Separation Anxiety

Abstract

Separation anxiety disorder (SAD) is one of the most common childhood anxiety disorders. SAD refers to an exaggeration of otherwise developmentally normal anxiety manifested by excessive concern, worry, and even dread of the real or anticipated separation from an attachment figure. Although separation anxiety is a developmentally appropriate phenomenon, the disorder manifests with inappropriate intensity or the inappropriateness of age and context. Although The Diagnostic and Statistical Manual of Mental Disorders, Edition 4 (DSM-IV) had limited the diagnosis of SAD to children and adolescents, the diagnosis has been extended to include SAD first diagnosed in adulthood in the 5th edition (DSM-V). SAD has serious implications for quality of life and functioning across several areas of life, including work, social interactions, and close relationships. SAD has been described as a gateway anxiety disorder that can lead to a variety of poor mental and physical health outcomes, including excessive worry, sleep issues, excessive distress in social settings, poor academic performance, and somatic complaints. Despite its prevalence, SAD is often underdiagnosed and undertreated. One of the marked differences in children diagnosed with separation anxiety compared to adults is the type of attachment figures involved. In the case of children, the attachment figures are usually adults, such as parents. Adults, in contrast, experience anxiety when experiencing real or anticipated separation from children, spouses, or romantic partners.