Question 218

Question:

A 10-month-old girl cries when her mother tries to put her in her grandmother’s arms. She happily allowed herself to be held when her grandmother visited 2 months ago. Which of the following best explains this behavior?

Correct Answer: E.  Stranger anxiety

Between the ages of 7-9 months, an infant develops stranger anxiety for individuals who are not primary caregivers. Stranger anxiety is a normal developmental milestone. It manifests as crying and physical discomfort when not in the presence of a primary caregiver, and usually resolves by 24 months. It is commonly confused with the pathologic entity of separation anxiety disorder, a condition usually seen beyond the age of two years and classified as three or more of the following DSM-IV criteria:
– Recurring distress when separated from the subject of attachment (such as the mother or home)
– Persistent, excessive worrying about losing the subject of attachment
– Persistent, excessive worrying that some event will lead to separation from a major attachment
– Excessive fear about being alone without subject of attachment
– Persistent reluctance or refusal to go to sleep without being near a major attachment figure, like a mother
– Recurrent nightmares about separation