Skip to main content
×
×
Home

Pervasive refusal syndrome

  • Bryan Lask
Abstract

Pervasive refusal syndrome is a severe, pervasive and life-threatening disorder. Most commonly seen in girls between the ages of 8 and 15, although also affecting boys and younger age groups, it is characterised by a profound and pervasive refusal to eat, drink, talk, walk and engage in any form of self-care. A determined resistance to treatment is a striking component of the condition. The causes are unclear, but likely to be complex, multiple and associated with a sense of hopelessness. Treatment needs to be comprehensive and is based on supporting the child in recovering at her own pace, while ensuring physical safety and well-being. The prognosis is good, provided treatment is appropriate, but recovery tends to take a year or more.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Pervasive refusal syndrome
      Available formats
      ×
      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Pervasive refusal syndrome
      Available formats
      ×
      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Pervasive refusal syndrome
      Available formats
      ×
Copyright
References
Hide All
Anon (2001) Pervasive refusal syndrome: a parent's perspective. Clinical Child Psychology and Psychiatry, 6, 455469.
Brown, R. & Perkins, M. (1989) Child sexual abuse presenting as organic disease. BMJ, 299, 614615.
Caron, C. & Rutter, M. (1991) Co-morbidity in child psychopathology: concepts, issues and research strategies. Journal of Child Psychology and Psychiatry, 32, 10631080.
Graham, P. & Foreman, D. (1995) An ethical dilemma in child and adolescent psychiatry. Psychiatric Bulletin, 19, 8486.
Lask, B. (1996) Pervasive refusal syndrome. ACPP Occasional Papers, 12, 3335.
Lask, B. & Bryant-Waugh, R. (1995) Annotation – eating disorders in children. Journal of Child Psychology and Psychiatry, 36, 191202.
Lask, B., Britten, C., Kroll, L. et al (1991) Children with pervasive refusal. Archives of Diseases in Childhood, 66, 866869.
McGowan, R. & Green, J. (1998) Pervasive refusal syndrome: a less severe variant with defined aetiology. Clinical Child Psychology and Psychiatry, 3, 583590.
Neiderman, M., Richardson, J., Farley, A. et al (2001) Nasogastric feeding in early onset eating disorders. International Journal of Eating Disorders, 29, 441448.
Nichols, D., Chater, R. & Lask, B. (2000) Children into DSM don't go: a comparison of classification systems of eating disorders for children. International Journal of Eating Disorders, 28, 317324.
Nunn, K. & Thompson, S. (1996) The pervasive refusal syndrome: learned helplessness and hopelessness. Clinical Child Psychology and Psychiatry, 1, 121132.
Nunn, K., Thompson, S., Moore, S. et al (1998) Managing pervasive refusal syndrome: strategies of hope. Clinical Child Psychology and Psychiatry, 3, 229249.
Nunn, K., Nichols, D. & Lask, B. (2000) A new taxonomy for child psychiatry. Clinical Child Psychology and Psychiatry, 5, 313328.
Richards, J. (2000) Chronic fatigue syndrome in children and adolescents: a review article. Clinical Child Psychology and Psychiatry, 5, 3151.
Seligman, M. (1990) Learned Optimism. New York: Knopf.
Taylor, S., Dossetor, D., Kilham, H. et al (2000) The youngest case of pervasive refusal syndrome? Clinical Child Psychology and Psychiatry, 5, 2330.
Thompson, S. & Nunn, K. (1997) The pervasive refusal syndrome: The Royal Alexandra Hospital for Children experience. Clinical Child Psychology and Psychiatry, 2, 145165.
Wessely, S., David, A., Butler, S. et al (1989) Management of chronic (post-viral) fatigue syndrome. Journal of the Royal College of Practitioners, 39, 2629.
Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

BJPsych Advances
  • ISSN: 1355-5146
  • EISSN: 1472-1481
  • URL: /core/journals/bjpsych-advances
Please enter your name
Please enter a valid email address
Who would you like to send this to? *
×

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 27
Total number of PDF views: 59 *
Loading metrics...

Abstract views

Total abstract views: 445 *
Loading metrics...

* Views captured on Cambridge Core between 2nd January 2018 - 17th July 2018. This data will be updated every 24 hours.

Pervasive refusal syndrome

  • Bryan Lask
Submit a response

eLetters

Intervention Technique

Andrew J. Davis, Psychology/ Meditation Teacher
25 February 2009

I would like to suggest as part of the extensive and very patient intervention process for children with Pervasive Refusal Syndrome the use of an object which can serve as a focus of compassion on the part of the child.My rationale is as follows: the child is in the grip of an inner state of emotion which appears to include a terror and deep negativity which they cannot express, and does not allow them to relate positively to anyone or anything more powerful than themselves, which means almost everyone. However, it is possible that at a certain stage they may be persuaded (forexample by the technique of 'musing' aloud) to consider a small object such as a doll or teddy bear as a living being who is suffering from a similar terror and negativity. This 'being,' who is even smaller and less powerful than themselves then becomes a focus for the child's own innate tendency for compassion.The state of compassion, protectiveness towards another being, if it can be induced, is one of the most positive and mood enhancing states of mind,of which even very young children are somewhat capable. It has the function of releasing one's mind from self-absorption: turning the mind away from self to focus on other and thus weakening one's own fear. From initial small results, this focus if re-established regularly by the childmay help to reintroduce positivity and freedom from fear within the child's inner world. ... More

Conflict of interest: None Declared

Write a reply

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *