Yetişkin Ayrılma Anksiyetesi Bozukluğu: Bir Gözden Geçirme

Yıl 2022, Cilt: 14 Sayı: 1, 46 - 56, 31.03.2022

Zeynep Namlı , Aynur Özbay Lut Tamam

https://doi.org/10.18863/pgy.940071

Cited By: 5

Öz

Ayrılma anksiyetesi; bireyin temel bağlanma figürlerinden ayrılma ya da ayrılma beklentisi durumlarında aşırı kaygı yaşamasıdır. Ayrılma anksiyetesi bozukluğu, Ruhsal Bozuklukların Tanısal ve İstatistiksel El Kitabının beşinci (DSM-5) baskısına kadar çocukluk ve ergenlik dönemi bozukluğu olarak kabul edilmekteydi. Günümüzde ayrılma anksiyetesi bozukluğunun yetişkinlikte devam edebildiği ya da başladığı bilinmektedir. Yetişkin ayrılma anksiyete bozukluğu (YAAB) çocukluk dönemindekine benzer klinik belirtiler göstermektedir. YAAB’nin, anksiyete bozuklukları, travma sonrası stres bozukluğu, kişilik bozuklukları gibi çeşitli komorbid ruhsal hastalıklarla ilişkili olduğu gösterilmiştir. YAAB eşlik ettiği diğer psikiyatrik bozuklukların klinik belirtilerini ve gidişatını etkileyebilmektedir. YAAB’ye yönelik tedavi yaklaşımlarıyla ilgili yeterli veri bulunmamaktadır.

Anahtar Kelimeler

ayrılma anksiyetesi, gözden geçirme, yetişkinlik

Destekleyen Kurum

-

Proje Numarası

-

Teşekkür

-

Adult Separation Anxiety Disorder: A Review

Öz

Separation anxiety is excessive anxiety in separation from or expectation of separation from basic attachment figures. Separation anxiety disorder was considered a childhood and adolescent disorder until the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Nowadays, it is known that separation anxiety disorder may continue or begin in adulthood. Adult separation anxiety disorder (ASAD) shows similar clinical manifestations than in the children population. ASAD has been associated with several comorbid mental disorders such as anxiety disorders, post-traumatic stress disorder, and personality disorders. ASAD can also affect the clinical symptoms and course of comorbid psychiatric disorders. There is not enough data about the treatment approaches for ASAD.

