Separetion Anxiety Flashcards
What is the prevalence of Separation Anxiety Disorder (SAD) in children?
Around 5%
SAD is the most common childhood anxiety disorder.
What is the key symptom of Separation Anxiety Disorder (SAD)?
Inappropriate distress or excessive and unrealistic fear upon separation from attachment figures or the home.
What is the most frequent cause of school refusal in young children?
Separation Anxiety Disorder (SAD).
What other psychiatric disorders are frequently associated with SAD?
- Other anxiety disorders
- Depression
- Disruptive behavior disorders.
What should always be the starting point in the treatment of SAD?
Psychoeducation and behavioral management.
What is the initial treatment of choice for SAD when children do not improve with psychoeducation and behavioral management?
Cognitive Behavioral Therapy (CBT).
When is medication indicated in the treatment of SAD?
When CBT achieves no response or partial response, or when the child is significantly impaired.
What is considered the most effective treatment for SAD?
Combination of CBT and medication.
Are there any FDA-approved medications for children and adolescents with SAD?
No, currently no medication is approved.
What type of medication is often used for SAD despite no FDA approval?
SSRIs.
What risks are associated with untreated SAD?
- Elevated risk for other internalizing disorders
- Impairments in educational attainment
- Impairments in social functioning.
What is the cardinal symptom of SAD according to the American Psychiatric Association?
Significant or developmentally inappropriate distress upon separation from attachment figures.
What are the three key characteristics of Separation Anxiety Disorder?
- Excessive and persistent fears or worries before and at the time of separation
- Behavioral and somatic symptoms before, during and after the separation
- Persistent avoidance or attempts to escape the separation situation.
What are common physical symptoms associated with SAD?
- Headaches
- Abdominal pain
- Fainting spells
- Nightmares
- Nausea
- Cramps
- Palpitations.
What situations can trigger symptoms of SAD?
- Change of school
- Starting a new school term
- Changing friends
- Adverse events such as bullying.
What are the DSM-V criteria for SAD regarding fear or anxiety?
Developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached, as evidenced by at least 3 of the 8 following:
* Recurrent excessive distress in separation situations
* Persistent and excessive worry about losing, or about possible harm befalling major attachment figures
*Persistent and excessive worry that an untoward event will lead to separation from a major attachment figure
* Persistent reluctance or refusal to go to school, work, or elsewhere because of fear of separation
* Persistent and excessive fear about or reluctance to be alone or without major attachment figures
* Persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home
* Repeated nightmares involving the theme of separation
* Repeated complaints of physical symptoms when separation occurs or is anticipated..
What is the minimum duration for symptoms to be considered persistent in children and adolescents?
At least 4 weeks in children and adolescents and typically 6 months or more in adults.
What are some differential diagnoses for SAD?
- Autism spectrum disorder
- Psychotic disorders
- Agoraphobia
- Generalized anxiety disorder
- Illness anxiety disorder.
What is the peak onset age for Separation Anxiety Disorder?
Between 7 and 9 years of age.
What is the heritability percentage for SAD according to a large scale twin study?
Around 73%.
What parenting behaviors are considered risk factors for SAD?
- Low parental warmth
- Overprotective behaviors
- Insecure attachment.
- Severe parental discord.
What can be considered as early experiences that contribute to SAD?
- Stressful life events
- Exposure to family violence
- Parent losing a job.
What comorbid conditions are frequently seen with SAD?
- Major depression
- Bipolar disorder
- Attention-deficit hyperactivity disorder.
What should psychoeducation for parents of children with SAD cover?
- Anxiety as a normal emotion
- Factors that may cause or maintain anxiety
- Treatment alternatives and prognosis.
What behavioral management techniques can clinicians recommend for parents?
- Listen empathically
- Keep calm during anxiety
- Teach relaxation techniques
- Praise child’s efforts.
What are the targets of Cognitive Behavioral Therapy (CBT) for SAD?
- Gain insight about anxiety symptoms
- Control worries
- Reduce arousal
- Confront feared situations.
Is medication generally recommended as a first line treatment for SAD?
No.
