Updated
Original VAYEMA symptom and impact self-check – not a validated scale
Adult separation anxiety
Answer the symptom statements below to see which experiences and areas of daily life you report as most affected. These are original VAYEMA questions, not a validated diagnostic scale. No clinical severity or probability score is calculated.
Answers are processed only in this page by this assessment. They are not submitted, monitored or automatically saved. No name, email or account is required. Use a private device and clear your answers when finished.
For adults aged 18 and over. This self-check cannot diagnose or rule out a condition. Concerns about a child require an age-appropriate professional assessment.
Thinking about the past four weeks, how well does each statement describe your experience?
Additional context – not included in any questionnaire score
These are original VAYEMA questions, not a diagnostic instrument or a validated severity scale. They summarise the experiences you select and do not predict a diagnosis or future harm. Background condition information; this source does not endorse this self-check.
What an adult assessment needs to understand
The clinician asks about the person or people involved, the situations that trigger distress and what you expect might happen while apart. They also consider persistence and the effect on functioning. The aim is not to judge how much you care for someone or diagnose from how often you communicate.
The American Psychiatric Association describes separation anxiety disorder as excessive, persistent fear with functional consequences. Those features need interpretation in context. A close relationship, shared responsibilities or a preference to spend time together does not automatically establish a disorder. An assessment should explain which part of the experience, if any, needs clinical treatment.
Describe the separation and the feared outcome
A work trip, a partner leaving for the day or sleeping away from someone may each involve a different concern. You might fear harm to the other person, feel unable to cope alone or become distressed by uncertainty about contact. The clinician needs that meaning rather than only a list of situations.
Use a recent example when possible, but do not stage an experience to make the notes more accurate. Describe what you expected, what you did and how the concern changed. If the fear is hard to name, that is something to explore. You do not need to arrive with a complete psychological explanation or a perfectly organised account of the relationship.
Explain reassurance, contact and avoidance
A clinician may ask what happens when you call, message, check or cancel an activity. Does it answer a practical question, create lasting clarity or provide brief relief before another worry appears? The function matters. Frequent contact can be appropriate in some circumstances and anxiety-driven in others, so the assessment should not use one arbitrary contact rule.
Also describe what happens when contact is delayed and which activities have become difficult. These details help identify the pattern without assuming the solution is abrupt withdrawal. You should not be asked to invade another person’s privacy or collect evidence from their device for a routine assessment. Your own observations and concerns can begin the conversation.
Include the effect on your life, not only the relationship
Separation-related distress may affect sleep, work, travel, concentration or decisions about activities. A person may maintain an outwardly functional routine by avoiding situations that require time apart. The clinician should understand that hidden restriction as well as visible episodes of distress.
Choose a few goals you would like more freedom to pursue. These might involve attending an event, sleeping in an appropriate setting or being less absorbed by repeated checking. They do not have to involve becoming fully independent. A useful assessment connects the fear with what matters to you rather than assume one ideal relationship style is the desired outcome.
Practical responsibilities and actual danger need separate assessment
If another person genuinely needs care, time apart may depend on reliable support being available. Medical conditions, disability, an unsafe home or unresolved practical arrangements can make worry understandable. A mental-health assessment should not erase those needs or label all reluctance to leave as irrational.
Relationship threats, coercion or violence also require an appropriate response. You may need a private conversation about safety rather than joint therapy or an exercise in tolerating separation. Immediate danger should be directed to local emergency or specialist support services. This worksheet cannot assess another person’s behaviour, verify safety or recommend that you remain in or leave a relationship.
The history can include childhood or adult onset
A clinician may ask whether the pattern was present earlier, appeared after a change or developed gradually. Adult onset is possible; a World Mental Health Survey study examined separation-anxiety onsets across the lifespan. You do not need childhood symptoms to justify asking about a current adult difficulty.
Relevant losses, separations or health changes may be discussed without assuming they caused the problem. Mark uncertainty rather than fill gaps with guesses. A diagnosis should not depend on discovering one dramatic event. The current pattern, functioning and context can guide useful next steps even when the origin remains unclear.
