This document discusses separation anxiety disorder and other childhood anxiety disorders. It defines separation anxiety disorder as significant distress when separated from caregivers. Onset is usually before age 4 but can also occur in adults. Factors like insecure attachment, overprotective parenting, and shy temperament can contribute to its development. Symptoms include excessive worry about harm befalling caregivers when separated, refusal to leave caregivers, and physical symptoms. Treatment involves behavioral therapy, cognitive behavioral therapy, family therapy, and in severe cases, medication. The document also briefly outlines other childhood anxiety disorders like generalized anxiety disorder, OCD, panic disorder, PTSD, social anxiety disorder, selective mutism, and specific phobias.

1. Separation Anxiety Disorder and other disorders of
childhood.
1Tanecia Stevens BA G&G

2. International University of the Caribbean
BA G&C
Presentation
By
Tanecia Stevens
To
Nicole Foster
2Tanecia Stevens BA G&G

3. Definition
 Separation anxiety
disorder is a medical
condition that is
characterized by
significant distress
when a person is
away from parents,
another caregiver, or
home.
 Video: http://www.youtube.com/watch?v=58khDB
vteTs
3
Tanecia Stevens BA G&G

4. On set of separation anxiety
disorder
 Separation anxiety can begin before a child’s first
birthday, and may pop up again or last until a child is
four years old, but both the intensity level and timing
of separation anxiety vary tremendously from child to
child. A little worry over leaving mom or dad is
normal, even when your child is older.
 SAD is noted as one of the earliest-occurring of all
anxiety disorders (those between 8 and 14 months
old).
4Tanecia Stevens BA G&G

5. Onset of separation anxiety
 In contrast to DSM-IV, the
diagnostic criteria no longer
specify that age at onset
must be before 18 years,”
according to the APA,
“because a substantial
number of adults report
onset of separation anxiety
after age 18. Also, a duration
criterion — “typically lasting
for 6 months or more” — has
been added for adults to
minimize overdiagnosis of
transient fears.”
5Tanecia Stevens BA G&G

6. Etiology
 Factors that contribute to the
disorder include a combination and
interaction of biological, cognitive,
genetic, environmental, child
temperament and behavioral factors.
 Commonly noted environmental
factors include parenting behavior.
Examples of parenting behavior as
contributing factors may include:
6Tanecia Stevens BA G&G

7. Cont.
 Low parental warmth, discouraging autonomy in child
 Attachment relationships with parents or caregiver —
insecure or anxious attachment styles have been
shown to produce feelings of vulnerability, fear of
being alone, and chronic anxiety
 Locus of control — this phenomena revolves around a
child's thoughts and ability to control one's own
environment
 Overprotective or intrusive parenting behaviors
 Genetics - studies have shown that infants of mothers
with an anxiety disorder had a higher risk
7Tanecia Stevens BA G&G

8. Temperament
 A child's temperament can
also impact the development
of SAD. Timid and shy
behaviors may be referred to
as "behaviorally inhibited
temperaments" in which the
child may experience anxiety
when they are not familiar
with a particular location or
person.
8Tanecia Stevens BA G&G

9. Prevalence
 Anxiety disorders are the most common type of
psychopathology to occur in today's youth, affecting
from 5–25% of children world-wide. 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.
9Tanecia Stevens BA G&G

10. Symptoms
 An unrealistic and lasting worry that something bad
will happen to the parent or caregiver if the child
leaves
 An unrealistic and lasting worry that something bad
will happen to the child if he or she leaves the
caregiver
 Refusal to go to school in order to stay with the
caregiver
 Refusal to go to sleep without the caregiver being
nearby or to sleep away from home
10Tanecia Stevens BA G&G

11. Symptoms cont. Fear of being alone
 Nightmares about being
separated
 Bed wetting
 Complaints of physical
symptoms, such as
headaches and
stomachaches, on school
days
 Repeated temper tantrums
or pleading
 Clinging to caregiver
11Tanecia Stevens BA G&G

