Childhood Separation Anxiety 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 ten 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 24 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 Effect of Mothers’ Attachment Styles on Separation Anxiety in Children with Autism

This research was designed to determine the effect of the attachment styles of mothers on separation anxiety in children with autism. One hundred forty mothers of children with autism contacted using the convenience sampling method were included in this descriptive and correlational research. The data were collected using a questionnaire containing a sociodemographic form, the Experiences in Close Relationships Inventory (ECRI) and the Separation Anxiety Assessment Scale-Parents’ Version (SAASP). An anxious attachment style among mothers of children with autism was found to exacerbate separation anxiety in those children.

School and separation anxiety in children: the psychotherapeutic value of art therapy

The clinical illustration presented here showcases the psychotherapeutic benefits of art therapy for children experiencing separation anxiety. Its containing quality facilitates the reconstruction of internal and external boundaries and fosters a sense of personal integrity. By stimulating creativity, imagination, and the projection of internal fears, art therapy enables children to process and express their emotions effectively, leading to improved emotional regulation and coping mechanisms. Separation anxiety can give rise to social and academic adaptation difficulties, which are often associated with learning challenges and academic failures. Based on this, we concluded through an experiment that introducing art therapy, as a form of mental health care for these children, is highly beneficial for improving their well-being.

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.

State-Trait and Separation Anxiety Among Mothers with an Only Child Entering Kindergarten

Parents are the first and best teachers for their children. In homeschooling, the level of separation anxiety in kindergarten children is closely related to the level of anxiety in their mothers. The mother's behavior has a greater impact on the child than the father's. Parents' attitudes toward their children, their attitudes toward kindergarten, their own level of education, and their ability to regulate their emotions all affect the level of separation anxiety of children with their mothers. Therefore, it is particularly important to study the anxiety state of mothers when studying kindergarten anxiety in younger children. Since children spend most of their time with their mothers after leaving kindergarten, they chose to study the state-traits and separation anxiety of mothers of only children entering kindergarten". As early as Bowlby's attachment theory, the infant's emotional attachment to the caregiver was mentioned. Hawke et al. argued that, based on Spielberg's theory of state-trait anxiety, the mother's parent-child separation anxiety is a state of infant anxiety caused by short-term separation. When mothers experience occasional separation anxiety, the mother's state emotions include the following three perceived levels: the mother's self-anxiety, the mother's awareness of her child's anxiety, and the mother's anxiety about her child's lack of maternal care.

Recalled Childhood Separation Anxiety in Relation to Sex, Sexual Orientation, and Gender Identity in Thailand

ABSTRACT Same-sex sexual attraction is an evolutionary paradox. It is influenced by genes but also associated with reduced reproduction. An altruistic disposition toward kin could increase relatives’ reproduction, thus addressing this paradox. Developmentally, such a disposition may manifest as anxiety during separation from kin. This hypothesis has been supported among androphilic (i.e. sexually attracted to males) males, but few similar studies of gynephilic (i.e. sexually attracted to females) females exist. We examined recalled childhood separation anxiety in Thailand and employed the largest and most sexually and gender-diverse sample to date (N = 1403). Among heterosexuals, men recalled less concern for parents’ and siblings’ well-being during separation than women. Androphilic males evidenced elevated concern for parents’ and siblings’ well-being during separation, and transfeminine androphilic males known as sao praphet song reported heightened anxiety when separated from parents. Among females, transmasculine gynephilic females known as toms recalled less concern about parents’ well-being during separation than feminine females who are attracted to toms and known as dees. Bisexual women recalled less anxiety when separated from parents than dees and lesbian and heterosexual women. These findings suggest a disposition toward heightened kin-directed altruism is evident in childhood among androphilic males, but not gynephilic females.

Parents' and nurses' perceptions and behaviours of family-centred care during periods of busyness.