Anahtar Kelimeler

separation anxiety, review, adulthood

Proje Numarası

-

Kaynakça

• Aaronson CJ, Shear K, Goetz RR, Allen LB, Barlow DH, White KS et al. (2008) Predictors and time course of response among panic disorder patients treated with cognitive-behavioral therapy. J Clin Psychiatry, 69(3):418–424.
• Abelli M, Chelli B, Costa B, Lari L, Cardini A, Gesi C et al. (2010) Reductions in platelet 18-kDa translocator protein density are associated with adult separation anxiety in patients with bipolar disorder. Neuropsychobiology, 62(2):98–103.
• Ainsworth MDS (1982) The place of attachment theory in human behavior. New York, Basic Books.
• Alfano CA, Beidel DC, Turner SM (2002) Cognition in childhood anxiety: Conceptual, methodological, and developmental issues. Clin Psychol Rev, 22(8):1209–1238.
• Alkın T (2010) Yetişkin ayrılma anksiyetesi bozukluğu. Türkiye Klinikleri J Psychiatry- Special topics, 3:53-63.
• American Psychiatric Association (1987) DSM-III-R: Diagnostic and Statistical Manual of Mental Disorders. revised. Washington, DC, American Psychiatric Association.
• American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision (DSM-IV-TR). Washington, DC, American Psychiatric Association.
• American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th ed., (DSM-5). Washington, DC, American Psychiatric Association.
• Atlı Ö (2011) Panik bozukluğu ve yetişkin ayrılma anksiyetesi bozukluğu hastalarında CO2 duyarlılığı (Uzmanlık tezi). İzmir, Dokuz Eylül Üniversitesi.
• Baldwin DS, Gordon R, Abelli M, Pini S (2016) The separation of adult separation anxiety disorder. CNS Spectrums, 21(4): 289–294.
• Bögels SM, van Dongen L, Muris P (2003) Family influences on dysfunctional thinking in anxious children. Inf Child Dev, 12(3):243–252.
• Bögels SM, Knappe S, Clark LA (2013) Adult separation anxiety disorder in DSM-5. Clin psychol rev, 33(5): 663–674.
• Bolton D, Eley TC, O'Connor T, Perrin S, Rabe-Hesketh S, Rijsdijk F et al. (2006) Prevalence and genetic and environmental influences on anxiety disorders in 6-year-old twins. Psychol Med, 36(3): 335-344.
• Bowlby J (1973) Attachment and Loss: Volume II: Separation, Anxiety and Anger. New York, Basic Books.
• Bowlby J (1980) Loss-Sadness and depression. London, Penguin.
• Brückl TM, Wittchen HU, Höfler M, Pfister H, Schneider S, Lieb R (2007) Childhood separation anxiety and the risk of subsequent psychopathology: Results from a community study. Psychother Psychosom, 76(1):47–56.
• Cartwright-Hatton S, McNicol K, Doubleday E (2006) Anxiety in a neglected population: Prevalence of anxiety disorders in pre-adolescent children. Clin Psychol Rev, 26(7): 817–833.
• Chelli B, Pini S, Abelli M, Cardini A, Lari L, Muti M et al. (2008) Platelet 18 kDa translocator protein density is reduced in depressed patients with adult separation anxiety. Eur Neuropsychopharmacol, 18(4): 249–254.
• Coldur EO, Cokmus FP, Suculluoglu Dikici D, Aydemir O (2020) The validity and reliability of DSM-5 separation anxiety disorder severity scale-adult form. Dusunen Adam, 33: 237–243.
• Costa B, Pini S, Martini C, Abelli M, Gabelloni P, Ciampi O et al. (2009b) Mutation analysis of oxytocin gene in individuals with adult separation anxiety. Psychiatry Res, 168(2): 87–93.
• Costa B, Pini S, Martini C, Abelli M, Gabelloni P, Landi S et al. (2009a) Ala147 Thr substitution in translocator protein is associated with adult separation anxiety in patients with depression. Psychiatr Genet, 19(2):110–111.
• Costello EJ, Mustillo S, Erkanli A (2003) Prevalence and development of psychiatric disorders in childhood and adolescence. Arch gen psychiatry, 60(8): 837–844.
• Cyranowski JM, Shear MK, Rucci P, Fagiolini A, Frank E, Grochocinski VJ et al. (2002) Adult separation anxiety: Psychometric properties of a new structured clinical interview. J Psychiatr Res, 36(2):77–86.
• Da Pozzo E, Costa B, Martini C (2012) Translocator protein (TSPO) and neurosteroids: implications in psychiatric disorders. Curr Mol Med, 12(4):426–442.
• Demir NÖ, Görgülü Y (2020) Bir üniversite hastanesi psikiyatri polikliniğine başvuran yaygın anksiyete bozukluğu tanılı hastalarda ayrılma anksiyetesi bozukluğu görülme sıklığı. Klin Psikiyatr Derg, 23(2):188-195.
