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School Refusal (cont.)

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Cross-cultural considerations should be taken into account when determining treatment of school refusal. Some students sent to boarding school may experience symptoms of physical illness caused by abrupt separation from family. These symptoms may include inability to eat and hallucinations. Some Native American tribes call these symptoms "bad spirits." Native American students may experience a reversal of symptoms upon returning to their tribe, or with the assistance of a Native American healer.



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Anxiety Disorder: Separation Anxiety and School Refusal »

According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV), separation anxiety is a fairly common anxiety disorder that consists of excessive anxiety beyond that expected for the child's developmental level related to separation or impending separation from the attachment figure (eg, primary caretaker, close family member) occurring in children younger than 18 years and lasting for at least 4 weeks.

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