Busyness as a construct within modern healthcare is complex and multidimensional. To date, few studies have sought to explore how busyness influences family-centred care. This study explored the influence of busyness on the delivery of family-centred care for nurses and parents. Ethnography was selected as the research design. The study site was a metropolitan tertiary hospital inpatient paediatric unit in Sydney, Australia. Semi-structured interview and non-participant observation techniques were used for data collection. Ten paediatric nurses and 10 parents were interviewed and 40 h of non-participant observations were undertaken. The COREQ was used to report the study. The findings are presented as three key themes: (i) 'Supporting family-centred care' in which participants detail beliefs about the nurse-parent relationships and how despite busyness nurses sought out moments to engage with parents; (ii) 'Being present at the bedside' identified the challenges in optimising safety and how parents adapted their way of being and interacting on the unit; and (iii) 'The emotional cost of busyness' and how this influenced nurse-parent interactions, care delivery and family-centred care. The ethnography has given shape to social understandings of busyness, the complexities of paediatric nursing and family-centred care. The culture of care changed in moments of busyness and transformed parent and nursing roles, expectations and collaborative care that at time generated internal emotional conflict and tension. Given the increasing work demands across health systems, new agile ways of working need to ensure maintenance of a family-centred approach. Strategies need to be developed during periods of busyness to better support collaborative connections and the well-being of paediatric nurses and parents. At an organisational level, fostering a positive workplace culture that shares a vision for family-centred care and collaboration is essential. Parents of sick children admitted to an acute paediatric inpatient ward were invited to be a participant in a single interview. Parents were aware of the study through ward advertisement and informal discussions with the researchers or senior clinical staff. Engagement with parents was important as healthcare delivery in paediatrics is focused on the delivery of family-centred care. To minimise the risk of child distress and separation anxiety, children were present during the parent interview. Whist children and young people voices were not silenced during the interview process, for this study the parent's voice remained the focus. While important, due to limited resources, parents were not involved in the design analysis or interpretation of the data or in the preparation of this manuscript. The data that support the findings of this study are available from the corresponding author upon reasonable request.

Efek Biblioterapi Dalam Menurunkan Kecemasan Pada Anak Usia Sekolah (7 – 12 tahun) Saat Perawatan Di Rumah Sakit

Background: The child has difficulty in understanding why they are sick, hospitalization can cause separation anxiety in children, which includes protest, despair, discharge, loss of control so it needs bibliotherapy. Bibliotherapy is the use of the book as a medium of therapy to minimize stressors, prevent the loss, reduce anxiety, and support children coping. Aims: The purpose of this study was to determine the effect Biblio therapy against anxiety levels in school-age children (7-12 years) in the Children's Room of Blambangan Banyuwangi Hospital. Methods: Pre-experimental research design using the technique of one group pre-post test design. A sample of 20 children with accidental sampling technique. Data obtained from observations before and after giving bibliotherapy, and then do the scoring, tabulating, and statistical tests using Wilcoxon match pair test. Results: Manually obtained calculation number 199> 52 = Ho is rejected and Ha is accepted, meaning that there are differences in anxiety levels before and after biblio therapy which means there is a significant effect of bibliotherapy on anxiety levels in school-aged children (7–12 years) in the Children's Room of Blambangan Hospital Banyuwangi. Conclusions: Billion therapy can be applied as one of the nursing interventions in the hospital to decrease the problem of children to keep children happy and cooperative during hospitalization.

Maternal Labor Force Participation During the Child's First Year and Later Separation Anxiety Symptoms.

Separation anxiety symptoms are frequent among preschool-aged children, but it is also a possible gateway for diagnosis of separation anxiety disorder. Early maternal employment after childbirth can increase the risk for the development of separation anxiety symptoms. From an economic perspective, however, securing employment is one effective strategy to ensure child well-being. This study investigated how mothers' participation in the labor force (vs. maternal leave) and the financial state of families when the child was 5 months old was prospectively associated with separation anxiety symptoms. This study is based on 1,295 Canadian families with children assessed longitudinally from 17 months to age 6 on their levels of separation anxiety. Separation anxiety was measured during face-to-face interviews with the mothers. Maternal labor force participation, financial status, and risk factors were measured at 5 months. Results adjusted for propensity scores and for sample weight revealed that children of working mothers, despite having sufficient income (n = 245, 18.9%), were at higher risk of separation anxiety during early childhood. In contrast, maternity leave was most beneficial for children's separation anxiety, whether they were in a family with sufficient income (n = 950, 73.4%) or temporary low income (n = 100, 7.7%). Children of mothers in maternity leave were at risk of heightened separation anxiety only if they experienced chronic economic hardship. Therefore, maternity leave uptake could help prevent the development of separation anxiety. Providing families with opportunity to care for the baby as their main occupation during this sensitive developmental period could help improve children's mental health.

