Dr. Roxanne Dryden-Edwards is an adult, child, and adolescent psychiatrist. She is a former Chair of the Committee on Developmental Disabilities for the American Psychiatric Association, Assistant Professor of Psychiatry at Johns Hopkins Hospital in Baltimore, Maryland, and Medical Director of the National Center for Children and Families in Bethesda, Maryland.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
What are the complications of Munchausen syndrome by proxy?
If left untreated, this illness can result in child victims who grow up to be
medically or emotionally disabled. It may even be fatal in more
than 5% of cases, and more than 7% may experience either
long-term or permanent injury as a result. Survivors of MSBP are unfortunately
at higher risk of becoming perpetrators of this and other forms of child abuse
Where can one get more information on Munchausen syndrome by proxy?
Child Welfare Information Gateway
1250 Maryland Avenue, SW,
Washington, D.C. 20024
National Child Abuse Hotline
Prevent Child Abuse America
500 North Michigan Avenue Suite 200
American Psychiatric Association
1000 Wilson Blvd. Suite 1825
American Psychological Association
750 First Street, N.E.
National Alliance for the Mentally Ill (NAMI)
Colonial Place Three
Wilson Blvd. Suite 300
Arlington, Va. 22201-3042
National Institute of Mental Health (NIMH)
Office of Communications
Executive Blvd. Room 8184
Bethesda, Md. 20892-9663
Munchausen Syndrome by Proxy At A Glance
Munchausen syndrome by proxy (MSBP) is classified as a factitious disorder
and is therefore characterized by feigning or intentionally producing physical
or emotional symptoms in order to assume the sick role.
This disorder is named
after Baron Karl Friedrich von Munchausen, who was known to invent fantastic
stories of his adventures, including his riding cannonballs and traveling to the
MSBP specifically involves a caretaker describing nonexistent symptoms
or inducing symptoms in a third person, usually a child they care for.
often MSBP occurs is likely very much underestimated, as evidenced by it often
taking years to be discovered, even being completely missed in siblings of the
victim that is eventually identified.
Males are victims of MSBP as often as
females. Women are perpetrators of this disorder the vast majority of the time,
theoretically because women remain the primary caretakers of children.
Perpetrators of MSBP are vulnerable to also suffering from depression, anxiety,
and some personality disorders.
While there is no specific cause for MSBP,
perpetrators tend to have trouble forming a healthy attachment to their
children, difficulty managing their anger and frustration, as well as having an
ability to overcome the more natural tendency for caretakers to protect the
children they care for.
Perpetrators are also more likely to have a history of
either losing a parent or being abused or neglected as a child.
symptoms the victim of MSBP presents with are highly variable, they may consist
of symptoms that are more easily faked or induced, like suffocation, seizure,
bleeding or nausea, vomiting, or diarrhea that can be the result of poisoning.
Theories about what perpetrators gain from assuming the sick role through their
child include seeking help, inducing symptoms, and being "addicted" to
interactions with medical professionals.
MSBP is usually diagnosed through
intense communication between medical, mental-health, and child-protection
professionals, as well as review of all available medical records and
interviewing family members, school personnel, and other pertinent community
Sometimes, covertly videotaping the suspected abuser when with the
child can be a useful additional diagnostic tool.
The treatment of MSBP
involves close collaboration with professionals, family, and community members,
intensive psychotherapy for the victim and the perpetrator, as well protecting
the child by either intensive supervision of the perpetrator, temporary or
permanent removal of the child from the care of the abuser, and sometimes
includes prosecution and incarceration of the perpetrator.
If left untreated,
MSBP can result in the child's death or growing up emotionally and/or medically
Survivors of MSBP are at higher risk of becoming perpetrators
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