Separation Anxiety: by Nidhi Dudhedia Mugdha Keskar Mohammed Sihan Shefali Kunwar

SEPARATION
ANXIETY
By Nidhi Dudhedia
Mugdha Keskar
Mohammed Sihan
Shefali Kunwar
M o n d a y 1 8 / 11
What Is Anxiety?
Intense, excessive and
persistent worry and fear about
everyday situations.
Fast heart rate, rapid

breathing, sweating and
exhaustion may occur.
Anxiety disorders form a

category of mental health
diagnoses that lead to
excessive nervousness, fear,
apprehension and worry.
What Is Separation
Anxiety?
A disorder in which a child
becomes excessively anxious
when separated from parents.
Children are especially

prone to separation
anxiety during times of
stress.
5
Prevalence
 Anxiety Disorders as a whole are
the most common psychiatric
disorders in children and
adolescents, with a reported
prevalence ranging from 6 to 18%.
 More than 1 million cases per year
in India.
 Among 11-year-old children from
the general New Zealand
population was found a 1-year
rate of 3.5% for SAD. In the same
population three years later, the
prevalence of SAD decreased to
2%
Vulnerability:
1. Genetic Influence
2. Gender
3. Temperament
4. Family-Parent/Child
Attachment
5. Environmental changes
6.Economical factors
7
Diagnostic Criteria,
Symptoms And
Co-morbidity
Diagnostic Criteria And
Duration
 They experience recurrent excessive distress when
separation from home or major attachment figures is
anticipated or occurs.
 They worry about the well-being or death of attachment
figures, particularly when separated from them, and they
need to know the whereabouts of their attachment figures
and want to stay in touch with them.
 Individuals with SAD are reluctant or refuse to go out by
themselves because of separation fears.
 Duration:
 Must persist for at least four weeks
 Must present itself before a child is eighteen years of age to be
diagnosed as SAD in children
 Although now, SAD can be diagnosed in adults with a duration
typically lasting six months.
9
Symptoms:
In case of children:
Unable to stay or go to a room all by themselves
May display “clinging” behaviour, staying close to or
“shadowing” the parent around the house
Also requiring someone to be with them when going to
another room in the house.
Reluctant or refuse to attend camp, sleep at friends’
homes, or go on errands.
Adults may be uncomfortable when travelling
independently (e.g., sleeping in a hotel room)
Physical Symptoms: headaches, abdominal complaints,
nausea, vomiting
Cardiovascular Symptoms: palpitations, dizziness, feeling
faint.
10
Case Study And Causes
Nadine Mortimer, 24
 Diagnosed when she went to a
clinician at age 24 when her parents Clear signs of SepAD when she was
decided to join Peace Corps. young-
 Father died when she was very • Impairment of functioning
young. • Couldn’t attend school own her
 Mother’s response was stoic, she own
remarried within a year. • Vomited at the mere thought of a
 First day of first grade new school new school year
year. No social life- sleepovers with
 Withdrawn and home-schooled after friends or going out for events
a few weeks of second grade.
Tracking her mother on GPS calmed
 Was reading and solving 12th grade down her anxiety
math in 10th grade.
Panic attack when phone battery
 Asked for a smart phone with GPS
died
Causes :
Genetic Influence: Stress
• Parental Anxiety disorder • Environmental:
• Switching schools
• Exposure to negative life events
Gender • Change in routine or surroundings
Family- Parent/ Child Attachment: • Family:

• Overprotective parent • Death of a family member or pet
• Insecure Attachment • Change in family structure (Divorce
or remarriage)
• Illness/ Lack of adequate rest
Co-morbidity
Co-morbidity:
 In Children, separation
anxiety is highly
comorbid with:  In Adults:
 Generalized Anxiety  Specific Phobia
Disorder
 PTSD
 Specific Phobia
 Panic Disorder
 Generalized Anxiety
Disorder
 Social Anxiety Disorder
 Agoraphobia
 Obsessive Compulsive
Disorder
 Personality Disorders
15
“ Some Basic Do’s And Don’ts Of
Helping Children With
Separation Anxiety
DO’s DON’Ts
Start Talking, Psycho-education, Children’s Introduce the idea

books
Go overboard
Familiarise school environment
Linger too long
Create a goodbye routine
Sneak out when they’re not looking
Appear calm and in control
Lure them with rewards or threaten them
Help them feel comfortable with their
emotions with consequences
Help them talk to themselves and reassure Show indifference to the child’s tears
them
Treatment options for
Separation Anxiety
Disorder
With Professional Help:
Behavioural Interventions: Pharmacological Treatment:

Systematic desensitization SSRIs
Flooding implosive therapy TCAs
Benzodiazepines
Contingency management
Buspirone
Modelling
Group Play Therapy
CBT
Art Therapy
Parent-Child Interaction therapy
Child Directed Psychotherapy or Talk therapy
Bravery Directed
Parent Directed
THANK YOU!
Nidhi Dudhedia
Mugdha Keskar
Mohammed Sihan
Shefali Kunwar

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SEPARATION

Fast heart rate, rapid

Anxiety disorders form a

Children are especially

Family- Parent/ Child Attachment: • Family:

Start Talking, Psycho-education, Children’s Introduce the idea

Behavioural Interventions: Pharmacological Treatment:

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