Child and Adolescent Behavioral Health

David, an 11-year-old boy in fifth grade, was brought for evaluation by his parents who expressed concerns over his anxious behavior regarding developing Acquired Immunodeficiency Syndrome (AIDS). David was a well-adjusted boy and who was doing well, but suddenly began to exhibit extremely disruptive behaviors related to his fears of AIDS. This began about four to five months ago. He also began to express concerns about getting sick, to wash his hands frequently, to seek reassurance continually, and to demonstrate rituals and avoidance.

David expressed concern many times that he can get AIDS from looking at a stranger with AIDS. Despite his parents’ reassurance, David insisted on washing or bathing for approximately one hour each time he gets home after being outside. He also began to have difficulty focusing on schoolwork. When reading assigned materials for school, David frequently experienced severe anxiety over possibly missing a word or misunderstanding a sentence, and he would reread the material many times. Eventually, he was not able to complete assignments and his grades began to deteriorate.