Other anxiety patterns and health concerns may overlap
The professional may explore panic, generalised worry, depression, grief or trauma-related symptoms. Fear of being alone because of possible physical symptoms may raise different questions from fear that an attachment figure will be harmed. More than one concern can be present, and the assessment should explain the distinctions rather than force everything into a single category.
Our panic disorder and generalised anxiety guides provide related background. Bring relevant medication and medical information when helpful. New or serious physical symptoms require appropriate medical care, not interpretation through a relationship or anxiety questionnaire.
Why this is not a separation-anxiety diagnostic test
Researchers and clinicians may use structured interviews or measures for defined purposes. A result still requires consideration of development, history, context and impairment. A questionnaire cannot judge whether a relationship is caring, coercive or appropriate for the people involved, and it should not determine treatment on its own.
The prompts here are original and unscored. They do not reproduce a validated adult separation-anxiety scale, assign an attachment style or provide a clinical threshold. They are not suitable for diagnosing a child. The NHS child-development guidance explains why normal early-childhood separation distress requires a different understanding from an adult clinical concern.
Ask what the recommendation is based on
A useful conclusion should explain the working understanding, relevant uncertainty and the proposed approach. Ask how treatment would address the actual fear, what contact or separation-related work might involve and how practical responsibilities will be respected. The clinician should also explain the evidence and any limits relevant to the person’s age and presentation.
The treatment guide discusses psychological care and cautious interpretation of adult-specific research. You should know the responsible professional, initial format, costs and review point. A recommendation should not automatically impose a family programme, a medication or an intensive schedule because a relationship is important to you.
Privacy and a first step that remains your choice
Entries remain in the open page and are not sent to VAYEMA, interpreted or added to an inquiry record. Reviewing them repeats your own words. You can clear the notes or choose a download, which becomes a private file under your control. Avoid unnecessary information about another person and use an agreed clinical channel for anything you decide to share.
You can instead go directly to the private assessment pathway or read the understanding guide. Family support may address relatives’ own needs separately. Immediate danger or inability to remain safe requires urgent local help, not a routine inquiry or another round of self-reflection.
Frequently asked questions about separation anxiety assessment
Can this tool tell me whether I am too dependent?
No. It does not judge personality, relationship style or independence. It is an unscored preparation aid for discussing fear and its impact. A professional should consider your context, practical responsibilities and preferences rather than apply a universal standard for how much contact or closeness is acceptable.
Can I use these prompts to assess my child?
No. They are intended for an adult’s own preparation, not child diagnosis. Separation distress can be normal in early development, while more persistent concerns require age-appropriate assessment. Discuss the child’s needs with a relevant professional rather than infer a disorder from an adult worksheet or a parent’s score.
What if I have real reasons not to leave someone alone?
Explain those reasons clearly. Medical or caregiving needs may require practical support before separation is safe or feasible. Anxiety can coexist, but necessary responsibilities should not be dismissed as symptoms. The assessment should identify which needs are practical, clinical or related to the fear pattern.
Do I need childhood memories to establish an adult problem?
No. Adult onset is possible, and a current concern can be assessed even when earlier history is unclear. Describe what you remember and what is uncertain. You should not be pressured to produce an origin story or infer a childhood event simply because the current difficulty involves separation.
Should the attachment figure complete the answers for me?
Your own experience should remain central. Another person may provide observations with appropriate agreement, but that is different from answering on your behalf or diagnosing you. Their privacy and needs also matter. A clinician can clarify how each account contributes and whether separate support would be helpful.
Will concerning entries generate a response from VAYEMA?
No. Nothing typed here is transmitted or monitored. Use direct professional contact for clinical concerns and local emergency services for immediate danger. A downloaded note is only information you choose to retain, not an appointment request, safety assessment or alert to a clinician.
Resources and references
[1] American Psychiatric Association: separation anxiety definitions and assessment context
[2] World Mental Health Survey: separation anxiety across the lifespan