It is essential for anyone involved in the investigation and prosecution of child abuse cases to be aware of the often hidden and subtle warning signs of Munchausen by Proxy. Munchausen syndrome, classified as a mental illness, occurs when a person inflicts or fabricates illness upon themselves, often as an attention-getting device. Munchausen by Proxy (MBP) is an even more insidious disorder in that such illness or injury is inflicted upon a victim-usually a child.
Awareness can stop the vicious cycle of abuse
Practical Aspects of Munchausen by Proxy and Munchausen Syndrome Investigation is the most comprehensive law enforcement handbook written on MBP, which is now considered an index factor in child abuse investigations and as a suspicion factor in the deaths of young children. This book offers detailed insight into the dynamics of MBP abuse and the Munchausen offender. The text chronicles real cases of MBP and Munchausen in the dominion of law enforcement and relates them to general principles of criminal investigations. With this practical guide, readers will be able to readily identify Munchausen-related behavior, apply that recognition in all types of investigations, improve the ability to detect covert or falsified crimes, have the basic knowledge to effectively combat MBP child victimization, or to successfully proscecute MBP cases.
Table of Contents
IDENTIFICATION OF STANDARDS
The Complicated Domain of MBP Understanding
Mental Illness Defined. Munchausen Syndrome Defined. Munchausen by Proxy (MBP) Defined. MBP Behavior Not Independently Considered Mental Illness. MBP as Child Abuse. Offender Benefit as Definitional Predicate. Together-Similar Yet Distinctive. Neglect. Alternative Answers to Unexplained Behavior. The History of Munchausen. Category Identification of Munchausen Syndrome or MBP. Presentation of Identified MBP Illness. MBP Warning Signs. MBP Screening for Families of Suspected MBP Offenders. Frequency and Reporting of Cases. Victimization Location. Preferences. MBP Case Resolution Factors. Mobility Factors and Trends. Conclusion
CHARACTERIZATION OF THE MUNCHAUSEN FAMILY
The MBP Offender: The MBP Victim. The Non-Offending Spouse of an MBP Offender.
COMPREHENSION OF THOUGHT
Understanding Munchausen and Gaining Entry Into the Realm
A General Understanding of Abuse. The Unique Sphere of MBP Behavior. MBP Potential Motivational Factors. Believe It or Not. Envisioning MBP and Munchausen Syndrome. How Society Enables MBP Victimization. Victimization Pathways. Victimization Control Factors The MBP Reactionary Gap. Recognizing What You See. The Sphere of Victimization Methodology. MBP Offender Typology-Categorization via Action. Subtle Indicators of Guilt. MBP/Munchausen Syndrome as Punishment. Eating Disorders. MBP Fact Sheet.
APPLICATION OF KNOWLEDGE
Assessing the Lethality of the MBP Offender
Lethality Links. MBP Continuum with Probable Cause Escalation Sequences. Intelligence Information. Intelligence/Interview Questioning. How Dangerous is the MBP Offender. The MBP Continuum. Likelihood of MBP Victim Death. Harsh Reality. Intentional Torture. Multiple Victims of MBP Abuse.
False Reports and Serial Victimization
Review and Expansion of MBP/Munchausen Syndrome Understanding. Munchausen Syndrome Within Criminal Victimizations. MBP/Munchausen Syndrome Transference: The Police Connection. The Involvement of Police Personnel in the Snare of Munchausen. Gravitation. Identification Indicators. The Importance of Attention. Police Personnel as MBP/Munchausen Syndrome Offenders.
Interviewing the Munchausen-Related Offender
Preparation. Application of Miranda. The Challenge of the MBP Interview. Offender Reactions. Does the Offender Enjoy Being Caught? Portrayed Multiple Personality Concerns. Fantasy vs. Reality. Suggested Interview Dialogue. Hidden Admissions. Investigative Observations. MBP Offender Confrontation/Interview Techniques. Procedural Interview Summation. Interview Tips.
STABILIZATION OF THEORY
Evidence by Definition. The Crime Scene. Tangible Evidence. Video Tape. The Expert Arrest Warrant. The Paper Trail. Organization of the Case File. Souvenirs/Trophies. Intangible Evidence. How does the Action of Exposure Affect the MBP Offender? Infliction Triggering Mechanisms. Multiple Suspects and Victims of MBP Abuse. Unexplained Blood Loss. Repetitive Ailments/Recidivism Issues. Anonymous Correspondence (Notes and Letters). Victim/Offender Seclusion Data. Weekly Observation Report. Child Neglect Evidence. Conclusion.
