Background: Separation anxiety disorder (SAD) is one of the most prevalent anxiety disorders in childhood and adolescence, typically emerging around the age of six and affecting approximately 4% of individuals across the lifespan. Global and national data indicate that SAD is highly common in preschool settings and pediatric clinical populations in Türkiye. Prior research suggests that its etiology is shaped by an interplay of genetic, environmental, psychological, and socioeconomic determinants, with girls showing higher prevalence rates than boys. However, a comprehensive developmental psychopathology perspective integrating these multidimensional factors remains limited.
Methods: A systematic literature search was undertaken in PubMed/MEDLINE, PsycINFO, Web of Science, and Scopus from inception until October 2025. This review synthesizes epidemiological findings and developmental psychopathology frameworks to examine the risk and protective factors associated with the onset and course of SAD. Evidence from genetic studies, environmental risk models, attachment theory, and socioeconomic determinants is integrated to provide a multidimensional understanding of SAD. Particular attention is given to parental behaviors, temperament traits, and contextual stressors that influence vulnerability to anxiety disorders.
Results: Findings indicate that genetic influences, especially among girls, play a significant role in the emergence of SAD. Environmental contributors—including overprotective or controlling parenting styles, insecure attachment patterns, and adverse socioeconomic conditions—further elevate risk. Children from lower socioeconomic backgrounds demonstrate higher rates of SAD, suggesting a strong contextual effect. Conversely, secure attachment with caregivers emerges as a key protective factor, reducing susceptibility to anxiety and supporting adaptive emotional development.
Conclusion: SAD arises from complex interactions between biological, psychological, and environmental processes, underscoring the multifactorial nature of anxiety disorders. Understanding these interactions is essential for informing evidence-based prevention and intervention strategies. This review highlights the psychosocial impact of SAD on child development and emphasizes the need for further longitudinal and interdisciplinary research. This work aims to contribute to the epidemiological and clinical understanding of SAD within both academic and applied contexts.
