Separation Anxiety Disorder

Abstract

Separation anxiety disorder (SAD) is one of the most commonly diagnosed anxiety disorders among children presenting for treatment. A child with SAD experiences excessive anxiety concerning separation from home or from caregivers as well as persistent, unrealistic worry about harm to self or loved ones. Fears may manifest as an unwillingness to leave home, reluctance to be alone, physical complaints around separation, and frequent reassurance seeking regarding safety. This chapter provides a review of the current literature regarding the course and etiology of SAD, with a focus on genetic studies, environmental factors, and parenting. The link between childhood SAD, panic disorder, and other forms of psychopathology in adulthood is also considered. Assessment and treatment of SAD are discussed, with a review of the empirical evidence for the use of traditional cognitive-behavioral therapy (CBT), camp-based CBT, modi fi ed parent-child interaction therapy, and psychopharmacological treatments. Research on assessments and treatments speci fi cally for SAD has been scarce. Given the relatively high prevalence of this disorder, and its role as a predictor of later psychopathology, further study is warranted. Future research might examine treatments designed speci fi cally for SAD or recruit a subject pool that would allow for independent investigation of results for those with SAD within a larger heterogeneous anxiety sample. Furthermore, additional attempts to understand SAD as a risk factor may lead to prevention of adult psychopathology in these children. Keywords Case ScenarioMelissa is a 9-year-old girl in the 4th grade whose parents brought her in for an evaluation because of her fears of being away from them. Before going to school each morning, she checks in with her mother about who is picking her up and where she should wait. Her mother reminds her that the plan

Anxiety Disorders

“…Approximately 90% of cases have onset before the age of 13 and the prevalence (3-4% in children) decreases as patients age [5]. Genetics and parental anxiety disorders are risk factors for developing separation anxiety disorder [6]. Primary symptoms include severe distress or anxiety from actual or possible separation from the home or attachment figure.…”