The Pervasive Refusal Syndrome was only recently described in a British sample of four children. This article presents an Australian sample of seven children seen over a period of four years at the Royal Alexandra Hospital for Children, Sydney. Criteria for case inclusion are specified. The features of this sample of children are described and the components of our treatment programme are summarized. Outcome is reported briefly. Issues of differential diagnosis are elaborated highlighting the distinctive nature of the syndrome and its relationship to other disorders. The study of the syndrome and the relationship of the Australian sample to the British sample are considered.
American Psychiatric Association
(1994). Diagnostic and statistical manual of mental disorders. (4th ed.). Washington, DC: author.
2.
Beck, A.T.
, Weissman, A., Lester, D., & Trexler, L. (1974). The measurement of pessimism: The hopelessness scale. Journal of Consultation and Clinical Psychology, 42, 861-865.
3.
Fink, M.
(1994). Catatonia in DSM-IV. Editorial. Biological Psychiatry, 36, 431-433.
4.
Fink, M.
, & Carlson, G.A. (1995). ECT and Prepubertal Children. Journal of the American Academy of Child and Adolescent Psychiatry, 34(10), 1258-1259.
5.
As cited in Hickie, I.B., Lloyd, A.R., & Wakefield, D. (1995). Chronic Fatigue syndrome: Current perspectives on evaluation and management. Medical Journal of Australia. 163, (18 Sept), 314-318.
6.
Germain, M. (1994). Refusal in childhood. A dissertation submitted for Part II of the entrance examination for the Royal Australian and New Zealand College of Psychiatrists.
7.
Graham, P.J.
, & Foreman, D.M. (1995). An ethical dilemma in child and adolescent psychiatry. Psychiatric Bulletin, 19, 84-86.
8.
Lask, B.
, Britten, C., Kroll, L., Magagna, J., & Tranter, M. (1991). Children with pervasive refusal. Archives of Disease in Childhood, 66, 866-869.
9.
Mechanic, D.
, & Volkart, E.H. (1960). Illness behavior and medical diagnosis. Journal of Health and Human Behavior, 1, 86-94.
10.
Nunn, K.P.
, Lewin, T.J., Walton, J.M., & Carr, V.J. (1996). The construction and characteristics of an instrument to measure personal hopefulness. Psychological Medicine, 26, 531-545.
11.
Nunn, K.P.
, & Thompson, S.L. (1996). The pervasive refusal syndrome: Learned helplessness and hopelessness. Clinical Child Psychology and Psychiatry, 1(1), 121-132.
12.
Parsons, T.
(1951). Social structure and personality. London: Collier-Macmillan.
13.
Pilowsky, I.
(1978). A general classification of abnormal illness behaviour. British Journal of Medical Psychology, 51, 131-137.
14.
Schulman, P.
, Castellon, C., & Seligman, M.E.P. (1989). Assessing explanatory style. The content analysis of verbatim explanations and the Attributional Style Questionnaire. Behaviour, Research and Therapy, 27, 505-512.
15.
Singh, B.
, Nunn, K., Martin, J., & Yates, J. (1981). Abnormal treatment behaviour. British Journal of Medical Psychology, 54, 67-73.
