Childhood Separation Anxiety Research Articles

The Validity and Reability of Turkish Version of Separation Anxiety Symptoms Inventory and Adult Separation Anxiety Questionnaire

The aim of this study is to evaluate the validity and reliability of Separation Anxiety Symptoms Inventory (SASI) that assess childhood separation anxiety retrospectively and Adult Separation Anxiety Questionnaire (ASA). The study sample included a group of 410 participants comprised of 282 adult psychiatric outpatients with anxiety and/or major depressive disorders according to DSM-IV criteria and 128 nonpsychiatric control subjects. The presence of psychiatric disorders was determined by using the M.I.N.I. (Mini International Neuropsychiatric Interview). Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS), Separation Anxiety Symptoms Inventory (SASI), Adult Separation Anxiety Questionnaire (ASA), Panic Disorder Severity Scale (PDSS), "Sensitivity to Separations" subscale of Panic Agorapfobic Spectrum Scale (PAS-SR), Anxiety Sensitivity Index (ASI) were also given. The validity assessments of the instruments revealed that SASI and ASA discriminated the psychiatric patients from control subjects. Both instruments displayed high correlation with SCI-SAS and PAS-SR, a moderate correlation with ASI and PDSS. Factor structure assessments revealed the existence of 3 factor for SASI and 5 factor for ASA. Both SASI and ASA has a high level of internal consistency (Cronbach alfa coefficients are 0.89 and 0.93 respectively) and their test-retest reliability is fairly good. Turkish versions of SASI and ASA were found to be valid and reliable. Results indicate that those instruments can be used in clinical studies for surveying adult separation anxiety disorder and determining its severity.

P01-142 - Adult separation anxiety in patients with complicated grief: relationship with post traumatic stress versus mood spectrum symptomatology

IntroductionAround 9–20% of bereaved individuals experience symptoms of complicated grief (CG) associated with significant distress and impairment. Increasing research has been focused on identifying the distinctive set of psychiatric symptoms that characterize this condition with respect to major depression, corroborating the need to include this syndrome in the forthcoming DSM-V as a distinctive diagnosis. Vulnerability to CG has been rooted in attachment disturbances and authors reported that symptoms of separation anxiety in childhood should be considered as predictors of CG onset in adulthood.ObjectivesTo date no study explored symptoms of adult separation anxiety among patients with CG with respect to healthy control subjects (HC).AimsTo explore adult separation anxiety and mood spectrum symptoms in patients with CG with respect to HC.Methods53 patients with CG and 50 control subjects were recruited, Department of Psychiatry, University of Pisa. Assessments: SCID-I/P, the Inventory of Complicated Grief (ICG), the Adult Separation Anxiety Questionnaire (ASA-27), the Work and Social Adjustment Scale (WSAS), the Impact of Event Scale (IES) and the Mood Spectrum-Self Report (MOODS-SR) lifetime version.ResultsPatients with CG reported significantly higher scores on the MOODS-SR, ASA_27, IES and WSAS with respect to controls. The scores on the ASA_27 were more strongly associated with IES scores with respect to other scales.ConclusionsOur results suggest a correlation between adult separation anxiety and CG onset after the loss of a loved one in adulthood, with a possible correlation to a post-traumatic stress symptomatology. Further studies are needed.

Wie entwickeln sich stationär behandelte trennungsängstliche Kinder?

