Murder Most Rare: The Female Serial Killer

By Michael D. Kelleher; C. L. Kelleher | Go to book overview

APPENDIX 3: MUNCHAUSEN
SYNDROME BY PROXY

In 1951, Richard Asher introduced the term Munchausen syndrome to describe an unusual psychological disorder that had been previously unrecognized by the medical profession. Victims of this disorder were characterized by behavior involving the fabrication of a variety, of self-induced illnesses so that the individual could demand and receive extensive, intense attention from medical professionals. Asher noted that individuals who were afflicted with this disorder would typically falsely create elaborate medical histories, induce a variety of physical symptoms to validate the medial attention they desperately craved, and travel great distances to a large number of medical facilities in search of the desired interaction. Asher's recognition of Munchausen syndrome was a significant contribution to medical science; it explained a growing number of medical and psychiatric case histories that had been previously considered inexplicable or been severely misdiagnosed.

In 1977, an English pediatrician recognized a derivation of this complex psychological disorder and introduced the concept of Munchausen syndrome by proxy (MSBP) into the medical literature. Unlike Munchausen syndrome, in which the victim of the disorder inflicts injury to herself in order to gain medical attention, MSBP involves the fabrication of illnesses in a dependent individual, who is typically a child or ward of the adult affected by the disorder. With MSBP, the perpetrator indirectly assumes the role of patient (by proxy) by fabricating or inducing illnesses in another person. Both Munchausen syndrome and MSBP are overwhelmingly diagnosed in females, although there exist case histories in which these disorders have been recognized in males.

The unfortunate victim of the adult who suffers from MSBP is most often a child under the age of six. However, on rare occasions the individual who suffers from MSBP will victimize another adult in order to induce or fabricate illnesses. In either case, the American Psychiatric Association (APA) has

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