pediatrics
Separation Anxiety Disorder
Introduction
Separation anxiety disorder is a persistent, intense, and developmentally inappropriate fear of separation from a major attachment figure (usually the mother). Affected children desperately attempt to avoid such separations. When separation is forced, these children are distressfully preoccupied with reunification. Diagnosis is by clinical criteria. Treatment is with behavioral therapy for the child and family and, for severe cases, selective serotonin reuptake inhibitors (SSRIs). (See also Overview of Anxiety Disorders in Children and Adolescents .) Separation anxiety is a normal emotion in children between about age 8 months and 24 months; it typically resolves as children develop a sense of object permanence and realize their parents will return. In some children, separation anxiety persists beyond this time or returns later; it may be severe enough to be considered a disorder. Separation anxiety disorder commonly occurs in younger children and is rare after puberty. Life stresses (eg, death of a relative, friend, or pet; a geographic move, a change in schools) may trigger separation anxiety disorder. Also, some people have a genetic predisposition to anxiety. 