Separation anxiety disorder (SAD) is often diagnosed in children, with average starting point at the age of six years old. (Battaglia et al., 2016). Current research confirms that parent intrusiveness and overinvolvement is one of the leading sets off for SAD in children who already are vulnerable to anxiety disorders ((Gar and Hudson, 2008, Wood, 2006, Brumariu and Kerns, 2010, Hudson and Rapee, 2001). Based on Erik Erikson’s psychosocial stages of development theory, recommendations are grounded in the goal of helping children with SAD assert all their growing freedom to eliminate the worry of separating from add-on figures.

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What is Separation Anxiety Disorder?

Between 5% and 20% of children experience anxiousness, with between 4% and 8% of kids suffering from splitting up anxiety disorder (Masi, Mucci, and Millepiedi, 2001, Battaglia ainsi que al., 2016). While most anxiety disorders impact generally white, middle-class individuals, among 50% and 75% of these with splitting up anxiety disorder come from low socioeconomic status (SES) homes (Masi, Mucci, and Millepiedi, 2001). SAD is quite often noticed in middle years as a child, with normal onset for 6 years older. Symptoms generally subside by simply adolescence (Battaglia et al., 2016).

SAD is categorized simply by excessive anxiousness about separation from accessory figures, anticipatory anxiety, and avoidant behavior. Of those diagnosed with SAD, 74% show indications of school refusal, a form of avoidant behavior (Masi, Mucci, and Millepiedi, 2001). The American Psychological Connection (“What will be Anxiety Disorders? “, 2017) specifies SAD as being excessively scared about separating from people that have whom an individual is fastened that is disproportionate to condition or age group inappropriate which hinders a person’s ability to function normally, continual for 5 or more several weeks in kids and for 6th or more several weeks in adults. While many physiological splitting up anxiety is adaptive and evolutionarily effective, common in most mammals, MISERABLE reaches the idea of dysfunction, with more exaggerated duration and intensity than physiological separation anxiety (Battaglia et al., 2016).

Children with SAD have reached risk for adverse long-term results. SAD is positively linked to lifetime diagnostic category of two or more adult anxiety disorders. There is strong correlation among childhood UNHAPPY and mature obsessive-compulsive disorder and cultural phobia, with weaker but nonetheless significant relationship between the child years SAD and adult anxiety attacks (Lipsitz ain al., 1994). SAD can also impact educational attainment, as many children suffering from SAD have difficulty attending college or focusing in class, because of the fear of what is going on to their loved ones outside of the classroom (Masi, Mucci, and Millepiedi, 2001).

Summary of Current Books

Combattimento and co-workers (2016) decided that key elements for early onset parting anxiety in preschool years include mother’s smoking, low maternal education, maternal depression, maternal overprotection, low SYNS, parent unemployment, and parental divorce. This kind of conclusion coincides with the current knowledge with regards to separation panic attacks ” especially the influence of maternal overprotection and SAD. Real wood (2006) hypothesized that children who currently exhibited troubled tendencies could exhibit more symptoms of UNHAPPY if mom and dad are highly invasive in daily routines and activities. The research found that intrusiveness is positively connected with SAD, with weaker correlations to other anxiety disorders including obsessive-compulsive disorder. Intense fear over separating may be displayed for multiple reasons. First of all, the child associated with an intrusive father or mother will have experienced few experience with 3rd party action with their parent and feels no level of mastery, control, or self-efficacy. Consequently , they are afraid when a parent or guardian is not really there to intervene with them. Secondly, the child of an distressing parent might have been negatively strengthened to avoid splitting up. For example , it can be developmentally typical for a young child to cry when initially separated from their parent. Nevertheless , if the parent immediately earnings to remove the kid from an annoyinh situation, your child will not discover how to calm themselves or function without a parent near.

