Evidence-Based Reviews

Child murder by parents: Toward prevention

Current Psychiatry. 2023 June;22(6):12-14,18-21 | doi: 10.12788/cp.0358

References

1. Friedman SH, Horwitz SM, Resnick PJ. Child murder by mothers: a critical analysis of the current state of knowledge and a research agenda. Am J Psych. 2005;162(9):1578-1587.

2. Mariano TY, Chan HC, Myers WC. Toward a more holistic understanding of filicide: a multidisciplinary analysis of 32 years of US arrest data [published corrections appears in Forensic Sci Int. 2014;245:92-94]. Forensic Sci Int. 2014;236:46-53.

3. Hatters Friedman S, Resnick PJ. Child murder by mothers: patterns and prevention. World Psychiatry. 2007;6(3):137-141.

4. Friedman SH, Resnick PJ. Neonaticide: phenomenology and considerations for prevention. Int J Law Psychiatry. 2009;32(1):43-47.

5. Hatters Friedman S, Hrouda DR, Holden CE, et al. Filicide-suicide: common factors in parents who kill their children and themselves. J Am Acad Psychiatry Law. 2005;33(4):496-504.

6. Daly M, Wilson M. Is the “Cinderella effect” controversial? A case study of evolution-minded research and critiques thereof. In: Crawford C, Krebs D, eds. Foundations of Evolutionary Psychology. Taylor & Francis Group/Lawrence Erlbaum Associates; 2008:383-400.

7. Friedman SH. Fathers and filicide: Mental illness and outcomes. In: Wong G, Parnham G, eds. Infanticide and Filicide: Foundations in Maternal Mental Health Forensics. 1st ed. American Psychiatric Association Publishing; 2020:85-107.

8. West SG, Friedman SH, Resnick PJ. Fathers who kill their children: an analysis of the literature. J Forensic Sci. 2009;54(2):463-468.

9. Putkonen H, Amon S, Eronen M, et al. Gender differences in filicide offense characteristics--a comprehensive register-based study of child murder in two European countries. Child Abuse Neglect. 2011;35(5):319-328.

10. Miller LJ. Denial of pregnancy. In: Spinelli MG, ed. Infanticide: Psychosocial and Legal Perspectives on Mothers Who Kill. American Psychiatric Association Publishing; 2003:81-104.

11. Friedman SH, Heneghan A, Rosenthal M. Characteristics of women who deny or conceal pregnancy. Psychosomatics. 2007;48(2):117-122.

12. Beyer K, Mack SM, Shelton JL. Investigative analysis of neonaticide: an exploratory study. Criminal Justice and Behavior. 2008;35(4):522-535.

13. Putkonen H, Weizmann-Henelius G, Collander J, et al. Neonaticides may be more preventable and heterogeneous than previously thought--neonaticides in Finland 1980-2000. Arch Womens Ment Health. 2007;10(1):15-23.

14. Friedman SH, Resnick PJ. Child murder and mental illness in parents: implications for psychiatrists. J Clin Psychiatry. 2011;72(5):587-588.

15. Resnick PJ. Child murder by parents: a psychiatric review of filicide. Am J Psychiatry. 1969;126(3):325-334.

16. Friedman SH. Searching for the whole truth: considering culture and gender in forensic psychiatric practice. J Am Acad Psychiatry Law. 2023;51(1):23-34.

17. Friedman SH, Hrouda DR, Holden CE, et al. Child murder committed by severely mentally ill mothers: an examination of mothers found not guilty by reason of insanity. J Forensic Sci. 2005;50(6):1466-1471.

18. Ash P. Fatal maltreatment and child abuse turned to murder. In: Friedman SH, ed. Family Murder: Pathologies of Love and Hate. Group for the Advancement Psychiatry; 2018.

19. Friedman SH, Appel JM. Murder in the family: intimate partner homicide in the elderly. Psychiatric News. 2018. Accessed April 8, 2023. https://psychnews.psychiatryonline.org/doi/10.1176/appi.pn.2018.12a21

20. Friedman SH, McEwan MV. Treated mental illness and the risk of child abuse perpetration. Psychiatr Serv. 2018;69(2):211-216.

