UNIVERSITY OF GONDER

COLLEGE OF MEDICINE AND

HEALTH SCIENCE
Anxiety assignment
Title;- separation anxiety disorder
Submitted to M.r setegn
2023/2015
Separation Anxiety
disorder
(SAD) by 3rd Year psychiatry students.
Group members

Name ID NO
• Soliyana Aregahegn • Gur/40047/13
• Tsion Solomon • Gur/40814/13
• Zumam kasahun • Gur/22979/13
• Dawit Alemzewd • Gur/00010/15
• Temesegen -Nahusenay • Gur/01665/11
 Objective

 Explor SAD
 SAD's Etiology
 See DSM5
crieteria
 Know
management
skill
 Introduction

Separation anxiety disorder

/ SAD /
• Is One of the Most common childhood disorders.

is an exaggeration of otherwise developmentally typical

anxiety manifested by excessive concern, worry, and
even dread of the actual or anticipated separation from
an attachment figure
 Introduction....

separation anxiety is a developmentally

appropriate phenomenon, the disorder manifests
with improper intensity at an inappropriate age or
in an inappropriate context.
Children ( SAD )
Definition
• Separation anxiety disorder (SAD ) is a condition in
which an individual experiences extreme distress in
the face of separation from someone whom the
individual has a significant emotional attachment
to.

• In DSM IV it was only child disorder, but in DSM V

it's also Adult's disorder
Adult ( SAD )
Etiology
Unkown
But some times It can be triggered by life stressor
Like separation from loved one/ breakup /
Trauma that leads to separation
Genetic 2/12
Prevalence
• Varies by age group, but most common in children
• 4% of children 7 - 11 age
• 3.9% 12 - 14 years
• 0.9 - 1.9% adults
• Male and Female equal ratio. (1:1)
Risk factor
• Life stress's, loss that result in separation
• Divorce of parents
• Moving away from adopted area
• Family history
• Over protective parents
• Having some type of disaster that result separation
Clinical manifestation (C/M)
• Refusing to sleep alone.
Repeated nightmares with a theme of separation.
• Lots of worry when parted from home or family.
Too much worry about the safety of a family
member.
• Refusing to go to school.
Fearful and reluctant to be alone.
C/M Cont...ed
worry about separation.
• worry about death or harm to a loved one.
• worry about something bad happening to self.
worry about being alone.
DSMV diagnostic criteria
• Disorder Class: Anxiety Disorders

• 🅰 Developmentally inappropriate and excessive fear

or anxiety concerning separation from those to
whom the individual is attached, as evidenced by at
least 3 of the following:
DSM5.....cont...ed
• Recurrent excessive distress when anticipating or
experiencing separation from home or from major
attachment figures.
• Persistent and excessive worry about losing major
attachment figures or about possible harm to them,
such as illness, injury, disasters, or death.
• Persistent reluctance or refusal to go out, away
from home, to school, to work, or elsewhere
because of fear of separation.
DSM5.....cont...ed
• Persistent and excessive fear of or reluctance about
being alone or without major attachment figures at
home or in other settings
• Persistent reluctance or refusal to sleep away from
home or to go to sleep without being near a major
attachment figure.

• Repeated nightmares involving the theme of

separation
DSM5.....cont...ed
• Persistent and excessive worry about experiencing
an distressing event ( like getting kidnapped being
in an accident... Etc ) that causes separation from
major attachment figure

• Repeated complaints of physical symptoms (such as

headaches, stomachaches, nausea, or vomiting)
when separation from major attachment figures
occurs or is anticipated.
DSM5.....cont...ed
• 🅱 The fear, anxiety, or avoidance is persistent,
lasting at least 4 weeks in children and adolescents
and typically 6 months or more in adults.

• C The disturbance causes clinically significant

distress or impairment in social, academic
(occupational), or other important areas of
functioning
• In DSM IV criteria C was onset is before 18
DSM5.....cont...ed
• D The disturbance is not better explained by
another mental disorder, like
• Autism spectrum, Hallucination, delusion,
GAD....etc
Complications
• Extreme worry.
• Sleep problems.
• Depression.
• Other anxiety disorders, including generalized
anxiety disorder and social anxiety disorder.
• Obsessive-compulsive disorder.

• Suicidal thought
SAD co-occurring
• Children with SAD are in high risk of developing
Anxiety or depressive disorder
• 60% have other anxiety disorder
• 30% have Depression
• Agoraphobia
• PTSD....etc are co occurring disorders.
Course & Prognosis
• Onset is Difficult to determine but common in
children
• The prognosis of separation anxiety disorder is
generally favorable But
• If left untreated, an estimated 36.1% of childhood
cases continue into adulthood

• can be controlled with therapy and medication

Differential diagnosis
• generalized anxiety disorder,
• panic attacks,
• phobias,
• social anxiety disorder or agoraphobia.
• Obsessive-compulsive disorder.
• Depression
Management
• First line Treatment is psychotherapy
cognitive behavioral therapy (CBT). Is best to adult.
• how to understand and manage their fears.
Dialectical behavioral therapy (DBT),
• helps to deal with difficult emotions.
Parent-Child Interaction Therapy (PCIT)
Group therapy.
Mgt...cont....ed
For severe, medication may be prescribed.
• Antidepressants called (SSRIs), and anti-anxiety
medication (benzodiazepines)
• Zoloft (sertraline),
References
• DSM V
• Stefano Pini, MD, of the department of clinical and
experimental medicine at University of Pisa in Italy,
and colleagues research.
Thanks for your
Attention.
End ! 🤗