Anorexia nervosa and bulimia nervosa are serious eating disorders whose onset typically occurs du... more Anorexia nervosa and bulimia nervosa are serious eating disorders whose onset typically occurs during adolescence. This article provides an overview of these disorders in children and adolescents, including ages of onset, prevalence, and clinical characteristics. Behavioral, cognitive, and affective characteristics are outlined. Strategies are provided for the teacher or school counselor who is concerned about students in his or her school or classroom who may have an eating disorder as well as those students who do have anorexia nervosa or bulimia nervosa.
This paper uses the idea that the story of factitiacs or exaggerated il.Zness is coauthored or th... more This paper uses the idea that the story of factitiacs or exaggerated il.Zness is coauthored or thut symptoms may be wached thmugh the dynamics of tk family. The physician is unwittingiy "gaged as a coauthor by per&ming diagnostic tests and tnxatments. Childnm and family members may be invited to coauthor OT collude in the presentation of false symptoms a5 well. The importance of assessing the participation of family members in iUn43s pxuntation was discussed as well as the difficvlty in dtrtemzining intentionulily of symptom #nvduction. Fmr cases am jn-esented including test d&a which indicate that the mom "acti&' the family may be in presentcrtion of symptoms, the m5re likely thg are to present a whesive family picture and to seek outside support and tk less likb thq an to rep& stressors. Teatme& ideas include acknowL&ging [email protected] of both conscious and unconscious jnvduction ofsymptoms by family members in the creation of a story of iUness. Treatment sugp4on.s includt?d the promotion of an alternative s@y to illness.
The purpose of this article is to propose guidelines for the evaluation of possible Munchausen by... more The purpose of this article is to propose guidelines for the evaluation of possible Munchausen by proxy child abuse for the court systems. These assessments require the evaluator to have an understanding of the complexity involved when this type of abuse is alleged. The evaluator should have an appreciation of how falsification of illness may or may not occur, recognize the need for careful analysis of medical records, and understand the problems associated with the use of a profile in determining the validity of an abuse allegation. This article presents guidelines for gathering pertinent data, analyzing records, and evaluating psychological testing for forensic evaluations when the questions for the evaluation are the following: (a) Is there evidence that child abuse did occur? (b) Does the alleged perpetrator meet criteria for factitious disorder, NOS (or factitious disorder by proxy)? and (c) What management and treatment recommendations should be made? Atask force from the American Professional Society on the Abuse of Children (APSAC) has proposed a clarification of definitional issues in Munchausen by proxy (MBP) (Ayoub et al., 2002 [this issue]). The authors begin with the premise that MBP is a form of child maltreatment in which an adult falsifies physical and/or psychological signs and/or symptoms in a victim causing that victim to be regarded as ill or impaired. The motivation for this behavior is for the perpetrator to meet his or her psychological needs. They then clarify that this form of child abuse consists of two components. The first is the identification of victimization to the child. The new term pediatric condition falsification was suggested as the appropriate
Anorexia nervosa and bulimia nervosa are serious eating disorders whose onset typically occurs du... more Anorexia nervosa and bulimia nervosa are serious eating disorders whose onset typically occurs during adolescence. This article provides an overview of these disorders in children and adolescents, including ages of onset, prevalence, and clinical characteristics. Behavioral, cognitive, and affective characteristics are outlined. Strategies are provided for the teacher or school counselor who is concerned about students in his or her school or classroom who may have an eating disorder as well as those students who do have anorexia nervosa or bulimia nervosa.
This paper uses the idea that the story of factitiacs or exaggerated il.Zness is coauthored or th... more This paper uses the idea that the story of factitiacs or exaggerated il.Zness is coauthored or thut symptoms may be wached thmugh the dynamics of tk family. The physician is unwittingiy "gaged as a coauthor by per&ming diagnostic tests and tnxatments. Childnm and family members may be invited to coauthor OT collude in the presentation of false symptoms a5 well. The importance of assessing the participation of family members in iUn43s pxuntation was discussed as well as the difficvlty in dtrtemzining intentionulily of symptom #nvduction. Fmr cases am jn-esented including test d&a which indicate that the mom "acti&' the family may be in presentcrtion of symptoms, the m5re likely thg are to present a whesive family picture and to seek outside support and tk less likb thq an to rep& stressors. Teatme& ideas include acknowL&ging [email protected] of both conscious and unconscious jnvduction ofsymptoms by family members in the creation of a story of iUness. Treatment sugp4on.s includt?d the promotion of an alternative s@y to illness.
The purpose of this article is to propose guidelines for the evaluation of possible Munchausen by... more The purpose of this article is to propose guidelines for the evaluation of possible Munchausen by proxy child abuse for the court systems. These assessments require the evaluator to have an understanding of the complexity involved when this type of abuse is alleged. The evaluator should have an appreciation of how falsification of illness may or may not occur, recognize the need for careful analysis of medical records, and understand the problems associated with the use of a profile in determining the validity of an abuse allegation. This article presents guidelines for gathering pertinent data, analyzing records, and evaluating psychological testing for forensic evaluations when the questions for the evaluation are the following: (a) Is there evidence that child abuse did occur? (b) Does the alleged perpetrator meet criteria for factitious disorder, NOS (or factitious disorder by proxy)? and (c) What management and treatment recommendations should be made? Atask force from the American Professional Society on the Abuse of Children (APSAC) has proposed a clarification of definitional issues in Munchausen by proxy (MBP) (Ayoub et al., 2002 [this issue]). The authors begin with the premise that MBP is a form of child maltreatment in which an adult falsifies physical and/or psychological signs and/or symptoms in a victim causing that victim to be regarded as ill or impaired. The motivation for this behavior is for the perpetrator to meet his or her psychological needs. They then clarify that this form of child abuse consists of two components. The first is the identification of victimization to the child. The new term pediatric condition falsification was suggested as the appropriate
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Papers by Mary Sanders