem to be distinct enough to each have their own articles. Munchausen Syndrome is an unarguably real condition that sufferers bring upon themselves for sympathy and other intangible reasons, while Munchausen-by-proxy is a "something" (a condition? a type of abuse? both?) that a guardian of some sort inflicts upon someone under their care for similar intangible reasons, and is of arguable actual existance. I don't think combining these two topics into one article is fair at all to either, and unless anyone objects, I may perform the split myself. - Pacula 15:58, 11 May 2005 (UTC)

The problem is that the evidence that Munchausen Syndrome by Proxy exists is (I know this will be disputed, but I say this carefully in consideration of the facts) just as unarguably real as Munchausen Syndrome itself. Has it been overdiagnosed? Unquestionably. But have there been cases where a caregiver has unquestionably done harm to a child in their care, and where the evidence (including testimony by the perpetrator) that the motive was to gain attention and sympathy would result in a solid diagnosis of Munchausen, if the harmer had been doing damage to themselves rather than to a child? The answer is yes.

There may be good reasons to split the article, but because some people can believe in one and not the other is not one of those reasons. -- Antaeus Feldspar 00:45, 12 May 2005 (UTC)

My point was not at all that MSbP should be split off into a seperate article because it might not be 'real', but that MS and MSbP should be seperate articles because they are different topics. I don't want to get into the MSbP exists/doesn't-exist argument, because I don't know enough about the controversy, but I will say this: in either case MSbP is worthy of it's own article because just in concept it's different enough from MS to warrant its own page. - Pacula 10:41, 12 May 2005 (UTC)

Well, I have no problem per se with splitting the articles. But your original suggestion that we should split seemed to be based on the presumptions that Munchausen by Proxy was unlikely to even exist, and that even if it exists, it's barely related to Munchausen -- views which are held strongly by some people, but which the medical experts seem to disagree with. -- Antaeus Feldspar 11:55, 12 May 2005 (UTC)

Sorry for the confusion, but I meant to basically say that they are two seperare subjects with diffeent histories. I did NOT mean to impy that because one is a bit controversioal that shuld be alome reason for the split. - Pacula 22:26, 17 May 2005 (UTC)

MSbP in adults

My question is, is there any evidence of MSbP where the victim is an adult? I am thinking particularly of elderly or infirm people who may have a carer (husband, wife or professional carer) who is causing or aggravating a condition in order to gain attention?

Yes. Dr. Marc Feldman discusses at least one such case in his book Patient or Pretender; if I remember details correctly, this was one of the rarer cases where the person inflicting the fake illnesses was a man, and incredibly, after he'd gone to jail for the damage he'd done secretly injecting his wife and others with gasoline, he actually was discovered doing the same thing to his cellmate. -- Antaeus Feldspar 23:11, 14 December 2005 (UTC)

M.S by Non-existent Proxy?

It seems that in some cases, disturbed people who want to gain attention and sympathy have done so, instead of by inflicting illness upon their children, by inventing completely fictional children with illness (Kaycee Nicole, Anthony Godby Johnson). The connection to MSbP seems pretty obvious; should we include a short mention of these cases? -- Antaeus Feldspar 17:17, 5 September 2005 (UTC)

I don't see that as the same - there is no harm to a child involved. Call it lying to gain sympathy. Midgley 20:42, 23 May 2006 (UTC)

Munchausen-by-proxy-LIKE behaviors

"In one of Douglas Preston and Lincoln Child's Pendergast novels, Dance of Death (novel), a character is accused of suffering from an unusual form of MSbP—committing murders in order to garner attention solving them."

This contribution raises a few questions. The first is, is it the judgement of characters in the novel that this behavior is a form of MSbP? If it is not, then I believe it should go out, it constitutes original research on the part of the editor. Frankly, even if it is a judgement contained in the novel itself, I'm not sure how educational it's going to be to note it; the connection between the behavior described and MSbP seems fairly tenuous when one looks at the dissimilarities. For instance, a crime-solver is going to receive admiration and attention, but not the sympathy that the parent and caretaker of a sick child receives; outside of the general similarity, they don't seem to have a connection. MSbP parents also don't take a forward role in solving the "problem"; they merely bring the problem to others for attention and then accept praise for their courage and strength.