Separation anxiety in children with severe school refusal evokes often worry about the future with regard to professional career and social integration. This study highlights the native outcome of inpatient children with separation anxiety disorder. 18 of 24 children, who required at the age of 6-13 years between 1996-2002 inpatient treatment because of separation anxiety disorder were assessed at follow up. Diagnostic Interview for Mental Disorders in Children and Adolescents (Unnewehr et al. 2005) was used and academic and social outcome was explored. The follow-up time ranged from 4.3 to 11.1 years (average 7.1 years). Mean age was 18.4 years at time of follow-up. We found at least one clinical psychiatric diagnosis in one third of all patients at follow-up. Even more of the formerly inpatients reported subthreshold psychic symptoms (55%). The mental outcome was strongly related to comorbid diagnosis at time of inpatient care. Estimated remission rate for separation anxiety disorder was high (89%). The results revealed an important shift of diagnosis to social phobia in one third of cases. There was no incidence of agoraphobic or panic disorders. The majority of young people considered academic outcome satisfactory but reported pronounced problems in social integration. The mental stress of young people with a former severe separation anxiety after an average time of seven years was high, especially for social phobic symptoms. The results are discussed in view of further therapeutic implications.

Separation Anxiety in Feminine Boys: Pathological or Prosocial?

Previous research has found that boys who exhibit Gender Identity Disorder in Children (GIDC) also commonly exhibit elevated traits of childhood separation anxiety. Here, we review recent cross-cultural, nonclinical research that suggests elevated childhood separation anxiety is simply a component of the more general pattern of femininity exhibited by pre-androphilic males (i.e., biological males who are sexually attracted to adult males in adulthood). Whereas clinical perspectives have tended to characterize the co-occurrence of femininity and elevated childhood separation anxiety as psychopathological, we propose an alternate perspective that views this co-occurrence as having a prosocial basis. Specifically, we argue that elevated childhood separation anxiety is a developmental precursor of cognitive biases that evolved to facilitate increased kin-directed altruism in androphilic males. We also detail findings concerning personality and behavioral characteristics of male androphiles that are consistent with this evolutionarily minded perspective. Possible clinical implications that arise from this evolutionarily minded perspective are also discussed.

Recalled Separation Anxiety and Gender Atypicality in Childhood: A Study of Canadian Heterosexual and Homosexual Men and Women

The current study tested the hypothesis that elevated childhood separation anxiety is associated with female-typical childhood behavior and identity by comparing retrospective reports of heterosexual and homosexual men and women (N=399). Participants completed measures of recalled childhood separation anxiety and childhood gender-atypical behavior and identity. Heterosexual men reported significantly less childhood separation anxiety relative to all other groups. Childhood gender atypicality was significantly positively correlated with childhood separation anxiety among homosexual men, but not among members of other participant groups. Discussion focused on the implications of these findings for the proposed hypothesis as well as future directions for research examining the bases of developmental associations among sex, sexual orientation, gender atypicality, and childhood separation anxiety.

Parent–child DRD4 genotype as a potential biomarker for oppositional, anxiety, and repetitive behaviors in children with autism spectrum disorder

The primary objective of the present study was to examine whether a combination of parent-child DRD4 genotypes results in more informative biomarkers of oppositional, separation anxiety, and repetitive behaviors in children with autism spectrum disorder (ASD). Based on prior research indicating the 7-repeat allele as a potential risk variant, participants were sorted into one of four combinations of parent–child genotypes. Owing to the possibility of parent-of-origin effects, analyses were conducted separately for mother–child (MC) and father–child (FC) dyads. Mothers completed a validated DSM-IV-referenced rating scale. Partial eta-squared (ηp 2) was used to determine the magnitude of group differences: 0.01–0.06 = small, 0.06–0.14 = moderate, and > 0.14 = large. Analyses indicated that children in MC dyads with matched genotypes had the least (7−/7−) and most (7+/7+) severe mother-rated oppositional-defiant (ηp 2 = 0.11) and separation anxiety (ηp 2 = 0.19) symptoms. Conversely, youths in FC dyads with matched genotypes had the least (7−/7−) and most (7+/7+) severe obsessive-compulsive behaviors (ηp 2 = 0.19) and tics (ηp 2 = 0.18). Youths whose parents were both noncarriers had less severe tics than peers with at least one parental carrier, and the effect size was large (ηp 2 = 0.16). There was little evidence that noncarrier children were rated more severely by mothers who were carriers versus noncarriers. Transmission Disequilibrium Test analyses provided preliminary evidence for undertransmission of the 2-repeat allele in youths with more severe tics ( p = 0.02). Parent genotype may be helpful in constructing prognostic biomarkers for behavioral disturbances in ASD; however, findings are tentative pending replication with larger, independent samples.

