Separation anxiety disorder

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Kiran Singh, M.D. [2]

Synonyms and keywords: Adult separation anxiety disorder; childhood separation anxiety disorder

Overview[edit | edit source]

Separation anxiety disorder is a psychological condition in which an individual has excessive anxiety regarding separation from home or from people to whom the individual has a strong emotional attachment (like a mother). Often, separation anxiety disorder is a symptom of a co-morbid condition. Studies show that children suffering from separation anxiety disorder are much more likely to have ADHD, bipolar disorder, panic disorder, and others later in life. [3] Separation anxiety disorder should not be confused with separation anxiety, which occurs as "a normal stage of development for healthy, secure babies."

Differential Diagnosis[edit | edit source]

• Agoraphobia
• Bereavement
• Bipolar disorders
• Conduct disorder
• Depression
• Generalized anxiety disorder
• Illness anxiety disorder
• Oppositional defiant disorder
• Panic disorder
• Personality disorders
• Post traumatic stress disorder
• Psychotic disorders
• Separation anxiety
• Social anxiety disorder^[1]

Separation anxiety disorder should not be confused with separation anxiety, which occurs as "a normal stage of development for healthy, secure babies." [4] Separation anxiety occurs as babies begin to understand their own selfhood - or understand that they are a separate person from their primary caregiver. At the same time, the concept of object permanence emerges - which is when children learn that something still exists when it is not seen or heard. As babies begin to understand that they can be separated from their primary caregiver, they do not understand that their caregiver will return, nor do they have a concept of time. This, in turn, causes a normal and healthy anxious reaction.

Epidemiology and Demographics[edit | edit source]

Prevalence[edit | edit source]

The prevalence of separation anxiety disorder is:

• 900-1,900 per 100,000 (0.9%-1.9%) in adults
• 4,000 per 100,000 (4%) in children 6-12 months of age
• 1,600 per 100,000 (1.6%) in adolescents^[1]

Age[edit | edit source]

Present in all age groups, adult separation anxiety disorder (affecting roughly 7% of adults) is more common than childhood separation anxiety disorder (affecting approximately 4% of children). [5][6].

Risk Factors[edit | edit source]

• Genetic predisposition

• Life stress (especially loss)

• Becoming a parent
• Change of schools
• Death of a relative or pet
• Disaster involving periods of separation from attachment figures
• Romantic relationship
• Illness
• Immigration
• Leaving the parental home
• New neighborhood
• Parental divorce ^[1]

Diagnostic Criteria[edit | edit source]

DSM-V Diagnostic Criteria for Separation Anxiety Disorder^[1][edit | edit source]

Symptoms[edit | edit source]

Separation anxiety disorder is often characterized by some of the following symptoms:

• Recurring distress when separated from the subject of attachment (such as the mother or home)
• Persistent, excessive worrying about losing the subject of attachment
• Persistent, excessive worrying that some event will lead to separation from a major attachment
• Excessive fear about being alone without subject of attachment
• Persistent reluctance or refusal to go to sleep without being near a major attachment figure, like a mother
• Recurrent nightmares about separation

References[edit | edit source]

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