Infants oftentimes look for their caregivers to give them a sense of comfort and familiarity, which causes separation to become challenging. Subsequently, the concept of object permanence emerges—which is when children learn that something still exists when it cannot be seen or heard, thus increasing their awareness of being separated from their caregiver. Consequently, during the developmental period where an infants sense self, incorporating object permanence as well, the child also begins to understand that they can in fact be separated from their primary caregiver. They see this separation as something final though, and dont yet understand that their caregiver will return causing fear and distress for the infant. It is when an individual (infant, child, or otherwise) consistently reacts to separation with excessive anxiety and distress and experiences a great deal of interference from their anxiety that a diagnosis of separation anxiety disorder (SAD) can be warranted.One of the difficulties in the identification of separation anxiety disorder in children is that it is highly comorbid with other behavioral disorders, especially generalized anxiety disorder. Behaviors such as refusal or hesitancy in attending school or homesickness for example, can easily reflect similar symptoms and behavioral patterns that are commonly associated with SAD, but could be an overlap of symptoms. The prevalence of co-occurring disorders in adults with separation anxiety disorder is common and includes a much broader spectrum of diagnostic possibilities. Common co-morbidities can include specific phobias, PTSD, panic disorder, obsessive-compulsive disorder, and personality disorders.
Encouraging a child with separation anxiety disorder to feel competent and empowered, as well as to discuss feelings associated with anxiety-provoking events promotes recovery. Children with separation anxiety disorder often respond negatively to perceived anxiety in their caretakers, in that parents and caregivers who also have anxiety disorders may unwittingly confirm a childs unrealistic fears that something terrible may happen if they are separated from each other. Thus, it is critical that parents and caretakers become aware of their own feelings and communicate a sense of safety and confidence about separation. Longitudinal effects
Several studies aim to understand the long-term mental health consequences of SAD. SAD contributed to vulnerability and acted as a strong risk factor for developing other mental disorders in people aged 19–30. Specifically disorders including panic disorder and depressive disorders were more likely to occur. Other sources also support the increased likelihood of displaying either of the two psychopathologies with previous history of childhood SAD.Studies show that children who have separation anxiety at younger ages have more complex fear acquisition. This means that there is likely an interplay between associative and non-associative processes concerning fear and anxiety later in life. Epidemiology
Anxiety disorders are the most common type of psychopathology to occur in todays youth, affecting from 5–25% of children worldwide. Of these anxiety disorders, SAD accounts for a large proportion of diagnoses. SAD may account for up to 50% of the anxiety disorders as recorded in referrals for mental health treatment. SAD is noted as one of the earliest-occurring of all anxiety disorders.