DSM-IV criteria for childhood separation anxiety disorder: Informant, age, and sex differences

Background The present study examines frequency of DSM-IV symptom and diagnostic criteria for separation anxiety disorder (SAD) by informant, age, and sex. Methods Children aged 4–15 years with a primary DSM-IV diagnosis of SAD ( N = 106) were assessed using structured diagnostic interviews (Kinder-DIPS; DSM-IV-TR Version). Frequency of DSM-IV symptom and diagnostic criteria were examined as a function of informant and child characteristics, along with impairment and distress ratings. Results The most frequently reported symptoms were separation-related distress, avoidance of being alone/without an adult and sleeping away from caregivers or from home, with nightmares the least frequently endorsed criterion. Child report did not yield any significant sex or age differences. However, parent report revealed greater reluctance or avoidance of school attendance for girls than boys, and for younger children (<8 years). Parent report indicated greater symptom-related impairment than child report, and the number of symptoms was correlated with impairment based on parent report, and with distress based on child report. Conclusions The primary indicators of SAD appear to be separation distress, avoidance of being alone, and sleeping away from caregivers. Findings suggest that parents may be best placed to determine impairment, while children may be the most accurate reporters of more covert internal distress. Implications for clinicians are that reports from multiple informants should be used to gain the most comprehensive information about childhood SAD.

Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders

To evaluate the frequency and clinical correlates of adult separation anxiety disorder in a large cohort of patients with mood and anxiety disorders. Overall, 508 outpatients with anxiety and mood disorders were assessed by the structured clinical interview for diagnostic and statistical manual (IV edition) axis I disorders for principal diagnosis and comorbidity and by other appropriate instruments for separation anxiety into adulthood or childhood. Overall, 105 subjects (20.7%) were assessed as having adult separation anxiety disorder without a history of childhood separation anxiety and 110 (21.7%) had adult separation anxiety disorder with a history of childhood separation anxiety. Adult separation anxiety was associated with severe role impairment in work and social relationships after controlling for potential confounding effect of anxiety comorbidity. Adult separation anxiety disorder is likely to be much more common in adults than previously recognized. Research is needed to better understand the relationships of this condition with other co-occurring affective disorders.

Comorbidity of anxiety disorders in schizophrenia: relationship with sociodemographic and clinical variables

Objective: In this study, we aimed to investigate the frequency of comorbidity of anxiety disorders and schizophrenia and to assess its relation with sociodemographic and clinical variables Methods: One hundered five patients diagnosed as having schizophrenia according to DSM-IV were recruited from Bakirkoy Research and Training Hospital for Psychiatry, Neurology and Neurosurgery, Treatment Education and Research Center for Psychotic Disorders. The data from the participants were collected using sociodemographic data form, Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, Positive and Negative Syndrome Scale (PANSS), Hamilton Anxiety Rating Scale (HAM-A), Barnes Akathisia Rating Scale (BARS). The collected data has been evaluated by using SPSS 10.0. Results: Among the participants, 23,80% (n=25) had no anxiety disorders whereas 47,61% (n=50) had diagnosis for more than one anxiety disorder; 4,76% (n= 5) had panic disorder, 0,95% (n=1) had obsessive-compulsive disorder, 0,95% (n=1) had agorophobia, 4,76% (n=5) had social anxiety disorder, 14,28% (n=15) had special phobia, and 2,85% (n=3) had anxiety disorder otherwise unspecified as comorbid diagnosis along with schizophrenia. Anxiety symptoms were more frequent in patients with a story of childhood separation anxiety, school phobia and childhood maltreatment. Conclusion: These results emphasize the importance of screening for comorbid anxiety disorders in the prognosis and treatment of schizophrenia and display the need for new contemporary treatment modalities.

