Adult Separation Anxiety Disorder Research Articles

Can nomophobia be a contemporary and novel cluster of symptoms of adult separation anxiety disorder?

Objective: The connection between adult separation anxiety disorder (ASAD) and nomophobia has been poorly investigated. The aim of this study is to evaluate whether there is a relationship between ASAD and nomophobia. Method: The sample consisted of 68 university students diagnosed with ASAD and 77 university students without ASAD. All participants were evaluated by a structured clinical interview, Adult Separation Anxiety Questionnaire (ASA), Separation Anxiety Symptom Inventory (SASI), Nomophobia Questionnaire (NMP-Q), and Smartphone Addiction Scale-Short Version (SAS-SV). Result: Participants with ASAD had longer daily phone usage times and had a higher frequency of checking the phone during the day and the rates of carrying a charger than controls. Compared to the control group, participants with ASAD had significantly higher ASA, SASI, NMP-Q, and SAS-SV scores and more severe nomophobia levels. The ASA scores were significantly positively correlated with SASI, NMP-Q, and SAS-SV. Regarding predictors of nomophobia, ASA, SASI, and SAS-SV scores had a positive and significant effect on nomophobia, and predicted nomophobia. Conclusion: Our research adds to the body of knowledge on nomophobia by demonstrating that people with ASAD are susceptible to developing nomophobia. Clinicians should be aware of the association between ASAD and nomophobia, and nomophobia may be an important concept that should be considered in the therapy approach to patients with ASAD.

Risk Factors Relevant to Adult Separation Anxiety Disorder

Separation anxiety disorder was previously often used to describe children; however, the age limit was removed from the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-5) and a new symptom called adult separation anxiety disorder (ASAD) was added to it. Nevertheless, because this is a relatively new field, the risk factors of developing separation anxiety disorder in adults are less clear. This article reviews the definitions and differences of separation anxiety in adults and children and evaluates the risk factors for adult separation anxiety in the literature. These factors include intolerance to uncertainty, sensitivity to anxiety, attachment style, and other mental disorders. This paper describes the effects of these factors on adult separation anxiety and presents limitations of existing research and recommendations for future development in this field. The purpose of this article is to make more people understand what adult separation anxiety is, to distinguish it from children's separation anxiety and to understand what risk factors can affect and cause adult separation anxiety. Another purpose of this article is to help people prevent and intervene in adult separation anxiety disorders.

The impacts of adult separation anxiety disorder on nomophobia

The impacts of adult separation anxiety disorder on nomophobia

Exploring Overlooked Anxiety Disorders: A Study on the Prevalence of Adult Separation Anxiety Disorder and Specific Phobia in the General Population

Objective: The current study aimed to investigate the prevalence of adult separation anxiety disorder and specific phobia in the general population, along with identifying the factors associated with these two disorders. Material and Method: The study was carried out in the Selçuklu district, encompassing 28 of the 34 family health centers selected through a simple random sampling method. The study sample included 1,218 individuals over 18, chosen using a systematic sampling approach by skipping one resident from each neighborhood covered by the family health unit. After collecting the sociodemographic data, face-to-face diagnostic interviews were performed using the Structured Clinical Interviews for Separation Anxiety Symptoms (SCI-SAS) for ASAD and the Structured Clinical Interview for DSM-5 (SCID-5) for specific phobia assessment. Results: The study revealed that the lifetime prevalence of ASAD was 5.9%, with a point prevalence of 1.5%, while the lifetime prevalence of specific phobia was 11.3%. The application rates for the treatment of both disorders were very low and clinicians demonstrated limited recognition of ASAD. ASAD was correlated with female gender, low income, childhood traumatic experiences, migraine presence, and family history of serious illness. On the other hand, specific phobia was associated with female gender and family history of psychiatric disease. Conclusion: Despite the high prevalence of both disorders, the alarming rates of clinical recognition and treatment underscore the need to develop health policies and awareness programs aimed at promoting early diagnosis and treatment.

Dual burden of chronic physical conditions and mental disorders: Findings from the Saudi National Mental Health Survey.

