I saw post-traumatic stress disorder (PTSD), separation anxiety disorder, enuresis (bedwetting), and depression in many children.
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Though it's true that nail biters sometimes have other psychiatric disorders like ADHD and separation anxiety disorder, OCD is an anxiety-driven obsession, while nail biting is not, they argue.
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When children experience separation anxiety disorder, it is often connected to excessive fear of losing major attachment figures—such as parents or other family members—to harm or tragedy from car accidents, disasters, or significant illness.
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"If your child's separation anxiety seems intense or prolonged — especially if it interferes with school or other daily activities, or includes panic attacks or other problems — he or she may have separation anxiety disorder," Mayo Clinic dictates.
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There may be a genetic predisposition in children with separation anxiety disorder. "Separation anxiety disorder in children may be heritable."American Psychiatric Association. (2013). Risk and Prognostic Factors of Separation Anxiety.
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That being said, a majority of children with separation anxiety disorder have school refusal as a symptom. Up to 80% of children who refuse school qualify for a diagnosis of separation anxiety disorder.Dryden-Edwards, R., MD. (2014, January 23). Separation Anxiety Disorder (M.
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Discomfort from separations in children from ages 8 to 14 months is normal. Children oftentimes get nervous or afraid of unfamiliar people and places but if the behavior still occurs after the age of six and if it lasts longer than four weeks, the child might have separation anxiety disorder. About 4% of children have the disorder. Separation anxiety disorder is very treatable especially when caught early on with medication and behavioral therapies.
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Fluvoxamine is also effective for GAD, SAD, panic disorder and separation anxiety disorder in children and adolescents. There is tentative evidence that fluvoxamine may help some people with negative symptoms of chronic schizophrenia.
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Preliminary evidence shows that heightened activity of the amygdala may be associated with symptoms of separation anxiety disorder. Defects in the ventrolateral and dorsomedial areas of the prefrontal cortex are also correlated to anxiety disorders in children.
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Adult separation anxiety disorder affects roughly 7% of adults. It has also been reported that the clinically anxious pediatric population are considerably larger. For example, according to Hammerness et al. (2008) SAD accounted for 49% of admissions.
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A significant minority of ex-military brats may exhibit symptoms of posttraumatic stress disorder, avoidant personality disorder, separation anxiety disorder, etc.Wertsch, Mary Edwards (April 23, 1991). Military Brats: Legacies of Childhood Inside the Fortress (1st hardcover edition). Harmony. .
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Studies show that many brats become very adaptable as a result of the mobile lifestyle, but there is also a higher than average incidence, among a minority of military brats, of avoidant personality disorder and separation anxiety disorder.
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Besides a separation anxiety disorder she has mysophobia and thinks her son smells. That’s why the boy must shower multiple times a day. She also divided the living room in imaginary areas which John may or may not enter.
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Helping children with separation anxiety to identify the circumstances that elicit their anxiety (upcoming separation events) is important. A child's ability to tolerate separations should gradually increase over time when he or she is gradually exposed to the feared events. 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 child's unrealistic fears that something terrible may happen if they are separated from each other.
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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.American Psychiatric Association. (2013). Comorbidity of Separation Anxiety.
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Non-medication based treatments are the first choice when treating individuals diagnosed with separation anxiety disorder. Counseling tends to be the best replacement for drug treatments. There are two different non-medication approaches to treat separation anxiety. The first is a psychoeducational intervention, often used in conjunction with other therapeutic treatments.
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The origins of separation anxiety disorder stem from attachment theory which has roots in the attachment theories both of Sigmund Freud and John Bowlby. Freud's attachment theory, which has similarities to learning theory, proposes that infants have instinctual impulses, and when these impulses go unnoticed, it traumatizes the infant. The infant then learns that when their mother is absent, this will be followed by a distressing lack of gratification, thus making the mother's absence a conditioned stimulus that triggers anxiety in the infant who then expects their needs to be ignored. The result of this association is that the child becomes fearful of all situations that include distance from their caregiver. John Bowlby’s attachment theory also contributed to the thinking process surrounding separation anxiety disorder.
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They see this separation as something final though, and don't 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.
