Separation Anxiety Disorder (SAD) By Samuel Mejia P.1

Separation Anxiety Disorder (SAD) Separation anxiety disorder is a mental health disorder that begins in childhood and is characterized by worrying that is out of proportion to the situation of temporarily leaving home or otherwise separating from other. It is diagnosed during childhood Separation anxiety disorder is likely caused by the combination of genetic and environmental vulnerabilities rather than by any one thing.

Associated Features repeated excessive anxiety about something bad happening to loved ones or losing them heightened concern about either getting lost or being kidnapped repeated hesitancy or refusal to go to day care or school or to be alone or without loved ones or other adults who are important to the anxious child persistent reluctance or refusal to go to sleep at nighttime without being physically close to adult loved ones Nightmares about being separated from the people who are important to the sufferers

Associated Features DSM-IV-TR Criteria: A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following: Recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated. Persistent and excessive worry about losing, or about possible harm befalling, major attachment figures. Persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g.; getting lost or being kidnapped). Persistent reluctance or refusal to go to school or elsewhere because fear of separation. Persistent and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings.

Associated Features B. The duration of the disturbance is at least 4 weeks. C. The onset is before age 18 years. D. Part 1 OR Part 2 Part 1. The disturbance causes clinically significant distress. Part 2. The disturbance causes clinically significant impairment in social, academic (occupational), or other important areas of functioning. E. The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder with Agoraphobia.

Etiology In addition to being more common in children with family histories of anxiety, children whose mothers were stressed during pregnancy with them tend to be more at risk for developing this disorder. A majority of children with separation anxiety disorder have school refusal as a symptom and up to 80% of children who refuse school qualify for the diagnosis of separation anxiety disorder. Approximately 50%-75% of children who suffer from this disorder come from homes of low socioeconomic status. Separation anxiety disorder (as with most mental-health conditions) is likely caused by the combination of genetic and environmental vulnerabilities rather than by any one thing.

Prevalence Separation Anxiety is a normal developmental stage. It helps children learn how to master their environment. However, if a child doesn’t overcome their separation, they will most likely develop the disorder. Approximately 4%- 5% of children & adolescents suffer from separation anxiety disorder ages 7 – 11 years. Affects about 1.3 of American teens and affects boys & girls equally.

Treatment Counseling, rather than medication, is the treatment of choice for SAD that is mild severity. Psychotherapy, Medication, & parent counseling are three interventions that have been found effective. If psychotherapy is unsuccessful or if the children’s symptoms are so severe, medication is considered a viable option. However, there are no medications specifically approved by the U.S. FDA to treat separation anxiety disorder.

Prognosis If left untreated, Separation anxiety disorder puts its sufferers at risk for depression and anxiety problems as adults, as well as personality disorders, in which anxiety is a major symptom. Adults may experience: wide-ranging separation anxiety symptoms, such as extreme anxiety and fear, when separated from major attachment figures; avoidance of being alone; and fears that harm will befall those close to them. Separation anxiety disorder may be a neglected diagnosis in adulthood.

References Halgrin, R.P, & Whitbourne, S.K. (2005). Abnormal Psychology: Clinical Perspectives on Psychological Disorders. New York: Mc Graw Hill Myer, D.G.(2011). Myer’s Psychology For AP. New York, NY: Worth Publishers Edwards, R.D., Separation Anxiety Disorder. Retrieved from Nichols, M. (June 30, 2008) Adult Separation Anxiety Disorder. Retrieved from

Discussion Question How does Separation Anxiety Disorder relate to Associative learning?