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Separation Anxiety Disorder is an anxiety disorder strongly connected to the idea of attachment relationship. This condition is typically associated with childhood diagnosis, as children are more vulnerable to suffering from it. Even with this, separation anxiety disorder is also likely to occur in adults who are separated from home or from individuals to whom they have a strong emotional attachment. Individuals with separation anxiety disorder are probable to put across unsuitable displays of panic and misery when they have to be separated from a place or from a person that they have a strong connection with. Developmental level and age are essential in determining whether or not a person is suffering, as symptoms might be perfectly normal in the case of young children.
It is perfectly normal for a person (a young child in particular) to experience distress as a consequence of being separated from an attachment figure or location. However, "children with separation anxiety disorder experience anxiety beyond the normal developmental period." (Blair Simpson, Neria, & Lewis-Fernandez, 2010, p. 232) Although separation anxiety disorder has been identified in adults, the DSM-V workgroup has had trouble deciding whether or not it would be required for them to introduce this idea into the new diagnostic manual. This is generally because the disorder happens with a greater incidence in young children.
Separation does not necessarily have to occur in order for a person to display separation anxiety disorder. Someone can anticipate separation and can thus engage in performing behaviors characteristic for the disorder. Children in particular can seem clingy, sobbing, and can cry inconsolably as a result of separation. In some cases individuals have trouble sleeping, experience nightmares, and put across fits of temper as their feelings become more intense. "Children with separation-related concerns also often present with somatic complaints, most commonly headaches, stomachaches, and nausea." (Altman & Sommer, 2009) In extreme cases children experience frequent visits to the pediatrician or to the school nurse and can have trouble attending school normally.
Anxiety resulting from separation is in many cases difficult to detect because many have the tendency to believe that it is perfectly normal for vulnerable groups such as children to exhibit sorrow as a result of being separated from a place or from a person. The fact that children often display symptoms similar to those characteristic to separation anxiety disorderinfluences many tutors to express little to no interest in the psychological aspect of the anxious person's condition.
Parents should be concerned in a series of cases that provide them with evidence that the condition is more serious than they might be inclined to believe:
when a child puts across excessive anxiety as a result of being separated from home or from a person the level of anxiety displayed is much more severe than anxiety levels typically associated with children belonging to the same developmental or age group the child is negatively affected by the anxiety and he or she finds it difficult to perform several basic functions
A child should be diagnosed with separation anxiety disorderonly when the previously mentioned symptoms are displayed with a significant frequency and for a prolonged period of time. Also, the person in charge of diagnosing the child needs to investigate and rule out other disorders before establishing that the individual is suffering from separation anxiety disorder (Altman & Sommer 2009).
The fact that affected individuals are typically separated from home or from a person that they are particularly attached to makes it difficult for them to have a complex understanding of the situation they are in. Many try to compensate for these feelings by focusing on putting across behaviors that they believe are going to influence others to acknowledge his or her point-of-view. "When a child with SAD expects to be separated from his or her caretaker or when separation has just occurred, the child displays significant subjective distress." (Dia, 2001) The prevalence of separation anxiety disorder is believed to be around four percent in young children and adolescents.
Separation anxiety disorder in children involves symptoms that are relatively similar to symptoms displayed in adults who suffer from panic induced by agoraphobia. Individuals are probable to put across catastrophic interpretations and to be panicked with regard to a series of concepts. "For example, a child with SAD tries to avoid separation from his or her caretaker (phobic avoidance), believes that if separated something terrible will happen and he or she will not be able to handle it (catastrophic interpretations), and experiences autonomic arousal such as palpitations, perspiration, hyperventilation, shaking, and fear (panic symptoms)." (Dia, 2001) A child's autonomic nervous system is activated as he or she feels that something catastrophic is about to happen and this triggers anxiety symptoms that gradually come to create a cycle making the individual feel that he or she is constantly in danger.
David Dia's journal article "Cognitive-Behavioral Therapy with a Six-Year-old Boy with Separation Anxiety Disorder: A Case Study" presents the case of Colt, a six-year-old boy who would feel a panic attack whenever he was not in the presence of one of his parents. Colt reported that he felt an increasing sentiment of fear whenever one of his parents left him alone. This fear influenced him to sweat, have weak legs, cry, and even to scream as he considered that he was abandoned. Colt actually claimed that he feared that his mother is going to get killed if he is not with her or that he is going to be kidnapped.
Colt's fears make it possible for readers to understand that he is displaying symptoms that are not normal for a child his age and that his thinking is owed to the fact that he is suffering from separation anxiety disorder. While it seems normal for a six-year-old to miss his parents, it is abnormal for him to think that they are going to die or that he is going to be kidnapped.