21. McEwan M, Friedman SH. Violence by parents against their children: reporting of maltreatment suspicions, child protection, and risk in mental illness. Psychiatr Clin North Am. 2016;39(4):691-700.

22. Hatters Friedman S, Beaman JW, Friedman JB. Fatality review and the role of the forensic psychiatrist. J Am Acad Psychiatry Law. 2021;49(3):396-405.

23. Friedman SH, Prakash C, Nagle-Yang S. Postpartum psychosis: protecting mother and infant. Current Psychiatry. 2019;18(4):12-21.

24. Stanton J, Simpson AI, Wouldes T. A qualitative study of filicide by mentally ill mothers. Child Abuse Negl. 2000;24(11):1451-1460.

25. Levitzky S, Cooper R. Infant colic syndrome—maternal fantasies of aggression and infanticide. Clin Pediatr (Phila). 2000;39(7):395-400.

26. Jennings KD, Ross S, Popper S, et al. Thoughts of harming infants in depressed and nondepressed mothers. J Affect Disord. 1999;54(1-2):21-28.

27. Barr JA, Beck CT. Infanticide secrets: qualitative study on postpartum depression. Can Fam Physician. 2008;54(12):1716-1717.e5.

28. Friedman SH, Sorrentino RM, Stankowski JE, et al. Psychiatrists’ knowledge about maternal filicidal thoughts. Compr Psychiatry. 2008;49(1):106-110.

29. Booth BD, Friedman SH, Curry S, et al. Obsessions of child murder: underrecognized manifestations of obsessive-compulsive disorder. J Am Acad Psychiatry Law. 2014;42(1):66-74.

30. Friedman SH, Hall RCW. Avoiding malpractice while treating depression in pregnant women. Current Psychiatry. 2021;20(8):30-36.

When conceptualizing prevention of child murder by parents, we can think of primary, secondary, and tertiary prevention. This means we want to encourage healthy families and healthy relationships within the family, as well as screening for risk and targeting interventions for families that have experienced difficulties, as well as for parents who have mental illness or substance use disorders.

Understanding the motive behind an individual committing filicide is also critical so that we do not conflate filicide and mental illness. Conflating these concepts leads to increased stigmatization and less help-seeking behavior.

Table 3^{3,4,7,18,22,23} describes the importance of understanding the motives for child murder by a parent in order to conceptualize appropriate prevention. Prevention efforts for 1 type of child murder will not necessarily help prevent murders that occur due to the other motives. Regarding prevention for fatal maltreatment cases, poor parenting skills, including inappropriate expressions of discipline, anger, and frustration, are common. In some cases, substance abuse is involved or the parent was acutely mentally unwell. Reporting to Child Protective Services can be helpful, but as previously noted, it is difficult to ascertain which cases will lead to a homicide. Recommendations from Child Fatality Review teams also are valuable.

Though many parents have frustrations with their children or thoughts of child harm, the act of filicide is rare, and individual cases may be difficult to predict. Regarding prediction, some mothers who committed filicide saw their psychiatrist within days to weeks before the murders.¹⁷ A small New Zealand study found that psychotic mothers reported no plans for killing their children in advance, whereas depressed mothers had contemplated the killing for days to weeks.²⁴

Several studies have asked mothers about thoughts of harming their child. Among mothers with colicky infants, 70% reported “explicit aggressive thoughts and fantasies” while 26% had “infanticidal thoughts” during a colic episode.²⁵ Another study²⁶ found that among depressed mothers of infants and toddlers, 41% revealed thoughts of harming their child. Women with postpartum depression preferred not to share infanticidal thoughts with their doctor but were more likely to disclose that they were having suicidal thoughts in order to get needed help.²⁷ Psychiatrists need to feel comfortable asking mothers about their coping skills, their suicidal thoughts, and their filicidal thoughts.^14,23,28 Screening and treatment of mental illness is critical. Postpartum psychosis is well-known to pose an elevated risk of filicide and suicide.²³ Obsessive-compulsive disorder may cause a parent to ruminate over ego-dystonic child harm but should be treated and the risk conceptualized very differently than in postpartum psychosis.^23,29 Screening for postpartum depression and appropriate treatment of depression during pregnancy and the postpartum period decrease risk.³⁰

Continue to: Regarding prevention of neonaticide...