Comorbidities of mental disorders and chronic physical conditions are a common medical burden reported among Western countries. National estimates of such comorbidities among the general population of Arab countries like Saudi Arabia are unknown. This study examined the prevalence of lifetime chronic physical conditions among the Saudi general population with DSM-IV 12-month mental disorders, and the associations with disability in the Kingdom of Saudi Arabia (KSA). The Saudi National Mental Health Survey, a cross-sectional household study - part of the World Mental Health (WMH) Survey Consortium - was conducted between 2013-2016 in the KSA, with 4,001 Saudi citizens aged 15-65 (response rate 61%). The World Health Organization Composite International Diagnostic Interview 3.0 was used to assess prevalence of lifetime chronic physical conditions and 12-month mental disorders; disability was measured in terms of days out of role. The prevalence of any comorbid 12-month mental disorder among those with chronic physical conditions was 24%. Major depressive disorder, social phobia, and adult separation anxiety disorder were the most common comorbid mental disorders across all chronic physical conditions. Gender, education, income, urbanicity, region, and employment were associated with the presence of any chronic physical condition. Respondents with mental / physical comorbidities had 2.97 days out of role (on average) in the last 30 days. Comorbidities of mental disorders and chronic physical conditions are common among Saudis. National efforts are needed to increase awareness of such comorbidities among the general population, and develop prevention and treatment services tailored to the needs of individuals at-risk for comorbidities.

The Association of Dysfunctional Attitudes and Adult Separation Anxiety in Pregnancy: A Cross-Sectional Study.

Background This study aims to examine adult separation anxiety in pregnant women and its relationship with dysfunctional attitudes from the perspective of cognitive theory. Methods The sociodemographic data, Adult Separation Anxiety Questionnaire (ASA-27), and Dysfunctional Attitudes Scale-Revised (DAS-R) questionnaire were utilised to examine the correlation between sociodemographic factors and the ASA and dysfunctional attitudes in women attending antenatal obstetric clinics. Results The study included 190 pregnant women. Of these, 45.8% (n=87) had significant adult separation anxiety disorder (ASAD) symptoms. There was no significant difference between the ASAD (+) and ASAD (-) groups in terms of sociodemographic characteristics (p>0.05). However, a significant association was found between ASAD and the gestational period (p=0.02). DAS-R scores were higher in patients with ASAD symptoms (p<0.001). Positive correlations were observed between DAS-R and perfectionism or achievement and between DAS-R and the need for approval or dependency (p=0.001). DAS-R and gestational week showed potential as predictors of ASAD positivity (Area under the ROC curve (AUC)=0.725 vs. 0.632, respectively). Conclusion Pregnancy can be a sensitive period for the development of separation anxiety in adults. The development and treatment of separation anxiety in adults may benefit from cognitive-behavioural interventions that address dysfunctional attitudes during pregnancy.

Impact of Childhood Trauma and Adult Separation Anxiety Disorder on Quality of Life in Individuals with Schizophrenia.

Childhood trauma and anxiety disorders are common in individuals with schizophrenia. This study aimed to investigate the effects of childhood trauma and adult separation anxiety disorder on the quality of life of individuals with schizophrenia. This cross-sectional study included 111 individuals with schizophrenia and 85 control subjects. The separation anxiety symptom inventory (SASI), adult separation anxiety questionnaire (ASAQ), Positive and Negative Syndrome Scale (PANSS), childhood trauma questionnaire (CTQ), and World Health Organization quality of life questionnaire (WHOQoL-BREF) were administered to the participants. More individuals with schizophrenia than control subjects were unemployed and single (p<0.05). Individuals with schizophrenia scored significantly higher on the SASI, ASAQ, and CTQ (p<0.05), whereas the control subjects scored significantly higher on the WHOQoL-BREF (p<0.05). ASAQ scores had mild positive correlations with total PANSS and PANSS subscale scores, and moderate positive correlations with total CTQ, CTQ emotional subscale scores, and CTQ physical abuse subscale scores. A negative moderate correlation was found between ASAQ and total WHOQoL-BREF scores. Mediation analysis revealed that CTQ scores significantly affected total WHOQoL-BREF and ASAQ scores. The model pathway for ASAQ scores showed a significant direct and indirect effect of CTQ on the total WHOQoL-BREF scores. Childhood trauma predicts adult separation anxiety disorder, which partially mediates the impact of childhood trauma on quality of life in individuals with schizophrenia. Therapeutic interventions for adult separation anxiety disorder in individuals with schizophrenia and a history of childhood trauma may help increase their quality of life.