Effect of two different doses of oral midazolam premedication on separation anxiety in children scheduled for herniotomy

Background: Peri-operative separation anxiety in children adversely impacts on their cognitive function and behavioural outcome. The aim of the study was to assess the effect of two different doses of oral midazolam premedication on separation anxiety in paediatric patients scheduled for herniotomy. Methods: Eighty-four eligible children aged 1-6 years, of American Society of Anesthesiologists (ASA) class I or II, scheduled for herniotomy, were randomized into two groups, A and B, of 42 each after ethical clearance and written parental consent. Children in group A and group B received 0.5 mg/kg and 0.75 mg/kg respectively of oral midazolam flavoured with paracetamol syrup, were observed, and later separated from parents at 30 min post-premedication. Premedicant acceptability was noted, and separation anxiety was assessed using the Richmond agitation sedation scale (RASS). Statistical significance was set at p<0.05. Results: All 84 children completed the study. At 30 min post-premedication, 47.6% in group A and 19.1% in group B had light sedation, while 52.4% in group A and 80.9% in group B were moderately sedated, p=0.0001. Premedicant acceptability and agitation scores between the groups were comparable, p>0.05. Conclusions: Oral 0.5 mg/kg and 0.75 mg/kg midazolam induced desirable sedation in children at the 30th min with comparable lower agitation scores; however, the 0.75 mg/kg dose achieved significantly faster onset and higher level of sedation in a greater proportion of the subjects.

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.

A comparative study of separation anxiety and sleep problems in school-aged children of health professionals during the COVID-19 pandemic

A comparative study of separation anxiety and sleep problems in school-aged children of health professionals during the COVID-19 pandemic

THE RELATIONSHIP BETWEEN EARLY MALADAPTIVE SCHEMAS, SEPARATION ANXIETY AND EMERGING ADULT INDIVIDUATION LEVEL

The aim of this study is to determine the relationship between early maladaptive schemas, individuation, childhood and adulthood separation anxiety. The sample of the study was consisted of 400 emerging adults, 265 (66.3%) women and 135 (33.8%) men, and determined according to the definition of emerging adulthood so the ages of partipants are between 18-25. Sociodemographic Information Form, Young Schema Questionnaire-Short Form 3 (YSQ-SF3), Separation Anxiety Symptom Inventory (SASI), Adult Separation Anxiety Questionnaire (ASAQ) were given to the participants. The data obtained from the scales were analyzed using Pearson Correlation Analysis and Multiple Linear Regression Analysis Stepwise Method. As a result of the study findings, all schema domains were found to be associated with separation anxiety in both childhood and adulthood. It was determined that childhood separation anxiety predicted adult separation anxiety (R=71, R2=.50, p

Comparison of Intravenous Versus Nebulized Dexmedetomidine for Laryngoscopy and Intubation-Induced Sympathoadrenal Stress Response Attenuation.

