stealth2 said:
Is it possible that the doctor has said this BECAUSE s/he (unknowingly) doesn't have an accurate family medical history?
That'a exactly right. The doctor without the accurate medical history would be left to assume that this was an anomoly when it is a known genetic disorder. OP posted 4 times, two times stating that she gives her husband's medical history, "only r parents know that hubby isn't the father. all doctors go by hubby and i's medical history." and "We tell doctors of husband and mine medical history for said child."
We don't even know if the husband knows this, how reliable is the use of the term, "WE" here? She may, as the primary caregiver have most contact with the doctors and the husband assume she is giving the doctors the truth and believe everything she relays to him.
She is avoiding the truth for some reason the most obvious of which is that the alledged bio-dad is not which puts her Marriage and family at risk and or "Factitious Disorder by Proxy - Munchausen Syndrome by proxy" This is sometimes seen in parents of disabled children who may exploit the child's disability for their own purposes. If that is the case here it is best for intervention sooner as opposed to later, I for one hope the alledged bio dad files to establish paternity if she doesn't admit to the doctors that she had been giving a false medical history.
The major feature of Factitious Disorder by Proxy is the deliberate production or feigning of physical or psychological symptoms in another person who is under that individual's care. Intentionally giving an inaccurate medical history would qualify and this would also affect treatment. The motive for the perpetrator's behavior is thought to be a psychological need to assume the sick role by proxy, and gain sympathy for their role as the caregiver and devoted parent. External incentives such as money are not present as in this case as she can't sue for malpractice for a genetic or congenital disorder, and she doesn't even want additional child support which might be ordered if she reveals the bio-dad. The perpetrator simulates the illness in the victim and then takes the victim for medical care while denying any knowledge about the cause of the problem, in this case false medical history and we don't know what else she is doing. The type and severity depend on the amount of medical knowledge on the part of the perpetrator. Some of the signs of Factitious Disorder by Proxy are:
Life stressors such as martial conflict;
Perpetrators may exhibit pathological lying in describing daily events and when presenting the victim for medical care.
Commonly have knowledge in health related areas and may thrive in a medical environment.
They often seem insufficiently concerned about the victim's medical condition.
Associated Features:
Equal distribution between males and females.
High incidence of unexplained sibling mortality.
Disorder may be present in more than one child at a time, or serially enmeshed family with marital dysfunction, substance and sexual abuse
Older children may engage in symptom collusion
Differential Diagnosis:
Some disorders have similar symptoms. The clinician, therefore, in his diagnostic attempt, has to differentiate against the following disorders which need to be ruled out to establish a precise diagnosis.
The perpetrator may become depressed or suicidal when confronted with consequences of their behavior. The perpetrator usually focuses on one victim at a time; however, other individuals may have been or might be victims. Other aspects to be considered are:
Real Medical illnesses
Overanxious Parenting
Normal Variability between illnesses
Illnesses resulting from discontinuation of medicines
Malingering (by an older child)
Cause:
Little is currently known about the etiology or psychopathology of factitious disorders with physical or psychological symptoms. Besides the difficulties involving the diagnosis, reluctance of those patients to undergone psychological testing and heterogeneity in details of cases published in literature are at the origin of this situation.
Many hypotheses have been developed try to explain factitious disorder. Some clinicians have remarked that patients with factitious disorder often present traumatic events particularly abuse and deprivation and numerous hospitalizations in childhood and as adults lack support from relatives and/or friends. Others consider that factitious disorder allows patients to feel in control as they never felt in childhood.
From a behavioral point of view factitious disorder is regarded as a coping mechanism, learned and reinforced in childhood.
Treatment:
Provide medical and psychological care as needed to treat comorbid conditions and complications arising.
Counseling and Psychotherapy
Psychotherapy should focus on establishing and maintaining a relationship with the patient. Supportive psychotherapy may help contain the symptoms of FD. Family therapy may help families to better understand patients and their need for attention. Cognitive-behavioral therapy may prove difficult when patients are unable to form a collaborative team, such as with comorbid antisocial personality disorder.