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A 15-year-old girl is brought by her father because her marks have fallen from the top band to failing over two school terms. She has given up netball, which she used to love, and now spends weekends in her room. She wakes at four each morning and cannot get back to sleep, and has lost 4 kg without trying. She does not snore and her father has never noticed pauses in her breathing. She read and spelled at age level right through primary school, and denies worrying about anything in particular. She says she is not sad, just over it. Which one of the following best explains her decline at school?
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