What do parents do if an eight-year-old child suddenly refuses to go to school? Dr. Amit Rotem, a pediatric psychologist at Maccabi Health Services, says that the phenomenon – which has social, emotional and educational implications – is not rare. It could involve depression and anxiety that may continue through adolescence. He suggests that parents and school advisers cooperate with the child to diagnose the problem early so the pupil can feel less stress and short- and long-term difficulties, even run-ins with the law – can be avoided.Writing in a recent issue of the Israeli Journal of Pediatrics, Rotem gives a typical example – an eight-year-old girl, the youngest of four, who attends third grade in a state school. Her parents had divorced before she was born and she had always lived with her mother. The girl earned only moderate grades and was suspected of having Attention-Deficit Disorder. She had missed second grade classes quite often, claiming she was in pain, but doctors did not find any physical cause. Since the beginning of the current year she has declined to go to class. Her mother, who stayed home from work to be with her, consulted a pediatrician.The author said many days of absenteeism may include insistence on going home early or missing all the classes. The child may suffer from anxiety about being abandoned, fear of exams, opposition to changes and a rebellious personality. Physical complaints such as headaches, stomach aches, nausea, fatigue and tremors could accompany the behavior. The symptoms could disappear during the day if the child is allowed to remain at home, Rotem wrote. If not treated, the problem can develop into family fights, a decline in learning skills and poor social skills.The Maccabi psychiatrist said that physical problems must first be ruled out. Then the parents, teachers and medical professionals must consider whether absences can be halted after only a few days, with the child helped to return to class gradually. Present a calm environment in the morning; a parent should accompany the child to school even if he/she knows how to get there alone; and remain in phone contact until the school day ends. The school can assist by initially cutting down homework assignments and offering private lessons to make up the material that was missed.The child’s mental state after return should be carefully observed and a pediatric psychologist or psychologist should be informed of progress. A truant officer from the educational authorities should also be brought into the picture, the author concludes, if the child continues to refuse to attend school.‘COMFORT WOMEN’ HAD NO COMFORT Except for historians, it is likely that most people who didn’t live through World War II would not remember the debasement of “comfort women,” who provided sexual services against their will to the Japanese Imperial Military during that period.Some of them are still alive and suffering from post-traumatic stress disorder (PTSD), according to researchers at the psychiatry department at Yonsei University College of Medicine in Seoul. The article was recently published in the Israel Journal of Psychiatry and Related Sciences.The team evaluated 26 former comfort women’s life histories, cognitive functioning, diagnosis of PTSD, depression, paranoid state, anger and Rorschach test results; then they compared the data with those of 24 healthy women.Cognitive functioning was not significantly different between former comfort women and the comparison group. All 26 former comfort women had undergone traumatic experiences such as sexual slavery and had suffered PTSD symptoms at least once in their lives. Nearly 31 percent were diagnosed as having PTSD, as opposed to none in the comparison group. The women’s PTSD symptoms were characterized by avoidance behavior, intrusive and distressing recollections and anger. There were no significant differences in depression or paranoid state between the two groups, but former comfort women had impairments in anger control and were more depressed.. On the Rorschach test, former comfort women revealed characteristic responses related not only to sex and morbidity but also to anger and violence.Although the study was small due to the passage of the years, the results suggest that former comfort women are still suffering from PTSD 60 years after the end of the war.