Separation Anxiety in Children and Adolescents

Anxiety disorders are among the most common psychological disorders in younger patients, affecting 6% to 20% of developed countries children and adolescents (Walkup et al. 2008). Separation anxiety is the only anxiety disorder restricted to infancy, childhood, or adolescence (APA, 2000). Separation anxiety disorder (SAD) is defined by developmentally inappropriate, excessive, persistent, and unrealistic worry about separation from attachment figures, most commonly parents or other family members. Youths with SAD display distress before separation or during attempts at separation. These children worry excessively about their own or their parents' safety and health when separated, have difficulty sleeping alone, experience nightmares with themes of separation, frequently have somatic complaints, and may exhibit school refusal. Children with separation anxiety disorder exhibit varying degrees of avoidant behaviour that correlate with the severity of their symptoms (Albano et al. 2003). This kind of anxiety in adolescents and schoolchildren significantly interferes with daily activities and developmental tasks. Children with separation anxiety disorder are usually brought to the clinician when SAD results in school refusal or embarrassing somatic symptoms. When analyzing responses to shown images, relative to controls, children with anxiety disorders experience greater negative emotional responses to the presented images, are less successful at applying reappraisals, but show intact ability to reduce their negative emotions following reappraisal. They also may report less frequent use of reappraisal in everyday life (Carthy et al, 2010).