To meet separation anxiety disorder diagnostic criteria, at least 3 of 8 defined separation anxiety disorder features must be seen. These 8 are:
- Extreme and persistent distress when actual or anticipated separation from attachment figures occurs.
- Unfounded worrying about harm or injury befalling attachment figures.
- Unreasonable fear of a scenario in which separation will occur, such as being kidnapped, or unexpectedly separated and unable to reunite.
- An avoidance of normal life activities (workplace, school, social outings) in preference for staying near an attachment figure.
- A staunch resistance to being alone for small amounts of time.
- Being reluctant or even refusing to sleep without being in close proximity (sometimes in the same room) as an attachment figure.
- Recurrent separation-themed nightmares.
- Separation, even planned, from attachment figures results in physical symptoms such as nausea, headaches, and body aches. Can occur in anticipation of separation.
Separation anxiety disorder cannot be transitory, meaning that it must have persisted (with the above symptoms) for at least 1 full month before the diagnosis can be made. This diagnosis is reserved for children, and the attachment figure is most typically a parent or other caretaker. Adults over the age of 18 will not be diagnosed with separation anxiety. As in most psychopathology, merely meeting the criteria is not enough, but it must cause significant impairment in the person’s life.
As is a concern for any of the other anxiety disorder diagnoses, the presenting symptoms cannot be restricted to symptoms that fit another disorder. For instance, if the fear about an attachment figure being harmed at their job stems from an underlying blood-injection-injury specific phobia, the separation anxiety disorder diagnosis is not a fit.