Separation Anxiety Disorder

Separation anxiety (SA) is nervousness or distress about being separated, or becoming separated, from the home or from an important person (e.g., mother, father) in the child's life. The anxiety experienced by the child impairs his or her ability to function in important areas of life (e.g., school and social settings). To make a diagnosis of separation anxiety, the child must be under 18 years of age at the onset of anxiety and the problem must exist for at least four weeks. The anxiety experienced by the child must be in excess of what is expected for the child's age. For example, it is normal (developmentally) for toddlers to cry or become upset when separated from their mother or father, but children, ages 5 years and older, should be able to separate from their parents for short periods of time (e.g., attending school).

Children with SA are reluctant to attend camp, school, or even sleep over at a friend's house. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition -Text Revision (DSM-IV-TR) (American Psychological Association [APA], 2000), children age six years who are diagnosed with “Early Onset Separation Anxiety” may exhibit noncompliance, aggression, or anger when separation from significant adults is forced. For some SA children, the prospect of being apart from parents at night may result in an insistence that someone stay with them until they fall asleep, demands to sleep with the parents, or nightmares about being lost or abandoned. Physical complaints or arousal such as shortness of breath, heart palpitations, or sweating may accompany an impending separation. When away from home or parents, these children frequently fear that something bad will happen to their parents (i.e., illness, injury or death). As a result, children with SA frequently call home and harbor reunion fantasies.