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Despite the evidence pointing to the existence of early-onset panic disorder, the DSM- IV-TR currently only recognizes six anxiety disorders in children: separation anxiety disorder, generalized anxiety disorder, specific phobia, obsessive- compulsive disorder, social anxiety disorder (a.k.a. social phobia), and post- traumatic stress disorder. Panic disorder is notably excluded from this list.
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Whereas separation anxiety disorder is characterized by "inappropriate and excessive fear or anxiety concerning separation from those to whom the individual is attached"American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders." 5th ed. Washington, DC: Author: 2013 symptoms of homesickness are most prominent after a separation and include both depression and anxiety.
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Although school refusal behavior is common among children with SAD, it is important to note that school refusal behavior is sometimes linked to generalized anxiety disorder or possibly a mood disorder.Eisen, A., Sussman, J., Schmidt, T., Mason, L., Hausler, L., & Hasim, R. (2012). Separation Anxiety Disorder. In Handbook of Child and Adolescent Anxiety Disorders (2011 ed.). Springer.
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New York: Worth Publishers. . Separation anxiety disorder affects roughly 7% of adults and 4% of children, but the childhood cases tend to be more severe; in some instances, even a brief separation can produce panic. Treating a child earlier may prevent problems. This may include training the parents and family on how to deal with it.
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Anxiety disorders are a group of mental disorders characterized by significant feelings of anxiety and fear. Anxiety is a worry about future events, while fear is a reaction to current events. These feelings may cause physical symptoms, such as increased heart rate and shakiness. There are several anxiety disorders, including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism.
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Anxiety disorders are a group of mental disorders characterized by exaggerated feelings of anxiety and fear responses. Anxiety is a worry about future events and fear is a reaction to current events. These feelings may cause physical symptoms, such as a fast heart rate and shakiness. There are a number of anxiety disorders: including generalized anxiety disorder, specific phobia, social anxiety disorder, separation anxiety disorder, agoraphobia, panic disorder, and selective mutism.
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While typically associated with pregnancy and childbirth, a maternal bond may also develop in cases where the child is unrelated, such as an adoption. Both physical and emotional factors influence the mother-child bonding process. In separation anxiety disorder a child becomes fearful and nervous when away from a loved one, usually a parent or other caregiver. New mothers do not always experience instant love toward their child.
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Retrieved October 6, 2014, from Encyclopedia.com According to the American Psychiatric Association (APA), separation anxiety disorder is an excessive display of fear and distress when faced with situations of separation from the home and/or from a specific attachment figure. The anxiety that is expressed is categorized as being atypical of the expected developmental level and age. The severity of the symptoms ranges from anticipatory uneasiness to full-blown anxiety about separation.
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Separation anxiety disorder (SepAD) is the feeling of excessive and inappropriate levels of anxiety over being separated from a person or place. Separation anxiety is a normal part of development in babies or children, and it is only when this feeling is excessive or inappropriate that it can be considered a disorder.Siegler, Robert (2006). How Children Develop, Exploring Child Develop Student Media Tool Kit & Scientific American Reader to Accompany How Children Develop.
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Separation anxiety disorder (SAD) is an anxiety disorder in which an individual experiences excessive anxiety regarding separation from home and/or from people to whom the individual has a strong emotional attachment (e.g., a parent, caregiver, significant other or siblings). It is most common in infants and small children, typically between the ages of six to seven months to three years, although it may pathologically manifest itself in older children, adolescents and adults. Separation anxiety is a natural part of the developmental process.
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By about 8–12 months, they go through a fairly rapid change and become fearful of perceived threats; they also begin to prefer familiar people and show anxiety and distress when separated from them or approached by strangers. Separation anxiety is a typical stage of development to an extent. Kicking, screaming, and throwing temper tantrums are perfectly typical symptoms for separation anxiety. Depending on the level of intensity, one may determine whether or not a child has separation anxiety disorder.
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Most observers report that fear of the dark seldom appears before the age of 2 years.] When fear of the dark reaches a degree that is severe enough to be considered pathological, it is sometimes called scotophobia (from σκότος – "darkness"), or lygophobia (from λυγή – "twilight"). Some researchers, beginning with Sigmund Freud, consider the fear of the dark to be a manifestation of separation anxiety disorder. An alternate theory was posited in the 1960s, when scientists conducted experiments in a search for molecules responsible for memory.