Philip Gosshalk's case involving Laura, a five-year-old girl who started to display separation anxiety symptoms one afternoon when she was in preschool is especially intriguing. Laura's parents had separated -- her mother suffered from depression for one year and her father left the family and was receiving treatment for his alcohol problem. Laura was staying with her brother and mother when symptoms first started to appear. The girl had experienced a nightmare while sleeping during the preschool's nap-time and woke up particularly concerned with the fact that her mother was not present.
What is curious about Laura is that, unlike Colt, she did not display separation anxiety disorder symptoms since she gained a more complex understanding of what was going on around her. She had been attending preschool with no problems for a series of months before coming to express her feelings. Her mother decided that there was no option but to force her to attend classes in spite of her reluctance. "Consequently, Laura was forced to attend school with her teacher having to hold onto her while her mother left the classroom. She settled at times through the day but asked for her mother or began crying." (Gosshalk, 2004)
Laura's mother considered that it was in her daughter's best interest to be forced to acknowledge that she was not in danger and that she needed to accept the fact that her mother could not stay with her all the time. This led to the condition worsening and to Laura even displaying symptoms of separation anxiety disorder at home as she was no longer willing to sleep in her bed and as she constantly wanted to be with her mother. Laura anticipated separation every time when it was time for her to go to school and did everything in her power in order to have her mother understand the feelings she was going through. Such behaviors were not characteristic to the young girl and the fact that they lasted for more than four weeks influenced her mother to seek specialized help.
Consequent to conducting a Devereaux Behavior Rating Scales School Form, Laura was found to experience interpersonal problems, inappropriate behaviors and sentiments, depression, and physical symptoms resulting from fear. This meant that she met many of the points that the DSM-IV TR considered to be a criteria for diagnosing separation anxiety disorder. A child mental health clinician diagnosed Laura on account of interviewing her parents, her teachers, and the girl.
Aydogan Aykut Ceyhan's study "Investigation of Early Separation Anxiety Symptom Levels in Turkish Young Adults" discusses with regard to how personal and family particularities have shape separation anxiety symptoms in young adults. "The sample consisted of 284 university students attending Anadolu University in Turkey, in the 2004-2005 academic years. Data were collected from the Separation Anxiety Symptoms Scale and a questionnaire." (Ceyhan, 2006)
Ceyhan's studies determined that young females are more predisposed to suffering from separation anxiety disorder when compared to young males. Similarly, individuals who were only children were more vulnerable to displaying symptoms when compared to individuals in larger families. The…[continue]
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This correlation was more pronounced among female subjects. The results showed that of the 134 test subjects, 84.3% had no comorbid condition while the rest (15.7%) had atleast one comorbid condition. These subjects also showed a higher SASI score (p = .053). The subgroup with comorbid condition also showed a history of early onset (p < .01) and poor recovery of global functioning (p < .05) when compared to
According to Perwien & Bernstein (2004), the results of the Kendall study indicated that those children who had received the CBT treatments showed a decrease in anxiety related symptoms and an increase in coping abilities. The results held strong during the three-year follow-up period as well. Another therapeutic approach to Separation Anxiety Disorder in children is Rational Emotive Behavior Therapy (REBT). REBT is a highly direct, action-oriented model for assessing problems
Separation Anxiety and Separation Anxiety Disorder, also known as SAD, are an acute distress that first occurs in children beginning in the first six to eight months of life (Weiten, 2005). Usually a parent will begin to notice changes in their infant when a usually confident child will show signs of distress when separated from an attachment figure, such as their mother or caregiver (Oltmanns, & Emery, 2010). Normal separation
For the delayed-treatment group, significant improvement was shown after they received self-examination therapy. From this study, the LaTorre work and the work of Dia, it is reasonable to conclude that empowerment is conducive to better outcomes in those with generalized anxiety disorder. Dia (2001) noted that cognitive-behavioral therapy (CBT) is now a respected and proven model of psychotherapy, as noted by a t ask force of the American Psychological Association.
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Relationships provide the key experience that connects children's personal and social worlds. It is within the dynamic interplay between these two worlds that minds form and personalities grow, behavior evolves and social competence begins." (1999) Howe relates that it is being acknowledged increasingly that "...psychologically, the individual cannot be understood independently of his or her social and cultural context. The infant dos not enter the world as a priori
Distracting a child while their parent is treated may lessen stress for a SAD child (Hillard, 2006). Nurses may also want to incorporate preventative methods into their routines, especially if they are pediatric nurses. Encouraging work in this area has been done at Mount Sinai Hospital, where nursing departments participated in the incorporation of supportive methodology in handling children who are in treatment (Justus et al., 2006). If a child