Wood (2006) found simply no relation among parental intrusiveness and parental anxiety disorders. Schier and Hudson (2008) agree with Wood’s (2006) studies, arguing that mothers of anxious children are more included than mothers of non-anxious children, irrespective of maternal anxiety status. Though previous books suggested that anxiety with the parent causes a dysfunctional parenting design that teaches the child to be more delicate towards risk and belief of risk, as well as increased parental tenderness towards children’s distress, growing literature disagrees (Last et al., 1987). Mothers of anxious children tend to be more overprotective, non-objective, self-sacrificing, and critical than mothers of non-anxious children, yet the status of mothers’ very own anxiety is usually not linked to the aforementioned qualities of the moms of stressed children (Gar and Hudson, 2008, Wooden, 2006, Brumariu and Kerns, 2010).

As recently stated, kids diagnosed with UNHAPPY already have large levels of sexual arousal levels and emotionality, putting all of them at higher risk for making a variety anxiety attacks (Hudson and Rapee, 2001). In the case of innate vulnerability, increased parental involvement and protection may reinforce this weakness, reduce the children’s perceived control of potential hazards, and maximize avoidance of threats. Rejecting parenting, including being much less supportive, less promoting of independence, and giving more help compared to the child demands, has been previously associated with tendencies disorders, depression, substance make use of, eating disorders, and schizophrenia. Rising literature suggests that mothers of anxious kids were far more negative than mothers of non-anxious kids, offering even more criticism and fewer praise once observing their child having difficulty completing a job. However , in studies that followed Hudson and Rapee’s (2001) unique study, study indicates there is a weaker association between child unease and maternal rejection than there is among parental control and child anxiousness (Gar and Hudson 2008). Consequently , one may conclude that while parent rejection is usually influential in the development of the child years anxiety disorders, it is not necessarily as influential as parent overinvolvement.

Quality of Proof

Current literature mainly concurs concerning the prevalence of and reasons behind childhood UNHAPPY. As previous literature is known as incorrect, new literature replicates studies regarding the impacts of parent intrusiveness on the progress child anxiety attacks. For example , Last and fellow workers (1987) suggested that parental anxiety amounts would have an adverse impact on their particular ability to rear their children. Multiple recent studies state the alternative, finding no significant link between parental anxiety and SAD (Hudson and Rapee 2001, Schier and Hudson 2008, Solid wood 2006). Nevertheless , the link between negative parenting and UNFORTUNATE is not clear, requiring future research. Current literature disagrees on the authentic impact of negative raising a child on childhood anxiety, since it is being associated with depression even more strongly than anxiety.

Unfortunately, research on this matter is certainly not culturally generalizable. Although Wood (2006) found a racially diverse human population for his study by using a convenience sample, Gar and Hudson (2008) studied primarily Caucasian and middle-class members. As recently stated, most of children with SAD will be from low SES homes (Masi, Mucci, and Millepiedi, 2001). Even though Wood (2006) and Gar and Hudson (2008) arrived at similar results with regards to parental intrusiveness and parent anxiety disorders, the combination of new research utilizing a convenience sample as well as the other using a non-diverse population means that their very own results absence generalizability. The cultural significance for the relationship between intrusiveness and MISERABLE are ambiguous and will need further analysis. For example , analysis suggests that behavioral, cognitive, linguistic, and motivational deficits observed in minority and immigrant youngsters are methods of adaption to the dominating culture (Coll and Szalacha, 2004). With this thought, SAD in children of color could possibly be a maladaptive way of ensuring family ties remain strong and secure. More studies needed with children and families of color and with low SES for a even more generalizable comprehension of SAD.

Theory Identification and Description

Erikson’s theory of psychosocial development says that when a crisis is experienced during any such stage, an individual should be able to overcome that crisis to move frontward with their advancement (Erikson, 1950). The target, according to Erikson (1968), is to deal with a provided crisis simply by developing positive qualities. Failing to develop a stage of development does not halt long term development, but may make it difficult to efficiently complete upcoming stages. Earlier stages and crises may be resolved another time. Erikson (1950) outlined eight stages of development. The first several stages ” Trust vs Mistrust, Autonomy vs Shame or Uncertainty, Initiative as opposed to Guilt, and Industry as opposed to Inferiority ” are more strongly related the experience of UNHAPPY than the later stages, while SAD is usually primarily a childhood knowledge. A brief description of these levels follows.

