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Attachment representations in mothers with abnormal illness behaviour by proxy
- Authors:
- ADSHEAD Gwen, BLUGLASS Kerry
- Journal article citation:
- British Journal of Psychiatry, 187(4), October 2005, pp.328-333.
- Publisher:
- Cambridge University Press
Abnormal illness behaviour by proxy (also known as factitious illness by proxy or Munchhausen syndrome by proxy) is a type of child maltreatment, the origins of which are poorly understood. This article describes attachment representations in a cohort of mothers demonstrating abnormal illness behaviour by proxy. Sixty-seven mothers who had shown this behaviour took part in a semistructured interview assessing their attachment representations. Only 12 mothers (18%) were rated secure in terms of their own childhood attachments. There was evidence of unresolved trauma or loss reactions in 40 mothers (60%). Eighteen mothers (27%) gave unusually disorganised and incoherent accounts of attachment relationships in their own childhoods. The frequency of these attachment categories is higher than in normal non-clinical samples. Insecure attachment is a risk factor for this type of child maltreatment. Therapeutic interventions could be offered in relation to unresolved traumatic stress or bereavement responses. Further study of similar groups, such as mothers with sick children or mothers with histories of traumatic experience, would be a useful next step.
Attachment representations and factitious illness by proxy: relevance for assessment of parenting capacity in child maltreatment
- Authors:
- ADSHEAD Gwen, BLUGLASS Kerry
- Journal article citation:
- Child Abuse Review, 10(6), November 2001, pp.398-410.
- Publisher:
- Wiley
The Department of Health assessment framework document indicates a need to assess parenting capacity in parents involved in child protection procedures. Parenting capacity includes an assessment of the parent's own experience of parenting as a child. This article presents data from a pilot study of attachment representations in a sample of mothers exhibiting factitious illness by proxy behaviours. The authors suggest that attachment representations can help to explain how such mothers fail to care for their children, and argue that attachment theory generally is helpful for understanding how normal and abnormal caregiving behavioural systems develop. Concludes that it is useful to understand child maltreatment, at least in part, as a failure of caregiving in the parent as a result of parental insecurity of attachment.