A vicious circle: transgenerational attachment representations in a case of Factitious Illness by Proxy

Attachment theory offers a robust way to investigate transgenerational child maltreatment; first because there is a coherent theoretical hypothesis of how this might be mediated by the development of insecure working models of relationships, and second, because there is existing evidence from prospective studies that transgenerational attachment patterns can be predicted. Specifically, attachment theory may be particularly useful in cases of Fictitious Illness by Proxy (FIP), where the maltreating behavior is characterized by disordered illness behavior and care-eliciting. We present a case history, using the Adult Attachment Interview (AAI), which examines attachment and child maltreatment in three generations. A single case history allows for hypothesis generation about the genesis of FIP behavior.     

Embracing survival: A grounded theory study of parenting children who have sustained burns

The positive effect of supportive family environment on burn-injured child's long term outcome is well established. How parents provide this support as they recover with their children is not addressed especially in low and middle income countries where the burn burden is high. It is assumed that parents are non-compliant in bringing their children for follow up. Using grounded theory methodology this study aimed to explore and discover the process of parenting children in India with burn injury. Semi-structured interviews with 22 family members of 12 burn-injured children and field notes yielded rich data. The analysis by open and focused coding and constant comparisons of participants’ accounts revealed a parenting process of embracing survival. For parents embracing survival involved (1) suffering the trauma along with their burn-injured child, (2) sustaining the survival of their child, and (3) shielding the child from stigma related to scarring and disfigurement. Parents perceived minimal support from health professionals and family members. Mothers and fathers formed a team and did their best for their burn-injured children. Assessing and meeting the needs of the parents and empowering parents to provide effective long term care are vital components of burn care. The health professionals’ perceptive on parenting burn-injured children need to be explored.