The initially stage of development is definitely Trust as opposed to Mistrust (Erikson, 1950). Skilled during the initial year and a half of life, the individual is learning how to react to the world surrounding them. Through developing attachments, an infant is taught to trust or certainly not trust the earth around them. Sporadic or tough child-rearing variations may lead to a delay through this stage. The goal in Trust compared to Mistrust is always to develop the positive quality of hope.

Stage two is known as Autonomy vs Shame or Uncertainty. Between 18 months and three years of age, small children begin to assert their independence (Erikson, 1950). The individual demands supportive parent figures to help in instructing their child “self-control without a loss of self-esteem” by providing an environment in which it is fine to fail yet providing enough assistance so that constant failure is avoided (Gross and Humphreys, 1992). The target in Autonomy vs Disgrace or Hesitation is the top quality of will (Erikson, 1950).

Stage 3 is targeted on Initiative versus Guilt between the ages of three and your five years old (Erikson, 1950). Since several children in america begin pre-school during this time, children are given elevated opportunities to develop interpersonal expertise with their colleagues during this time and find out self-initiative. Yet , if a infant’s independence is definitely hindered during this time period, they may continue to feel like a nuisance in front of large audiences and develop feelings of guilt. A proper amount of guilt is necessary to learn self-control but a lot of may lead to low self-esteem. The objective of this level is to develop the positive top quality of purpose.

The fourth stage of Erikson’s psychological development is definitely Industry or Competence vs Inferiority (Erikson, 1950). Between ages of 5 and 12 years outdated, children begin the feel the necessity to accomplish specific competencies that are valued by their social stratosphere and think a sense of satisfaction when these types of competencies will be successfully completed. However , if deterred simply by negative father and mother or teachers, the child can start to doubt their own abilities and build a sense of inferiority. However, with no inability a child will not develop a impression of modesty. A healthy stability between sector and modesty will result in the positive top quality of skills.

Interpretation and Implications

During the initial 18 months of life, infants are attempting to identify the answer to a single question ” is the universe safe? In case their interactions give reliability, attention, and passion, infants will build up a sense of trust (Erikson, 1950). However , if the child can be exposed to bad or rejecting parenting, they shall be unsure of whom to trust and turn distressed. Erikson’s theory for the stages of development signifies that unhealthy attachments in childhood may lead to the impression of being struggling to control the situations surrounding them later in life, a sign of years as a child SAD (Wood 2006).

Between 1 . 5 years and three years of age, a toddler starts to assert all their independence. It is essential that they are allowed to explore their particular limits during this time, allowing them to nourish and clothe themselves towards the best of all their ability so they may find out new skills and conquer new challenges (Erikson, 1950). Nevertheless , children clinically determined to have SAD frequently have overprotective and intrusive father and mother (Hudson and Rapee 2001, Gar and Hudson 2008, Wood 2006). Without these early on experiences of exploration, success, and inability, an individual will never learn self-efficacy or self-pride. Instead, they will become overly dependent on others and truly feel inadequate within their own capacity to survive on the globe (Erikson, 1968). This stage in Erikson’s theory suggests that SAD is exasperated simply by few experience of independent success within a safe or perhaps comfortable environment before getting school era, where onset of SAD is most likely to occur (Wood 2006, Masi, Mucci, and Millepiedi, 2001).

