Introduction to Separation Anxiety: A Guide to the Clinical Syndrome

Abstract

Seemingly newly recognized yet prevalent and ubiquitous, separation anxiety has only been officially acknowledged by the DSM as affecting adults as well as children since the publication of DSM-5 (2013). Yet its prevalence, which varies by country and culture is broad. Its importance has been well-known and well-described for decades, particularly if we broaden the strict description of the DSM syndrome a bit to encompass attachment dysregulation and its complicated psychiatric and emotional fallout. Frequently comorbid with other mood and anxiety disorders, the presence of separation anxiety disorder imparts a worse clinical course, more impairment in role functioning, and decreased efficacy of treatment, regardless of modality, regardless of primary mood or anxiety disorder diagnosis. The symptoms of separation anxiety can be overshadowed by other comorbidities, such as mood or other anxiety disorders. There is some evidence that improvements in adult separation anxiety and related attachment status may be active mechanisms of change in affect-focused psychotherapies for mood and anxiety disorders, making this a crucial mediator of treatment response to investigate across research domains.