However, it does make me wonder: is there any research in the field on that general pattern? Of people secretly causing problems so that they can reap rewards? It seems like it might be a notable enough topic for Wikipedia to have something on it; Richard Jewell was considered a major suspect by the FBI based on the theory that he was seeking attention in this way. Does anyone know if there is such a theoretical model? -- Antaeus Feldspar 17:16, 11 September 2005 (UTC)

Point of view

In the MSbP: clues that indicate Muchausen Syndrome, it keeps on saying her child or herself. I think someone should go in the and change all those the one's or oneself. I won't right now until we ghet some disscussion going on this but i'll put up a POV thing above it for right now.schyler 04:10, 14 December 2005 (UTC)

I would just change it. As it sits, there is false emphasis on gender as opposed to the behavior Fred Bauder 01:52, 16 December 2005 (UTC)

With the overwhelming majority of the perpetrators of MSbP being female, it doesn't strike me as a particularly important edit. It would be less work to just add a note saying "As most perpetrators are female, this text uses the feminine third person form in referring to them; this should not be taken to mean that males are entirely incapable of this behaviour." or something to that effect.

Plenty of articles place some emphasis on the gender commonly associated with something, so it's not really all that inconsistent. Zuiram 16:23, 16 October 2006 (UTC)

In fact, it is improper to ignore that there is a significant gender difference in MSbP. It must be pointed out that the vast majority of MSbP perpetrators are women; some estimates are as high as 90%. That is a significant statistic; that MSbP is largely a woman's crime is a disturbing and cogent aspect of MSbP that must be explored in this article. In Wikipedia articles detailing criminal behaviour that is largely perpetrated by men (eg: rape), the gender bias is not hidden. Grammatical units such as "he" and "his" are blatant and frequent in those articles. Thus, "she" and "her" are appropriate in this article.

Indeed, we need a sub-section in this article that dwells upon the fact that women are by far the largest group of MSbP perpetrators, and tries to explain why. This gender difference is a significant aspect of MSbP and can not be ignored. It goes towards explaining an organic basis to MSbP by addressing the biological differences between males and females.

Lastly is the issue of fairness and, in particular, gender equality: if you insist on changing all references in this article from "her" to "one's", then you must go into all other Wikipedia articles and change "his" to "one's" as well. Otherwise Wikipedia is fomenting a strong anti-male bias that borders on racism (yes, "racism", since many feminists claim that misogyny is a form of racism). At the very least, obviating the gender bias in MSbP by changing "her" to "one's" leans towards misandry in this particular article. Atikokan 18:08, 8 June 2007 (UTC)

Spoiler Warning

As the reference to Munchausen's gives away the core plot for several of the referenced items, I added a spoiler warning 67.42.57.142 00:34, 16 December 2005 (UTC)

THe film

How accurate is the description? TO describe it as a documentary is true ... it is a documentary of three cases. I've not seen it, so better if someone who has reviews that. Why was it made - is there an interest in the producer, was it sparked by a specific case? To what extent does it depart from its description as following three cases into arguing that a specific medical diagnosis is in all otehr cases as well incorrect, and what additional material does it use for that? And no, I shouldn't watch it instead of asking, those questions should be addressed in the article or at least in teh talk page if the current description of the film is to stand. Midgley 01:02, 1 May 2006 (UTC)

Please split the MSbP info into a separate page

There is no reason to have two different subjects, MS and MSbP, on one single page, could someone with more experience please split the two. —Preceding unsigned comment added by 81.233.252.253 (talk • contribs) (11:26, May 23, 2006)

Why is there no reason? It seems perfectly reasonable to me to have them on a single page. - Zepheus 21:51, 3 July 2006 (UTC)

As I've suggested before, a possibly valid reason to split the article is because the two subjects - even though related - are quite distinct. I don't think it's fair to either subject to mix the two like the current article does. It also seems unbalanced and a bit confusing, since most of the article is on the 'by-proxy' variant, and there is not always a clear seperation between discussion of the two in the article. - Pacula 14:19, 5 August 2006 (UTC)

I agree. I unfortunately know one girl with MS and one with MSbP, and these two conditions are very different. Not just in who it affects and how, but in the manner in which they go about their attention seeking behaviours, and the manner in which they respond to such behaviour. The extent to which it appears to be under (partial?) voluntary control also differs, as does the apparant awareness of their own behaviour.

Also, conceptually and practically, there is a major difference between harming another person, possibly even shifting the blame to innocent third parties in the process, and confining it to yourself.

