The present study has several limitations. First, the groups in this study differed in the overall mean of symptoms at baseline (i.e., the parental control group had lower psychopathology scores than parents of treated children), and it is possible that comparisons (parents of healthy children) in this study did not decrease significantly over the course of the study because their symptom scores were already lower at baseline (i.e., “soil effect”). However, the quasi-control group gives initial evidence that the change in depression and separation anxiety in SepAD mothers may not be just a time effect. Second, children who received TAFF and Coping Cat therapy were combined in the present study to increase statistical significance. Although previous research has shown no difference in outcomes for children between these two therapies, the TAFF program includes not only the treatment of children, but also sessions for parents and family. Although the treatment of parental psychotherapy is not the direct goal of these sessions, the involvement of parents in the children`s session may have had a direct impact on the parents` mental health. However, when the type of therapy was included in the models, it had no effect and did not change the meaning of the other effects. Third, the present study lacked a clinical control group. The study was not specifically designed for the issue of transgenerational effects, and data on parental pathology are only available at baseline and after treatment. Therefore, pathology data from parents were not collected on the post-waiting list. Had this been the case, it would have allowed for a clinical comparison of controls (i.e., the comparison of parents of children with SepAD under immediate and delayed treatment conditions). The absence of a clinical control group receiving delayed or no treatment or alternative treatment (i.e., drugs) or isolated therapeutic components (i.e., only cognitive therapy, exposure only) means that it is not possible to identify the mechanism of action in this study.
The effect could be due to the transfer of knowledge between children and parents, direct involvement of parents in therapy, reduction of the burden on parents of a healthier child or simply time in combination with greater potential for improvement in treating mothers. A clinical control group can help answer these questions in the future. Fourth, parental psychopathology was dimensionally assessed and evaluated in the present study, and the results provide no information on whether the parents` clinical disorder status may change in relation to the treatment of children. Finally, in this study, it is not possible to determine the order of effects (cause and effect). We measure changes in parents and children at a certain time (after the measurement), so we cannot deduce whether the change occurred first in children or parents. The effects may be interactive. Other designs with multiple measurements during treatment would be needed to determine the order of effects. Somatic symptoms such as abdominal pain, headache, and nausea are another common feature of SAD.
Children with SAD are also more likely to report such somatic complaints than children diagnosed with phobic disorders (Last, 1991). Somatic complaints often arise in the context of separation situations that reflect either an avoidance strategy or actual physical strain (Albano, Chorpita, & Barlow, 1996; Tonge, 1994). In addition to more general somatic symptoms, children with SAD often have sleep disturbances when a parent is absent and may refuse to sleep alone (Black, 1995). Children with SAD may also have nightmares about separation that can further disrupt sleep (Francis, Last, & Strauss, 1987). One of the distinct differences in children diagnosed with separation anxiety compared to adults is the type of attachment figures involved. In children, attachment figures are usually adults, such as . B parents. In contrast, adults experience anxiety when they experience an actual or expected separation from children, spouses or romantic partners. [7] Most of us learn to master this fear, to develop skills that allow us to go into new situations, to meet new people. We need to help these children catch up in mastery development and skills development until they are at the point where they are strong enough to stand on their own. Separation anxiety disorder (SAD) refers to an exaggeration of normal developmental anxiety that manifests as excessive worry, anxiety, and even a fear of the actual or expected separation of a liaison figure.
This activity describes the diagnostic criteria, available assessment tools and evidence-based treatments for SAD, including psychotherapy and psychopharmacological intervention, and highlights the role of the interprofessional team, including paediatricians, general practitioners and specialist providers, in the assessment and treatment of patients with this disease. This study aims to investigate the transgenerational effects of SepAD treatment in children on parents` mental health (i.e., symptoms of separation anxiety, general anxiety, and depression). To control for normal changes over time, the analyses compared parents of children treated with SepAD (with one of two well-established treatment programs) with a near-control group of parents of healthy children who did not receive treatment. Previous studies have shown the effectiveness of CBT programs in reducing pathology in children, as well as in reducing parental anxiety disorders after treatment. In the present study, the hypothesis was put forward that treating children would also improve the mental health of parents, such as. B symptoms of anxiety and depression in parents, which often occur with pediatric pathology. It was expected that these effects would be particularly noticeable in mothers, as they are more likely to be afraid during pre-treatment. Screening for Anxiety-Related Emotional Disorders in Children – Revised (SCARED-R; Muris, Merckelbach, Schmidt and Mayer, 1999) is a self-assessment questionnaire for children from the age of seven. There is also a parent version of this measure.
Scared-R contains 66 elements that measure all DSM-IV anxiety disorders in children and adolescents, including 8 elements that specifically assess SAD. In a sample of clinically referred adolescents, most scarED-R scales were reliable in terms of internal consistency, and the Cronbach alpha of 0.72 for the child version and 0.81 for the parent version was found for the SAD subscale. In addition, the parent-child agreement was adequate, with correlations of 0.69 for the overall score and 0.62 for the reported SAD subscale. Convergent and discriminating validity was also found, as SCARED-R totals were significantly associated with CBCL`s internalization problems, but not with outsourcing problems (Muris, Dreessen, Bogels, Weckx, & van Melick, 2004). Kessler RC, Petukhova M, Sampson NA, Zaslavsky AM, Wittchen H-U, twelve-month and lifetime prevalence and lifetime morbid risk of mood and anxiety disorders in the United States. .