A Meta-Synthesis of Filicide Classification Systems: Psychosocial and Psychodynamic Issues in Women Who Kill Their Children

Marie E. Mugavin

Disclosures

J Foren Nurs. 2005;1(2):65-72. 

In This Article

Prevention Through Synthesis

Homicide, like all human behavior, is heterogeneous in nature and as such requires a complex of preventive approaches (Bourget & Labelle, 1992; Bourget & Gagne, 2002). Resnick (1969) found that 75% of parents had psychiatric symptoms prior to committing filicide. Some parents had talked openly of suicide and expressed concern about the future of their children, but the significance of these thoughts was not recognized at the time.

Psychiatrists must be alert to the filicide potential of depressed mothers contemplating suicide. The focus of the psychiatric interview is on the suicidal threat of a depressed person rather than his or her homicidal potential (Bourget & Bradford, 1987; Resnick, 1969; Rodenburg, 1971). Clinicians should consider phenotypic vulnerabilities; current and past illness variables; psychosocial stressors; and the quality and stability of key interpersonal relationships of a mother. Psychotic symptoms coupled with agitation; hypochondriasis; delusions of sinfulness and self-guilt; and fear are prominent signs of risk and indicate a need for hospitalization (Bourget & Bradford, 1987). In addition, if a mother expresses fear of harming her offspring, has delusions associated with the suffering or health of her child, or demonstrates enmity toward the favorite child of a spouse, hospitalization must also be considered.

Other prevention strategies may include immediate access to psychiatric care and prompt intervention by health care providers, law enforcement, and social agencies at the first report of an abused or unwanted child (Guileyardo, Prahlow, & Barnard, 1999; Korbin, 1989). A multidisciplinary approach has been suggested in the literature but it is unclear whether a comprehensive effort is being made to bring this proposal to fruition. According to Guileyardo, Prahlow, & Barnard (1999), as many as 60% of parents who committed filicide had been in contact with either a social worker, doctor, or nurse prior to the crime indicating that these women cross paths with a variety of disciplines.

Ideally, a committee would be formed with the specific aim of gathering experts from these disciplines to create uniform meanings for the concepts that build the categorization schema. Once a common language is being spoken, even if it is relatively complex in nature initially, there will be a common reference from which to draw and lend information. Ultimately, it could be implemented into the curricula of human and social science professional programs.

Nurses of all levels are significant resources as they are on the "frontline" and are the individuals with whom patients share thoughts and most often feel at ease. Nurses are ubiquitous and work at many levels from aides to advanced practice midwives and family nurse practitioners. They work in all specialties including but not limited to obstetrics, gynecology, pediatrics, psychiatry, and family practice. When properly prepared, nurses would be able to discern mothers who need further assessment. Detailed record keeping and collaboration with coworkers from different disciplines could enhance information- sharing and ultimately fill in the gaps that filicidal women keep slipping through.

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