pediatrics
Separation Anxiety Disorder
Symptoms and Signs of Separation Anxiety Disorder
Like Social Anxiety Disorder in Children and Adolescents , separation anxiety disorder often manifests as school (or preschool) refusal. Dramatic scenes typically occur at the time of separation. Separation scenes are typically painful for both the child and attachment figure (usually the mother but can be either parent or a caregiver). Children often wail and plead with such desperation that the parent cannot leave, resulting in protracted scenes that are difficult to interrupt. When separated, children fixate on reunification with the attachment figure and are often worried that this person has been harmed (eg, in a car accident, by a serious illness). Children may refuse to sleep alone and may even insist on always being in the same room as the attachment figure. Children often develop somatic complaints (eg, headache, stomachache). The child’s demeanor is often normal when the attachment figure is present. This normal demeanor can sometimes give a false impression that the problem is minor. However, some children have persistent and excessive worry about losing the attachment figure (eg, to illness, kidnapping, or death). Separation anxiety is often compounded by a parent’s anxiety, which exacerbates the child’s anxiety; the result is a vicious circle that can be interrupted only by sensitive and appropriate treatment of parent and child simultaneously. 