Download - Seperation anxiety disorders
International University of the Caribbean
BA G&C
Presentation
By
Tanecia Stevens
To
Nicole Foster
2Tanecia Stevens BA G&G
Definition Separation anxiety
disorder is a medical condition that is characterized by significant distress when a person is away from parents, another caregiver, or home.
Video: http://www.youtube.com/watch?v=58khDBvteTs
3Tanecia Stevens BA G&G
On set of separation anxiety disorder Separation anxiety can begin before a child’s first
birthday, and may pop up again or last until a child is four years old, but both the intensity level and timing of separation anxiety vary tremendously from child to child. A little worry over leaving mom or dad is normal, even when your child is older.
SAD is noted as one of the earliest-occurring of all anxiety disorders (those between 8 and 14 months old).
4Tanecia Stevens BA G&G
Onset of separation anxiety In contrast to DSM-IV, the
diagnostic criteria no longer specify that age at onset must be before 18 years,” according to the APA, “because a substantial number of adults report onset of separation anxiety after age 18. Also, a duration criterion — “typically lasting for 6 months or more” — has been added for adults to minimize overdiagnosis of transient fears.”
5Tanecia Stevens BA G&G
Etiology
Factors that contribute to the
disorder include a combination and
interaction of biological, cognitive,
genetic, environmental, child
temperament and behavioral factors.
Commonly noted environmental
factors include parenting behavior.
Examples of parenting behavior as
contributing factors may include:
6Tanecia Stevens BA G&G
Cont. Low parental warmth, discouraging autonomy in child
Attachment relationships with parents or caregiver —insecure or anxious attachment styles have been shown to produce feelings of vulnerability, fear of being alone, and chronic anxiety
Locus of control — this phenomena revolves around a child's thoughts and ability to control one's own environment
Overprotective or intrusive parenting behaviors
Genetics - studies have shown that infants of mothers with an anxiety disorder had a higher risk
7Tanecia Stevens BA G&G
Temperament A child's temperament can
also impact the development of SAD. Timid and shy behaviors may be referred to as "behaviorally inhibited temperaments" in which the child may experience anxiety when they are not familiar with a particular location or person.
8Tanecia Stevens BA G&G
Prevalence Anxiety disorders are the most common type of
psychopathology to occur in today's youth, affecting from 5–25% of children world-wide. Of these anxiety disorders, SAD accounts for a large proportion of diagnoses. SAD may account for up to 50% of the anxiety disorders as recorded in referrals for mental health treatment.
9Tanecia Stevens BA G&G
Symptoms An unrealistic and lasting worry that something bad
will happen to the parent or caregiver if the child leaves
An unrealistic and lasting worry that something bad will happen to the child if he or she leaves the caregiver
Refusal to go to school in order to stay with the caregiver
Refusal to go to sleep without the caregiver being nearby or to sleep away from home
10Tanecia Stevens BA G&G
Symptoms cont. Fear of being alone
Nightmares about being separated
Bed wetting
Complaints of physical symptoms, such as headaches and stomachaches, on school days
Repeated temper tantrums or pleading
Clinging to caregiver
11Tanecia Stevens BA G&G
According to the American Psychiatric Association
(APA), the publisher of the DSM-5, the DSM-5 chapter
on anxiety disorder no longer includes obsessive-
compulsive disorder or PTSD (posttraumatic stress
disorder). Instead, these disorders have been relocated
to their own respective chapters.
12Tanecia Stevens BA G&G
Generalized Anxiety Disorder
If your child has generalized anxiety disorder, or GAD, he or she will worry excessively about a variety of things such as grades, family issues, relationships with peers, and performance in sports.
Children with GAD tend to be very hard on themselves and strive for perfection. They may also seek constant approval or reassurance from others.
13Tanecia Stevens BA G&G
Obsessive-Compulsive Disorder (OCD) OCD is characterized by unwanted and intrusive
thoughts (obsessions) and feeling compelled to repeatedly perform rituals and routines (compulsions) to try and ease anxiety.
Most children with OCD are diagnosed around age 10, although the disorder can strike children as young as two or three. Boys are more likely to develop OCD before puberty, while girls tend to develop it during adolescence.
14Tanecia Stevens BA G&G
Panic Disorder
Panic disorder is diagnosed if your child suffers at least two unexpected panic or anxiety attacks—which means they come on suddenly and for no reason—followed by at least one month of concern over having another attack, losing control, or "going crazy."
15Tanecia Stevens BA G&G
There are no significant changes to the criteria for
panic attacks. However, the DSM-5 removes the
description of different kinds of panic attacks and
lumps them into one of two categories — expected
and unexpected.
16Tanecia Stevens BA G&G
Posttraumatic Stress Disorder (PTSD)
Children with posttraumatic stress disorder, or PTSD, may have intense fear and anxiety, become emotionally numb or easily irritable, or avoid places, people, or activities after experiencing or witnessing a traumatic or life-threatening event.
Not every child who experiences or hears about a traumatic event will develop PTSD. It is normal to be fearful, sad, or apprehensive after such events, and many children will recover from these feelings in a short time.
17Tanecia Stevens BA G&G
Risk Factors Children who directly witnessed a traumatic even.
Children who suffered directly (such as injury or the death of a parent).
