Munchausen by Proxy and Pediatric Factitious Disorder Imposed on Self

Abstract

The term Munchausen by proxy refers to abuse and/or neglect by a caregiver who intentionally falsifies an illness or condition in another individual due to the caregiver's factitious disorder imposed on another psychopathology. When the falsification behavior is directed toward oneself, the psychopathology is called factitious disorder imposed on self. To diagnose someone with a factitious disorder, the individual has to have engaged in intentional deception, differentiating it from anxiety, psychosis, or other psychiatric disorders. Similar to those with a substance abuse disorder or pedophilia, those with factitious disorders frequently ignore the needs and well-being of others in order to satisfy their own needs. The individual may provide false information, fail to report or deny clinically relevant data, induce or worsen illness, neglect medical protocols and regimens, and/or simulate symptoms. They may coach victims and others into corroborating false claims. It is important for psychologists to be skilled on the topic of factitious disorders because they may (1) encounter patients they come to suspect as being victims or perpetrators of condition falsification, (2) be asked to assist in a clinical or forensic evaluation, and/or (3) receive requests for treatment referrals. This chapter reviews the basic information needed for minimal competency as a pediatric psychologist related to the topics of Munchausen by proxy and pediatric factitious disorder imposed on self.