Re: Profile of suspected MSBP perpetrators -Reply

[<SPOONPIPER@xxxxxxx>]

In a message dated 99-05-28 08:44:58 EDT, you write:

<< 
 As a Paediatrician I would agree that MBPS is a
 Paediatric diagnosis and is made when a child
 presents with symptoms and signs of illness that do
 not add up or when the course of the illness is not
 what would be expected. The quiet common
 scenario is that the child has an illness which
 baffles the most experienced physicians.
  >>

Dear Dr. Ryan,

No doubt your medical training leaves you qualified
to Dx medical conditions.  However, MSBP, as traditionally
conceptualized, is deemed a behavioral consequence of
unconscious psychological antecedents.  Any induced 
medical condition is an outcome, as are the sequalae to a
hammer blow to the head.  Judging a head injury was caused 
by a hammer blow does not let one conclude that the carpenter 
did it, for example.  Inferring method and motive from outcome
is not justified, particularly when the "profile" data relied upon
do not have sufficient research underpinnings to be reliable.
For example, there is no demonstrated discriminant validity
to the "criteria" for MSBP that allows for reliable differential
Dx.  And of course, even meeting "profile" criteria does not 
demonstrate proof of guilt.  Proof requires hard  physical 
or eyewitness evidence.  One is easily lead to partaking in 
a witchhunt divining "signs," etc.  

I would recommend that persons in your profession exercise
extreme caution in speculating re MSBP perpretation and not
let yourselves get seduced into idle psychodiagnostic speculation.
The methodology involved in  creating reliable and valid psycho-
logical measurement tools in my field is extremely complex
and requires vast knowledge of the literature in psychopathology,
research design, psychodiagnostic test design, etc.  Major 
attention is paid to construct definability, reliability, validity,
stability across time and populations, generalizability, to name 
but a few important variables.  Politely, attempting to "Dx"
MSBP from a medical knowledge base and within
the current state of knowledge re the "syndrome" amounts to 
nothing more than "pop psychology" and does a real disservice
to the public, in my opinion.

Kirk Witherspoon, Ph.D.
Clinical Psychologist