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| Anxiety disorders
Symptoms
- Distress and agitation when separated from parent and home
- School refusal
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Pervasive worry and fearfulness
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Restlessness and irritability
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Timidity, shyness, social withdrawal
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Terror of an object (e.g., dog)
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Associated headache, stomach pains
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Restless sleep and nightmares
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Poor concentration, distractibility and learning problems
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Reliving stressful event in repetitive play
Family factors
- Parental anxiety, overprotection, separation
difficulties
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Parental (maternal) depression and agoraphobia
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Family stress: marital conflict, parental illness, child abuse
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Family history of anxiety
Management
- Cognitive-behavioural therapy
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Family therapy for overprotection
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Treat parental anxiety/depression
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Psychotherapy (interpersonal therapy)
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Teacher support
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Drug therapy (tricyclic antidepressant or selective serotonin
reuptake inhibitor) as adjunct to psychological interventions
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