Childhood Separation Anxiety Disorder Research Articles

Evaluating the Effectiveness of Cognitive-Behavioral Play Therapy on Reducing Separation Anxiety in Boys in the First Grade of Primary School

Background: Separation anxiety disorder (SAD) is one of the most common disorders among children's behavioral problems, which leads to disruption in academic performance, social adjustment, family life, and peer relationships. Cognitive-behavioral play therapy (CBPT) is one of the appropriate treatment methods for correcting children's behavioral problems. It is designed for children aged three to eight. Objectives: Considering the importance of controlling separation anxiety in primary school children, the main aim of this research was to assess the effectiveness of CBPT in reducing SAD in boys in the first grade of primary education. Methods: A total of 30 primary school students with SAD were selected and then divided into the experimental group (15 students) and the control group (15 students) to conduct the present study. For the control group, no intervention was performed, but CBPT was done in eleven sessions for the experimental group. The level of SAD was evaluated in both groups and then compared with each other before and after the intervention. In addition, the level of SAD in both groups was compared between the pre- and post-study stages to assess the effect of CBPT. The statistical analysis of the results was performed using SPSS software version 22 and using relevant tests at the significance level (α = 0.05) Results: The results showed that the average SAD score before the intervention was equal to 78.84 ± 1.26 for the control group and 78.66 ± 1.28 for the CBPT group. The statistical analysis revealed no significant distinction across these average levels (P = 0.975). After the intervention, the average SAD for the control and experimental groups was 77.50 ± 1.65 and 47.75±0.76, respectively, showing a significant difference between the two values (P < 0.001). Conclusions: Based on the findings, CBPT can reduce SAD in primary school children. Therefore, psychologists and educational counselors of elementary school students can recommend using CBPT to treat some behavioral problems of elementary students.

Childhood Separation Anxiety Disorder and Panic Disorder

Childhood Separation Anxiety Disorder and Panic Disorder

The effectiveness of child-centered group play therapy and narrative therapy on preschoolers’ separation anxiety disorder and social-emotional behaviours

ABSTRACT This study examined the effectiveness of child-centered group play therapy (CCGPT) and narrative therapy in reducing separation anxiety disorder (SAD) and boosting social-emotional behaviours in early childhood (2.5-4-year-olds). An 8-week-randomized controlled trial design with three intervention groups, i.e. CCGPT, narrative therapy, and a combination of both interventions (i.e. combined group), and one control group that provided data at a pre-test and post-test, was adopted. A total of 48 children who showed signs of SAD participated in the study. Results showed that compared to the control group, CCGPT and combined group interventions showed a lower separation anxiety level. Children in all three intervention groups showed lower behavioural problems and higher prosocial behaviours than the control group. The findings suggest that the three interventions could be effective selective psychotherapy methods to promote social-emotional competencies. The CCGPT and combined group, particularly, were effective psychotherapy methods for reducing SAD in early childhood.

Effectiveness of Group Therapy of Psychodrama on Reduce the Symptoms of Separation Anxiety Disorder in Children Aged 5 to 9 Years in Zahedan

Effectiveness of Group Therapy of Psychodrama on Reduce the Symptoms of Separation Anxiety Disorder in Children Aged 5 to 9 Years in Zahedan

Separation Anxiety Disorder in Children

Separation Anxiety Disorder in Children

Comparison of Efficacy of Child Cognitive – Behavioral Therapy (CCBT) Versus Family Cognitive – Behavioral Therapy (FCBT) and Mother - Child Attachment Intervention in Reduction of Separation Anxiety Disorder in Children between 7-12 Years Old

