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Anxiety and Stress Disorders (Children)

Vomit Phobia in A Seven Year Old?



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.


Reassurance and CBT should be just the thing in this situation, success rates for CBT approach 80% in the hands of a competent therapist. Simple phobias are extremely common in children and the particular one you mention is just one of a host of various forms that simple phobia takes. Anxiety tendencies are present in about 20-25% of the population and appear to be genetically based.

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Response by:

Floyd R Sallee, MD
College of Medicine
University of Cincinnati