• seperation anxiety
• specific phobias
• social anxiety
• obsessive-compulsive disorder
• post-traumatic stress disorder
• generalized anxiety disorder

_____ = most common

• Developmentally normal

-cry when being separated during infancy and childhood

-grow out of it eventually 

• Some children show excessive amounts of distress and impairment for a long time = qualification for disorder diagnosis

• Biological factors
  - family history
  -heritability seems to be higher in girls (twin studies)
• Behavioral Inhibition
  -children born with a fearful temperament
  -ex. shy children 
• Parenting Behaviors
  -parents not encouraging independence  
  -being overprotective
  -parents with anxiety
• Traumatic events
  -natural disasters
  - family members in accident
  - getting lost 

How do you treat Separation Anxiety?

By Cognitive Behavioral Therapy

• Relaxation techniques
  -controlled breathing and muscle relaxation
• Challenge negative thoughts
  -"My mommy will be ok"
• Being reinforced for being "Brave"
  -sticker charts and rewards
• Parents model nonanxious behavior
  -ignore crying and worrying
  -refrain from acting distressed at seperation 

1. Traumatic Event
   -natural disaster
   -accident/injuries
        -themselves or witnessing others
   -abuse
        - sexual, physical, or family violence
2. Fear Responce
   -fight or flight (extreme responce)
   -adaptive until not needed anymore 

1. Re-experiencing Traumatic Events
   - distressing memories and dreams
   -feeling as if it were reoccuring
   -reenacting scenes with toys
   -distress when exposed with situations that remind them of the event 
2. Hyper-vigilance & Chronic Arousal
   -difficulty sleeping
   -outbursts of anger
   -no concentration
   -hyper vigilance (exaggerated behavior & paranoia)
   -exaggerated startle response 
   * some kids get wrongly diagnosed with ADHD or depression 
3. Emotional Numbing & Dissociation
    -avoiding thoughts, feelings, or conversation
   -aviodance of activities, places, or people associated
   -trouble remembering the event
   -feelings of detatchment from others
   -possible regressive behavior (wetting the bed-etc.) 

1. Biological factors
   -genetics
   -Physiological hyper reactivity  
2. -greater response in brain with stress responce
3.     ex.-release of cortisol(suppresses immune syst.)
           - release of adrenaline
4. Psychological factors: 
   - preexisting distress
       - those already experiencing distress are more
         vulnerable
   -coping styles
       - use maladaptive coping (avoidance,
         rumination, dissociation) 
5. Social Factors:  
   - severity, duration, & proximity of trama
       -more severe, longer trauma, and trauma that directly affects someone is more likely to lead to PTSD
          (ex. being raped for years vs. one time molestation) 
   -social support
       -close supportive family and friends protect against developing PTSD
       - those without support and who are isolated may be more vulnerable
            (ex. kids w/o many friends, rejected by peers)    

• Graudual Exposure
  - telling the story of what happened
• affective & cognitive processing
  - identify inaccurate or unhelpful thoughts
  - experience feelings the child has been avoiding
• Behavior management skills training
  - may be acting out abuse that happened
  -parents feel guilty and provide less discipline 

• get rid of negative feelings and trauma cues
• increase tolerance of trauma thoughts and memories
• decreasing reliance on maladaptive coping (reduce symptoms while maintaining and strengthening the disorder.)
• model effective coping by parent or therapist
  
• reinforce positive coping

• intrusive thoughts
• physiological arousal
• distress
• impairment in daily functioning due to symptoms
  - can't concentrate due to thoughts
  -avoidance behaviors 

Feeling of detachment from certain thoughts or experiences
-"numb"
-"outside of body"

ex. PTSD