JPL-2010-38-3-04-Pankratz, Persistent Problems with the “Separation Test” in Munchausen Syndrome by Proxy

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By LOREN PANKRATZ, PH.D.

Munchausen syndrome by proxy remains a controversial diagnosis
because information is easily tainted to make the mother appear
responsible for her child’s symptoms. This article focuses on the
“separation test,” which is often recommended on the basis of
misrepresented mortality rates. Once the child has been removed,
the separation test is seldom used to evaluate alternative hypotheses
(falsify the diagnosis), but most often to gather evidence against
the mother. The basic rules of science and clinical medicine must
be followed or false positive cases will be unacceptably high.
Alternatives to the separation test are recommended.

Season: 
2010
Volume: 
38
Number: 
3
Keywords: 
Munchausen syndrome by proxy, separation test, false positives.

LOREN PANKRATZ, PH.D. was a consultation psychologist at the
Portland VA Medical Center and a professor in the Department of
Psychiatry at Oregon Health Sciences University.