Objective: The purpose of this study was to compare and evaluate the effectiveness of child-based cognitive-behavioral therapy (CCBT), family-based cognitive-behavioral therapy (FCBT) and mother-child attachment intervention in reducing separation anxiety in children aged 7 to 12 years. Methods and Materials: The method of this semi-experimental study was pre-test-post-test with a control group and a three-month follow-up. For this purpose, 48 children with separation anxiety disorder were selected by purposive sampling and were divided into four groups of 12 people. The first group received child-based cognitive behavioral therapy, the second group received family-based cognitive behavioral therapy, the third group received mother-child attachment intervention, and the control group did not receive any intervention. The measurement tools of this research include the semi-structured diagnostic interview of mood disorders and schizophrenia for children and adolescents (K-SADS-PL) and Separation Anxiety Scale (Parental Form). The data were analyzed using mixed variance analysis with repeated measurement and Bonferroni's post hoc test. Findings: The findings show that child-centered cognitive-behavioral therapy has been more successful in reducing separation anxiety compared to family-centered cognitive-behavioral therapy and mother-child attachment-centered intervention. Also, family-centered cognitive-behavioral therapy has been more effective in reducing children's separation anxiety compared to mother-child attachment-centered intervention (P<0.05). Conclusion: The results of the present study show that the therapeutic methods used can be effective in the treatment of separation anxiety disorder by psychologists and psychiatrists.

The Impact of Separation Anxiety Disorientation on Children's Social Interaction

Anxiety is a form of the body's response to the environment as a form of pressure and one's inner turmoil. This anxiety can be overcome easily, but in some cases anxiety often occurs excessively, especially in babies who are about to start a long phase of separation from their parents. This journal aims to find out how the social interaction of children with symptoms of separation anxiety disorder. The method in this research is a literature study, namely analyzing journals, books and articles that discuss separation anxiety disorder in children. This neglected anxiety disorder can have an impact on how the child begins to interact in a new environment later. It takes understanding and sensitivity of parents to the child's condition.

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.

Effect of Child-Parent Relationship Therapy on the Severity of Separation Anxiety Disorder in Children: A Clinical Trial with a Parallel Groups Study Design

Effect of Child-Parent Relationship Therapy on the Severity of Separation Anxiety Disorder in Children: A Clinical Trial with a Parallel Groups Study Design

Evaluation of Cognitive-Behavioral Therapy Efficacy in the Treatment of Separation Anxiety Disorder in Childhood and Adolescence: a Systematic Review of Randomized Controlled Trials

Evaluation of Cognitive-Behavioral Therapy Efficacy in the Treatment of Separation Anxiety Disorder in Childhood and Adolescence: a Systematic Review of Randomized Controlled Trials

Investigating the Effect of Implementing a Family-Friendly Program (Based on the MBCT Approach with Parent-Child Interaction) on the Reduction of Parental Anxiety Sensitivity and Separation Anxiety Disorder in Children and Adolescents

This study aimed to investigate the effect of the family-friendly program (FFP) on reducing parental anxiety sensitivity (PAS) and also Separation Anxiety disorders (SAD) in children and adolescents. Subjects in both groups responded to the Screen for Child Anxiety Related Disorder-71 (SCARED-71) (to diagnose separation) and the anxiety sensitivity questionnaire for parents, before intervention (pretest) and immediately after the intervention (posttest). ANCOVA test via SPSS 23 showed that there was a significant difference between the test and control groups in the post-test (p < 0.0001). Teaching FFP affects reducing PAS and also SAD in children and adolescents.

Separation Anxiety Disorder in Panic Disorder Patients with and without Comorbid Agoraphobia