Children who had mental health problems before the event.
Children who lack a strong support network.
Violence at home also increases a child’s risk of developing PTSD after a traumatic event.
18Tanecia Stevens BA G&G
Social Anxiety Disorder Social anxiety disorder, or social phobia, is
characterized by an intense fear of social and performance situations and activities such as being called on in class or starting a conversation with a peer.
This can significantly impair the child’s school performance and attendance, as well as his or her ability to socialize with peers and develop and maintain relationships.
19Tanecia Stevens BA G&G
Selective Mutism Children who refuse to speak in situations where
talking is expected or necessary, to the extent that their refusal interferes with school and making friends, may suffer from selective mutism.
These children can be very talkative and display normal behaviors at home or in another place where they feel comfortable. Parents are sometimes surprised to learn from a teacher that their child refuses to speak at school.
20Tanecia Stevens BA G&G
Signs of Selective Mutism Signs includes:
Stand motionless and expressionless
Turn their heads
Chew or twirl hair while trying to speak
Avoid eye contact
Withdraw into a corner to avoid talking.
21Tanecia Stevens BA G&G
Cont. The average age of diagnosis is
between 4 and 8 years old, or around the time a child enters school.
Selective mutism was previously classified in the section “Disorders Usually First Diagnosed in Infancy, Childhood, or Adolescence” in the DSM-IV. It is now classified as an anxiety disorder.
22Tanecia Stevens BA G&G
Specific Phobias A specific phobia is the
intense, irrational fear of a specific object, such as a dog, or a situation, such as flying. Common childhood phobias include animals, storms, heights, water, blood, the dark, and medical procedures.
23Tanecia Stevens BA G&G
Cont. Children will avoid
situations or things that they fear, or endure them with anxious feelings, which can manifest as crying, tantrums, clinging, avoidance, headaches, and stomachaches. Unlike adults, they do not usually recognize that their fear is irrational
24Tanecia Stevens BA G&G
Treatment Modalities Non-pharmacological
Non-pharmacological treatments are methods of treatment that do not involve drugs.
Non-pharmacological treatments are to be used before using pharmacological treatments.
Counseling tends to be the best replacement for drug treatments.
25Tanecia Stevens BA G&G
Play therapy.
The therapeutic use of play is a common and effective way to get kids talking about their feelings.
Behavioral therapy
Behavioral therapies are types of non-pharmacological treatment which are mainly exposure-based techniques. These include techniques such as systematic desensitization, emotive imagery, participant modelling and contingency management. Children are forced to go to school and eventually show decreasing symptoms of SAD
26Tanecia Stevens BA G&G
Contingency management
Contingency management is a form of treatment found to be effective for younger children with SAD.
Contingency management revolves around a reward system with verbal or tangible reinforcement.
When children undergoing contingency management show signs of independence, they are praised or given a reward.
27Tanecia Stevens BA G&G
Family Therapy
Family therapy is highly effective in helping children overcome separation anxiety. A family therapist examines the entire family in an effort to understand why the child is experiencing separation anxiety.
Cognitive behavioral therapy (CBT)
Cognitive behavioral therapy focuses on helping children with SAD reduce feelings of anxiety through practices of exposure to anxiety-inducing situations and active metacognition to reduce anxious thoughts.
28Tanecia Stevens BA G&G
Pharmacological
Pharmacological treatment is used in extreme cases of SAD when non-pharmacological treatments fail, typically for school refusal.
Pharmacological management of SAD includes the use of selective serotonin reuptake inhibitors.
29Tanecia Stevens BA G&G
Recommendations for Treatment and Prevention
Assessment: The first step to successful treatment
begins with a comprehensive evaluation of your child.
This evaluation would include:
A review of current symptoms and concerns, their
duration, and level of intensity
A thorough review of your child's development and
background
30Tanecia Stevens BA G&G
Past medical and psychiatric history
Important family background as well as family
psychiatric history
A mental status exam
31Tanecia Stevens BA G&G
Treatment Centres CGC (Child Guidance Clinic)
Street Address Bustamante HospitalCity / Town Kingston
Promise Learning CentreAddress1 North Ave Kingston 5Phone Number (876) 906-8283
32Tanecia Stevens BA G&G
Case Javauhn is 5 years old, a very hyperactive boy, admitted
to the pediatrics ward with a fracture ulna. It was noticed that when his mother is present, he would run and play with the other children, climb on the beds and table in the playing area, while his mother watch. But as soon as she is ready to leave, he is a different child. He cries loudly, with a tantrum, some times as if he is out of breath. When he calms down he refused to speak, refused to eat, afraid to sleep and refused to be held by anyone. Even though he did not care much about her, as long as she is present. Funny, he does not behave this way when other family member leaves.
33Tanecia Stevens BA G&G
Reference http://www.webmd.com/children/guide/separation-
anxiety
http://www.helpguide.org/mental/separation_anxiety_causes_prevention_treatment.htm
http://www.adaa.org/living-with-anxiety/children/childhood-anxiety-disorders
http://www.anxietydisorderinchildren.com/treatments-for-children-with-separation-anxiety/
34Tanecia Stevens BA G&G
Thanks you For your quarries and assistance please contact me at:
Tanecia Stevens BA G&G 35