Jaspers et al modified the criteria of Thompson and Nunn for the Pervasive Refusal Syndrome (PRS). The authors are from Maastricht University Medical Center in the Netherlands.


Patient selection: pediatric


Criteria for the Pervasive Refusal Syndrome:

(1) partial or complete refusal in >= 3 of 4 domains (see below)

(2) active and angry resistance to encouragement or help

(3) social withdrawal (school refusal, isolation, etc)

(4) exclusion of an organic condition that can explain the findings better

(5) exclusion of an alternative psychiatric diagnosis that can explain the findings better

(6) hospitalization required due to the endangered state of the patient


Domains evaluated for refusal:

(1) mobilization

(2) speech

(3) attention to personal care

(4) eating


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