Diagnostic criteria for 309.21 Separation Anxiety Disorder

A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following: 

(1) recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated 
(2) persistent and excessive worry about losing, or about possible harm befalling, major attachment figures 
(3) persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped) 
(4) persistent reluctance or refusal to go to school or elsewhere because of fear of separation 
(5) persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings 
(6) persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home 
(7) repeated nightmares involving the theme of separation 
(8) repeated complaints of physical symptoms (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated 

B. The duration of the disturbance is at least 4 weeks. 

C. The onset is before age 18 years. 

D. The disturbance causes clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning. 

E. The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder With Agoraphobia. 

Specify if: 
Early Onset: if onset occurs before age 6 years

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision. Copyright 2000 American Psychiatric Association

A. Developmentally inappropriate and excessive anxiety concerning separation from home or from those to whom the individual is attached, as evidenced by three (or more) of the following: 

(1) recurrent excessive distress when separation from home or major attachment figures occurs or is anticipated 
(2) persistent and excessive worry about losing, or about possible harm befalling, major attachment figures 
(3) persistent and excessive worry that an untoward event will lead to separation from a major attachment figure (e.g., getting lost or being kidnapped) 
(4) persistent reluctance or refusal to go to school or elsewhere because of fear of separation 
(5) persistently and excessively fearful or reluctant to be alone or without major attachment figures at home or without significant adults in other settings 
(6) persistent reluctance or refusal to go to sleep without being near a major attachment figure or to sleep away from home 
(7) repeated nightmares involving the theme of separation 
(8) repeated complaints of physical symptoms (such as headaches, stomachaches, nausea, or vomiting) when separation from major attachment figures occurs or is anticipated 

B. The duration of the disturbance is at least 4 weeks. 

C. The onset is before age 18 years. 

D. The disturbance causes clinically significant distress or impairment in social, academic (occupational), or other important areas of functioning. 

E. The disturbance does not occur exclusively during the course of a Pervasive Developmental Disorder, Schizophrenia, or other Psychotic Disorder and, in adolescents and adults, is not better accounted for by Panic Disorder With Agoraphobia. 

Specify if: 
Early Onset: if onset occurs before age 6 years

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition. Copyright 1994 American Psychiatric Association