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Clinical Case Studies
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Cognitive-Behavioral Treatment of Generalized Anxiety

Disorder and Vomiting Phobia in an Elementary-Age Child

Sarah W. Whitton

The May Institute

James K. Luiselli

The May Institute, jluiselli{at}mayinstitute.org

Deidre L. Donaldson

The May Institute

This case report describes cognitive-behavioral treatment (CBT) with a 7-year-old girl diagnosed with generalized anxiety disorder (GAD) and specific phobia (fear of vomiting). Developmental history was significant for excessive worry, pervasive anxiety, and complaints of stomach discomfort. Her fear of vomiting had resulted in eating inhibition and weight loss. Treatment focused on teaching behavioral skills to reduce anxiety (distraction, relaxation), correcting misattributions about physiological sensations, reducing anxiety-inducing self-statements, and eliminating reinforcement of somatic symptoms in the family system. Self-report on the State-Trait Anxiety Inventory for Children (STAIC) before and following CBT documented clinically significant changes in anxiety. At termination, the client no longer met diagnostic criteria for GAD or specific phobia. Over the course of treatment, complaints of stomachaches were significantly reduced, and the client demonstrated weight gain. A 5-month posttreatment evaluation revealed that clinical improvement was maintained.

Key Words: generalized anxiety disorder • specific phobia • vomiting • cognitive-behavioral treatment

Clinical Case Studies, Vol. 5, No. 6, 477-487 (2006)
DOI: 10.1177/1534650105284476
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