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Title: Understanding Munchausen Syndrome by Proxy as child abuse
Author: Tough, Essie Mary Bridget
Awarding Body: University of Edinburgh
Current Institution: University of Edinburgh
Date of Award: 2009
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This thesis will demonstrate how Munchausen Syndrome and, by derivation Munchausen Syndrome by Proxy, grew out of historical themes of assigning disease labels to anomalous or problematic behaviour, replicating issues of gender, particularly in respect of illness and madness and power biases, in society. The literature review will demonstrate how the early case notifications provided 'a Munchausen narrative', which came both to construct and to pathologise, first patients and later women, as mothers. It is argued that psychiatric models account for few cases of child abuse. A more coherent theory allows child abuse and, therefore, Msbp to be understood within a framework, which takes account of past and present ecological influences on the development of individual experience, characteristics and competency, and importantly, the meaning of a child within the life-cycle of that individual. The research, in this thesis, was designed to provide an estimate of the incidence of Msbp in Scotland. While it confirmed die findings of earlier studies diat illness induction and fabrication are rare events, it demonstrated a range of manifestations of abnormal behaviour among parents, in presenting their children to doctors, which were recognisable as being abusive and which often overlapped other forms of child maltreatment and neglect. It became apparent that the connotations of the title Msbp, particularly in relation to its psychodynamic formulations and evidencing actual or a risk ofsignificant harm, makes this a professionally fraught and ill-defined area of child protection work for Paediatricians, irrespective of recent Guidance (RCPCH 2002). The concluding sections of the thesis will consider inherent difficulties in working in this difficult area of child abuse and will provide recommendations for facilitating professional and child protection practices.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available