Relationship Between Adult Separation Anxiety Disorder and Suicide in Patients with Bipolar Disorder

The present study aimed to investigate the comorbidity of Adult Separation Anxiety Disorder (ASAD) and the relationship between this comorbidity and suicide in patients with bipolar disorder (BD). A total of 138 outpatients with BD at remission between the ages of 18-65 years and 63 healthy controls were included in our study. All participants were administered a sociodemographic data form, Hamilton Depression Scale (HMDS), Young Mania Rating Scale (YMRS), Adult Separation Anxiety Questionnaire, and Structured Clinical Interview for Separation Anxiety Symptoms (ASAD-SCI). The age and gender of the participants did not differ significantly between the control group, the BD and BD+ASAD groups. The mean age of the participants was 42.3±11.9 years. When categorized according to gender, 42.3% of the participants were male and 57.7% were female. ASAD was detected in 46.3% of the participants. The suicide attempt rate was significantly higher in the BD and BD+ASAD groups than in the control group. The rate of suicide attempt was significantly higher in the BD+ASAD group than in the BD group. We demonstrated that the comorbidity of ASAD was associated with previous suicide attempts in patients with BD. Recognizing and treating ASAD in patients with BD may reduce suicide attempts in these patients.

The relationships between separation anxiety disorder, childhood traumas, and anxiety sensitivity in a sample of medical students

• SEPAD is very common in early years medical students. • The rate of childhood SEPAD criteria is found as 14.9% (n: 55). • The rate of adult SEPAD criteria is found as 20.1% (n: 74). • Adult SEPAD patients have much more childhood traumatic life experiences than others. • Adult SEPAD patients have higher anxiety sensitivity scores than others. The present article aims to investigate the relationships between Separation Anxiety Disorder (SEPAD), anxiety sensitivity, and childhood traumatic life experiences (CTLE) in a sample of medical students. The sample of this study consisted of 369 young adults. The Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) was applied for all participants by researchers. Participants were asked to fill in the socio-demographic form, Separation Anxiety Symptoms Inventory, Adult Separation Anxiety Questionnaire, Anxiety Sensitivity Index-3, and Childhood Trauma Questionnaire. The rate of those with significant childhood SEPAD is 14.9% (n: 55), the rate of those with adult SEPAD is 20.1% (n: 74) in the present study. A statistically significant difference was found in emotional abuse, sexual abuse, and physical abuse sub-scores between participants who met childhood or adult SEPAD criteria of SCI-SAS and those who did not. Moreover, all anxiety sensitivity scores were significantly higher in both groups who met childhood or adult SEPAD criteria than those who did not meet the childhood or adult SEPAD criteria. A limitation of our study is that since we investigated participants based on retrospective recall of childhood SEPAD criteria, this lead to being subject to memory and reporting biases. Second, we measure anxiety sensitivity and CTLE on scales by self-report, sometimes it can cause misinformation. SEPAD may be diagnosed commonly in a medical student sample. Moreover, CTLE and anxiety sensitivity may have a key role in the progress of SEPAD.

