seperation anxiety disorders

Separation Anxiety Disorder and other disorders of childhood.

1Tanecia Stevens BA G&G

International University of the Caribbean

BA G&C

Presentation

By

Tanecia Stevens

To

Nicole Foster


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


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).


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.”


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:


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


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.


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.


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


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


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.


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.


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.


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."


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.


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.


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.


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.


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.


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.


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.


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.


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


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.


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


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.


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.


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.


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


Past medical and psychiatric history

Important family background as well as family

psychiatric history

A mental status exam


Treatment Centres CGC (Child Guidance Clinic)

Street Address Bustamante HospitalCity / Town Kingston

Promise Learning CentreAddress1 North Ave Kingston 5Phone Number (876) 906-8283


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.


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/


Thanks you For your quarries and assistance please contact me at:

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Tanecia Stevens BA G&G 35

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seperation anxiety disorders

Education

tanecia stevens ba ggsymptoms

tanecia stevens ba ggcont

timing of separation

child temperament

child leavesan unrealistic

disorders of childhood

lasting worry

environmental factors