The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic

BackgroundAdult separation anxiety disorder (ASAD) has been identified recently, but there is a paucity of data about its prevalence and associated characteristics amongst anxiety patients. This study assessed the prevalence and risk factor profile associated with ASAD in an anxiety clinic.MethodsClinical psychologists assigned 520 consecutive patients to DSM-IV adult anxiety subcategories using the SCID. We also measured demographic factors and reports of early separation anxiety (the Separation Anxiety Symptom Inventory and a retrospective diagnosis of childhood separation anxiety disorder). Other self-report measures included the Adult Separation Anxiety Symptom Questionnaire (ASA-27), the Depression, Anxiety, Stress Scales (DASS-21), personality traits measured by the NEO PI-R and the Work and Social Adjustment Scale. These measures were included in three models examining for overall differences and then by gender: Model 1 compared the conventional SCID anxiety subtypes (excluding PTSD and OCD because of insufficient numbers); Model 2 divided the sample into those with and without ASAD; Model 3 compared those with ASAD with the individual anxiety subtypes in the residual group.ResultsPatients with ASAD had elevated early separation anxiety scores but this association was unique in females only. Except for social phobia in relation to some comparisons, those with ASAD recorded more severe symptoms of depression, anxiety and stress, higher neuroticism scores, and greater levels of disability.ConclusionsPatients with ASAD attending an anxiety clinic are highly symptomatic and disabled. The findings have implications for the classification, clinical identification and treatment of adult anxiety disorders.

Maternal Daily Diary Report in the Assessment of Childhood Separation Anxiety

The current study evaluated the feasibility and validity of a parent-report measure of separation anxiety, the Separation Anxiety Daily Diary (SADD). Mother and child participants consisted of three groups: 96 children (aged 4–15 years) with separation anxiety disorder, 49 children with “other” anxiety disorders, and 43 healthy controls. The SADD assesses the frequency of anxiety-provoking and non-anxiety-provoking separations, along with associated parental anxiety, thoughts, child behaviors, and corresponding parental reactions. The SADD demonstrated acceptable compliance and convergent validity with hypothesized measures. Substantial improvement in the prediction of diagnostic group membership was shown when SADD items assessing child symptoms were added to information gathered from a separation anxiety symptom questionnaire.

Do family mealtime interactions mediate the association between asthma symptoms and separation anxiety?

Respiratory problems have been shown to be associated with the development of panic anxiety. Family members play an essential role for children to emotionally manage their symptoms. This study aimed to examine the relation between severity of respiratory symptoms in children with asthma and separation anxiety. Relying on direct observation of family interactions during a mealtime, a model is tested whereby family interactions mediate the relation between asthma severity and separation anxiety symptoms. Sixty-three children (ages 9-12 years) with persistent asthma were interviewed via the Diagnostic Interview Schedule for Children IV; family interactions were assessed via direct observation of a mealtime; primary caregivers completed the Childhood Asthma Severity Scale; youth pulmonary function was ascertained with pre- and post-bronchodilator spirometry; adherence to asthma medications was objectively tracked for six weeks. Poorer pulmonary function and higher functional asthma severity were related to higher numbers of separation anxiety symptoms. Controlling for medication adherence, family interaction patterns mediated the relationship between poorer pulmonary function and child separation anxiety symptoms. Family mealtime interactions may be a mechanism by which respiratory disorders are associated with separation anxiety symptoms in children, potentially through increasing the child's capacity to cognitively frame asthma symptoms as less threatening, or through increasing the child's sense of security within their family relationships.

