Adolescent Awkwardness

Anna is a 13-year-old girl. She started grade 8 at the beginning of the year at a new school. Anna was a sickly child who required several long-term admissions to hospital, but she seems to have outgrown a lot of her early medical problems now. She used to be a bubbly, happy- go-lucky girl who was open about her feelings. She enjoyed spending time with her friends and family alike. She also loved dancing and singing. Anna generally is a high achiever in the academic context.

Recently, Anna seems to have become very quiet and withdrawn. She rarely spends time with family, preferring to isolate herself. She spends long periods of time alone in her bedroom. She no longer communicates openly with her parents and seems to be apathetic and irritable a lot of the time. She insists on wearing long-sleeved garments all of the time and when asked why, she becomes angry and defiant. Two weeks ago, Anna fainted at school. Her parents were called and they took her to an emergency department so that she could be medically assessed. During her physical examination the doctor noticed several healed scars on her arms and thighs as well as some newer fresh wounds. Anna tearfully admitted that she had inflicted these injuries on herself.

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