Separation Anxiety Legal Definition

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Many psychology professionals have suggested that early or traumatic separation of a central caregiver in a child`s life may increase the likelihood of being diagnosed with SAD, school phobia, and depressive disorders. Some children may be more susceptible to SAD because of their temperament, for example, because of their anxiety when they are put in new situations. [19] [20] Epidemiological data show that anxiety disorders often occur in children and adolescents. Overall, lifetime prevalence estimates for children and adolescents for each anxiety disorder vary by approximately 10-20% (Costello et al., 2004). Certain types of anxiety disorders such as panic disorder (PD), specific phobias, social phobias, obsessive-compulsive disorder (OCD), post-traumatic stress disorder (PTSD), acute stress disorder, separation anxiety disorder (SAD), and generalized anxiety disorder (GAD) occur differently during childhood and adolescence. Epidemiological studies show that GAD is the most common, followed by SAD, social phobia and specific phobias. Much less common are PTSD, OCD and PD, with a prevalence of less than 1% in population samples. Taking into account gender differences, research shows that girls are more affected and that the overall sex ratio for anxiety disorders during childhood and adolescence is ∼2:1 (Costello et al., 2004). Untreated anxiety disorders tend to become chronic, with only a minority of adults (12-30%) experiencing spontaneous remission. Adolescents have slightly higher recovery rates and the majority of early anxiety disorders occur in early adulthood. Stress related to separation from home or key endearing people (often in the form of tantrums in otherwise well-behaved children) The median age of onset of SAD is about 7.5 years, and longitudinal studies show that the average duration of SAD is about 3.5 years (Lewinsohn, Holm-Denoma, Small, Seeley and Joiner, 2008). SAD in childhood is most commonly associated with school refusal, with approximately 75% of children with SAD reporting persistent refusal to attend school (Masi et al., 2001). The prognosis of adolescents with SAD varies widely, with many adolescents experiencing stress and impairment in adulthood (Lewinsohn et al., 2008).

SAD in childhood is associated with an increased risk of psychopathology in adulthood, particularly other anxiety disorders (e.g., panic disorder) and depressive disorders (Lewinsohn et al., 2008). Lewinsohn et al. (2008) found that 73.5% of people diagnosed with SAD in childhood developed another form of psychopathology in adulthood, even though they recovered from SAD in childhood, further highlighting the risk of SAD in children. Therefore, prompt treatment of SAD is essential. Anxiety can manifest itself in the same way as other disorders. The intrusive or unwanted thoughts, images, or urges associated with stress in OCD can be mistaken for anxiety. OCD was classified as an anxiety disorder, but has since been classified in its own category in the DSM-5. In addition, the hypervigilance, flashbacks, and emotional dysregulation typical of PTSD can be misunderstood for anxiety symptoms. Like OCD, PTSD has been reclassified from an anxiety disorder to a traumatic and stress-related disorder. In the case of a panic order, the source of the fear is essential.

Anxiety that focuses on separating parents or caregivers can lead to severe anxiety and panic attacks, but does not represent panic disorder due to a lack of anxiety with anticipation of another panic attack. The same distinction must be made for panic symptoms associated with perceived flight difficulties in agoraphobia. Typical grief may also be accompanied by anxiety, but largely focuses on the desire of the deceased or managing the circumstances of the death, rather than separating caregivers. Although a diagnosis of SAD can be made, it is important to note that many children and adults diagnosed with SAD may have a comorbid mood disorder, attention deficit disorder, and other anxiety disorders that require further investigation. [1] [17] Symptoms of separation in children aged 8 to 14 months are normal. Children often become nervous or afraid of unfamiliar people and places, but if the behavior still occurs after the age of six and lasts more than four weeks, the child may have separation anxiety disorder. [55] Approximately 4% of children have this disorder. Separation anxiety disorder is highly treatable, especially if detected early with medication and behavioral therapies.

