Relevance of separation anxiety in the autism spectrum and related disorders

Symptoms of separation anxiety disorder (SAD) are common among individuals with autism spectrum disorder (ASD) or subthreshold manifestations of the autism spectrum, also known as autistic traits (ATs). However, studies focusing on the association between SAD and ASD are still limited, especially from a dimensional perspective, and even fewer are carried in the adult population. In elucidating the relationship between autism spectrum and separation anxiety, borderline personality disorder (BPD) and feeding and eating disorders (FED), often masking a female autism spectrum phenotype and associated with separation anxiety symptoms, could play an extremely significant role. Specifically, in the relationship between these psychopathological entities, the development of insecure attachment patterns in individuals with autism, possibly due to the known difficulties in communication and social interaction presented by the patient and his family context, could promote the development of SAD and other mental disorders in continuity, such as BPD and eating spectrum disorders. We believe that investigating the relationship between ATs and separation anxiety can clarify the pathogenesis of these two disorders interpreted in the full spectrum of their manifestations and promote understanding of their comorbidities in an integrated model of psychopathology.