4. Separation Anxiety Disorders.pdf

Separation Anxiety Disorder (SAD)  Separation Anxiety Disorder Overview Separation anxiety is a normal stage of development for infants and toddlers. Young...

Separation Anxiety Disorder (SAD)  Separation Anxiety Disorder Overview Separation anxiety is a normal stage of development for infants and toddlers. Young gels ric auf children often experience a period of separation anxiety, but most children outgrow E Rarely appears at separation anxiety by about 3 years of age.- addesence or adulthood In some children, separation anxiety is a sign of a more serious condition known as separation anxiety disorder, starting as early as preschool age. (SAD) social anxiety disorder  Diagnostic Criteria 1. All Major criteria should be met for diagnosis 2. At least 3 Minor criteria are required to meet the requirement of A - Major criteria A. Developmentally inappropriate and excessive fear or anxiety concerning separation from > - If If the disorder 4. Persistent reluctance or refusal to go out, away from home, to school, to work, or persists to adulthood elsewhere because of fear of separation. 5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings. 6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure. 7. Repeated nightmares involving the theme of separation. 8. Repeated complaints of physical symptoms (e.g., headaches, stomachaches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.  B. The fear, anxiety, or avoidance is persistent, lasting at least 4 weeks in 4 weeks 6 months children and adolescents and typically 6 months or more in adults. - - C. The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning. To diagnose any symptoms as a disorder → they should be clinically significant (interfere with daily life) If not all Major Criteria are met → Separation Anxiety Symptoms NOT Separation Anxiety Disorder uWe should deal with these symptoms without releasing a diagnosis  D. The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism : Psychotic Disorders spectrum disorder; delusions or hallucinations concerning separation in Agoraphobia psychotic disorders; refusal to go outside without a trusted companion in Differential GAD Diagnosis agoraphobia; worries about ill health or other harm befalling significant - Illness Anxiety Disorder > others in generalized anxiety disorder; or concerns about having an illness in illness anxiety disorder. · Important · Prevalence The 12-month prevalence of separation anxiety disorder among adults is 0.9%–1.9%. In children, 6- to 12-month prevalence is estimated to be approximately 4%. In adolescents, the 12-month prevalence is 1.6%. Separation anxiety disorder decreases in prevalence from childhood through adolescence and adulthood and is the most prevalent anxiety disorder in children Dream younger than 12 years. In clinical samples of children, the disorder is equally - common in males and females. In the community, the disorder is more frequent in 3 Clinical females. > Community -  Development and Course Periods of heightened separation anxiety from attachment figures are part of normal early development and may indicate the development of secure attachment relationships (e.g., around 1 year of age, when infants may suffer from stranger anxiety). Onset of separation anxiety disorder may be as early as preschool age and may occur at any time during childhood and more rarely in adolescence.  Risk and Prognostic Factors Environmental Factors. Separation anxiety disorder often develops after life stress, especially a loss (e.g., the death of a relative or pet; an illness of the individual or a relative; a change of schools; parental divorce; a move to a new neighborhood; immigration; a disaster that involved periods of separation from attachment figures). In young adults, other examples of life stress include leaving the parental - home, entering into a romantic relationship, and becoming a parent. Parental overprotection and intrusiveness may be associated with separation anxiety disorder.  physical + psychological Lisenses ↑ General DD / Differential Diagnosis & Specific DD ↳ psychologic Generalized anxiety disorder. Separation anxiety disorder is distinguished disorders from generalized anxiety disorder in that the anxiety predominantly concerns separation from attachment figures, and if other worries occur, they do not predominate the clinical picture. Agoraphobia. Unlike individuals with agoraphobia, those with separation anxiety disorder are not anxious about being trapped or incapacitated in situations from which escape is perceived as difficult in the event of panic- like symptoms or other incapacitating symptoms.  Social anxiety disorder. School refusal may be due to social anxiety disorder (social phobia). In such instances, the school avoidance is due to fear of being judged negatively by others rather than to worries about being separated from the attachment figures. Illness anxiety disorder. Individuals with illness anxiety disorder worry E about specific illnesses they may have, but the main concern is about the medical diagnosis itself, not about being separated from attachment figures.  Psychotic disorders. Unlike the hallucinations in psychotic disorders, the unusual perceptual experiences that may occur in separation anxiety disorder are usually based on a misperception of an actual stimulus, occur only in certain situations (e.g., nighttime), and are reversed by the presence of an attachment figure.  Comorbidity In children, separation anxiety disorder is highly comorbid with generalized - anxiety disorder and specific phobia. In adults, common comorbidities - include specific phobia, PTSD, panic disorder, generalized anxiety disorder, social anxiety disorder, agoraphobia, obsessive-compulsive disorder, and personality disorders.