Separation Anxiety Disorder

DSM-V criteria for separation anxiety disorder

The DSM-V characterises separation anxiety disorder as a developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least three of the following symptoms:


  1. Recurrent excessive distress when anticipating or experiencing separation from home or from major attachment figures.
  2. Persistent and excessive worry about losing major attachment figures or about possible harm to them (i.e. illness, injury, disasters or death).
  3. Persistent and excessive worry about experiencing untoward events that may lead to separation from attachment figures (i.e. getting lost, being kidnapped, having an accident or becoming ill).
  4. Persistent reluctance or refusal to go out, away from home, to school, work or elsewhere because of fear of separation.
  5. Persistent and excessive fear of or reluctance about being alone or without major attachment figures at home or in other settings.
  6. Persistent reluctance or refusal to sleep away from home or to go to sleep without being near a major attachment figure.
  7. Repeated nightmares involving the theme of separation.
  8. Repeated complaints of physical symptoms (e.g., headaches, stomach aches, nausea, vomiting) when separation from major attachment figures occurs or is anticipated.

A diagnosis of separation anxiety disorder is warranted if:

  • The fear, anxiety or avoidance persists, lasting at least 4 weeks in children and adolescents and typically 6 months or more in adults;
  • The disturbance causes clinically significant distress or impairment in social, academic, occupational, or other important areas of functioning;
  • The disturbance is not better explained by another mental disorder.


Prevalence of separation anxiety disorder

Separation anxiety is more common in girls.

Studies have shown that separation anxiety disorder is not very stable over time – 44 percent of youngsters showed recovery at a 4-year follow-up. However, some children continue to exhibit problems such as school refusal and maintain difficulties with adjustment.


Comorbidities with separation anxiety disorder

Some children with separation anxiety disorder may also experience a high number of other anxiety-based disorders like phobia and obsessive- compulsive disorder.

Certain symptoms of separation anxiety disorder can appear on the surface as purely physiological ones. For example, a child may experience headaches, stomach aches, nausea and vomiting in anticipation of or upon being separated. Thus, it may not initially be apparent that a child is experiencing separation anxiety.