• Diriöz M, Alkin T, Yemez B, Eminagaoglu N, Onur E (2012b) Ayrilma anksiyetesi belirtileri için yapilandirilmis klinik görüsmesi Türkçe versiyonunun psikometrik özellikleri/Psychometric properties of the Turkish version of the structural clinical interview for separation anxiety symptoms. Noro Psikyatr Ars, 49(1):6-13.
• Diriöz M, Alkin T, Yemez B, Onur E, Eminağaoğlu N (2012a) Ayrılma anksiyetesi belirti envanteri ile yetişkin ayrılma anksiyetesi anketinin Türkçe versiyonunun geçerlik ve güvenirliği. Turk Psikiyatri Derg, 23(2):108–116.
• Eapen V, Silove DM, Johnston D, Apler A, Rees S (2012) Adult separation anxiety in pregnancy: how common is it? Int J Women’s Health, 4:251-256.
• Eaves L, Silberg JL, Meyer JM, Maes HH, Simonoff E, Pickles A e al. (1997) Genetics and developmental psychopatology: 2. the main effects of genes and environment on behavioral problems in the Virginia twin study of adolescent behavioral development. J Child Psychol Psychiat, 38(8):965-980.
• Ehringer MA, Rhee SH, Young S, Corley R, Hewitt JK (2006) Genetic and environmental contributions to common psychopathologies of childhood and adolescence: A study of twins and their Siblings. J Abnorm Child Psychol, 34(1):1–17.
• Elbay RY, Görmez A, Kılıç A, Avcı SH (2021) Separation anxiety disorder among outpatients with major depressive disorder: Prevalence and clinical correlates. Compr Psychiatry, 105:152219.
• Eley TC, Rijsdijk FV, Perrin S, O'Connor TG, Bolton D (2008) A multivariate genetic analysis of specific phobia, separation anxiety and social phobia in early childhood. J Abnorm Child Psychol, 36(6):839–848.
• Foley DL, Pickles A, Maes HM, Silberg JL, Eaves LJ (2004) Course and short-term outcomes of separation anxiety disorder in a community sample of twins. J Am Acad Child Adolesc Psychiatry, 43(9):1107–1114.
• Franz AP, Rateke L, Hartmann T, McLaughlin N, Torres AR, do Rosario MC et al. (2015) Separation anxiety disorder in adult patients with obsessive-compulsive disorder: Prevalence and clinical correlates. Eur Psychiatry, 30(1):145-151.
• Gadow KD, DeVincent CJ, Olvet DM, Pisarevskaya V, Hatchwell E (2010) Association of DRD4 polymorphism with severity of oppositional defiant disorder, separation anxiety disorder and repetitive behaviors in children with autism spectrum disorder. Eur J Neurosci, 32(6):1058–1165.
• Gillath O, Shaver PR, Baek JM, Chun DS (2008) Genetic correlates of adult attachment style. Pers Soc Psychol Bull, 34(10):1396–1405.
• Gregory AM, Eley TC (2007) Genetic influences on anxiety in children: What we’ve learned and where we’re heading. Clin Child Fam Psychol Rev, 10(3):199–212.
• Heinrichs N, Rapee RM, Alden LA, Bögels S, Hoffman SG, Oh KJ et al. (2006) Cultural differences in perceived social norms and social anxiety. Behav Res Ther, 44(8):1187–1197.
• Hock E, McBride SL, Gnezda T (1989) Maternal separation: Mother-infant separation from the maternal perspective. Child Development, 60:793-802.
• İlhan E (2018) Yetişkin ayrılma anksiyetesi ve bağlanma arasındaki ilişki (Yüksek lisans tezi). İstanbul, İstanbul Gelişim Üniversitesi.
• Karamustafalıoğlu O, Yumrukçal H (2011) Depresyon ve anksiyete bozuklukları. Şişli Etfal Hastanesi Tıp Bülteni, 45(2):65–74.
• Kessler RC, Wang PS (2008) The descriptive epidemiology of commonly occurring mental disorders in the United States. Annu Rev Public Health, 29:115–129.
• Kirsch P, Esslinger C, Chen Q, Mier D, Lis S, Siddhanti S et al. (2005) Oxytocin modulates neural circuitry for social cognition and fear in humans. J Neurosci, 25(49): 11489–11493.
• Kossowsky J, Pfaltz MC, Schneider S, Taeymans J, Locher C, Gaab C (2013) The separation anxiety hypothesis of panic disorder revisited: A meta-analysis. Am J Psychiatry, 170(7): 768–781.
• Lahey BB (2009) Public health significance of neuroticism. Am Psychol, 64(4): 241-256.
• Leyfer O, Janet WB, Carolyn BM (2009) Anxiety disorders in children with williams syndrome, their mothers, and their siblings: Implications for the etiology of anxiety disorders. J Neurodev Disord, 1(1):4–14.
• Loas G, Atger F, Perdereau F, Verrier A, Guelfi JD, Halfon O et al. (2002) Comorbidity of dependent personality disorder and separation anxiety disorder in addictive disorders and in healthy subjects. Psychopathology, 35(4):249–253.
• Mancini AD, Robinaugh D, Shear K, Bonanno GA (2009) Does attachment avoidance help people cope with loss? The moderating effects of relationship quality. J Clin Psychol, 65(10):1127–1136.
