Identifying and Analyzing Medical Child Abuse Cases Through Collateral Sources
Medical Child Abuse (MCA) is a form of child maltreatment in which a caregiver exaggerates, feigns, or induces illness or injury in a child, resulting in unnecessary, and often harmful, medical procedures (Roesler & Jenny, 2008, p. 1). As a result of the deceptive nature of MCA, empirical research is difficult to conduct, and our knowledge of MCA is largely limited to case studies. One approach that circumvents the deceptiveness and elusiveness of perpetrators is to collect information about medically abused children and their caregivers from collateral sources. In the present study a convenience sample (N = 203) was recruited to report on a child known to them who has a chronic or complex medical condition. After collecting basic information about the child and their caregiver, participants were asked about their suspicions that the caregiver was exaggerating or fabricating the child’s medical problems. Of the 203 index children reported on, 62 (30.5%) were strongly suspected of being overmedicalized or medically abused. Compared to children who were not suspected to be overmedicalized, the OM/MCA cases were characterized by increased healthcare use (e.g., number of doctor visits) and a trend of overall increased medical care, supporting patterns observed in the clinical case literature. Other expected differences, including a predominance of female caregivers and higher risk to younger children, were not supported. Although MCA is widely believed to be under-recognized and under-reported clinically, the prevalence implied by this study is shockingly high. My results suggest that there may be cases of MCA that depart from the prototype that arises from the clinical case literature, and that some of the clinical features that are regarded as diagnostic on MCA may not actually differentiate overmedicalized from non-overmedicalized children.