Munchausen Syndrome By Proxy

Munchausen Syndrome by Proxy (MSBP), in which subjects injure or induce illness in children in order to gain attention and sympathy for themselves.13 min read

By Kathryn A. Artingstall

Detective Artingstall serves with the Orlando, Florida, Police Department.

The dawn of the 1990s brought widespread recognition of a once-obscure criminal act, Munchausen Syndrome by Proxy (MSBP), in which subjects injure or induce illness in children in order to gain attention and sympathy for themselves. Since its recognition by the criminal justice community, MSBP has been identified most closely with mothers who induce in their children breathing difficulties that mimic the symptoms of apnea and sudden infant death syndrome, who poison them, or who fabricate illnesses in their children. These mothers then bask in the attention afforded them by relatives, doctors, and hospital personnel. However, because the child's illness has no medical cause, doctors have difficulty making a diagnosis.

As the baffling symptoms continue, doctors or hospital administrators may call on law enforcement to investigate the mysterious circumstances surrounding such cases. In fact, as the medical community becomes increasingly familiar with MSBP and its warning signs, doctors and medical staffs seem to be more inclined to request the assistance of local law enforcement agencies.

The growing list of MSBP cases underscores the need for investigators to understand the various-- and often complex -- issues related to MSBP. During the past several years, a number of variations to the normal offender patterns have emerged, accompanied by a clearer understanding of how law enforcement should respond to cases believed to involve MSBP. The more investigators know about MSBP, the better able they will be to identify perpetrators, clear innocent suspects, and most important, protect children.

Research on MSBP

Researchers documented the serial nature of MSBP victimization in a study of 5 families with a total of 18 children.1 In this study, 72 percent of the children were known to be MSBP victims. In each family, only one child was involved at any given time, and a total of five children seemed to be unaffected. Of those children affected, 31 percent died. In only one instance was there any other form of abuse present.

The characteristics of the maternal perpetrators in this study indicated the following: 80 percent possessed backgrounds in health professions; 80 percent manifested Munchausen Syndrome (self-inflicted injury) themselves; 80 percent received psychiatric treatment prior to diagnosis; and 60 percent of the mothers attempted suicide. Denial persisted in most cases.