Nancy Lanza part 3

James Coplan, MD, continues his review of the OCA report on the shootings at Sandy Hook Elementary School, focusing on Nancy Lanza’s mental health.

Previous articles on this topic:

Shooting At Sandy Hook Elementary School – Report Of The Office Of The Child Advocate.

Who’s Story Is It, Anyway?

Unfounded Claims Of Illness

Now we enter the realm of informed speculation.

We know that Nancy Lanza represented herself to others as having a variety of medical disorders (Multiple Sclerosis, seizures, an immunologic disorder). What we don’t know is whether she actually believed it herself. If she truly believed that she was suffering from a crippling, terminal illness, despite repeated normal exams and test results, that would point us in the direction of Illness Anxiety Disorder, Somatic Symptoms Disorder (SSD), and Conversion Disorder (Functional Neurological Symptoms Disorder). If she was experiencing symptoms (albeit psychogenic in origin), then SSD or Conversion Disorder rise to the top of the list. If she were consciously “making it all up,” then malingering would need to be considered, but given the totality of what we know, this option seems unlikely. If she were inventing illness in herself in a “driven” way, stemming from unconscious, deeply rooted psychiatric need, then Factitious Illness Disorder becomes a leading contender, diagnostically. Regardless of exactly how the cards fall, “Mrs. Lanza’s statements regarding her medical condition…[raise] important questions regarding the parents’ mutual understanding of the trajectory of [Adam]’s educational and mental health treatment, much of which was guided by Mrs. Lanza’s interpretation of unfolding events.” (OCA p 31) Read the rest of this entry »

Unfounded Claims Of Illness

Unfounded claims of illness

James Coplan, MD, continues his discussion of the OCA report on the Newtown massacre, focusing on Adam Lanza’s mother, Nancy Lanza, and her tendency to present herself as having life-threatening illnesses in the absence of medical documentation.

Why do people who are not physically ill make claims to the contrary?

The first group of persons who claim non-existent illness are malingerers. Malingerers deliberately fake illness for some specific benefit (e.g. financial, avoiding military service, eliciting sympathy from others, etc.) These benefits are referred to collectively as “secondary gain.” Depending on circumstances, some forms of malingering (e.g., insurance fraud) qualify as criminal behavior. Malingerers do not believe that they are ill. They know they are intentionally faking, and if apprehended will sometimes “fess up” to their behavior. Malingerers may be unscrupulous, but their thought patterns are “normal” (i.e., without any distortion of reality). Read the rest of this entry »