Relationship of behavioral inhibition to separation anxiety in a sample (N = 377) of adult individuals with mood and anxiety disorders

BackgroundBehavioral Inhibition (BI) is an early temperamental trait characterized by shyness, withdrawal, avoidance, uneasiness, and fear of unfamiliar situations, people, objects, and events. The DSM-5 refers to behavioral inhibition as a temperamental factor related to neurodevelopmental conditions in childhood, including attention deficit hyperactivity disorder, selective mutism, and specific phobias; and to its influence on adult anxiety disorders including social anxiety disorder, agoraphobia, and generalized anxiety disorder, but, interestingly, not separation anxiety disorder (SAD). However, there are phenomenological overlaps between BI and SAD. We aimed to explore whether there is a correlation between BI as an early temperamental trait and childhood or adult separation anxiety disorder. MethodsThe study was conducted in 377 consecutive adults (mean age 40.2±12.4 years) outpatients with anxiety and mood disorders as the principal diagnosis, grouped on the presence/absence of a DSM-5 diagnosis of childhood or adult separation anxiety disorder. Separation anxiety was assessed by the Structured Clinical Interview for Separation Anxiety (SCI-SAS) and the Adult Separation Anxiety Checklist (ASA27). Behavioral inhibition was assessed by the Retrospective Self-Report of Inhibition (RSRI). ResultsThe four comparison groups included: 1) 168 patients without childhood or adult SAD, 2) 81 with adult SAD, 3) 97 with both adult SAD and childhood SAD, and 4) 31 with childhood SAD only. The group with both adult and childhood SAD had the highest scores on RSRI total and sub-scale scores. Both groups with adult SAD had significantly higher RSRI scores than the group with only childhood SAD or without SAD. Significant bivariate correlations were found between ASA-27 scores and RSRI scores. Correlations between RSRI scores and measures of anxiety and depressive symptoms were significantly weaker than those on the ASA-27. Regression analyses showed a significant predictive value of RSRI scores on ASA-27 total score, but not of age of onset of SAD. ConclusionsBI has an onset in the very first years of life and may represent a potential developmental endophenotype for later anxiety disorders. Our findings indicate that BI and separation anxiety are connected in individuals with affective and anxiety disorders. This may have important clinical and therapeutic implications for preventive interventions.

Adult Separation Anxiety Disorder in the Geriatric Population with Major Depressive Disorder

Adult Separation Anxiety Disorder in the Geriatric Population with Major Depressive Disorder

Associates of Adult Seperation Anxiety Disorder among University Students: A Case Control Study

Purpose: Separation anxiety is a state of extreme anxiety, felt by an individual in case of separation from attachment figure. It was aimed to investigate attachment styles, temperament traits, childhood trauma and dissociative experiences of university students diagnosed with adult separation anxiety disorder (ASAD). &#x0D; Methods: Sixty five university students, diagnosed to have ASAD by a structured clinical interview were compared with healthy students via˝Adult Attachment Style Questionnaire (AAQ)," "Childhood Trauma Questionnaire (CTQ)," "Temperament Evaluation of Memphis, Pisa, Paris and San Diego Auto-questionnaire (TEMPS-A)," and "Dissociative Experiences Scale (DES)." &#x0D; Results: Twenty two (33.8%) students with ASAD had problems with orientation and getting used to university. According to AAQ, students with ASAD had higher prevalence of insecure attachment styles, and especially high ambivalent attachment styles and to CTQ, students with ASAD had significantly higher scores in all subscales except physical abuse. Overall DES score was higher in students with ASAD compared to the control group. DES score and history of physical disease in the family were independent associates of ASAD. &#x0D; Conclusion: DES score and history of physical disease in the family were independent associates of ASAD among university students. Hence, early awareness of dissociative symptoms and family history might help early identify students with ASAD.

Relationship Between Adult Separation Anxiety and Attachment Styles and Vaginismus

