Libow, Schreier, & Munchausen by Proxy: Part 20 – Libow’s Direction

This series of posts takes an in-depth look at the writings of Drs. Libow & Schreier on the topic of Munchausen Syndrome by Proxy (MSbP). In my early posts in this series, I describe a book they wrote together in 1993 called “Hurting for Love”, and reflect on the scientific reaction to it. Next, I reviewed on Dr. Schreier’s research direction after the publication of that book.

glasses and book

After the book, Dr. Libow was listed on only four additional publications on the topic as a co-author:

  1. Most interestingly, Dr. Libow single-authored the only article on adult survivors of MSbP.
  2. She also wrote a 2001 article she co-authored with Dr. Schreier where she played “consultant” with Dr. Marc Feldman
  3. She co-authored a position paper I describe in a previous post she also co-authored with Dr. Schreier (and another researcher who joined their writing team, Dr. Ayoub), and
  4. She co-authored a letter with both Drs. Schreier and Ayoub in response to another article about MSbP that her team did not write.

I will discuss the first article in another post. This post will actually focus on the fourth item, but let me give a quick review of the second item.

Dr. Libow’s Consultation

I cannot neglect to mention a paper that Libow & Schreier co-author with individuals from Boston Children’s hospital in 2001 called, “A case of factitious disorder by proxy: the role of the health-care system, diagnostic dilemmas, and family dynamics”. It’s basically another tabloid, and it’s 14 pages, which is really huge.

It is probably huge because it is published in the Harvard Review of Psychiatry. Also, they do this weird thing at the end where they give these three questions to some “consultants”, one who is a more contemporary MSbP star, Dr. Marc Feldman, and the other being our old friend, Dr. Judith Libow!

In my opinion, the article is not very useful. They ask some hairsplitting questions about how to diagnose MSbP perpetrators, but I’m not worried about that.

Personally, if I catch a person poisoning a kid, I wouldn’t care why, I’d stop them. Wouldn’t you?

Food Fight #2

Now, onto the next food fight that Libow & Schreier get in in the literature. In previous posts, I describe an earlier food fight in the scientific literature that develops in response to one of Libow & Schreier’s articles, where a Dr. Carek writes a letter calling them out on some points. I also explain how they respond with what looks to me like a very vicious counterattack.

one way signs

In this food fight, Libow & Schreier’s team actually attacks the article of not only a different person, but of a whole committee – Dr. John Stirling of the Committee on Child Abuse and Neglect. The article, titled “Beyond Munchausen Syndrome by Proxy: Identification and Treatment of Child Abuse in a Medical Setting”, says that the point of the article is to:

  1. [identify factors] that may help the physician recognize this insidious type of child abuse that occurs in a medical setting, and
  2. [provide] recommendations … for physicians regarding when to report a case to their state’s child protective service agency

The article is very technical and provides a lot of lists: examples of MSbP behavior, a list of three questions to ask to determine if it is MSbP behavior, a list of treatment priorities and consideration, and a list of suggestions titled “clinical advice”.

You can have a food fight about that?

You can if you are Libow & Schreier! Read my next blog post to learn their two main criticisms of Dr. Stirling’s paper.

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Photo of direction signs by geralt. Photo of glasses on top of a book by cookiephoto.


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