Nebulized dexmedetomidine has been used for procedural sedation and allaying separation anxiety in children. Literature regarding its use in the attenuation of laryngoscopy and intubation response via the nebulized route is scarce. We evaluated preoperative dexmedetomidine nebulization on the hemodynamic response arising from laryngoscopy/intubation, hemodynamics, analgesic consumption, and postoperative sore throat. The primary objective was to evaluate/compare the hemodynamic effects of preoperative intravenous and nebulized dexmedetomidine on laryngoscopy/intubation and compare the efficacy of the two routes in blunting the sympathoadrenal response. The secondary objective was to evaluate their effects on intraoperative analgesic consumption and incidence and sore throat postoperatively. 120 ASA I & II adult patients undergoing elective surgeries requiring tracheal intubation were randomized to receive intravenous dexmedetomidine (1 µg/kg over 10 minutes) and nebulized dexmedetomidine (1 µg/kg in 3 - 4 mL of 0.9% saline), 30 min before anesthesia induction. Heart rate and non-invasive blood pressure were monitored for 10 min following laryngoscopy and then throughout the surgery. Intraoperative analgesic consumption, postoperative sore throat, and recovery from anesthesia were assessed. No significant hemodynamic difference was found between the two groups till three minutes. Then, the difference turned significant owing to a greater fall in the heart rate and mean arterial pressure in the intravenous group. Nebulized dexmedetomidine exhibited a lesser tendency of hypo/hypertension and brady/tachycardia, while hemodynamics was more stable. There was lesser sore throat and sedation in the nebulized group. Intraoperative analgesic and propofol consumption was comparable between the two groups. Nebulized dexmedetomidine attenuated laryngoscopy and intubation response, although to a lesser extent than the intravenous group in equivalent doses. However, the nebulized route provided greater hemodynamic stability in the intraoperative period and lesser sedation/sore throat postoperatively without an increase in adverse effects. Nebulized dexmedetomidine may provide a more holistic and viable alternative in patients who poorly tolerate hypotension, bradycardia, and sedation.

Phagophobia in A 6-Year-Old Child : Case Report

Introduction: Photophobia or swallowing phobia is a rarely studied clinical entity. Classified as a specific phobia by the DSM-V. Through our clinical case, we highlight the diagnosis difficulty of this clinical entity and the interest of early therapeutic management appropriate to the age of the child. Clinical observation: A 6-year-old female patient was hospitalized in pediatric surgery for esophageal caustic stenosis that required esophageal replacement. Thereafter, the persistence of swallowing disorders was observed while the organic etiological assessment was negative. Manifestations of phobic anxiety were identified starting the first psychiatric consultation. These manifestations were found to be linked to the memory of traumatic events that the patient experienced during the gastro esophageal fibro copy. The diagnosis of phobic disorder was retained and the treatment was essentially based on behavioral therapy. The evolution was globally favorable. Discussion: Photophobia, or swallowing phobia, is an uncommon phobic disorder listed in the 11th edition of the International Classification of Mental Disorders and the DSM-5. The important question before diagnosing this disorder is to determine its psychogenic basis. In most cases, the onset of the disorder follows a swallowing accident, which leads to swallowing phobia, which in turn is considered a particular form of post-traumatic stress disorder. It can also be associated with separation anxiety in children as in our case. Conclusion: Swallowing phobia is considered a specific, non-developmental phobia. Swallowing phobia and other childhood anxiety disorders are closely correlated. Cognitive behavioural therapies have shown favourable responses in most cases.

Virtual Reality Glasses versus Midazolam in Alleviation of Child’s Anxiety during Dental Rehabilitation: Randomized Controlled Clinical Trial

Objective: To evaluate virtual reality glasses versus premedication with oral midazolam, and their effect on separation anxiety and postoperative behavioural changes in children experiencing dental rehabilitation under general anaesthesia. Introduction: Several children suffer anxiety when experiencing dental rehabilitation under general anaesthesia, which may be caused by separation from parents, and negative anticipation of surgical procedures. Midazolam (MDZ) is a generation of Benzodiazepines that have been widely used as a premedication. Whereas distraction is a common technique used to reduce pain and anxiety during short invasive procedures. Methodology: This was a randomized clinical trial; children aged 4-6 years who were healthy, uncooperative, and planned to be treated using general anaesthesia were randomly distributed between two groups (Group I), using the Virtual glasses and (Group II), given oral midazolam. The baseline heart rate (HR) was recorded twice. Ease of separation was assessed for all the participants using the Parental Separation Anxiety Scale (PSAS). The Postoperative behavioural changes were scored using (PHBQ) Questionnaire after 24 hours and 14 days after the operation. Results: Regression analysis showed that the type of intervention was non-significantly associated with the acceptability of separation. Males showed significantly less acceptable separation than females. There was a statistically significant increase in the heart rate readings in both groups when compared before and after separation. The parent-reported child morbidity following the surgery showed no significant difference except when regarding the children “who were upset at mentioning doctors, dentists or hospitals” where (P=0.000). Conclusion: VR and premedication with oral midazolam were both effective strategies for controlling preoperative anxiety in children during parental separation, with lots of advantages when using the VR distraction approach.