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The SCARED was developed to screen for anxiety disorders in children; there is a parent version as well as a youth self-report version. The original version developed in 1997 was available in 38 items. The SCARED is most commonly used in the 41-item version published in 1999 which was updated with three additional items in the social phobia scale. There is also a 66-item SCARED-Revised (SCARED-R) that includes the panic disorder, generalized anxiety disorder, social phobia, and separation anxiety disorder scales.
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Most often, the onset of separation anxiety disorder is caused by a stressful life-event, especially a loss of a loved one or pet, but can also include parental divorce, change of school or neighbourhood, natural disasters, or circumstances which forced the individual to be separated from their attachment figure(s). In older individuals, stressful life experiences may include going away to college, moving out for the first time, or becoming a parent.Adults with separation anxiety may be invasive and overprotective of their friends and loved ones. American Psychiatric Association. (2013).
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Separation Anxiety Disorder. In Handbook of Child and Adolescent Anxiety Disorders (2011 ed.). Springer An important signifier to establish a difference between SAD and other anxiety or psychological disorders is to investigate where the individual's fear of separation is stemming from; this can be accomplished by asking “what they fear will occur during a separation from their significant other”. What stands out about SAD, as mentioned above, are the avoidance behaviors which present within an individual. Individuals “typically exhibit excessive distress manifested by crying, repeated complaints of physical symptoms (e.g.
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Coping Cat is a "well supported" intervention for treating separation anxiety disorder, social anxiety disorder, and generalized anxiety disorder. Based on the numerous rigorous research evaluations, the program has met the criteria for an "empirically supported treatment". The program has been evaluated in several randomized clinical trials with one-year follow-up data conducted both in the United States, Norway, and in Australia. The outcomes have been very favorable, with 3.35 year-follow-up of one study and 7.4 year follow-up of the second study providing evidence of the maintenance gains.
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Prior to the development of the SCARED, three rating scales were used to measure anxiety in children and adolescents: the Revised Children's Manifest Anxiety Scale, the Revised Fear Survey Schedule for Children, and the Somatic State and Trait Anxiety Scale. While these methods were useful in assessing general anxiety symptoms, they were unable to discriminate between anxiety disorders. To address this shortcoming, the SCARED was developed based on DSM- IV classification to screen specifically for general anxiety disorder (GAD), separation anxiety disorder (SAD), panic disorder, social phobia, and school phobia.
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In DSM terms, homesickness may be related to Separation Anxiety Disorder, but it is perhaps best categorized as either an Adjustment Disorder with mixed anxiety and depressed mood (309.28) or, for immigrants and foreign students as a V62.4, Acculturation Difficulty. As noted above, researchers use the following definition: "Homesickness is the distress or impairment caused by an actual or anticipated separation from home. Its cognitive hallmark is preoccupying thoughts of home and attachment objects." Recent pathogenic models support the possibility that homesickness reflects both insecure attachment and a variety of emotional and cognitive vulnerabilities, such as little previous experience away from home and negative attitudes about the novel environment.
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The Child and Adolescent Symptom Inventory (CASI) is a behavioral rating checklist created by Kenneth Gadow and Joyce Sprafkin that assesses a range of behaviors related to common emotional and behavior disorders identified in the Diagnostic and Statistical Manual of Mental Disorders (DSM), including attention deficit hyperactivity disorder, oppositional defiant disorder, conduct disorder, generalized anxiety disorder, social phobia, separation anxiety disorder, major depressive episode, mania, dysthymic disorder (pervasive depressive disorder in DSM-5), schizophrenia, autism spectrum, Asperger syndrome, anorexia, and bulimia. In addition, one or two key symptoms of each of the following disorders are also included: obsessive-compulsive disorder, specific phobia, panic attack, motor tics, vocal tics, and substance use. CASI combines the Child Symptom Inventory (CSI) and the Adolescent Symptom Inventory (ASI), letting it apply to both children and adolescents ages 5 to 18. The CASI is a self-report questionnaire completed by the child's caregiver or teacher to detect signs of psychiatric disorders in multiple settings.
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