Quite simply, I don't think we're doing the MS people any favours by associating them with the MSbP people, particularly from the POV of the readers that may be unfamiliar with the topic. Zuiram 16:31, 16 October 2006 (UTC)

I agree this article should be split --62.251.90.73 19:59, 29 October 2006 (UTC)

This discussion has been going on for over 6 months now and the consensus has clearly been for split. So who is going to create the new page and what will the title be and who will help with the move and who will help with spreading the links and choosing the categories? Get the move done now. --A green Kiwi in learning mode 11:24, 1 November 2006 (UTC)

Um, if you scroll up a bit, you'll see an earlier discussion that I started about splitting the page dating way back to May of 2005. At the time, there wasn't a clear consensus either way, so the matter was basically dropped. However, it seems there's a lot more support now for making the split, as well as a lot more validity to the reasons for doing so, so I added the {{split}} tag to the article and put the matter up for a formal vote. As per a suggestion made by the first voter, I moved this 'formal vote' discussion thread to the top of this page. Assuming we don't get a wave of dissenters with valid reasons for not doing so ('wah wah I don't want you to' != valid :) ), I'll do the initial split myself in the very near future - a week seems to be the standard time allotment for a 'formal vote' here. I have no doubt that once the split is actually made, I'll have plenty of help cleaning up the resulting messes afterwords. :) - Pacula 13:39, 2 November 2006 (UTC)

parent or patient?

In "Clues that may indicate Fabricated or Induced Illness" it reads "A parent who appears to be unusually calm in the face of serious difficulties in their child’s medical course while being highly supportive and encouraging of the physician, or one who is angry, devalues staff, and demands further intervention, more procedures, second opinions, and transfers to other, more sophisticated, facilities." Shouldn't that be patient instead of parent? 155.207.254.128 20:39, 17 September 2006 (UTC)

No, the parent caused the affliction, so reacts oddly to it, either by not being worried enough or by seemingly worrying far too much. StuRat 11:39, 18 September 2006 (UTC)

Eminem's "Cleanin' out my closet" and munchausen syndrome

It says he's a victim of munchausen syndrome-- which the article "dispells" by claiming he meant munchausen syndrom by proxy. However, I firmly believe that he means he's a victim of it as a result of his mother having Munchausen Syndrome, and projecting her side effects and derangements onto him. It's frequently noted in MANY of his songs that his mother has been the bane of his existence for the last 15 years, and I believe this suggestion is much more likely.

Consensus? —The preceding unsigned comment was added by PublicSecrecy (talk • contribs) 05:57, 17 March 2007 (UTC).

I didn't know that. The trouble is that Munchausen syndrome is a mental disorder, and MSbP is a pattern of abuse, so it's best not to confuse the two. Maybe you could put a description specifying the circumstances? Joie de Vivre 16:11, 17 March 2007 (UTC)

Treatment section?

Most disease and disorder pages have a section devoted to treatment. Seems like there ought to be one here NoahWH 06:03, 2 June 2007 (UTC)

Subjective content

These lines at the end of the "Syndrome" section stand out as subjective opinions by the author:

"A disease may be initiated in the child by the parent or guardian, and this is considered to be a form of serious child abuse. The parent or guardian needs serious psychiatric help and the child needs to be saved on all accounts."

They should be struck from the article, simply leaving:

"A disease may be initiated in the child by the parent or guardian." —Preceding unsigned comment added by Naturalethic (talk • contribs) 08:23, 13 February 2008 (UTC)

I noticed this too. I'm changing it. Michael Keats (talk) 07:04, 13 October 2008 (UTC)

Missing Description of faking psychological trauma

The opening states that they "fake disease, illness, or psychological trauma," but there's very little about faking psychological trauma, and most of this article doesn't pertain to that behavior. It then claims that "It is in a class of disorders known as factitious disorders," but the "factitious disorders" article is even more narrowly focused on faking diseases. What about people who fake a personal crisis to gain attention from a friend/lover? This seems to fit the description of faking psychological trauma, but most of the article doesn't cover this case. Is there another mental-illness category that would fit that behavior better? Neither this article nor the "factitious disorders" article gives me any clue. --MiguelMunoz (talk) 23:58, 20 June 2008 (UTC)

Illnesses and conditions that are feigned by Münchausen sufferers

This list is completely unreferenced--where did it come from? Some of the list seems a little suspicious to me; I have never heard of a Munchausen patient faking a learning disability, and faking something like ADHD sounds more like drug-seeking behavior than a psychiatric problem. Anorexia is diagnosed by body weight--something impossible to fake without actually dieting to the point that an anorexic does, which is arguably the same thing as typical anorexia. (MsBP on the other hand lends itself to anorexia nicely.) I suggest we comb through the existing references and only mention conditions that are actually listed as having been used by recorded Munchausen patients.--24.164.85.127 (talk) 02:14, 18 April 2009 (UTC)

How can faking death get you in to a hospital?

You can't fake it well for long. —Preceding unsigned comment added by 86.45.75.180 (talk) 21:07, 6 December 2008 (UTC)