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Separation Anxiety Disorder

Separation Anxiety Disorder is a topic covered in the 5-Minute Pediatric Consult.

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Separation anxiety disorder (SAD) is defined as developmentally inappropriate fear and anxiety about being away from home and/or apart from the individuals to whom a child is most attached.

  • This diagnosis should be distinguished from developmentally appropriate worries, fears, and responses to stressors.


  • Prevalence estimates range from 4% in children aged 7 to 9 years to 1.6% in adolescents.
  • Prevalence is slightly higher in females than males.
  • Symptoms tend to peak between 7 and 9 years of age, but the disorder can present at any age.


Studies show that there are genetic and environmental precursors to the development of SAD:

  • A temperament of behavioral inhibition in which a child tends to approach unfamiliar situations with distress, restraint, and avoidance has been shown to be associated with development of anxiety disorders.
  • Low experience of control over the environment
  • Early development of stranger anxiety
  • Insecure attachment between parent and child
  • Increased parental anxiety
  • Parenting style of being excessively controlling and overprotective
  • Exposure to negative life events or stressors
  • Genetic predisposition with family history of anxiety or depression

Commonly Associated Conditions

Comorbid conditions are present in up to 80% of children with SAD, most commonly including the following:

  • School refusal
  • Depression
  • Simple phobia
  • Social phobia
  • Generalized anxiety disorder
  • Obsessive-compulsive disorder
  • Agoraphobia

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Cabana, Michael D., editor. "Separation Anxiety Disorder." 5-Minute Pediatric Consult, 8th ed., Wolters Kluwer, 2019. Pediatrics Central, peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617167/all/Separation_Anxiety_Disorder.
Separation Anxiety Disorder. In: Cabana MD, ed. 5-Minute Pediatric Consult. 8th ed. Wolters Kluwer; 2019. https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617167/all/Separation_Anxiety_Disorder. Accessed April 23, 2019.
Separation Anxiety Disorder. (2019). In Cabana, M. D. (Ed.), 5-Minute Pediatric Consult. Available from https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617167/all/Separation_Anxiety_Disorder
Separation Anxiety Disorder [Internet]. In: Cabana MD, editors. 5-Minute Pediatric Consult. Wolters Kluwer; 2019. [cited 2019 April 23]. Available from: https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617167/all/Separation_Anxiety_Disorder.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Separation Anxiety Disorder ID - 617167 ED - Cabana,Michael D, BT - 5-Minute Pediatric Consult UR - https://peds.unboundmedicine.com/pedscentral/view/5-Minute-Pediatric-Consult/617167/all/Separation_Anxiety_Disorder PB - Wolters Kluwer ET - 8 DB - Pediatrics Central DP - Unbound Medicine ER -