• Manicavasagar V, Marnane C, Pini S, Abelli M, Rees S, Eapen V et al. (2010) Adult separation anxiety disorder: A disorder comes of age. Current Psychiatry Reports, 12(4): 290–297.
• Manicavasaga V, Silove D, Curtis J (1997) Separation anxiety in adulthood: A phenomenological investigation. Compr Psychiatry, 38(5):274–282.
• Manicavasagar V, Silove D, Curtis J, Wagner R (2000) Continuities of separation anxiety from early life into adulthood. J Anxiety Disord, 14(1):1–18.
• Manicavasagar V, Silove D, Marnane C, Wagner R (2009) Adult attachment styles in panic disorder with and without comorbid adult separation anxiety disorder. Aust N Z J Psychiatry, 43(2):167–172.
• Manicavasagar V, Silove D, Rapee R, Waters F, Momartin S (2001) Parent–child concordance for separation anxiety: A clinical study. J Affect Disord, 65(1): 81–84.
• Manicavasagar V, Silove D, Wagner R, Drobny J (2003) A self-report questionnaire for measuring separation anxiety in adulthood. Compr Psychiatry, 44(2): 146–153.
• Manicavasagar V, Silove D, Wagner R, Hadzi-Pavlovic D (1999) Parental representations associated with adult separation anxiety and panic disorder-agoraphobia. Aust N Z J Psychiatry, 33(3):422–428.
• Mayseless O, Scher A (2000) Mother’s attachment concerns regarding spouse and infant’s temperament as modulators of maternal separation anxiety. J Child Psychol Psychiat, 41(7):917–925.
• Meinlschmidt G, Heim C (2007) Sensitivity to intranasal oxytocin in adult men with early parental separation. Biol Psychiatry, 61(9):1109–1111.
• Mercer Jean (2006) Understanding Attachment: Parenting, Child Care, and Emotional Development. Portsmouth, Greenwood Publishing Group.
• Milrod B, Markowitz JC, Gerber AJ, Cyranowski J, Altemus M, Shapiro T et al. (2014) Childhood separation anxiety and the pathogenesis and treatment of adult anxiety. Am J Psychiatry, 171(1):34–43.
• Nestadt G, Samuels J, Riddle MA, Liang KY, Bienvenu OJ, Hoehn-Saric R et al. (2001) The relationship between obsessive-compulsive disorder and anxiety and affective disorders: Results from the Johns Hopkins OCD family study. Psychol Med, 31(3): 481-487.
• Ogliari A, Spatola CA, Pesenti-Gritti P, Medda E, Penna L, Stazi MA et al. (2010) The role of genes and environment in shaping co-occurrence of DSM-IV defined anxiety dimensions among Italian twins aged 8–17. J Anxiety Disord, 24(4):433–439.
• Osone A, Takahashi S (2006) Possible link between childhood separation anxiety and adulthood personality disorder in patients with anxiety disorders in Japan. J Clin Psychiatry, 67(9): 1451-1457.
• Peleg O, Halaby E, Whaby EN (2006) The relationship of maternal separation anxiety and differentiation of self to children’s separation anxiety and adjustment to kindergarten: A study in Druze families. J Anxiety Disord, 20(8): 973–995.
• Pine DS, Klein RG, Roberson R (2005) Response to 5% carbon dioxide in children and adolescents: Relationship to panic disorder in parents and anxiety disorders in subjects. Arch Gen Psychiatry, 62(1): 73–80.
• Pine DS, Wasserman GA, Workman SB (1999) Memory and anxiety in prepubertal boys at risk for delinquency. J Am Acad Child Adolesc Psychiatry, 38(8):1024–1131.
• Pini S, Abelli M, Shear KM, Cardini A, Lari L, Gesi C et al. (2010) Frequency and clinical correlates of adult separation anxiety in a sample of 508 outpatients with mood and anxiety disorders. Acta Psychiatr Scand, 122(1): 40–46.
• Pini S, Abelli M, Troisi A, Siracusano A, Cassano GB, Shear KM et al. (2014) The Relationships among separation anxiety disorder, adult attachment style and agoraphobia in patients with panic disorder. J Anxiety Disord, 28(8): 741–746.
• Pini S, Gesi C, Abelli M, Muti M, Lari L, Cardini A et al. (2012) The relationship between adult separation anxiety disorder and complicated grief in a cohort of 454 outpatients with mood and anxiety disorders. J Affect Disord, 143(1–3): 64–68.
• Pini S, Martini C, Abelli M, Muti M, Gesi C, Montali M et al. (2005) Peripheral-type benzodiazepine receptor binding sites in platelets of patients with panic disorder associated to separation anxiety symptoms. Psychopharmacology, 181(2):407–411.
• Quirin M, Gillath O, Pruessner JC, Eggert LD (2010) Adult attachment insecurity and hippocampal cell density. Soc Cogn Affect Neurosci, 5(1):39–47.