Through the years a young child attends pre-school or kindergarten, the individual is definitely learning abilities of effort and management through impartial social connection with their colleagues. When supported in their hunt for this new placing, the child discovers about their capability to lead or make decisions. However , because aforementioned, if a child’s attempt for independence in this stage is usually blockaded, the kid will develop a feeling of guilt and become slow to interact with others (Erikson, 1968). It therefore can be reasonable in conclusion based on Erikson’s psychosocial theory of creation that distressing parenting potential clients the child to trust that they do not have control over scenarios around them (Wood, 2006, Erikson, 1950). A young child who has not really successfully conquered the problems of Effort vs Sense of guilt may think that they are a nuisance in front of large audiences and not do something to trigger social relationships, only sense comfortable the moment their accessory figure can be near, bringing about SAD.

Industry during middle the child years is not stopped simply by restricting freedom, such as in previous periods of Erikson’s (1950) theory. Instead, a kid will not truly feel confident in their abilities in the event criticized or perhaps does not get proper support from father and mother and educators. By the time MISERABLE symptoms set out to exhibit, throughout the age of six, the child was already told during stages you ” 3 of Erikson’s stages of development that independence is an unwise choice (Masi, Mucci, and Millepiedi, 2001). If they will continue to be informed this throughout the stage of Industry compared to Inferiority, they are going to begin to doubt their own capabilities. Just as they doubt the safety of their universe in Trust vs Doubtfulness, doubt all their ability to make it through in the world during Autonomy vs Doubt, and fear interactions with their colleagues during Effort vs Guilt, the child with SAD will certainly feel no level of mastery, control, or self-efficacy during Market vs Inferiority (Wood, 2006, Erikson, 1950, Gar and Hudson 08, Hudson and Rapee 2001).

Erikson’s theory signifies that SAD is triggered by the compounded effect of a lifetime of restricted independence. Children with SAD, according to this presentation, have not had the support needed to experience confident within their own skills and become really distressed the moment separated from the attachment figure upon which they depend for the completion guaranteed difficult duties. Parental intrusiveness and overprotectiveness may stop the emotional development of a kid, resulting in your child feeling which the world can be an unsafe and unpredictable place which they cannot navigate without any assistance when asked to during middle childhood. SAD takes place most often during the stage Industry vs Inferiority because it is the first time for many kids that they have recently been forced to take an environment pertaining to an extended period without their attachment figure. They are not used to having to function independently with no intrusive parent or guardian critiquing their actions and become distraught without the constant negativity to which they may have become used.

Professional Perspective

The Program Director of King Wide open Extended Day time (KOED) in Cambridge, Ma, Bucky O’Hare, agreed with the aforementioned exploration findings (B. O’Hare, July 20, 2017). KOED delivers after-school providers to a different group of children from various racial, cultural, social, and economic skills. Bucky mentioned that his biggest job in the beginning of your new school year can be helping parents of pre-school students to leave go. “I know it’s a difficult transition for a friends and family, but children are taking their particular cue via [their parents]”, Bucky explained concerning parental intrusiveness and separation panic. He proceeded to day job about kids he offers known more than his 15-year tenure for KOED that had a more difficult time than others giving their parents, not just your children he countless that had been diagnosed with SAD, affirming that a many children he knew who difficulty separating from their parents to attend university had a lower level of independence and self-efficacy than students who did in fresh social conditions.

However , Bucky was concerned in the quality of evidence and variety of populations studied. He brought up a specific case of a family in Cambridge that recently immigrated from the Dominican Republic. This kind of family has been through multiple traumatic experience and their three children have got a variety of particular needs. The youngest girl, a recent pre-school graduate, frequently has melt-downs which effect her functioning in school. The girl with unable to calm down until your woman hears her mother’s tone on the phone. Neither mother, dad, nor step-father are excessively intrusive in their children’s lives. Bucky will not believe this student’s separating anxiety is caused by over-intrusive parenting, alternatively by disturbing experiences by a young age group. He indicated his desire to have more generalizable research, citing the Tuskegee Syphilis Test as a cause that there is not more research executed with minority populations (“U. S Public well-being Service Syphilis Study at Tuskegee”, 2016).