Objective: Previous studies have focused on the relationship between childhood separation anxiety disorder (SAD) and adult panic disorder (PD)-agoraphobia. It is not clear enough whether SAD, which continues into adulthood, is associated with PD with and without comorbid agoraphobia in adult patients. Our primary hypothesis was that PD patients with comorbid agoraphobia had a higher rate of SAD that continues into adulthood than those without agoraphobia. We also hypothesized that adulthood SAD symptoms were more likely to be associated with PD-agoraphobia than PD without agoraphobia. Method: 151 patients who were diagnosed with PD with (n = 106), and without comorbid agoraphobia (n = 45) were compared using Panic and Agoraphobia Scale, Structured Clinical Interview for Separation Anxiety Symptoms, Separation Anxiety Symptom Inventory, Adult Separation Anxiety Questionnaire, and State-Trait Anxiety Inventory. We performed Student’s t-test, Pearson correlation test, and multiple linear regression analysis in this study. Results: PD patients with comorbid agoraphobia were more likely to have SAD both in childhood and adulthood (p = .028), than those without agoraphobia. There were mild to moderate significant correlations between PD severity and state anxiety (p = .002), trait anxiety (p = .006), and SAD in childhood (p = .049), and in adulthood (p = .001). SAD in adulthood (β = 0.278, Exp(B) = 0.136, p = .003), and state anxiety (β = 0.236, Exp(B) = 0.164, p = .012) significantly predicted the severity of PD in patients with comorbid agoraphobia. Conclusion: SAD that continues in adulthood may be related to the severity of PD in patients with agoraphobia. Our findings might provide some evidence of the role of SAD in adulthood in patients with adult-onset PD-agoraphobia.

Prevalence, Comorbidity and Predictor of Separation Anxiety Disorder in Children and Adolescents

Separation Anxiety Disorder(SAD) is one of the earliest anxiety disorders. The effect of this disorder on the performance of children and adolescents reveals the need for awareness of the prevalence and comorbidity of this disorder in each region. This study is a cross-sectional analytical study implemented in all provinces of Iran. The instrument used in this study is the Persian version of the Kiddie Schedule for Affective Disorders and Schizophrenia-Present and Lifetime Version(K-SADA-PL) questionnaire. The total number of participants was 29,699. The overall prevalence of SAD was 5.3%. The comorbidity rate of 65.3% was found between SAD and other psychiatric disorders. Specific phobia and oppositional defiant disorder had the highest comorbidity with this disorder in the studied population. The more prevalence of separation anxiety disorder in the age range of 6-9years old highlights the need for early detection of this disorder and targeting screening programs in childhood and adolescence.

Do Youth with Separation Anxiety Disorder Differ in Anxiety Sensitivity From Youth with Other Anxiety Disorders?

Studies on the relationship between separation anxiety disorder (SAD) in childhood and panic disorder (PD) in adolescence and adulthood have yielded results which suggest a common underlying vulnerability for both disorders. In this study, we examined whether one such possible vulnerability-anxiety sensitivity-differed for youth diagnosed with SAD versus other anxiety disorders. Anxiety sensitivity was assessed using the Childhood Anxiety Sensitivity Index (CASI) in 315 clinic-referred youth (ages 6-17, 113 girls). 145 children (46%) were diagnosed with one or more primary anxiety disorder, including SAD (n = 22), generalized anxiety (GAD) (n = 79), social anxiety (SocA) (n = 55), and specific phobia (SP) (n = 45). Children with SAD reported higher levels of anxiety sensitivity and fears of physical symptoms than children with SP and SocA, but not children with GAD. We speculate that children who have SAD and GAD and high anxiety sensitivity may be more vulnerable to develop PD.

