Separation anxiety disorder

A disorder with onset before age 18 years consisting of inappropriate anxiety concerning separation from home or from persons to whom the child is attached. Among the symptoms that may be seen are unrealistic concern about harm befalling to or loss of major attachment figures; refusal to go to school (school phobia) in order to stay at home and maintain contact with this figure; refusal to go to sleep unless close to this person; clinging; nightmares about the theme of separation; and development of physical symptoms or mood changes (apathy, depression) when separation occurs or is anticipated.


A disorder in which a child feels intense fear and apprehension when away from someone on whom he or she is dependent. Some believe may be a factor in the cause of school phobia.


Childhood anxiety centered on the child’s attachment figures or home that is not developmentally appropriate, is excessively frequent and persistent, and interferes with a child’s normal daily routine is characteristic of separation anxiety disorder (American Psychiatric Association [APA], 1994). Separation anxiety is developmentally appropriate for children between 7 months and 6 years of age; however, most children resolve their fears about separation by 24 months of age (U.S. Public Health Services, 2000). Intense fear of separation may lead to attendance problems at school. Younger children may cling to caregivers, whereas older youth are more likely to refuse outings with peers and have a preoccupation with the caregiver’s schedule to avoid separations. Differential diagnoses for social phobia or school phobia should be considered. Separation anxiety revolves around fears of separations or excessive concern about the caregivers’ safety and is not a fear of school or social interactions (APA, 1994).


 


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