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Dr. Vijayakumar D.R MBBS, DPM, DNB (NIMHANS), CCST (UK)
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Separation Anxiety Disorder

Diagnostic Criteria

A.      Developmentally  inappropriate  and  excessive  fear  or  anxiety  concerning  separation  from  those  to  whom  the  individual  is  attached,  as  evidenced  by  at  least  three  of  the  following:

  1. Recurrent  excessive  distress  when  anticipating  or  experiencing  separation  from  home  or  from  major  attachment  figures.
  2. Persistent  and  excessive  worry   about  losing  major attachment  figures or  about  possible  harm  to  them,  such  as  illness,  injury, disasters,  or  death.
  3. Persistent  and  excessive  worry  about  experiencing  an  untoward  event (e.g.,  getting  lost,  being  kidnapped,  having  an  accident,  becoming  ill)  that  causes  separation  from  a  major  attachment  figure.
  4. Persistent   reluctance  or  refusal to  go  out,  away  from  home,  to  school,  to  work , or  elsewhere  because  of  fear  of  separation.
  5. Persistent  and  excessive  fear  of  or  reluctance  about  being  alone  or  without  major  attachment  figures  at  home  or  in  other  settings.
  6. Persistent  reluctance  or  refusal  to  sleep  away  from  home  or  to  go  to  sleep   without  being  near  a major  attachment  figure.
  7. Repeated nightmares involving the theme of separation.
  8. Repeated  complaints  of   physical  symptoms (e.g.,  headaches,  stomachaches, nausea,  vomiting) when  separation  from  major  attachment  figures  occurs  or  is  anticipated. 


B.      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.

D.     The disturbance is not better explained by another mental disorder, such as refusing to leave home because of excessive resistance to change in autism spectrum disorder; delusions or hallucinations concerning separation  in psychotic  disorders; refusal to go outside without a trusted companion in agoraphobia; worries  about  ill health  or other harm befalling  significant  others in  generalized  anxiety  disorder; or  concerns about having an illness in illness  anxiety  disorder.