What is separation anxiety?

Physical and Psychological Factors

Infants are often wary or even fearful when someone other than the usual caregiver approaches them or tries to touch or carry them. This may be partly attributable to anticipation of separation. Furthermore, in the second year of life, negative reactions to strangers may compound toddlers’ concerns about separation from the caregiver.

Self-initiated separations and those that are brief, in familiar settings, and explained by the departing caregiver are less likely to elicit distress, while separations that occur when the child is ill, hungry, or fatigued are more likely to elicit distress. Factors that do not seem to be related to separation distress are gender, birth order, and experience within the normal range for a given culture and economic class. Usually, separation anxiety occurs in children between eight and eighteen months and subsides by about two to three years of age.

Disorders and Effects

Researchers used to think that the intensity of separation distress was an index of the strength of the attachment bond. However, the child’s reaction during reunion with the caregiver is a better indicator of the security of attachment.

Child psychiatrists have described an uncommon disorder (with a prevalence of 3 to 5 percent) called "separation anxiety disorder." This disorder must be distinguished from many other types of disorders that children may have. Because a child is anxious does not mean that separation anxiety disorder is present. The disorder may develop in early childhood for no apparent reason or may develop after a life stress, such as the death of a relative, the birth of a sibling, or a change in school or neighborhood. Gender, low socioeconomic class, and family history of anxiety or depressive disorders appear to be risk factors for separation anxiety disorder. Children with this disorder show excessive anxiety about separation from the caregiver or home that is more characteristic of younger children and therefore developmentally inappropriate. Separation anxiety disorder is typically long lasting and can cause significant disruption to functioning, such as school avoidance, panic attacks, sleep disruptions, physical complaints, excessive worry about losing caregivers, and fear of being left alone. Treatments for separation anxiety disorder may include psychological counseling for the child (either individually or with parents), anti-anxiety medications, family education, or adjustments in parenting.

A relationship may exist between very strong and long-lasting separation anxiety as an infant and separation anxiety disorder in later life, but infant distress about separation is very common, almost universal, and is usually relatively short lived. Thus, there is usually little reason to be concerned about separation anxiety in infancy.

Bibliography

A.D.A.M. Medical Encyclopedia. "Separation Anxiety." MedlinePlus, April 26, 2010.

American Academy of Pediatrics. "Soothing Your Child's Separation Anxiety." HealthyChildren.org, May 11, 2013.

Berk, Laura E. Child Development. 8th ed. Boston: Pearson/Allyn & Bacon, 2009.

Caplan, Theresa. The First Twelve Months of Life: Your Baby’s Growth Month by Month. New York: Bantam, 1995.

Craig, Grace J., Marguerite D. Kermis, and Nancy Digdon. Children Today. 2d ed. Toronto, Ont.: Prentice Hall, 2002.

Leach, Penelope. Your Baby and Child: From Birth to Age Five. London: Dorling Kindersley, 2010.

Mooney, Carol Garhart. Theories of Childhood: An Introduction to Dewey, Montessori, Erikson, Piaget, and Vygotsky. 2d ed. St. Paul, Minn.: Redleaf Press, 2013.

Ollendick, Thomas H., and Carolyn S. Schroeder, eds. Encyclopedia of Clinical Child and Pediatric Psychology. New York: Kluwer Academic/Plenum, 2003.

Porretto, Denise. "Emotion Overload: Understanding Your Toddler's Moods." Health Library, January 3, 2013.