Separation Anxiety Disorder

Separation anxiety disorder (SAD) is a common disorder of children, and is characterized by extreme anxiety and worry concerning separation from home or from those to whom the individual is attached. It is often first diagnosed in preschool or kindergarten, when the child experiences a separation from home and the “attachment object.” Although some anxiety symptoms may persist, separation anxiety disorder is generally a disorder of childhood, and remits with advancing age.

Clinical Description

Table 8.1 provides criteria for a diagnosis of SAD.

Table 8.1 Diagnosis of Separation Anxiety Disorder

When the child is frightened of being separated he or she will PUSH or NAGS. This is a mnemonic to recall the eight criteria for Separation Anxiety Disorder (three of eight required).
Physical symptoms and complaints with anticipated separation
Untoward event anxiety
Sleep difficulties
Harm to attachment figures a concern
Nightmares
Alone is a big fear
Going to school or out of home difficult
Separation fears
The onset of symptoms must be in childhood, occur for at least 4 weeks, and cause clinically significant impairment.

Adapted from American Psychiatric Association (2000), Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Text revision. Washington, DC. American Psychiatric Association.

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