Towards a translational model of panic attack.

years ago, Deakin and Graeff proposed that whereas generalized anxiety disorder is produced by the overactivity of 5-HT excitatory projections from dorsal raphe nucleus to the areas of prefrontal cortex and amygdala which process distal threat, panic attacks are a dysfunction of 5-HT inhibitory projections from dorsal raphe nucleus to the dorsal periaqueductal gray matter, thereby releasing the responses to proximal threat, innate fear or anoxia. Besides, they suggested that the decrease in 5-HT1A neurotransmission in the hippocampus results in learned helplessness and depression. Accordingly, the Deakin Graeff hypothesis provided a unified frame to the widespread use of 5-HT selective reuptake inhibitors in generalized anxiety, panic disorder and depression. Competitor hypotheses implicate panic attacks with the abnormal functioning of locus coeruleus, basolateral amygdala, dorsomedial hypothalamus or an as-yet-unknown suffocation alarm system. Conversely, cognitive psychologists suggest that panic attacks result from the catastrophic (cortical) interpretation of bodily symptoms. In any event, translational models of panic attack are expected to reproduce the main features of clinical panic, namely, the patient's higher sensitivity to both lactate and CO2, the drug specific sensitivity, the lack of stress hormone responses during panic attacks, the higher vulnerability of women and the high comorbidity with agoraphobia, major depression and childhood separation anxiety. Therefore, here we review the main steps in the experimental approach to anxiety disorders which are paving the route towards a translational model of panic attack. Keywords: Panic, Anxiety, Stress, Suffocation, Serotonin, Periaqueductal Gray Matter

Traits of Separation Anxiety in Childhood: A Retrospective Study of Samoan Men, Women, and Fa’afafine

Gender Identity Disorder in Childhood (GIDC) and Separation Anxiety Disorder have been found to be co-morbid for boys in Western populations. In a Samoan cultural context, fa'afafine are defined as androphilic males (i.e., biological males who are sexually attracted to and aroused by adult males) who are effeminate or transgendered and occupy an "alternative" gender role category, which is distinct from the gender normative categories of "man" and "woman." Because some Western clinicians would likely conclude that many of the fa'afafine had GIDC, we examined whether adult fa'afafine would also recall traits indicative of elevated separation anxiety in childhood. Given this, the present study compared retrospective reports of childhood separation anxiety for Samoan men, women, and fa'afafine. Our results indicated that Samoan fa'afafine recalled significantly more separation anxiety in childhood compared to Samoan men and women. These findings, coupled with research on U.S. and Canadian boys with GIDC, suggest that separation anxiety in childhood may represent a universal pattern of psychosexual development shared by most gender-atypical, androphilic males, regardless of their cultural milieu. As such, this study adds to a growing body of literature that documents the existence of cross-culturally invariant behavioral and psychological traits in male androphiles.

Development and Preliminary Evaluation of a One-Week Summer Treatment Program for Separation Anxiety Disorder

Numerous clinical trials have demonstrated the efficacy of cognitive behavior therapy (CBT) for the treatment of childhood Separation Anxiety Disorder (SAD) and other anxiety disorders yet additional research may still be needed to better access and engage anxious youth. In this study, we investigated the acceptability and preliminary utility of a group cognitive-behavioral intervention for school-aged girls with SAD provided within an intensive, 1-week setting. The development of the proposed treatment strategy, a 1-week summer treatment program, was predicated on evidence supporting the need for childhood treatments that are developmentally sensitive, allow for creative application of intervention components, incorporate a child's social context, and ultimately establish new pathways for dissemination to the community. The summer treatment program for SAD was pilot-tested using a case-series design with 5 female children, aged 8 to 11, each with a principal diagnosis of SAD. For 4 of the 5 participants, treatment gains were evidenced by changes in diagnostic status, significant reductions in measures of avoidance, and improvements on self- and parent-report measures of anxiety symptomology. Specifically, severity of SAD symptoms decreased substantially at posttreatment for each participant and, 2 months following treatment, none of the participants met diagnostic criteria for the disorder. A fifth participant experienced substantive improvement in diagnostic status prior to the onset of treatment and, though she evidenced continued improvements following treatment, the role of the intervention in such improvements is less clear.

