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Distinct trajectories of separation anxiety in the preschool years: persistence at school entry and early-life associated factors
Evolution of separation anxiety symptoms in early childhood
Article [Accepted Manuscript]
Is part ofJournal of Child Psychology and Psychiatry ; vol. 57, no 1, p. 39-46
- Université de Montréal. École de santé publique. Département de médecine sociale et préventive
Background: Little is known about how children differ in the onset and evolution of separation anxiety (SA) symptoms during the preschool years, and how SA develops into separation anxiety disorder. In a large, representative population-based sample, we investigated the developmental trajectories of SA symptoms from infancy to school entry, their early associated risk factors, and their associations with teachers’ ratings of SA in kindergarten. Methods: Longitudinal assessment of SA trajectories and risk factors in a cohort of 1933 families between the ages of 1.5 and 6 years. Results: Analyses revealed a best-fitting, 4-trajectory solution, including a prevailing, unaffected Low-Persistent group (60.2%), and 3 smaller groups of distinct developmental course: a High-Increasing (6.9%), a High-Decreasing (10.8%) and a Low-Increasing group (22.1%). The High-Increasing group remained high throughout the preschool years and was the only trajectory linked to teacher-assessed SA in kindergarten. Except for the High-Increasing, all trajectories showed substantial reduction of symptom profile by age 6. The High-Increasing and High-Decreasing groups shared several early risk factors, but the former was uniquely associated with higher maternal depression, maternal smoking during pregnancy, and parental unemployment. Conclusions: Most children with high SA profile at age 1.5 years are expected to progressively recover by age 4-5. High SA at age 1.5 that persists over time deserves special attention, and may predict separation anxiety disorder. A host of child perinatal, parental, and family contextual risk factors were associated with the onset and developmental course of SA across the preschool years.