• Quirin M, Pruessner JC, Kuhl J (2008) HPA system regulation and adult attachment anxiety: Individual differences in reactive and awakening cortisol. Psychoneuroendocrinology, 33(5):581–590.
• Roberson‐Nay R, Eaves LJ, Hettema JM, Kendler KS, Silberg JL (2012) Childhood separation anxiety disorder and adult onset panic attacks share a common genetic diathesis. Depress Anxiety, 29(4): 320–327.
• Sahin G, Durat G, Sahin S (2019) Evaluation of the relationship between separation anxiety and functionality in patients with bipolar disorder/Bipolar bozukluk hastalarinda ayrilma anksiyetesi ve islevselligin degerlendirilmesi. Anadolu Psikiyatri Derg, 20(1):60–68.
• Schneier FR, Moskow DM, Choo TH, Galfalvy H, Campeas R, Sanchez-Lacay A (2017) A randomized controlled pilot trial of vilazodone for adult separation anxiety disorder. Depress Anxiety, 34(12):1085–1095.
• Seligman LD, Wuyek LA (2007) Correlates of separation anxiety symptoms among first-semester college students: An exploratory study. J Psychol, 141(2):135–145.
• Shear K, Jin R, Ruscio AM, Walters EE, Kessler RC (2006) Prevalence and correlates of estimated DSM-IV child and adult separation anxiety disorder in the national comorbidity survey replication. Am J Psychiatry, 163(6):1074-1083.
• Silove D, Alonso J, Bromet E, Gruber M, Sampson N, Scott K, et al. (2015) Pediatric-onset and adult -onset separation anxiety disorder across countries in the world mental health survey. Am J Psychiatry, 172:647-656
• Silove D, Manicavasagar V, Drobny J (2002) Associations between juvenile and adult forms of separation anxiety disorder: A study of adult volunteers with histories of school refusal. J Nerv Ment Dis, 190(6): 413–415.
• Silove D, Manicavasagar V, O'connell D, Blaszcynski A, Wagner R, Henry J (1993) The development of the Separation Anxiety Symptom Inventory (SASI). Aust N Z J Psychiatr, 27(3): 477–488.
• Silove D, Manicavasagar V, O’connell D, Yates M (1995) Genetic factors in early separation anxiety: Implications for the genesis of adult anxiety disorders. Acta Psychiatr Scand, 92(1):17–24.
• Silove DM, Marnane CL, Wagner R, Manicavasagar VL, Rees S (2010) The prevalence and correlates of adult separation anxiety disorder in an anxiety clinic. BMC psychiatry, 10(1):1–7.
• Silove D, Slade T, Marnane C, Wagner R, Brooks R, Manicavasagar V (2007) Separation anxiety in adulthood: Dimensional or categorical? Compr Psychiatry, 48(6): 546–553.
• Strober M, Freeman R, Lampert C, Diamond J (2007) The association of anxiety disorders and obsessive compulsive personality disorder with anorexia nervosa: Evidence from a family study with discussion of nosological and neurodevelopmental implications. Int J Eat Disord, 40(3): 46–51.
• Tasdemir A, Tamam L, Keskin N, Evlice YE. (2016) Assessment of co-morbidity of adult separation anxiety in patients with bipolar disorder. Nord J Psychiatry, 70(2): 93–102.
• Tops M, Van Peer JM, Korf J, Wijers AA, Tucker DM (2007) Anxiety, cortisol, and attachment predict plasma oxytocin. Psychophysiology, 44(3): 444–449.
• Van Ijzendoorn MH, Bakermans-Kranenburg MJ (2006) DRD4 7-repeat polymorphism moderates the association between maternal unresolved loss or trauma and infant disorganization. Attach Hum Dev, 8(4):291–307.
• Vanderwerker LC, Jacobs SC, Parkes CM, Prigerson HG (2006) An exploration of associations between separation anxiety in childhood and complicated grief in later life. J Nerv Ment Dis, 194(2):121–123.
• Vasa RA, Nay RR, Klein RG, Mannuzza S, Moulton JL, Guardino M et al. (2007) Memory deficits in children with and at risk for anxiety disorders. Depression and Anxiety, 24(2): 85–94.
• Vrtička P, Andersson F, Grandjean D, Sander D, Vuilleumier P (2008) Individual attachment style modulates human amygdala and striatum activation during social appraisal. PloS One, 3(8): e2868.
• Weinfield NS, Ogawa JR, Sroufe LA (1997) Early attachment as a pathway to adolescent peer competence. J Res Adolesc, 7(3):241–265.
• Wijeratne C, Manicavasagar V (2003) Separation anxiety in the elderly. J Anxiety Disord, 17(6):695–702.
• Wilhelm K, Boyce P, Brownhill S (2004) The relationship between interpersonal sensitivity, anxiety disorders and major depression. J Affect Disord, 79(1–3):33–41.