Anxiety, Mood, and Substance Use Disorders in Parents of Children With Anxiety Disorders

Examined the prevalence of anxiety, mood, and substance use disorders in the parents of anxiety disordered (AD) children relative to children with no psychological disorder (NPD). The specificity of relationships between child and parent anxiety disorders was also investigated. Results revealed higher prevalence rates of anxiety disorders in parents of AD children relative to NPD children. Specific child-mother relationships were found between child separation anxiety and panic disorder and maternal panic disorder, as were child and maternal social phobia, obsessive compulsive disorder, and specific phobias. Findings are discussed with reference to theory, clinical implications, and future research needs.

A Genetically Informed Study of the Association Between Childhood Separation Anxiety, Sensitivity to CO2, Panic Disorder, and the Effect of Childhood Parental Loss

Childhood separation anxiety disorder can predate panic disorder, which usually begins in early adulthood. Both disorders are associated with heightened sensitivity to inhaled CO(2) and can be influenced by childhood parental loss. To find the sources of covariation between childhood separation anxiety disorder, hypersensitivity to CO(2), and panic disorder in adulthood and to measure the effect of childhood parental loss on such covariation. Multivariate twin study. Seven hundred twelve young adults from the Norwegian Institute of Public Health Twin Panel, a general population cohort. Personal direct assessment of lifetime panic disorder through structured psychiatric interviews, history of childhood parental loss, and separation anxiety disorder symptoms. Subjective anxiety response to a 35% CO(2)/65% O(2) inhaled mixture compared with compressed air (placebo). Our best-fitting solution yielded a common pathway model, implying that covariation between separation anxiety in childhood, hypersensitivity to CO(2), and panic disorder in adulthood can be explained by a single latent intervening variable influencing all phenotypes. The latent variable governing the 3 phenotypes' covariation was in turn largely (89%) influenced by genetic factors and childhood parental loss (treated as an identified element of risk acting at a family-wide level), which accounted for the remaining 11% of covariance. Residual variance was explained by 1 specific genetic variance component for separation anxiety disorder and variable-specific unique environmental variance components. Shared genetic determinants appear to be the major underlying cause of the developmental continuity of childhood separation anxiety disorder into adult panic disorder and the association of both disorders with heightened sensitivity to CO(2). Inasmuch as childhood parental loss is a truly environmental risk factor, it can account for a significant additional proportion of the covariation of these 3 developmentally related phenotypes.

