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Forum Name: Psychiatric Topics

Question: Vomit Phobia in 7 year old?


 RainieB - Wed Mar 12, 2008 1:58 pm

Dear Dr,

My 7 year old daughter witnessed a close friend vomit at school about 6 weeks ago.

Since then she seemed traumatized by the event. She fears she will vomit in school. Last year she had a few stomach bugs which must have been really bad experiences.

She asks me constantly "will I throw-up in school mommy", several times a day. Sometimes her anxiety level is so high, that she doesnt realize she is hungry, or full. Before bedtime, she also asks me if she will throw-up.

I think she actually sees the other kids reactions and combination of looks of horror or amusement.
She doesnt like the fact that she will be caught off gaurd, as she sees with her classmates. One minute they are fine, the next minute they are sick. Its not like a cold, where there is some warning, perhaps a sore throat, or runny nose. She tries to anticipate if she will be sick by a feeling in her stomach.
The problem with this is it is bi-directional, where anxiety creates stomach discomfort, the stomach discomfort creates more anxiety, etc...Also hunger gas all create more anxiety of impending vomit.

We have just started her in CBT therapy because I am afraid it will get worse..

Do you know of any success rates with this phobia in children? Is this a common fear in kids? I am really concerned about her future and her level of anxiety.

Thank you so much,
Rainie
 Dr. E. Seigle - Wed Mar 12, 2008 6:55 pm

Dear Rainie B.,

The good news is that phobias usually respond well to treatment. Generally, a behavioral treatment known as systematic desensitization is successful, with an experienced child psychotherapist. The cognitive-behavioral therapy that you have engaged your daughter in may include this therapy, but you should ask. A phobia centered on a fear of body injury, blood, vomiting, etc. is fairly common. Your therapist should also, when evaluating your daughter, also screen for other anxiety disorders, such as OCD, generalized anxiety disorder, separation anxiety disorder, and depression. I'm not implying that she has one of these,it's just good to be sure since kids can often have more than one anxiety or anxiety plus a mood disorder.

Good job responding to this so quickly and getting your daughter help!

-Dr. Seigle
 RainieB - Thu Mar 13, 2008 12:45 pm

Dear Dr,
Thank you so much for your quick response. It made me feel better.

Do you think she is considered to have OCD if she keeps asking me if she will throw up? Would that be considered to be the compulsion?

Thank you again
 Dr. E. Seigle - Thu Mar 13, 2008 4:50 pm

Hi Rainie B,

I can't be sure without evaluating your daughter, but my speculation is that asking about vomiting a lot may not be an OCD-related obsession or compulsion, but just a question resulting from the anxiety related to the phobia. But, when you have your daughter evaluated, you can get a more definitive answer to that. Good luck!

-Dr. Seigle
 RainieB - Mon Mar 24, 2008 8:49 pm

Dear Dr. Seigle,
Thank you for your responses. They help give me some needed information. Danielle did have some set-backs and ends up at the nurse at school. Lately she does complain about headaches daily, and right above her eyes. Of course this incresaes her anxiety about getting sick! She looks for any clue she can get.

Do you think these headaches are part of the anxiety in addition to the stomach discomfort?

Sometimes I get very discouraged, and feel her anxiety will never be relieved!

Thank you so much,
RainieB

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