Recommendations ” The Road to Independence

To help a child with MISERABLE with their anxiety about separation and improve their social interactions, early stages of Erikson’s (1950) psychosocial stages of development theory has to be addressed. As previously stated, Erikson’s theory suggests that UNHAPPY is caused by the compounded effect of not reaching the target of each level of expansion before the UNHAPPY average starting point age of six (Masi, Mucci, and Millepiedi, 2001). Equally parent and child must relearn how you can interact with one another until the indications of SAD possess subsided and functioning features returned to the age appropriate level. This recommendations are to help a kid with SAD assert independence and complete any stage of development which may have been slower due to mother or father intrusiveness.

The goal of Trust vs Mistrust is Desire (Erikson, 1950). To develop the caliber of Hope, father and mother and kids should conduct age appropriate tasks, such as puzzles or mazes, collectively. The Social Worker present will give the parent precise instructions how ways to become supportive and gives encouragement for their child devoid of becoming overbearing. This activity focuses on rearing-style, teaching the parent tips on how to offer trusted, affectionate, and caring support to their kid. The child learn, through multiple exposures to the task, that their parent is a safe base and pay attention to a new response to the question “Is the world a safe place? “. By dealing with parenting rearing-style, this suggestion hopes to place a new groundwork for the partnership between parent or guardian and kid.

The objective of Autonomy as opposed to Shame or Doubt is always to develop the standard of Will, thought as “the teachers by which a person choosess and starts action” (Erikson, 1950, “Definition of Will in English”, 2017). It is important during this level for the child to experience accomplishment in self-employed actions. To begin with, parents should certainly allow their child to make tiny decisions at your home that are appropriate for their age group. For example , a great overly invasive parent may possibly lay out clothes for their child to put on just about every morning. Being able to control this kind of a apparently small component to their time may make a difference in their expansion and emotions of control of the world surrounding them for children with SAD. Even if the child decides to wear stripes, polka dots, and a rain cover on a sunlit day, it is suggested the parents reward their infant’s creativity and independence through this activity.

The objective for Motivation vs Guilt is Goal (Erikson, 1950). To give the kid a sense of control and self-efficacy, they should be offered more jobs around their house. The child may be upset at first because they are used to their father and mother doing each of the housework or perhaps giving very specific instructions about how tasks should be completed. Father and mother may clarify this change in the home to their child simply by letting the child know that all their contributions happen to be valued plus they are an important family member. To allow the child to develop a sense of purpose in their family and household, age ideal tasks must be given to the child. After the responsibilities is completed, every time the child will the task without being asked or perhaps reminded, or perhaps if the children’s level of skill at this job improves, the parents should verbally recognize the youngster for this improvement. Through constant and consistent praise and encouragement, the child may begin to step outside of their rut and see different ways they are able to contribute to the world surrounding them. This task increases their feeling of purpose and their emotions of power over the world around them.

The objective of Industry versus Inferiority is usually Competency (Erikson, 1950). To assist the child develop new skills and competencies, the parent and child should certainly learn a fresh activity together. Not only will certainly learning a new activity increase the child’s emotions of self-efficacy, it will also produce a more secure connect between parent and kid. If the mother or father does not have found that how to develop a task, they are often less likely to over-correct the youngster. It is important to get the parent or guardian in this scenario to not become over critical of their children’s learning design or their particular ability to learn a new skill. In this situation, the parent or guardian should provide verbal reward to themselves in front of their child, so the kid may find out positive strategies to address the self. The parent must also express the several ways that they can be proud of the youngster in a new situation. Learning a new skill together may ease the child’s fear of new situations as they figure out how to conquer a brand new challenge within a new method with their father or mother.


Unfortunately, even though SAD affects primarily people from low SES people, current study does not sufficiently address just how SES influences different households who have children struggling with anxiety disorders. Future exploration should strive to report on how SAD affects families of distinct cultural, monetary, and racial backgrounds. Recommendations for helping kids with UNFORTUNATE are structured from Erik Erikson’s psychosocial stages of development theory and concentrate on helping extremely intrusive father and mother to repair their very own relationship with their child by providing the child more independence and support in various situations.

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