Biological Perspectives

Annie dreaded what would happen next--she had been down this road many times before. There she was--minding her own business, just wanting to watch a movie like any normal person--when she noticed her breathing was off. Immediately she began to monitor her breathing and soon seemed as if she just could not get enough air. She remembered a recent visit to the ER when the nurse patiently showed her that the oxygen saturation levels were good. She remembered, but didn't help. It wasn't that she believed this time was different--that this time she was going to suffocate. No, that might be a textbook explanation but wasn't her explanation. She just couldn't breathe, and knowing that it was all in her head just didn't seem to help. Soon she would be spiraling into symptoms that, like Old Testament prophet, would beget more apprehension, which would beget more symptoms--palpitations, dizziness, a fear of fainting, trembling, feeling that things around her were unreal, fear of going crazy--which would beget more dread. Worst of all, she feared looking foolish. What if she fainted right there in the movie theater? What if she lost control and started gulping big chunks of air down? What if she...? What would they think of her? ********** Annie's experience may be a little different from others' who suffer from panic disorder, but not too different. For some, panic may occur in specific situations or in certain types of environments while for others these come of the blue. The final common pathway, however, is not unique--it is pure human misery. It is not uncommon to find talented men and women who live truncated lives because of panic attacks, the fear of having a panic attack, and the fear of the fear of having a panic attack. Overview of Panic Disorders Panic disorder is one of the most studied anxiety disorders. While about 25% of Americans suffer from anxiety, only a small subgroup will ever be diagnosed with panic disorder (Dugue & Neugroschl, 2002). Clark (1986) described panic as an intense feeling of apprehension or impending doom which is of sudden onset and which is associated with a wide range of distressing physical (p. 461). These physical sensations include all those exhibited by Annie as well as a number of other symptoms (Table 1). According to established criteria, at least four of these symptoms must occur abruptly and peak within 10 minutes (American Psychiatric Association [APA], 2000). Lifetime prevalence rates for panic disorder are thought to be between 1% and 3.5%, with significantly higher prevalence rates found in general medical settings (e.g., patients with chest pain, asthma, headaches, epilepsy) (APA, 2000; Plewa, 2002). Prevalence is higher for women (2:1). Panic disorder results in considerable morbidity (e.g., 10%-20% attempt suicide, 7%-28% have history of substance abuse) and increased mortality (Malizia et al., 1998; Plewa). A considerable variance occurs among individuals related to frequency of attacks and course of illness. Many, but not all, patients report a lifelong history of anxiety before the actual diagnosis of panic disorder is made. A bimodal distribution of onset can be predicted with first panic occurring during late adolescence or during the mid 30s. The majority of patients report their first panic attack happening out of the blue, but subsequent are often attached to situational or environmental stimuli. Elderly individuals are less likely than younger people to suffer from panic attacks, with a number of competing hypotheses generated from this observation. Individuals with a family history of panic are more likely to suffer from panic themselves than is the general population, suggesting a genetic contribution. Finally, a history of childhood separation anxiety correlates to adult panic disorder. Models for Panic Disorders Historically, both psychologic and biologic models for panic disorders have been advanced in the literature. …

Separation Anxiety Disorder in Childhood as a Risk Factor for Future Mental Illness

To ascertain the extent to which childhood separation anxiety disorder (SAD) confers risk for the development of psychopathology during young adulthood (ages 19-30). A subset of the participants of the Oregon Adolescent Depression Project (n = 816) was used. Subjects provided retrospective reports of lifetime mental illness (including SAD) and concurrent reports of current mental illness at age 16 and were then followed prospectively until age 30. Diagnostic assessments were conducted twice during adolescence and again at ages 24 and 30. Based on diagnosis during childhood/adolescence, the subjects were partitioned into four orthogonal groups: SAD (n = 42), other anxiety disorders (n = 88), a heterogeneous psychiatric disorders control group (n = 389), and a not mentally ill control group (n = 297). Adjusting for demographic variables that were significantly associated with group status and for comorbid disorders prior to age 19, the results were analyzed with hierarchical multiple logistic regression. SAD was a strong (78.6%) risk factor for the development of mental disorders during young adulthood. The major vulnerabilities were for panic disorder and depression. Because SAD creates a major vulnerability for mental disorders during young adulthood, clinicians should be sensitive to the presence of SAD, and children and adolescents with SAD should be treated. Future research should evaluate whether successful treatment of SAD and/or the provision of a preventive intervention during childhood/adolescence reduce the risk for future psychopathology.

Psychometric properties and diagnostic ability of the separation anxiety scale for children (SASC)

This research describes the psychometric properties of a new child self-report measure, the separation anxiety scale for children (SASC), which assesses the frequency of symptoms of separation anxiety in children from 8 to 11. The factor solution with a sample of 1,201 children from 8 to 11, isolated three factors, discomfort from separation, worry about separation, and calm at separation, tested by confirmatory factor analysis, which accounted for 32.80% of the total variance. Results indicated that the SASC has a high internal consistency (alpha = 0.83). The results revealed a high test-retest reliability of the instrument, and a high number of correctly diagnosed cases. The correlation of scores with other anxiety measures shows that the variable most associated with separation anxiety is trait-anxiety.