False Münchausen

I am not as concerned with the day to day statistics as I was during the early days of blogging. I realized I needed a longer perspective and my most popular posts this year are two and three years old. I usually look at the stats anyway and it sometimes gives me reason to reflect. I had one of those moments a few days ago when someone had googled: “Help the Child Protection Services think I have Münchausen by proxy.”

I am without a computer at the moment and have limited opportunities to research and write, but I can tell you this much. Münchausen is a controversial theory, and it isn’t actually more than a theory. Münchausen is a condition where the patient fabricates symptoms. It could be ailments it isn’t possible for doctors to document with physical evidence, or injuries inflicted through physical violence or poison.

What do you think when you hear words like science, study and research? Most people would probably say that it’s about truth. Alternative medicine is pure speculation, real science is about patiently waiting for evidence. That may not always be the most accurate description because there is more speculation and assumption in research than many realize. The early autism research launched “the refrigerator mama-theory” in the 1940’s, and research blamed autism on cold mothers for a long time. No one really questioned this before Lorna Wing in the early 80’s. We know today that this was rubbish of course, and it turned out we had been listening to the wrong people. Lorna Wing rediscovered 40 year old research by Hans Asberger that had been completely ignored.

When I was working as a teacher my colleagues liked fashionable terms like “evidencebased measures”. Research was the magic word and any suggestion that had been harvested from a study guaranteed you success. I am afraid it’s not quite that simple. Publication bias is a major problem in research on medicine and has probably killed a lot of people. This means that if they don’t get the result they want the study is less likely to be published.

A study from 2008 wanted to find out whether they had the same problem in psychology. There were 270 researchers involved and they tried to copy the result from 100 studies in cognitive and social psychology. One of the most elementary scientific principals is that researchers anywhere in the world should get the same result, but in this case 75 percent of the studies failed on that account. The remaining studies managed to copy half the original findings. That doesn’t mean that psychology/psychiatry is pure speculation, but I think it tells us that we should be careful about drawing legal conclusions in questions the health authorities don’t have an answer to.

Münchausen is probably real enough, but very rare. There are cases where parents deliberately hurt their children, but there seems to be a serious problem with inflation because this accusation keeps coming up in the CPS. They are certainly not evidencebased. How do you defend yourself against  an accusation like this when denying it is likely to be interpreted as denial?


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