Mental health status of children with disorders of sexual development and their correlates.

Disorders of sexual development (DSD) refer to the congenital abnormalities of chromosomes, gonads, or gender anatomy. Children with DSD usually experience more stress. The present study aims to evaluate the mental health status of children with DSD, and to explore the potential relevant factors. We included 30 children with DSD and 30 age- and gender-matched children without DSD as the control group. All the children and their parents completed the scales of the Hamilton Anxiety Scale (HAMA). Children over 8 years old (n = 22) completed the Screen Scale for Child Anxiety Related Emotional Disorders (SCARED), the Depression Self-rating Scale for Children (DSRSC), and the Egna Minnen av Barndoms Uppfostran-own memories of parental rearing practices in childhood. DSD children had significantly higher somatic anxiety, mental anxiety, and total anxiety scores than the control group (p < 0.001). The scores of the SCARED, anxiety, and depression subscales of DSD children were higher than those of control children (p < 0.05 and p < 0.001, respectively). The correlation analysis showed that the score of generalized anxiety was positively related to age and entertainment. The regression analysis showed that age was a major factor that affected generalized anxiety in DSD children, and neuroticism was a major factor of anxiety disorder and separation anxiety in DSD children. Children with DSD have obvious anxiety problems, which are associated with family environmental factors (entertainment, success, and conflicts) and age. It is important to focus emphasis on emotional stability in children with DSD for detecting anxiety-related emotional disorders early.

Attachment Style and Its Relationships with Early Memories of Separation Anxiety and Adult Separation Anxiety Symptoms among Emerging Adults.

Emerging adulthood concerns the transition from adolescence to adulthood. It foresees the separation from the family and the creation of new significant relationships, whereby specific attachment styles might be triggered when facing these challenges. The present study investigates the influence of retrospective memories associated with childhood separation anxiety symptoms upon emerging adults’ romantic avoidant vs. anxious attachment styles including adult separation anxiety symptoms as mediators. Age and gender were included as covariates. A community sample of N = 394 Italian emerging adults (Mage = 23.64, SD = 4.00, 70% females) completed self-report measures. The results showed that the participants presented a greater anxious attachment rather than an avoidant attachment style. Moreover, both adult separation anxiety and the memories of early separation anxiety were positively and significantly associated with anxious attachment and not with avoidant attachment. A mediation model conducted and focused on anxious attachment showed that, although not directly associated, child separation anxiety did show a significant positive indirect effect on anxious attachment as mediated by adult separation anxiety symptoms. Thus, the findings highlighted the influence of adult separation anxiety symptoms and retrospective childhood memories of separation anxiety upon anxious adult romantic attachment, yet not on avoidant attachment style. Clinical implications are discussed and suggestions for future research are provided.

Is adult separation anxiety associated with offspring risk for internalizing psychiatric problems?

Awareness of adult separation anxiety (ASA) is growing, but there is a dearth of knowledge about how separation anxiety aggregates in families. We examined the intergenerational associations of separation anxiety and other forms of internalizing problems in an American community sample of 515 predominantly white children and their parents. Children's separation anxiety (CSA), depression, and other anxiety disorders were modeled as latent factors using diagnoses from interviews and symptom scores from questionnaires completed by mothers, fathers, and children when children were 9 years old and again 3 years later. Parents' separation anxiety was assessed via a questionnaire and parents' other anxiety, depressive, and substance use disorders were assessed with a diagnostic interview when children were nine. Relationships between parents' and children's psychopathology were modeled using s.e.m. Mothers' and fathers' ASA were related to all three psychopathology factors in offspring, over and above other parental disorders, in concurrent and prospective analyses. CSA was also related to maternal depression concurrently and prospectively and to maternal anxiety prospectively. Of all paternal psychopathology variables, only ASA was significantly related to children's psychopathology in either model. Results indicate that parental separation anxiety is an important, but non-specific, risk factor for children's psychopathology. The pathway by which this risk is transmitted may be genetic or environmental, and the observed statistical associations likely also encompass child-to-parent effects.