Attachment representations and factitious illness by proxy: relevance for assessment of parenting capacity in child maltreatment

The Department of Health assessment framework document indicates a need to assess parenting capacity in parents involved in child protection procedures. Parenting capacity includes an assessment of the parent's own experience of parenting as a child. In this paper, we present data from a pilot study of attachment representations in a sample of mothers exhibiting factitious illness by proxy behaviours. We suggest that attachment representations can help to explain how such mothers fail to care for their children, and argue that attachment theory generally is helpful for understanding how normal and abnormal caregiving behavioural systems develop. We conclude that it is useful to understand child maltreatment, at least in part, as a failure of caregiving in the parent as a result of parental insecurity of attachment. Copyright © 2001 John Wiley & Sons, Ltd.