Separation anxiety
Separation anxiety is a common emotional response observed in infants and toddlers, characterized by fear or distress when separated from their primary caregiver. Typically onset between eight and eighteen months, this condition is usually transient and subsides by the age of two to three. However, in some cases, it can develop into a more persistent condition known as separation anxiety disorder (SAD), which affects approximately 3 to 5 percent of children. Factors such as stressful life events—like the death of a loved one or changes in the family dynamic—can contribute to the onset of SAD. Symptoms include excessive worry about separation, school avoidance, panic attacks, and disruptions in sleep. While the reactions to separation may vary, they are usually influenced by the child’s emotional state, such as hunger or fatigue, rather than inherent traits like gender or birth order. Treatment options for SAD may include psychological counseling, family education, and, in some cases, medication. Understanding and addressing separation anxiety can help support children through their developmental stages and manage any potential long-lasting effects.
Separation anxiety
Anatomy or system affected: Psychic-emotional system
Definition: Common distress shown in toddlers at the departure of a caregiver that may extend throughout the preschool years
Physical and Psychological Factors
Infants are often wary or even fearful when someone other than the usual caregiver approaches them or tries to touch or carry them. This may be partly attributable to anticipation of separation. Furthermore, in the second year of life, negative reactions to strangers may compound toddlers’ concerns about separation from the caregiver.
Self-initiated separations and those that are brief, in familiar settings, and explained by the departing caregiver are less likely to elicit distress, while separations that occur when the child is ill, hungry, or fatigued are more likely to elicit distress. Factors that do not seem to be related to separation distress are gender, birth order, and experience within the normal range for a given culture and economic class. Usually, separation anxiety occurs in children between eight and eighteen months and subsides by about two to three years of age. According to information provided by Boston Children's Hospital, separation anxiety disorder (SAD) affects around 4 percent of children.
Disorders and Effects
Researchers used to think that the intensity of separation distress was an index of the strength of the attachment bond. However, the child’s reaction during reunion with the caregiver is a better indicator of the security of attachment.
Child psychiatrists have described separation anxiety disorder as uncommon in terms of prevalence, with only about 3 to 5 percent of children presenting with symptoms that qualify for such a diagnosis. The symptoms of this disorder must be distinguished from symptoms of other disorders that children may have. A child presenting with anxiety does automatically mean that separation anxiety disorder is present. The disorder may develop in early childhood for no apparent reason or may develop after a life stress, such as the death of a relative, the birth of a sibling, or a change in school or neighborhood. Gender, low socioeconomic class, and family history of anxiety or depressive disorders appear to be risk factors for separation anxiety disorder. Children with this disorder show excessive anxiety about separation from the caregiver or home, which is more characteristic of younger children and, therefore, developmentally inappropriate. Separation anxiety disorder is typically long lasting and can cause significant disruption to functioning, such as school avoidance, panic attacks, sleep disruptions, physical complaints, excessive worry about losing caregivers, and fear of being left alone. Treatments for separation anxiety disorder may include psychological counseling for the child (either individually or with parents), anti-anxiety medications, family education, or adjustments in parenting.
A relationship may exist between very strong and long-lasting separation anxiety as an infant and separation anxiety disorder in later life, but infant distress about separation is very common, almost universal, and is usually relatively short lived. Thus, there is usually little reason to be concerned about separation anxiety in infancy.
Bibliography
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