Brain Facts

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What is Separation Anxiety?

According to most experts, separation anxiety is a natural event in human development. It begins at around eight months, when infants are starting to differentiate between objects in the world. At this time, a child begins to understand that objects exist even when they disappear from view. Consequently, children also begin to realize that they have parents. This recognition spawns deep concerns for children surrounding the periodic absence of these caregivers. Who, the baby seems to ask, is going to take care of vulnerable me?

Evolutionarily speaking, it makes sense that babies would develop tactics for keeping a parent close at hand: they cry, whimper, and cling. And when a child is in the throes of being separated from her parent, you might be in for one of those heart-rending, high-decimal rages that nobody within earshot soon forgets.

That is part of the joy of being a parent. But if these behaviors-and the anxiety behind them-continue well past three years of age (particularly up to six years and beyond), then a child might be experiencing separation anxiety disorder. Affecting some 4 percent of children in the United States, separation anxiety, says Phil Cowan, director of the Institute of Human Development at the University of California, Berkeley, “is often a problem for parents, sometimes [one] for children.”

To reach the diagnostic threshold for an anxiety disorder, according to the American Psychiatric Association’s Diagnostic and Statistics Manual-IV (DSM-IV), “the anxiety or fear must cause distress or affect social, academic, or job functioning and must last at least one month.”

A child with separation anxiety can exhibit a number of behaviors, including clinging to parents and having difficulty being away at school or camp. Sometimes it’s difficult for a child to spend time at a friend’s house. Occasionally, children will even develop health problems like insomnia, dizziness, nausea, or heart palpitations. In addition, mounting evidence suggests a link between separation anxiety disorder and other later-developing disorders, most notably, panic disorder, depression, and post-traumatic stress disorder. A French study, published last year in the journal Encephale suggests a connection between separation anxiety disorder and anorexia nervosa and bulimia.

Judy McDougal, a senior clinician at Victoria University of Wellington’s Institute for Early Childhood Studies, in Wellington, New Zealand, says there are a number of different “causes” for separation anxiety disorder. “The etiology of childhood disorders is messy,” she says. For this reason, she steers away from pathologizing separation anxiety as a disorder of the child: “Separation anxiety disorder rests in the relationship with the caregiver.”

Which raises important and interesting questions.

British psychologist John Bowlby, argued as early as the mid-1940s that separation anxiety was the result of a much more sophisticated version of imprinting, which he called “attachment.” (Bowlby’s research was based on earlier studies of goslings.) In Bowlby’s model, the urge to attach oneself to a parent is hard-wired, and the failure of a child to “separate” from that parent at the appropriate time?usually starting around two and a half or three years in humans?is the result of some malfunction in the relationship. “Perhaps the primary caregiver has separation issues with his or her own mother, which certainly carry over to the child.”

“Perhaps the primary caregiver has separation issues with his or her own mother, which certainly carry over to the child.”

More recently, a behavioral genetics position has emerged. Typified by the work of Harvard psychologist Jerome Kagan, this view suggests that many of the traits explained by attachment-including separation anxiety-are hard-wired themselves, or at least leanings toward them are, in the form of temperament.

Griffith University’s Dadds says that children’s separation anxiety results from some marriage of the two ideas. “There is a biological or genetic component,” he says, “in that kids with an ‘inhibited’ temperament-they don’t, for instance, like novelty-are at higher risk. Learning, however, is also involved; bad experiences with separation like getting bullied at school or a parent going A.W.O.L. play a role. Furthermore, anxious parents often feel uneasy about separation themselves and so this, too, influences the child. Once established, the patterns of [reinforcements] available for separation versus closeness can maintain the problem all by themselves.”

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