The Multidisciplinary Approach to Case Management
Organizational Diversity. Defining the Multi-Disciplinary Team. Why is a Protocol Necessary? The Uniqueness of MBP Victimization and Protocol Understanding. Effects of Community Involvement. Developing a MBP Case Management Protocol. Cases that Do Not Meet MBP Criteria. Obstacles to Effective Case Management. Standardized Problem Solving Chronology. Conclusion. MBP Investigative Checklist.
Video Surveillance Child Protection Application. Evidence Gathering. The Role of the Child Protective Case Worker. The Assessment of Risk. Unique MBP Intervention Methodology Risk Factors. Inherent Risk Factors in Cases of MBP Child Abuse. Victim Safety Planning. Investigative MBP Victim Survival Strategies. Modification of Policy to Accommodate an MBP Inference. Arguments For Termination of Parental Rights in MBP Cases. A Prosecutorial View of Parental Right Termination in MBP Cases. Custody of MBP Victims and Siblings. Hazards of Appointed Family Care (for MBP Victims). The Guardian Ad Litem. Visitation Issues. Conclusion
MASTERY OF DECEPTION: DIVERSITY OF THE MUNCHAUSEN THEME
Chronically Ill Children Caught in a MBP World
Pre-Natal Knowledge and Actions. Fetal Murder Premeditation Potential in MBP Cases. Linking Offender Action to MBP Through Motivation. The Threshold of Homicide. The Non-Offending Spouse's Contribution to MBP-Related Homicide. Case Flow of MBP Child Victimizations (Chronic Illness Variable). Homicidal Actions Involving Chronically Ill Children-Reviewed. Non-Offending Parental Reactions. Children Born With Birth Defects.
The Unseen Murder of Children
MBP as a Homicidal Agent. Intentional or Accidental Acts. Premeditation Factors. Law Enforcement Stakes. Death as a Means of Proof. Multiplicity: A Potential Pool of Victims. Hidden Historical Homicides: SIDS or MBP? Exhumation Orders. Sudden Infant Death Syndrome (SIDS). Key Points Relative to SIDS and MBP. Potential SIDS Risk Factors. An Investigatory Team Effort. Correlating MBP/SIDS Criteria. The Incorrect Labeling of MBP In Child Abuse Cases. MBP in the Index of Homicide Causation. The Comportment of Murder. Indirect MBP Offender Implications. Why Kill?. When a Parent is Suspected of Killing a Child but the Spouse is Responsible. Specific Vehicles of Death With a MBP Factor.
The Medical Staff. The Premier Medium. Hospital Deception and Insurance Fraud. Public Trust: The Fraud, Money, and Know-How. MBP Offender's Relationships With Celebrities. Assistance of the Media. Skill of the Offender vs. Caution of the Law. Man's Best Friend. Conclusion.
MBP as a Defense in Sexual Battery Cases
False CSA Accusations: The Effect Upon the Child. MBP as a Sexual Abuse Defense. Parental Abduction, Sexual Abuse Allegations and MBP. Differentiation Between Child Sexual Abuse (CSA) and MBP. Commonalities of both CSA and MBP. Reasonable Doubt-Munchausen and Case Building.
The Significance of Fire in MBP and Munchausen Syndrome Cases
Arson Detectives and Criminal Investigators: Mini Team Concepts. Investigative Interviews: Children and Fire. Children and Trust. Environment of the Interview. The Parents of Adolescent Burn Victims. Accepted Norms and Media Influence. Witnesses in Burn Injury Investigations. Ritualistic Abuse by Fire. Gauging Parental Responses. Investigation of Accidental Burn Injuries. Using Fire Within the World of MBP Child Abuse Victimization. Significance of Fire. The Gratification Scale of MBP Arson. MBP and the Utilization of Arson. By the Hand of God. The Factor of Repetition. Gathering Intelligence in Potential MBP/Munchausen Syndrome Related Arson. Interview Tips for Children Involved in Fires.
PRINCIPLES OF ENGAGEMENT
The MBP Prosecutive Stance
The Status of Exclusion. Barriers to Effective Prosecution of MBP Child Abuse. Offender Accountability. Prosecution Strategy. Case Presentation. Refutable Defense Standards. The Use of Expert Testimony. The Defense of Insanity. Case-Law. Education of Judges. Sentencing Tendencies in MBP-Related Victimizations.