Separation Anxiety Disorder 193
The manifestations of separation anxiety di sorder vary with age. Younger children are
more reluctant to go to school or may avoi d school altogether. Younger children may not
express worries or specific fears of definite th reats to parents, home, or themselves, and the
anxiety is manifested only when separation  is experienced. As children age, worries
emerge; these are often worries about specific  dangers (e.g., accidents, kidnapping, mug-
ging, death) or vague concerns about not being reunited with attachment figures. In adults,
separation anxiety disorder may limit their ability to cope with changes in circumstances
(e.g., moving, getting married). Adults with the disorder are typically overconcerned about
their offspring and spouses and experience ma rked discomfort when separated from them.
They may also experience significant disruption in work or social experiences because of
needing to continuously check on the whereabouts of a significant other. 
Risk and Prognostic Factors  
Environmental. Separation anxiety disorder often deve lops after life stress, especially a
loss (e.g., the death of a relative  or pet; an illness of the individual or a relative; a change of
schools; parental divorce; a move to a new neighborhood; immigratio n; a disaster that in-
volved periods of separation from attachment  figures). In young adults, other examples of
life stress include leaving the parental home, en tering into a romantic relationship, and be-
coming a parent. Parental overprotection and intrusiveness may be associated with sepa-
ration anxiety disorder.
Genetic and physiological. Separation anxiety disorder in  children may be heritable.
Heritability was estimated at 73% in a communi ty sample of 6-year-old twins, with higher
rates in girls. Children with separation an xiety disorder display particularly enhanced