Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders

Department of Psychiatry, University of Pisa, Italy. <>
Acta Psychiatrica Scandinavica (Impact Factor: 5.61). 10/2009; 122(1):40-6. DOI: 10.1111/j.1600-0447.2009.01480.x
Source: PubMed


To evaluate the frequency and clinical correlates of adult separation anxiety disorder in a large cohort of patients with mood and anxiety disorders.
Overall, 508 outpatients with anxiety and mood disorders were assessed by the structured clinical interview for diagnostic and statistical manual (IV edition) axis I disorders for principal diagnosis and comorbidity and by other appropriate instruments for separation anxiety into adulthood or childhood.
Overall, 105 subjects (20.7%) were assessed as having adult separation anxiety disorder without a history of childhood separation anxiety and 110 (21.7%) had adult separation anxiety disorder with a history of childhood separation anxiety. Adult separation anxiety was associated with severe role impairment in work and social relationships after controlling for potential confounding effect of anxiety comorbidity.
Adult separation anxiety disorder is likely to be much more common in adults than previously recognized. Research is needed to better understand the relationships of this condition with other co-occurring affective disorders.

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    • "In addition, the category has been relocated to the section for the general subtypes of anxiety disorders. The adult form of separation anxiety disorder was first identified amongst clinic populations where the prevalence of the disorder was found to vary between 20% and 40% (Pini et al., 2010; Silove, Marnane, Wagner, Manicavasagar, & Rees, 2010b). The 0887-6185/© 2015 Elsevier Ltd. "
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    ABSTRACT: There is some evidence that adult separation anxiety disorder (ASAD) symptoms are closely associated with posttraumatic stress disorder (PTSD) amongst refugees exposed to traumatic events (TEs), but the pathways involved remain to be elucidated. A recent study suggests that separation anxiety disorder precedes and predicts onset of PTSD. We examined a path model testing whether ASAD symptoms and worry about family mediated the path from traumatic losses to PTSD symptoms amongst 230 refugees from West Papua. Culturally adapted measures were applied to assess TE exposure and symptoms of ASAD and PTSD. A structural equation model indicated that ASAD symptoms played an important role in mediating the effects of traumatic losses and worry about family in the pathway to PTSD symptoms. Although based on cross-sectional data, our findings suggest that ASAD symptoms may play a role in the path from traumatic losses to PTSD amongst refugees. We propose an evolutionary model in which the ASAD and PTSD reactions represent complementary survival responses designed to protect the individual and close attachments from external threats. Copyright © 2015 Elsevier Ltd. All rights reserved.
    Journal of anxiety disorders 07/2015; 35:1-8. DOI:10.1016/j.janxdis.2015.07.001 · 2.68 Impact Factor
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    • "Considering the prevalence of separation anxiety in general population, the National Comorbidity Survey Replication (NCS-R) [6] showed a 12-month ASAD prevalence of 1.9% and a lifetime prevalence of 6.6% [5]; more than half of those diagnosed with ASAD had a history of mood disorders (53%), and the majority (75%) had received or were in treatment for emotional problems. Scanning the clinical studies, Pini et al. [21] reported that 42.4% of the anxiety and mood disorder outpatients screened also met the ASAD criteria. The prevalence of ASAD in dependent personality disorder patients was examined in a large patient sample with alcohol or drug addiction compared to nonpatient controls [14]: the rates in the control participants were from 2 to 5%, whilst in patients the results were significantly higher, ranging from 6 to 31%; in both cases, those with alcohol addictions had the lowest prevalence of ASAD. "
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    ABSTRACT: Background. Nowadays, adult separation anxiety disorder (ASAD) is an established diagnostic category but is little investigated in subjects with addictive behaviours. Objective. To assess the presence of ASAD among patients with addictive disorders in comparison with anxiety patients and measure the personality correlates in all these groups. Methods. 103 outpatients, meeting DSM-IV-TR criteria for anxiety disorders (38 patients), alcohol dependence (30 patients), or pathological gambling (35 patients), were assessed by the Structured Clinical Interview for Separation Anxiety Symptoms (SCI-SAS) and the Adult Separation Anxiety Checklist (ASA-27) for separation anxiety and by the Temperament and Character Inventory-Revised (TCI-R) for personality characteristics. Results. ASAD is detected in 34.2% of anxiety patients, 13.3% of alcoholics, and 11.4% of gamblers. Separation anxiety scores correlate positively with harm avoidance and negatively with self-directedness in all groups; further correlations are seen among addictive patients only, that is, self-transcendence for gamblers and cooperativeness for both alcoholics and gamblers. Conclusions. The prevalence of ASAD is lower among addictive patients than in those with anxiety disorders; correlations are found between separation anxiety and specific TCI-R dimensions, with some matching across the three diagnostic groups.
    BioMed Research International 07/2014; 2014. DOI:10.1155/2014/680985 · 3.17 Impact Factor
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    • "One exception is separation anxiety disorder which includes a criterion that the onset age is before 18 years (APA, 2000). However, separation anxiety is also commonly found in adults (Pini et al., 2010) and in the DSM-5 the age criterion is dropped allowing for a diagnosis of separation anxiety disorder in adulthood (APA, 2013). Because of the lack of distinction between child anxiety disorders and anxiety disorders in adulthood in the DSM-IV-TR (and DSM-5), it is very likely that the items of the SCARED-71 measuring symptoms of anxiety disorders in children will be transferable to adults. "
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    ABSTRACT: Many questionnaires exist for measuring anxiety; however, most are developed for children or adults only, or do not capture symptoms of all anxiety disorders. The Screen for Child Anxiety Related Emotional Disorders (SCARED) is a well-validated questionnaire for children, measuring symptoms of most anxiety disorders, but has not been validated for adults. The aim of the current study was to investigate the applicability of the SCARED for adults (SCARED-A). Participants were 175 females and 152 males, who were all included in a study examining the relation between parental rearing and anxiety in children and parents. All participants filled in the SCARED-A and the STAI (State-Trait Anxiety Inventory), and the ADIS-IV-L (Anxiety Disorders Interview Schedule for DSM-IV Lifetime version) was administered. The internal consistency of the SCARED-A total scale was excellent, and acceptable-to-good internal consistencies were found for almost all subscales. The SCARED-A significantly correlated with the STAI and ADIS-VI-L, providing support for convergent validity. The SCARED-A was able to differentiate between participants with and without an anxiety disorder, and cut-offs for the total score were established. The SCARED-A may be a valuable instrument for future research to investigate intergenerational anxiety, and the course of anxiety development from childhood to adulthood. However, research is needed to replicate the findings in a more representative sample, to examine the test-retest reliability, and to establish cut-offs for the different subscales.
    Netherlands journal of psychology 01/2014; 68:81-87.
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