Separation anxiety disorder in young children: a longitudinal and family analysis.

We conducted a longitudinal study of young children with clinical, subclinical, or nonclinical levels of separation anxiety to evaluate the diagnostic stability and concomitant parent and family variables of separation anxiety disorder (SAD). Youngsters were assessed at age 3 years (n = 60) and 3.5 years later (n = 44). Data were collected from children, parents, teachers, and clinicians. Results revealed that most diagnoses of SAD were not stable during this developmental period, as many children drifted toward subclinical or nonclinical status. In addition, children with clinical SAD, compared to those with subclinical SAD or no symptoms of SAD, had a disproportionately higher number of comorbid diagnoses and experienced significantly greater somatic concerns, anxiety, and general internalizing behavior. In addition, their parents experienced greater depression, obsessive-compulsive behavior, phobic anxiety, and general distress. The results preliminarily support prior findings that most children experience a dissipation of SAD symptoms in young childhood but that some children continue to experience stable, significant distress. The results are consistent with prior research on older children that SAD remits for many but not all youth and suggest that parent and family variables may have much to do with cases of poor remission in this population.