12.  According to the American Psychiatric Association
(APA), the publisher of the DSM-5, the DSM-5 chapter
on anxiety disorder no longer includes obsessive-
compulsive disorder or PTSD (posttraumatic stress
disorder). Instead, these disorders have been relocated
to their own respective chapters.
12Tanecia Stevens BA G&G

13. Generalized Anxiety Disorder
 If your child has generalized anxiety disorder, or GAD,
he or she will worry excessively about a variety of
things such as grades, family issues, relationships with
peers, and performance in sports.
 Children with GAD tend to be very hard on themselves
and strive for perfection. They may also seek constant
approval or reassurance from others.
13Tanecia Stevens BA G&G

14. Obsessive-Compulsive Disorder
(OCD)
 OCD is characterized by unwanted and intrusive
thoughts (obsessions) and feeling compelled to
repeatedly perform rituals and routines (compulsions)
to try and ease anxiety.
 Most children with OCD are diagnosed around age 10,
although the disorder can strike children as young as
two or three. Boys are more likely to develop OCD
before puberty, while girls tend to develop it during
adolescence.
14Tanecia Stevens BA G&G

15. Panic Disorder
 Panic disorder is diagnosed if
your child suffers at least two
unexpected panic or anxiety
attacks—which means they
come on suddenly and for no
reason—followed by at least
one month of concern over
having another attack, losing
control, or "going crazy."
15Tanecia Stevens BA G&G

16.  There are no significant changes to the criteria for
panic attacks. However, the DSM-5 removes the
description of different kinds of panic attacks and
lumps them into one of two categories — expected
and unexpected.
16Tanecia Stevens BA G&G

17. Posttraumatic Stress Disorder
(PTSD)
 Children with posttraumatic stress disorder, or PTSD,
may have intense fear and anxiety, become
emotionally numb or easily irritable, or avoid places,
people, or activities after experiencing or witnessing a
traumatic or life-threatening event.
 Not every child who experiences or hears about a
traumatic event will develop PTSD. It is normal to be
fearful, sad, or apprehensive after such events, and
many children will recover from these feelings in a
short time.
17Tanecia Stevens BA G&G

18. Risk Factors
 Children who directly witnessed a traumatic even.
 Children who suffered directly (such as injury or the
death of a parent).
 Children who had mental health problems before the
event.
 Children who lack a strong support network.
 Violence at home also increases a child’s risk of
developing PTSD after a traumatic event.
18Tanecia Stevens BA G&G

19. Social Anxiety Disorder
 Social anxiety disorder, or social phobia, is
characterized by an intense fear of social and
performance situations and activities such as being
called on in class or starting a conversation with a
peer.
 This can significantly impair the child’s school
performance and attendance, as well as his or her
ability to socialize with peers and develop and
maintain relationships.
19Tanecia Stevens BA G&G

20. Selective Mutism
 Children who refuse to speak in situations where
talking is expected or necessary, to the extent that
their refusal interferes with school and making
friends, may suffer from selective mutism.
 These children can be very talkative and display
normal behaviors at home or in another place where
they feel comfortable. Parents are sometimes surprised
to learn from a teacher that their child refuses to speak
at school.
20Tanecia Stevens BA G&G

21. Signs of Selective Mutism
 Signs includes:
Stand motionless and expressionless
Turn their heads
Chew or twirl hair while trying to speak
Avoid eye contact
Withdraw into a corner to avoid talking.
21Tanecia Stevens BA G&G

22. Cont.
 The average age of diagnosis is
between 4 and 8 years old, or
around the time a child enters
school.
 Selective mutism was previously
classified in the section “Disorders
Usually First Diagnosed in Infancy,
Childhood, or Adolescence” in the
DSM-IV. It is now classified as an
anxiety disorder.
22Tanecia Stevens BA G&G

23. Specific Phobias
 A specific phobia is the
intense, irrational fear of
a specific object, such as a
dog, or a situation, such
as flying. Common
childhood phobias
include animals, storms,
heights, water, blood, the
dark, and medical
procedures.
23Tanecia Stevens BA G&G

