Munchausen Syndrome by Powers: symptoms and causes

April 2, 2024

Unfortunately, there are many children abused every day in our society. There are several forms of child abuse and multiple classifications. In general terms, we can specify the following types of abuse: physical, psychological, sexual and neglect.

In 2002, an epidemiological study was carried out in Spain that confirmed the existence of 11,148 child victims of abuse in the family. 86.37% of these minors suffered negligence, 35.38% psychological abuse, 19.91% physical abuse and 3.55% sexual abuse .

However, as in almost any epidemiological study, there is "submerged" data and only the tip of the iceberg can be seen. In this article we are going to talk about a form of child abuse that is very difficult to diagnose, we could even call it "hidden child abuse": Munchausen Syndrome by Powers .

Related article: "Münchhausen syndrome: causes, symptoms and treatment"

What is Munchausen Syndrome by Powers?

The Munchausen Syndrome by proxy (SMP), or according to the DSM-5 Factice Disorder applied to another, constitutes a particular form of high-risk child maltreatment, difficult to diagnose, since it often goes unnoticed for a long time, even years. It is a syndrome that has increased its incidence due to greater knowledge of the same and professional awareness.

Following the DSM-5, it is a disorder that is characterized by the falsification of physical or psychological signs or symptoms, or induction of injury or illness, in another, associated with a deception. It is a mental disorder that typically it is appreciated in adults who are in the care of other dependents to them (usually defenseless, which has its logic). Frequently, the victims of this disorder are minors, and it is considered a form of child abuse.

The parents of the child (generally, according to epidemiological studies on the subject, the mother) simulate the existence of diseases or cause symptoms in the minor with the objective of receiving medical assistance, some of them at high risk and cost. It seems that one of the parent's objectives is to deceptively present his child to others as a sick, vulnerable, dysfunctional and / or troubled person.

Experts in the study of this disorder claim that the parent continues with the deception even without receiving in return any visible benefit or reward . The most serious consequences of this syndrome are the serious physical and psychological complications for the child and, ultimately, his death.

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Symptoms and signs

The symptoms or signs are usually incoherent, often inexplicable, and resistant to any treatment , since the parent performs them deliberately and recurrently. Some examples are:

Suspicious repeated incidents that threaten the life of the minor or the victim.
Poisoning and apnea.
Bleeding or bleeding .
Various infections generated by diverse organisms and, sometimes, rare.
Medical history with little coherence and logic : the victims usually spend a lot of time in the hospital with varied, contradictory and diffuse diagnoses, the causes are almost never usually clear.
The caregiver takes the victim very frequently to the doctor or to several doctors, until he feels enough satisfaction and attention.
There are no witnesses in the family who have seen the various symptoms that the mother refers to, since they only occur in her presence.
The symptoms that the minor presents often disappear in the hospital However, they are reproduced at the child's home, especially when they are in the care of one of the parents.
Signs or symptoms occur comorbidly when the caregiver is present.
Families with a history of sudden infant death or other serious problems in the child.
The caregiver may have been seen performing somewhat suspicious acts that may imply a worsening of the victim.

As we have commented previously, the diagnosis of this syndrome is a challenge for the clinician : it is difficult to detect it when the mother tends to go to different hospitals, since for the health professionals the observed facts will be isolated. Although pediatricians are trained to evaluate the credibility of certain stories, they do not tend to pose as an initial hypothesis that this is an elaborate lie.

History of Munchausen Syndrome by Powers

SPM is a variant of Munchausen Syndrome , term introduced for the first time in 1977 by the English pediatrician Roy Meadow. This professional described at that time patients who had this syndrome as people who had spectacular, strange clinical histories, with inventions and lies, with the aim of getting medical attention.

Curiously, in that same year two authors, Burman and Stevens, described a case in which a mother who suffered from Munchausen Syndrome (now Factice Disorder) was displacing her in her two young children. They called this phenomenon "Polle Syndrome" , synonymous in his day of the Munchausen Syndrome by Powers.

Related article: "Factitious Disorders: symptoms, causes and treatment"

Causes and motivations

The causes of Munchausen Syndrome by proxy are still unknown . Studies on the subject that have interviewed perpetrators suggest that they suffered abuses in childhood, or suffer a Factice Disorder.

The causes are not known, but progress has been made in the study of the motivations of the parents involved . In the first place, the person suffering from this syndrome does not act in order to obtain material or economic benefits. Paradoxically, they can invest large amounts of their money, effort and sacrifice in the "care" of their victim, even though they are inflicting great harm.

In short, their motivations lie in an excessive need for attention, care, compassion, pity and / or recognition by medical personnel and other people for their great dedication to the victim. In addition, it seems that there is a relationship of pathological ambivalence towards the victim (of care vs. possible hidden rejection).

Treatment

What should be done in these situations? How should professionals who detect a case like this proceed? Can the father or mother who has this syndrome continue caring for their child?

There is no one proper way to act, and less when there may be a judicialization of the problem. Ultimately who can receive the most collateral damage is the least (We must also evaluate the other children of the family, if they exist).

In these cases, the most important thing will always be the best interests of the child . Clinicians must ensure the accuracy of the diagnosis and safeguard the minor in the most serious cases (prudentially separating the family, for example), contacting social services. It is very important to collaborate with other professionals and carry out a multidisciplinary intervention.

Confession on the part of the perpetrator is not usually frequent . That is why the treatment is usually complex due to the father's difficulties in recognizing his problems and trying to give them a coherent explanation. Necessarily, the father who suffers from Munchausen Syndrome by Powers must commit to psychotherapy, family therapy and / or the taking of psychotropic drugs.