SSRIs Appear Superior to SSNRIs for Pediatric Anxiety, Study Shows

Back to table of contents Previous article Next article Clinical and Research NewsFull AccessSSRIs Appear Superior to SSNRIs for Pediatric Anxiety, Study ShowsMark MoranMark MoranSearch for more papers by this authorPublished Online:5 Apr 2018https://doi.org/10.1176/appi.pn.2018.4a9AbstractThe serotonin system may mature earlier than the noradrenergic system, accounting for differences in how youth respond to selective serotonin reuptake inhibitors (SSRIs) and selective serotonin-norepinephrine reuptake inhibitors (SSNRIs).Selective serotonin reuptake inhibitors (SSRIs) appear to be superior to selective serotonin-norepinephrine reuptake inhibitors (SSNRIs) in the treatment of pediatric anxiety disorders, though both are associated with statistically significant improvement after two weeks, according to a meta-analysis posted February 7 in the Journal of the American Academy of Child and Adolescent Psychiatry. “These results are meaningful to clinicians as they choose which antidepressant class to use when treating anxious youth,” wrote Jeffrey Strawn, M.D., of the University of Cincinnati College of Medicine and colleagues. “Additionally, given the magnitude and trajectory of SSRI response, relative to SSNRI response observed herein, clinicians might preferentially use SSRIs as first-line psychopharmacologic interventions in pediatric patients with anxiety disorders.” Strawn and colleagues searched the literature for prospective, randomized, placebo-controlled trials (RCTs) that evaluated the efficacy of SSRIs or SSNRIs in the treatment of social, generalized, and/or separation anxiety disorder in children and adolescents. Overall, nine double-blind RCTs (1,805 patients) conducted between 1997 and 2014 were included in the analysis. Four SSRIs were evaluated: fluoxetine, fluvoxamine, paroxetine, and sertraline. Three SSNRIs were evaluated: atomoxetine, duloxetine, and venlafaxine. Five studies were federally funded, and four were funded by industry. All studies were conducted in outpatient settings. The primary outcome for these analyses was the change in Pediatric Anxiety Rating Scale (PARS) total score from baseline to endpoint at week 12.Patients taking both SSRIs and SSNRIs improved significantly by week two over those taking placebo and continued to have statistically significant improvement throughout the study period. However, treatment response among those taking SSRIs was statistically greater at week two than among those taking SSNRIs, and that difference remained statistically significant over the subsequent 10 weeks of treatment.Over time, response did not differ between high-dose SSRI treatment compared with low-dose treatment. However, statistically significant improvement occurred earlier (week 2) with high-dose treatment. At week 12, both high-dose and low-dose treatments were associated with significant improvement compared with baseline.Strawn and colleagues said the superiority of SSRIs may be because the pathophysiology of anxiety involves more serotonergic dysfunction relative to noradrenergic dysfunction. Additionally, the serotonin system matures earlier than the noradrenergic system, and this developmental lag in the noradrenergic system may underlie differences in the effectiveness of SNRI antidepressants that mechanistically target norepinephrine and SSRIs that target serotonin. “Our results suggest that antidepressant response in pediatric patients occurs early in the course of treatment and occurs with a greater magnitude and more rapid trajectory with SSRIs compared to SSNRIs,” Strawn and colleagues wrote. “These data raise the possibility that SSRIs should be first-line antidepressants in youth with anxiety disorders and extend prior observations in pediatric patients with anxiety that more serotonergically selective agents may be more effective.” ■“The Impact of Antidepressant Dose and Class on Treatment Response in Pediatric Anxiety Disorders: A Meta-Analysis” can be accessed here. ISSUES NewArchived

A Cross-Cultural Comparison of Parental Perceptions of Childhood Separation Anxiety Disorder Symptoms and Likelihood to Seek Help

This study examined cross-cultural differences in parental interpretations of childhood separation anxiety disorder (SAD) symptoms and their subsequent likelihood to seek help or advice. It also as...

Reappraising Preclinical Models of Separation Anxiety Disorder, Panic Disorder, and CO2 Sensitivity: Implications for Methodology and Translation into New Treatments.

Separation anxiety applies to multiple forms of distress responses seen in mammals during postnatal development, including separation from a caregiver. Childhood separation anxiety disorder is an important risk factor for developing panic disorder in early adulthood, and both conditions display an increased sensitivity to elevated CO2 concentrations inhaled from the air. By interfacing epidemiological, genetic, and physiological knowledge with preclinical animal research models, it is possible to decipher the mechanisms that are central to separation anxiety and panic disorders while also suggesting possible therapies. Preclinical research models allow for environmentally controlled studies of early interferences with parental care. These models have shown that different forms of early maternal separation in mice and rats induce elevated CO2 respiratory sensitivity, an important biomarker of separation anxiety and panic disorders. In mice, this is likely due to gene-environment interactions that affect multiple behavioural and physical phenotypes after exposure to this early adversity. Although several questions regarding the causal mechanism of separation anxiety and panic disorder remain unanswered, the identification and improved understanding of biomarkers that link these mental health conditions under the guise of preclinical research models in conjunction with human longitudinal cohort studies can help resolve these issues.

