ABSTRACT
The central feature of separation anxiety disorder (SAD) is unrealistic and excessive anxiety upon separation or anticipation of separation from major attachment figures (American Psychiatric Association; APA, 1994). Primary symptoms include excessive worry about potential harm to oneself (e.g., getting kidnapped, becoming ill at school) and/or major attachment figures (e.g., car accident). The child may avoid situations that lead to separation from primary caregivers. Common situations include refusing to attend school, sleep alone at night, or visit with a friend. Children may resort to oppositional behaviours when avoidance becomes unlikely (e.g., temper tantrums, screaming, pleading, and threats). Physical complaints are also common and include stomachaches, headaches, nausea and vomiting. Recurrent physical symptoms necessitate a complete physical examination to rule out a general medical condition. Most somatic complaints are in response to the anticipated separation, and will lessen when the threat of separation is removed. In many cases, however, the physical symptoms are exaggerated to gain attention or postpone separation (Eisen and Kearney, 1995).