BackgroundVaginismus has an unknown etiology, is comorbid with anxiety, and is the most common sexual dysfunction in sexual dysfunction outpatient clinics in Turkey. AimThis study aimed to determine the frequency of adult separation anxiety disorder (ASAD) and styles of attachment in patients with vaginismus and to investigate its relationship with female sexual dysfunction. MethodsSixty women with vaginismus and 60 healthy controls were compared using the Relationship Scales Questionnaire, Female Sexual Function Index (FSFI), and Adult Separation Anxiety Questionnaire (ASA-27). OutcomesWe report the results of the questionnaires with their implication on the etiology of vaginismus. ResultsSeparation anxiety and fearful and dismissive avoidance attachment style in the vaginismus group were significantly higher than in the control group. Both total FSFI scores and arousal, pain, and satisfaction subscale scores were higher in the control group. Clinical ImplicationsASAD should be evaluated and addressed separately, when necessary, in the treatment of vaginismus. Strengths & LimitationsThe relationship between ASAD and vaginismus has been shown for the first time. Study limitations included the assessment of factors influencing the study results based on self-reporting and possible recall bias. ConclusionAttachment and comorbidity research in vaginismus needs to shift from just reporting disturbances, to identify various clinical variables, such as the severity of the vaginismus, response to therapy, and differences in therapeutic modalities, in terms of outcome. Unlubilgin E, Tetik S, Aksoy I, et al. Relationship Between Adult Separation Anxiety and Attachment Styles and Vaginismus. J Sex Med 2021;18:1752–1758.

Anxiety Sensitivity and Intolerance of Uncertainty as Factors Related to Adult Separation Anxiety Disorder Symptoms

Anxiety Sensitivity and Intolerance of Uncertainty as Factors Related to Adult Separation Anxiety Disorder Symptoms

Portuguese validation of the Adult Separation Anxiety—Questionnaire (ASA-27)

Adult separation anxiety disorder (ASAD) is characterized by developmentally inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached. Despite the high rates of this diagnosis among Portuguese adults, there is a lack of measures to assess it. In this study, we assessed the psychometric properties of a Portuguese adaptation of the Adult Separation Anxiety questionnaire (ASA-27) on a sample of 267 adults (72.7% women) aged 18–80 years (M = 40.5, SD = 13.1). Factor structure, internal consistency, and convergence validity were examined. This study confirmed the single-factor structure of the Portuguese version of ASA-27. Consistency was high for the total sample (ω = .92) and by gender (ω = .93 and 92, men and women groups, respectively). The scale was positively related to the Portuguese version of State-Trait Anxiety Inventory (STAI) (r = .57, p< .001, for both State and trait anxiety scales) and Composite Codependency Scale total score (r = .29, p< .001). In addition, the ASA-27 total score showed incremental validity in the explanation of anxiety measured by STAI. In conclusion, results show that the Portuguese version of the ASA-27 is a reliable and valid measure of ASAD.

Parental Acceptance–Rejection and Adult Separation Anxiety: The Mediation of Adult Attachment Insecurity

Adult separation anxiety disorder (ASAD) is classified under anxiety disorders in Diagnostic and Statistical Manual of Mental Disorders (5th ed.; DSM- 5). However, the reasons for ASAD are uncertain. The relationship between ASAD and childhood experiences is one of the frequently debated issues. The purpose of this study was to develop a model that would examine the mediating roles of insecure attachment dimensions—avoidance and anxiety—in the relationship between adults’ retrospective perceptions of parental acceptance–rejection in childhood and separation anxiety. A total of 1,534 participants completed Parental Acceptance–Rejection Questionnaire, Experiences in Close Relationships–Revised, Adult Separation Anxiety Questionnaire, and personal information form. The results of the structural equation model indicated that insecure attachment dimensions—avoidance and anxiety variables—fully mediated the relationship between perceived parental acceptance–rejection and separation anxiety. These findings shed new light on the relationship between adults’ retrospective perceptions of childhood experiences and adult separation anxiety.

Adult Separation Anxiety Disorder Symptomology as a Risk Factor for Thin-Ideal Internalization: The Role of Self-Concept Clarity

The study of when and how individuals compare themselves against standards has been an enduring focus for clinical and social psychology researchers in efforts to facilitate well-being and health. Our study focused on internalization of the societal thin-ideal standard for feminine attractiveness, a construct that has proven to be very important in women’s psychological health. Although multiple adverse consequences of thin-ideal internalization have been documented, the understanding of variability in the extent of thin-ideal internalization across women (e.g., why do some women strongly internalize thin-ideal standards when others do not?) is much less well developed. This research was conducted to explore the role of adult separation anxiety disorder (ASAD) symptomology and conceptions of the self in young women’s propensity to internalize the thin-ideal attractiveness standard. Results show that elevated ASAD symptoms are associated with greater thin-ideal internalization. A structural equations model demonstrates the reason for this association; young women with higher ASAD symptomology exhibit lower self-concept clarity, which drives greater thin-ideal internalization. This research makes novel practical and conceptual contributions by (a) delineating a new risk factor for the development of thin-ideal internalization, (b) highlighting a previously undocumented vulnerability of women who experience ASAD symptoms, and (c) documenting the relationship between ASAD and lower self-concept clarity. Implications for mental health practitioners are discussed.

