Separation anxiety disorder
[4] SAD may cause significant negative effects within areas of social and emotional functioning, family life, and physical health of the disordered individual.
Bowlby suggests that infants are instinctively motivated to seek proximity with a familiar caregiver, especially when they are alarmed, and they expect that in these moments they will be met with emotional support and protection.
The child might scream and cry for an extended period of time after his or her parents are gone (for several minutes to upwards of an hour) and refuse to interact with other children or teachers, rejecting their attention.
Just how SAD affects a child's attendance and participation in school, their avoidance behaviors stay with them as they grow and enter adulthood.
[16] Recent research by Daniel Schechter and colleagues have pointed to difficulties of mothers who have themselves had early adverse experiences such as maltreatment and disturbed attachments with their own caregivers, who then go on to develop responses to their infants' and toddlers' normative social bids in the service of social referencing, emotion regulation, and joint attention, which responses are linked to these mothers' own psychopathology (i.e. maternal post-traumatic stress disorder (PTSD) and depression).
[18] Living in a low socioeconomic status has also been shown to contribute to childhood SAD by increasing levels of parental depression.
[19] Many psychological professionals have suggested that early or traumatic separation from a central caregiver in a child's life can increase the likelihood of them being diagnosed with SAD, school phobia, and depressive-spectrum disorders.
[25] Low levels of child effortful control and self-regulation, the abilities to regulate one's emotional, sensory, and behavioral responses and impulses, have also been shown to contribute to the development of SAD.
[25] Some studies have shown that hormonal influences during pregnancy can result in lower cortisol levels later in life, which can later lead to psychological disorders, such as SAD.
For example, children who emigrated from another country at an early age may have a stronger tendency for developing this disorder, as they have already felt displaced from a location they were starting to become accustomed to.
[36] Subsequently, the concept of object permanence emerges—which is when children learn that something still exists when it cannot be seen or heard, thus increasing their awareness of being separated from their caregiver.
Consequently, during the developmental period where an infant's sense self, incorporating object permanence as well, the child also begins to understand that they can in fact be separated from their primary caregiver.
Individuals "typically exhibit excessive distress manifested by crying, repeated complaints of physical symptoms (e.g., stomach aches, headaches, etc.
The Strange Situation process assisted in evaluating and measuring the individual attachment styles of infants between the ages of 9 and 18 months.
The variations in stressfulness and the child's responses are observed and, based on the interaction behavior that is directed towards the caregiver, the infant is categorized into one of four different types of attachment styles: 1.
It is also important to verify that the child who is reporting on their experiences has the cognitive and communication skills appropriate to accurately comprehend and respond to these measurements.
[41] As noted by Altman, McGoey & Sommer, it is important to observe the child, "in multiple contexts, on numerous occasions, and in their everyday environments (home, daycare, preschool)".
In both of the assessments the interviewer depicts a scenario where separation and reunion occur; the child is then told to point at one of the four facial expressions presented.
[4] This specifically involves educating the individual and their family so that they are knowledgeable about the disorder, as well as parent counseling and guiding teachers on how to help the child.
This pattern continues until the child is able to handle being away from their parent in a developmentally typical way that causes them and their caregiver(s) minimal amounts of stress.
[50] When the child undergoing contingency management shows signs of independence or achieves their treatment goals, they are praised or given their reward.
[50] According to Kendall and colleagues, there are four components which must be taught to a child undergoing CBT:[52] In the application phase, individuals can take what they know and apply it in real time situations for helpful exposure.
The results suggested that cognitive therapy for children suffering from separation anxiety (along with social phobia and generalized anxiety) should be aimed at identifying negative cognition of one's own behavior in the threat of anxiety-evoking situations and to modify these thoughts to promote self-esteem and ability to properly cope with the given situation.
[4] The theory behind this technique is that the child's dysfunctional thoughts, attitudes, and beliefs are what leads to anxiety and causes anxious behavior.
[4] Examples of such disordered thoughts include polarized thinking, overgeneralization, filtering (focusing on negative), jumping to conclusions, catastrophizing, emotional reasoning, labeling, "shoulds", and placing blame on self and others.
Medication prescribed for adults from the Food and Drug Administration (FDA) are often used and have been reported to show positive results for children and adolescents with SAD.
Children oftentimes get nervous or afraid of unfamiliar people and places but if the behavior still occurs after the age of six and if it lasts longer than four weeks, the child might have separation anxiety disorder.
[59] SAD contributed to vulnerability and acted as a strong risk factor for developing other mental disorders in people aged 19–30.
For preschool children, high and persistent levels of separation anxiety were shown to predict worse academic achievement, poorer physical health, and higher internalizing symptoms throughout middle-childhood and early adolescence.
[3] Research continues to explore the implications that early dispositions of SAD in childhood may serve as risk factors for the development of mental disorders throughout adolescence and adulthood.