24. Cont.
 Children will avoid
situations or things that
they fear, or endure them
with anxious feelings,
which can manifest as
crying, tantrums,
clinging, avoidance,
headaches, and
stomachaches. Unlike
adults, they do not
usually recognize that
their fear is irrational
24Tanecia Stevens BA G&G

25. Treatment Modalities
 Non-pharmacological
Non-pharmacological treatments are methods of
treatment that do not involve drugs.
Non-pharmacological treatments are to be used
before using pharmacological treatments.
Counseling tends to be the best replacement for
drug treatments.
25Tanecia Stevens BA G&G

26.  Play therapy.
The therapeutic use of play is a common and effective
way to get kids talking about their feelings.
 Behavioral therapy
Behavioral therapies are types of non-pharmacological
treatment which are mainly exposure-based
techniques. These include techniques such as
systematic desensitization, emotive imagery,
participant modelling and contingency management.
Children are forced to go to school and eventually
show decreasing symptoms of SAD
26Tanecia Stevens BA G&G

27.  Contingency management
Contingency management is a
form of treatment found to be
effective for younger children
with SAD.
 Contingency management
revolves around a reward system
with verbal or tangible
reinforcement.
When children undergoing
contingency management show
signs of independence, they are
praised or given a reward.
27Tanecia Stevens BA G&G

28.  Family Therapy
Family therapy is highly effective in helping children
overcome separation anxiety. A family therapist
examines the entire family in an effort to understand
why the child is experiencing separation anxiety.
 Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy focuses on helping
children with SAD reduce feelings of anxiety through
practices of exposure to anxiety-inducing situations and
active metacognition to reduce anxious thoughts.
28Tanecia Stevens BA G&G

29.  Pharmacological
Pharmacological treatment is
used in extreme cases of SAD
when non-pharmacological
treatments fail, typically for
school refusal.
Pharmacological
management of SAD includes
the use of selective serotonin
reuptake inhibitors.
29Tanecia Stevens BA G&G

30. Recommendations for Treatment
and Prevention
Assessment: The first step to successful treatment
begins with a comprehensive evaluation of your child.
This evaluation would include:
 A review of current symptoms and concerns, their
duration, and level of intensity
 A thorough review of your child's development and
background
30Tanecia Stevens BA G&G

31.  Past medical and psychiatric history
 Important family background as well as family
psychiatric history
 A mental status exam
31Tanecia Stevens BA G&G

32. Treatment Centres
 CGC (Child Guidance Clinic)
Street Address Bustamante Hospital
City / Town Kingston
 Promise Learning Centre
Address
1 North Ave Kingston 5
Phone Number (876) 906-8283
32Tanecia Stevens BA G&G

33. Case
 Javauhn is 5 years old, a very hyperactive boy, admitted
to the pediatrics ward with a fracture ulna. It was
noticed that when his mother is present, he would run
and play with the other children, climb on the beds
and table in the playing area, while his mother watch.
But as soon as she is ready to leave, he is a different
child. He cries loudly, with a tantrum, some times as if
he is out of breath. When he calms down he refused to
speak, refused to eat, afraid to sleep and refused to be
held by anyone. Even though he did not care much
about her, as long as she is present. Funny, he does not
behave this way when other family member leaves.
33Tanecia Stevens BA G&G

34. Reference
 http://www.webmd.com/children/guide/separation-
anxiety
 http://www.helpguide.org/mental/separation_anxiety
_causes_prevention_treatment.htm
 http://www.adaa.org/living-with-
anxiety/children/childhood-anxiety-disorders
 http://www.anxietydisorderinchildren.com/treatment
s-for-children-with-separation-anxiety/
34Tanecia Stevens BA G&G

35. Thanks you
 For your quarries and assistance please contact me at:
 tanstevens100@yahoo.com
 fancyface081@gmail.com
 tanstevens100@hotmail.com
Tanecia Stevens BA G&G 35