Differentiate between separation anxiety and school refusal

The changes in the medical and psychological criteria when naming problems in childhood mean that we come across many terms that can be confusing . Some of them are the so-called separation anxiety disorder and school rejection or school phobia.

Below we discuss how each of these phenomena are and what are the characteristics that allow them to be differentiated .

SEPARATION ANXIETY DISORDER

Separation anxiety is a very common fear in young children. It usually appears between the first year of life and 6 years . This fear of leaving the parents or significant others for the child can also be observed in other species and has an important adaptive value .

Around the age of 2, this fear of separation is very frequent (up to 75% of children present it) and it disappears as they grow older , being practically non-existent in adolescence.

The anxiety separation is a disorder when the fear inappropriate for developmental level of the birthday person’s least 3 of a set of symptoms that establish the different diagnostic reference manuals for professionals, for at the least 4 weeks in children and adolescents more than 6 months in adults:

In summary, these symptoms consist of excessive and persistent discomfort or concern when separation with attachment figures is expected or experienced , in the event of their possible loss or suffering any type of damage . It is also accompanied by fear of being alone at home or anywhere, preventing the child from staying to sleep with friends or at friends’ houses. Above all, the variety of physical symptoms stand out (headaches, stomach, skin rashes …) before the separation or when you know that it is going to occur

SCHOOL REFUSAL OR SCHOOL PHOBIA

School phobia consists of a specific rejection of school or a specific element of the school environment that causes an emotional disturbance . As it is a specific stimulus, the manuals classify it as a specific phobia (sharing the criteria with the phobia of spiders or heights).

The characteristics of school phobia resulting from the consensus of professionals are:

• • A severe difficulty going to school that causes prolonged absences from school. It is often said that absences are a problem when they occur twice a week or more for a minimum of one month.

• • A serious emotional disturbance that includes intense fear, outbursts of anger or rage, sadness and complaints of physical discomfort (dizziness, nausea and stomach pain) without a justified organic cause.

• In some phase of the problem, children or adolescents remain at home with the consent of their parents.

DIFFERENTIATION BETWEEN SEPARATION ANXIETY DISORDER AND SCHOOL PHOBIA

The confusion stems from the fact that some authors consider school phobia a subtype of separation anxiety disorder . However, most agree that the latter is actually a broader and more complex problem .

As the main characteristic that differentiates them, we have the stimulus generated by fear . In the case of school rejection or phobia, children have an excessive fear of the school environment that is not due to bullying or some type of abuse at school.

For its part, in separation anxiety disorder, fear is due to withdrawal from attachment figures . Thus, a child with this problem would be afraid both of going to school and of staying one night with a caregiver, while having a phobia only symptoms would appear when going to school.

In school phobia, the fear or rejection of going to school increases as the time to go to school approaches . While in separation anxiety disorder, when dealing with a broader symptomatology, we will have a more generalized problem (nightmares, thoughts about possible abandonment or kidnapping …).

It is more common for children with separation anxiety disorder to find a pervasive pattern of social withdrawal and behavioral inhibition . Thus, even if their parents were present, they would not feel safe and would try to avoid socializing with other children and adults. In the case of school refusal, all the symptoms of fear and those derived from it revolve around the school. Also, recurring nightmares are less common .

Yet the differences are always easier to see on paper than in reality . When there is such a problem in the family, the emotional reactions of each blur the reasons and cause other problems to appear and others to be masked.

Therefore, it is best to seek the advice of a professional either in the clinical or school setting . In addition, the collaboration between the school and the family when dealing with any problem in childhood and adolescence is essential to obtain good results .