اختلال اضطراب جدایی در سراسر طول عمر: DSM-5 ، محدودیت سنی در تشخیص را جابجا می کند

DSM-5 has lifted the age criterion in the definition of separation anxiety disorder thereby overturning the long-standing convention of restricting the diagnosis to childhood. Previously, adults with separation anxiety symptoms were assigned to other conventional categories such as panic disorder, agoraphobia or generalized anxiety disorder. Over the past two decades, an evolving body of research has identified separation anxiety disorder in adulthood, with 20–40% of adult psychiatric outpatients being assigned that diagnosis. In the US, the lifetime prevalence of the disorder in adulthood is 6.6%. The removal of the age restriction on diagnosis has important implications for clinical practice. Whereas parents (particularly mothers) of children with separation anxiety disorder commonly attracted the diagnosis of agoraphobia, the latter are more likely now to be diagnosed with the adult form of separation anxiety disorder, focusing attention on the importance of intervening with both members of the dyad to overcome mutual reinforcement of symptoms. In addition, adults with separation anxiety disorder have been found to manifest high levels of disability and they tend to show a poor response to conventional psychological and pharmacological treatments. There is an urgent need therefore to devise novel psychological and pharmacological interventions for the adult form of the disorder. The reformulation of separation anxiety disorder in DSM-5 therefore requires a paradigm shift in which clinicians are alerted to identifying and treating the condition in all age groups. Research across countries is needed to examine the new formulation of separation anxiety disorder amongst populations of diverse ethnic and cultural backgrounds.

DSM-5 has introduced key changes to the criteria for diagnosing separation anxiety disorder, lifting the age of onset restriction and modifying symptom descriptors to facilitate their application to adults as well as children and adolescents (APA, 2013). In addition, the category has been re-assigned to the general section of the anxiety disorders, giving it equal status with other common lifetime anxiety subtypes such as generalized anxiety disorder, social phobia and panic disorder. This shift advances the process of reconciling childhood and adult subtypes of anxiety, bringing symmetry to the classification of the anxiety disorders across the lifespan. The present article considers the historical and theoretical factors that may have delayed recognition of separation anxiety disorder as a condition that can occur in adulthood; evidence supporting the changes in the criteria for the disorder in DSM-5; implications of the new formulation to theories of developmental psychopathology; and the impact of these changes on the assessment and treatment of children and adults.