Adult Separation Anxiety Disorder Symptomology as a Risk Factor for Thin-Ideal Internalization: The Role of Self-Concept Clarity.

The study of when and how individuals compare themselves against standards has been an enduring focus for clinical and social psychology researchers in efforts to facilitate well-being and health. Our study focused on internalization of the societal thin-ideal standard for feminine attractiveness, a construct that has proven to be very important in women's psychological health. Although multiple adverse consequences of thin-ideal internalization have been documented, the understanding of variability in the extent of thin-ideal internalization across women (e.g., why do some women strongly internalize thin-ideal standards when others do not?) is much less well developed. This research was conducted to explore the role of adult separation anxiety disorder (ASAD) symptomology and conceptions of the self in young women's propensity to internalize the thin-ideal attractiveness standard. Results show that elevated ASAD symptoms are associated with greater thin-ideal internalization. A structural equations model demonstrates the reason for this association; young women with higher ASAD symptomology exhibit lower self-concept clarity, which drives greater thin-ideal internalization. This research makes novel practical and conceptual contributions by (a) delineating a new risk factor for the development of thin-ideal internalization, (b) highlighting a previously undocumented vulnerability of women who experience ASAD symptoms, and (c) documenting the relationship between ASAD and lower self-concept clarity. Implications for mental health practitioners are discussed.

The relationship between separation anxiety and intolerance of uncertainty in pregnant women

Background and aim: Pregnancy is a risky period to develop Adult Separation Anxiety Disorder (ASAD). The aim of this study was to investigate the frequency of separation anxiety in pregnant women, and the relationship of separation anxiety with sociodemographic variables and intolerance of uncertainty.Methods: This study included 310 pregnant women and used the Adult Separation Anxiety Questionnaire (ASAQ) and Intolerance of Uncertainty Scale-Short Form (IUS-12).Results: The average age in pregnant women with ASAD was lower. IUS-12 total score, prospective anxiety, and inhibitory anxiety subscale scores were significantly higher in the ASAD group. There were moderate and statistically significant positive correlations between the ASAD score and the IUS-12 total, prospective anxiety and inhibitory anxiety subscale scores.Conclusion: Intolerance of uncertainty may be an important factor in the mental processes of individuals with separation anxiety. Pregnancy period can be a risky period for developing ASAD. Cognitive behavioral treatments including intolerance of uncertainty may be effective in the treatment of ASAD. There is a need for follow-up studies on the effects of separation anxiety during pregnancy on maternal–fetal health.

Separation Anxiety Blended with Superstitious Belief in an Adult Female: A Case Report in Bangladesh

Introduction: Adult separation anxiety disorder (ASAD) has been reported in the psychiatric literature with lifetime prevalence of 6.6%, which is associated with different comorbidities. Here, we report an adult Bangladeshi female presented with ASAD for her pets with superimposed superstitious beliefs. Case Presentation: A 27 year- old- female presented with excessive unusual preferences and preoccupation with her 2 cats for the last 4 years. She also presented with severe anxiety, fear, and sleep disturbances with bad dreamsrelated to her pets. She had persistent fear of losing her pets and suspected that people including her family members might harm them. She was increasingly unwilling to keep herself away from the cats, resulting in her social isolation and limitation in other activities. She married 2 years ago after long period of affairs, but refused to stay in her in-laws residence without her pets and she even avoided her husband. She behaves with pets as if they are her children and does not want to have children anymore. Conclusions: Extreme pet preference with avoidance of usual family life contrasting the cultural belief encouraged the authors to draw the attention of scientific community.