Separation Anxiety Disorder in School-Age Children: What Health Care Providers Should Know

Separation anxiety disorder (SAD) is the most common childhood anxiety disorder, and it has many consequences, particularly for school-age children. These consequences include excessive worry, sleep problems, distress in social and academic settings, and a variety of physical symptoms that, left untreated, can cause social and academic decline. Pediatric providers routinely see children in the primary care office and have the unique opportunity to diagnose, treat, and manage children with SAD. Despite this, SAD continues to be underdiagnosed and undertreated because of a gap in the literature regarding evidence-based practice guidelines for pediatric providers. The purpose of this article is to discuss the diagnosis and management of SAD in school-age children and highlight the role of pediatric providers in managing separation anxiety.

Identifying Effective Therapeutic Mechanisms in Psychodynamic Parent Work

This case study examines therapeutic mechanisms in the work with the parents of a latency aged child, with child separation anxiety disorder, according to the DSM-5 classification. In this single–case study design, the mechanisms identified are practitioner-researcher’s intervention narratives within a theoretically informed framework that is shaped by the psychodynamic understanding of the causes and treatment for the child separation anxiety disorder. The study evaluates the process and the effectiveness of the practitioner-researcher’s treatment throughout the analysis of 11 sessions with the parents. These intervention narratives modified the often unconscious “aggressive” parental beliefs and attitudes toward the child. They also contributed to the progressive reduction and, finally, extinction of his separation anxiety disorder. The study finally demonstrates that, apart from the intervention on the current relationship dynamics between the parents and the child, parent work involves intervention in the emotional difficulties of the parents as well as intervention focused on the couple relationship problems, especially those that reinforce the separation anxiety of the child. The parents were treated in a Child and Adolescent Community Mental Health Centre in a major urban area in southern Europe, and they consented to the publication of anonymous information of the case.

The Bidirectional Associations Between Psychotic Experiences and DSM-IV Mental Disorders.

While it is now recognized that psychotic experiences are associated with an increased risk of later mental disorders, we lack a detailed understanding of the reciprocal time-lagged relationships between first onsets of psychotic experiences and mental disorders. Using data from World Health Organization World Mental Health (WMH) Surveys, the authors assessed the bidirectional temporal associations between psychotic experiences and mental disorders. The WMH Surveys assessed lifetime prevalence and age at onset of psychotic experiences and 21 common DSM-IV mental disorders among 31,261 adult respondents from 18 countries. Discrete-time survival models were used to examine bivariate and multivariate associations between psychotic experiences and mental disorders. Temporally primary psychotic experiences were significantly associated with subsequent first onset of eight of the 21 mental disorders (major depressive disorder, bipolar disorder, generalized anxiety disorder, social phobia, posttraumatic stress disorder, adult separation anxiety disorder, bulimia nervosa, and alcohol abuse), with odds ratios ranging from 1.3 (95% CI=1.2-1.5) for major depressive disorder to 2.0 (95% CI=1.5-2.6) for bipolar disorder. In contrast, 18 of 21 primary mental disorders were significantly associated with subsequent first onset of psychotic experiences, with odds ratios ranging from 1.5 (95% CI=1.0-2.1) for childhood separation anxiety disorder to 2.8 (95% CI=1.0-7.8) for anorexia nervosa. While temporally primary psychotic experiences are associated with an elevated risk of several subsequent mental disorders, these data show that most mental disorders are associated with an elevated risk of subsequent psychotic experiences. Further investigation of the underlying factors accounting for these time-order relationships may shed light on the etiology of psychotic experiences.