Children with separation anxiety disorder have excessive anxiety about separation from caregivers to whom they are emotionally attached. They worry that some hard or tragedy will occur to those they love, leading to loss or long-term separation. For example, one young boy with separation anxiety disorder believed that if his mother went out to see a movie with his father, she would be killed, either in the car while travelling there or while watching the movie. Separation fears are most commonly centred on the primary caregiver – usually the moth – but fathers, grandparents, and other family members can sometimes be included.
Children with separation anxiety experience a great deal of distress on separation or even the threat of separation. They cry, plead desperately with the caregiver, and may throw tantrums. They are often clingy, and like to stay in close proximity to the caregiver. Somatic complaints such as headaches, nausea, and vomiting are common. They may experience nightmares involving themes of separation, death and loss, and may have associate sleep difficulties. They do whatever is within their power to avoid separating from important attachment figures: they avoid situations such as attending school, sleeping alone, playing at others friends’ homes, and staying away overnight. The disorder is most typical of younger children and is less common in adolescents. When making the diagnosis of separation anxiety, it is important to ensure that the anxiety is inappropriate to the child’s developmental level and is not within the normal range of behaviours for their age.
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