Preparation for Child Psych PRITE and Boards
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(Diagnosis)
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DSM-5 puts it under the umbrella of '''Anxiety Disorders''', and relatedly eliminated the requirement for presence of symtpoms/dysfunction before 18.
 
DSM-5 puts it under the umbrella of '''Anxiety Disorders''', and relatedly eliminated the requirement for presence of symtpoms/dysfunction before 18.
 
* adults can be diagnosed with separation anxiety disorders if the symtpoms persist for at least 6 months.
 
* adults can be diagnosed with separation anxiety disorders if the symtpoms persist for at least 6 months.
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 +
===Comorbidities===
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co-occurring anxiety disorders, such as '''generalized anxiety disorder''' and social anxiety disorder''', are the rule rather than the exception
  
 
==Treatment==
 
==Treatment==

Revision as of 17:34, 18 September 2014

Introduction

Separation anxiety is a normal phase of child development, beginning in the first year of life (6-12 mo) and peaking around 18 months.

  • Separation anxiety that persists past 6 years of age, is generally pathological, or generally signifies a separation anxiety disorder
  • Separation anxiety is distinct from the phenomenon of "stranger anxiety" which peaks in the first year of life, and generally resolves by 24 months.

Epidemiology

Children have a 12-month prevalence of 4%
Adolescents have a 12-month prevalence of 1.4%
DSM-5 recognized that separation anxiety disorder occurs in adults, with estimated 12-mo prevalence of 0.9-1.9%.
Heritability is estimated at 73%, suggesting appreciable genetic contribution to the disorder. (DSM-5)


Diagnosis

Separation anxiety disorders often develop after a loss of a family member, friend, or a pet; it may also be triggered by illness in the family, parental separation, and natural disasters.

The core feature of SAD is excessive fear or anxiety with sepration from home or from attachment figures.

  • in younger children this may manifest as school refusal, difficulty sleeping alone or at friend's house, "clingy" behaviors, tantrums, and nightime illusions and hallucinations.
  • in pre-teens and adolescents, fears about kidnapping of parent, sickness, or accidents emerge.
  • in adults, "home sickness" may be reported as a significant symtpoms, as well as overall difficulty with life transitions (moving to college, getting married). (DSM-5)

DSM changes

DSM-IV classified sepration anxiety under the Disorders of Infancy, Childhood, or Adolescence.

  • criteria call for 1mo of dysfunction beginning before age 18 years.

DSM-5 puts it under the umbrella of Anxiety Disorders, and relatedly eliminated the requirement for presence of symtpoms/dysfunction before 18.

  • adults can be diagnosed with separation anxiety disorders if the symtpoms persist for at least 6 months.

Comorbidities

co-occurring anxiety disorders, such as generalized anxiety disorder and social anxiety disorder, are the rule rather than the exception

Treatment