[44] It is important to help children with separation anxiety identify the circumstances that trigger their anxiety (upcoming separation events). A child`s ability to tolerate separations should gradually increase over time as they are gradually exposed to the feared events. Encouraging a child with separation anxiety disorder to feel competent and empowered and to discuss feelings associated with anxiety-provoking events promotes recovery. Cognitive behavioral therapy (CBT) aims to help children with SAD reduce feelings of anxiety through anxiety-provoking exposure practices and active metacognition to reduce anxious thoughts. [3] Separation anxiety: A developmental phase in which a child is anxious when separated from the primary caregiver (usually the mother). Separation anxiety is normal between 8 months and can last until the age of 14 months. Non-drug treatments are the first choice in treating people diagnosed with separation anxiety disorder. [4] Counselling tends to be the best substitute for drug treatments. There are two different non-drug approaches to treating separation anxiety. The first is a psychoeducational intervention, which is often used in conjunction with other therapeutic treatments. [4] This includes, in particular, educating individuals and their families to be aware of the disorder, as well as advice to parents and advice from teachers on how to help the child.

[4] [43] The second is a psychotherapeutic intervention when previous attempts are not effective. Psychotherapeutic interventions are more structured and include behavioural, cognitive-behavioural, contingency, psychodynamic and family therapy. [4] SAD is associated with an increased risk of developing other mood and anxiety disorders, including panic disorder, agoraphobia, and obsessive-compulsive disorder. [6] Recent research suggests that there may be a significant risk of developing depression or substance use disorders. [4] [6] [18] The Achenbach Empirical Assessment System (ASEBA; provides a comprehensive assessment approach and may be useful in identifying anxiety, depression, social problems, somatic complaints, attention difficulties, and behavioral problems (including rule breaking and aggressive behavior). There are several forms of this measure and, in particular, for youth, this includes the youth self-assessment (which is completed by the youth), the Children`s Behaviour Checklist (completed by the primary caregiver), and the Teacher Report Form (completed by the youth`s teacher). These can be completed individually or in coordination with each other to obtain a more complete overview of the young person`s functioning. These are available from In the case of DACS, separation anxiety disorder appears to work in families with high SAD rates among 1st and 2nd degree parents of children diagnosed with CSAD. This effect also extends to the immediate family, as evidenced by the increase in school refusal among siblings or children of SAD patients. Parental anxiety (general, separation, or specific phobia) was correlated with higher separation anxiety in their children, especially mothers and daughters. Studies on twins have shown a relatively strong genetic component of separation anxiety compared to environmental modeling or attachment figure modeling.

[7] Behavioral inhibition (BI) plays an important role in many anxiety disorders, including SAD. Compared to children without IB, children with IB show more signs of anxiety when they experience a new stimulus, especially those that are social in nature. [30] Children with IB have a higher risk of developing a mental disorder, especially anxiety disorders, than children without IB. [31] CBT consists of three phases: education, use and relapse prevention. [48] In the educational phase, the individual is informed of the different effects that anxiety can have physically and, above all, mentally. Understanding and being able to recognize their reactions will help manage and eventually reduce their overall reaction. [48] The Separation Anxiety Avoidance Inventory (SAAI) is the only diagnostic tool specifically designed for the specific diagnosis of SAD. [1] There is a child version and a parent version, both of which have good interrater and test-retest reliability. [1] A litany of other screenings and assessments for anxiety disorders is helpful in identifying the presence of anxiety disorders and includes the following assessments:[1][8] Some studies have shown that hormonal influences during pregnancy can lead to lower cortisol levels later in life, which can lead to mental disorders such as SAD later in life. It is also important to note any significant changes in the child`s life before or at the onset of the disorder. For example, children who emigrated from another country at a young age may have a stronger tendency to develop this disorder, as they have already felt displaced from a place they have begun to get used to.

It is not uncommon for them to constantly cling to their caregiver when they arrive at the new place, especially if the child is not familiar with the language of their new country. [26] These symptoms may decrease or disappear as the child gets used to the new environment.

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