Child and adolescent mental health

Separation anxiety disorder

What is generalised separation anxiety disorder?

From around the age of 6 months and through the early toddler/preschool years, most  children experience some degree of anxiety about being apart from  their main caregivers. However, when it returns during the school years, separation anxiety disorder may be considered. This is excessive fear or anxiety about separation from home or attachment figures. This fear or anxiety is more extreme than would be  expected of their chronological age, and affects the child's development, education and family life.

Symptoms of separation anxiety disorder

  • Refusing to sleep alone

  • Repeated nightmares with a theme of separation

  • Lots of worry when parted from home or family

  • Excessive fear about getting lost from family

  • Refusing to go to school

  • Fearful and reluctant to be alone

  • Frequent stomach aches, headaches, feeling or being sick

  • Muscle aches or tension

  • Excessive worrying about safety of self or family member

  • Excessive worrying about or when sleeping away from home

  • Being very clingy, even when at home

  • Panic or temper tantrums at times of separation from parents or caregivers

Case studies

Allison is a 7-year-old girl who lives with her parents and two younger siblings. Allison has missed numerous days of school since starting kindergarten, and is becoming increasingly upset about going to school; insists that her mom be present when she goes to birthday parties or on play dates; wants her mum to be in sight at all times if they go to the park; has nightmares about monsters coming “to get her and take her away”; and worries about her parents being harmed in an accident or being beaten up by burglars. This case study is presented in the form of a podcast.

James is a 13-year-old boy whose parents have recently separated. James’s parents lovingly refer to James as Velcro-boy as he demands that he be in sight of his parents at all times when at home. When younger he used to join his parents in the middle of the night to sleep with them, but since their separation they insist he sleeps in his own room all night. However, each parent often finds him curled up outside the bedroom door in the morning. James complains of stomachaches and feeling ill, and has missed a few days of school this semester, spending the day with a parent at their work.  James prefers to do things with his parents more than with his friends and refuses sleepover invitations. This case study is presented in the form of a podcast.

The Reynolds adopted Serena as an infant five years ago. She has been a bright, happy and well-adjusted five-year-old, who has had an easy time in day care and preschool. However, Serena’s parents have become increasingly concerned about her over the past few months since she started Kindergarten, because several weeks after school began, Serena started complaining of stomach aches and feeling “bad”. In addition, she was having nightmares and refusing to sleep alone, and consequently was far more clingy than usual.

Web pages and web pages

Anxiety Canada™ is a leader in developing free online, self-help, and evidence-based resources on anxiety and anxiety disorders and promotes understanding about anxiety and anxiety disorders  in children, young people and adults. They have a page dedicated to separation anxiety in children and adolescents, including a video which provides valuable information about how separation anxiety affects children and youth, and four effective interventions that can offer relief not only for your child, but for the entire family

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HelpGuide is an American non-profit mental health and wellness website. Our mission is to provide empowering, evidence-based information that you can use to help yourself and your loved ones. The page on separation anxiety explains the difference between normal separation anxiety and separation anxiety disorder and, If your child’s anxieties get in the way of school or other activities, suggests steps that can help to make the separation process easier.

Diagnostic criteria

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