Separation Anxiety Disorder

About Separation Anxiety Disorder

Separation anxiety disorder involves fear or anxiety about separation from home or attachment figures that is excessive for the developmental stage of the person. Symptoms can include distress when separation occurs or is anticipated, persistent worry that harm will come to attachment figures or that an event such as getting lost will cause separation, reluctance to go to school or elsewhere, reluctance to sleep alone, nightmares about separation, and physical complaints such as headaches or stomachaches. It is one of the most common anxiety disorders in children, and DSM-5 recognized that it can also begin in or persist into adulthood, when worries often center on partners or children. Some separation distress is normal in infants and toddlers, so the diagnosis depends on intensity and impairment, with symptoms lasting at least four weeks in children and typically six months in adults. School refusal is a common presentation and is usually addressed through cooperation between family, school and clinicians. Cognitive behavioral therapy that includes gradual practice with separation is the main evidence based treatment, often with parent involvement to reduce accommodation of avoidance, and SSRIs are sometimes used for more severe cases. Childhood separation anxiety is associated with a higher risk of later anxiety disorders.