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J Child Psychol Psychiatry. 2016 Jan;57(1):39-46. doi: 10.1111/jcpp.12424. Epub 2015 Apr 22.

Distinct trajectories of separation anxiety in the preschool years: persistence at school entry and early-life associated factors.

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Department of Psychiatry and Neurosciences, Université Laval, Québec city, QC, Canada.
Centre de Recherche Institut Universitaire en Santé Mentale de Québec, Québec city, QC, Canada.
Département de psychoéducation, Université du Québec à Trois-Rivières, Québec city, QC, Canada.
GRIP, École de psychologie, Université Laval, Québec city, QC, Canada.
Department of Pediatrics and Psychology, Université de Montréal, Montreal, QC, Canada.
Département de Psychoéducation, Université de Montréal, Montreal, QC, Canada.
Institute of Genetic, Neurobiological and Social Foundations of Child Development, Tomsk State University, Tomsk, Russia.
School of Public Health, Physiotherapy and Population Sciences, University College Dublin, Dublin, Ireland.



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.


Longitudinal assessment of SA trajectories and risk factors in a cohort of 1,933 families between the ages of 1.5 and 6 years.


Analyses revealed a best-fitting, 4-trajectory solution, including a prevailing, unaffected Low-Persistent group (60.2%), and three 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 to predict teacher-assessed SA at age 6 years. Except for the High-Increasing, all trajectories showed substantial reduction in symptoms by age 6 years. 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.


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.


Separation anxiety; development; internalising disorders; risk factors; trajectories

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