Case of Anxiety Disorder Sinem Batum

Complaining Reject going to school Somatic symptoms like crying, vomiting Reject being alone Does not want to be separated from caregivers

Demographic 30.07.1998 Information is obtained from parents and teacher Lives with parents Mother is 45 and father is 48 years old Mother has a high school and father has a college degree Goes to a private school

History of the present problem Problem came out this year both at home and school ’99 earthquake as stress factor Somatic symptoms hinder daily functioning and relationships with peers

Social and Developmental History of the Case Relationships with Parents Parents’ desire to have a child for a long time (pregnancy period) Sleep with parents until ’99 earthquake Not differentiating parental roles Close family ties and dinners every weekend Physical and behavioral similarities with mother

School and Peer context Ambitious teacher and exam anxiety Successful as a student but high expectations and pressure Doesn’t like teacher, afraid of her shouting Doesn’t have many friends, only two friends Complaints about school

Medical History of Case and Parents Mother cannot go out alone According to school advisor’s report mother takes drugs because of anxiety problems No medical problems of the child

Assessment Methods Draw a Child Louisa Duss Psychoanalytic Stories Test Play with Toy House Kinetic Family Drawing CAT

Developmental Perspective Equifinality Biological and psychosocial factors Environment (school, peer context, neighborhood) Parenting Temperament Results as anxiety disorder especially separation anxiety and school refusal

Facts to be considered Demanding teacher, exam anxiety and pressure Parents’ overprotection: cannot perform age appropriate social skills Peer context: not so many friends around Problem about self-efficacy belief Mother’s anxiety problems Guilt induction Parents as a role model Cannot form intimate relationships with others

Literature and Theories Transactional model Parenting as control : behavioral and psychological control overprotection, guilt induction: poor self-worth Emotional bonds & parent-child attachment Tripartiate model: cognitive representational models, level of monitoring, affect management skills Temperament : emotional fit hypothesis, interaction between socialization and temperament, experiential canalization, goodness of fit Peer context: only vertical relationships, withdrawn Modeling

Recommendations & Approach Try to form self-efficacy belief Social and emotional role model Try to differentiate role models Suggestion of family therapist Behavioral or cognitive-behavioral approach?