Impact of Separation Anxiety on Vulnerability of Children without Parental Care

The present study examined the impact of separation anxiety on the vulnerability of children without parental care. Parenting is no doubt one of the most tedious, diverse, and complex jobs to execute, and when it goes wrong, it affects society deeply. Parents are the first form of protection for their children, and when the roles are not executed, it tends to affect the child’s moral and psychological abilities. Separating children from their loved ones and/or familiar environments has a great impact on the developmental milestones of such children. Separation anxiety is a required distress-response to being separated from one’s caregivers during infancy, which is critical to the child’s emotional or psychological development. Regardless of the fact that some children develop coping strategies to regulate how they react to this distress, others hardly handle it, and it affects their behaviors and how they react to things. The United Nations Convention on the Rights of the Child (UNCRC) suggests that bringing up a child under the care of a parent or close relative is of great help to the child. However, children who are not privileged to have such opportunities are subjected to negligence and severe vulnerability. Some of the factors that contribute to child vulnerability include, but are not limited to, disability, parents’ educational level, and mental health status. Therefore, this commentary aims to investigate the previous empirical studies and other psychological implications and triggers of vulnerability in children without parents. It suggests that, apart from the physical and socio-economic challenges faced by children without parents, some psychological challenges (e.g., separation anxiety) predispose them to being vulnerable.


Introduction
Parenting is no doubt one of the most tedious, diverse, and complex jobs to execute, and when it goes wrong, it affects society deeply (Ezaka et al., 2020). Parents are the first form of protection for their children, and when parenting roles are not executed, it tends to affect the child's moral and psychological abilities. Across the globe, millions of children are reported to live without parental care, and this can be traced to the separation of parents, poverty, negligence, abuse, being displaced, trafficking, or the death of parents (Calis, 2022). Children without parental care who live in institutions or under foster care are at higher risk of abuse, exploitation, neglect, and being barely cared for. This inhospitable living condition has a negative impact on a child's social and psychological development and exposes them to physical and sexual abuse (UNICEF, 2013). Between 2001 and2007, an estimate given by UNICEF indicates that over 2 million children are reportedly living in institutional care (UNICEF, 2009), and this figure may not be accurate due to the fact that some governments may underreport in order to avoid critics, protect their international images, and be in line with International Children's Rights [ICR] (Engle et al., 2011).
Statistics show that in Eastern and Central Europe, an estimated 1.5 million children live under public care, while about 900,000 of them are in institutions (UNICEF, 2010). UNICEF and USAIDS (2004) reported that among Latin America, Asia, the Caribbean, and Sub-Saharan Africa, an estimated 143 million children (<18 years) may have lost one or both parents; 15 million out of this figure are orphaned by AIDS, mostly in Sub-Saharan Africa. The number of children without parents has continued to increase every year, and previous studies have focused more on the physical and socio-economic hardships faced by these children. However, this study aims to explore the psychological impact of being separated from families and loved ones and the level of social, physical, and emotional vulnerability among these children.
On a general level, the World Bank's policy framework [WBPF] (2004) defines vulnerability as "the likelihood of being harmed by unforeseen events or as susceptibility to exogenous shocks". According to WBPF, vulnerable children are children who subjectively face a higher risk than their local peers of infant, child, or adolescent mortality, low immunization, low access to healthcare services, high malnutrition, a high burden of disease, and low school enrollment rates. Others include family abuse, community abuse, maltreatment, and economic and sexual exploitation due to a lack of care and protection. The United Nations Convention on the Rights of the Child suggests that bringing up a child under the care of a parent or close relative is of great help to the child; this indicates that children who are not privileged to have such an opportunity are subjected to negligence and severe vulnerability (Voorst, 2006). Over the years, child vulnerability has been addressed in several child development and children's rights literatures, but the concept is neither well classified nor analyzed (Schweiger, 2019;Jopling & Vincent, 2016;Brown, 2011). Child vulnerability describes the interaction between environmental and individual factors that change over time, e.g., age, as it modifies the child's needs over time and subjects them to impending needs (OECD, 2019). It indicates a child's total lack of all dimensions of quality of life: physical health, psychological health, social health, environmental health, and general health.
In Nigeria, child vulnerability requires a multidimensional approach as it poses a great danger to the achievement of the 1-5 Sustainable Development Goals (SDGs). Notwithstanding the increase in the number of international and local nongovernmental agencies and organizations providing help to orphans and vulnerable children in Nigeria, there is an increase in insurgency, economic crisis, and militancy, which necessitates the need for strategic plans and programs that directly target vulnerable children in Nigeria (Nnama-Okechukwun & Erhumwunse, 2021). There is a diverse view on the factors responsible for child vulnerability in Nigeria. While some studies acknowledged poverty (Abdullahi, 2020; Aransiola & Zarowsky, 2014;Folami et al., 2019;Victor, 2018), others pointed out harmful cultural and religious practices (such as child marriage, child witchcraft, female genital mutilation, and Almajiri institutions), rural-urban migration, the non-availability of preventive health practices, and child labor. Others include child trafficking, a lack of essential health services for poor families, and illegal adoption (Anyacho & Anyacho, 2016;Aransiola & Zarowskyky, 2014a;Ebharevba et al., 2018;Essia, 2012;Igwe et al., 2019;Isioma, 2019;Muhammad et al., 2019;Muktar et al., 2017;Nwaolikpe, 2018).
Separating a child from his or her loved ones or familiar environments has a great impact on the developmental milestones of such a child and can lead to sudden apprehension. Separation anxiety is a required distress response to being separated from one's caregivers during infancy and is critical to the child's emotional or psychological development (Blatt, 2004;. Regardless of the fact that some children develop coping strategies to regulate how they react to this distress, others hardly handle it, and it affects their behaviors and how they perceive the world around them. According to Cartwright-Hotton et al., (2006), separation anxiety disorder (SAD) is regarded as the commonest form of anxiety among children under the age of 12. DSM-IV-TR of the American Psychological Association [APA], (2000), describes SAD as an incongruous fear of being separated from one's home that is intensive, distressing, persistent, impairing, and lasts for a period of 4 weeks. It can be linked to worries such as caregivers leaving home, caregivers getting hurt or injured, being involved in personal safety and injury, being alone, or sleeping alone (Mattis & Pincus, 2004;Silverman et al., 1995;Farach, 2002). While this form of anxiety is linked with adult anxiety disorder, it triggers depression in younger adults (Hirshfeld-Becker et al., 2008). Among children, the mean age of SAD is 7 years (Masi et al., 2001), and one third of children with early SAD have been found to carry on clinical SAD into adulthood (Shear et al., 2006). These clinical but negative outcomes associated with separation from loved ones and familiar environments add to the crises and vulnerability of children without parental care. SAD is mostly recorded among girls, nevertheless, the anxiety symptoms are found more frequently among boys, simply because the symptoms are less socially acceptable (Compton, et al., 2000). Separation apprehensions are found mostly among children with both internal and external problems, highly comorbid with depression, generalized anxiety disorder [GAD], social phobia, and specific phobias (Weems et al., 2000;Last, 1991;Kendall et al., 2001;Verduin & Kendall, 2003). There has been greater emphasis on the issue of separation between mother and child. According to developmental theories, mother-child bonding is crucial for the child's psychological development . A cross-sectional study found that maternal perceived separation was related to observed separation anxiety among children in 38 preschoolers and predicted symptoms of separation anxiety among 99 children aged six (Peleg et al., 2006b;Dallaire & Weinraub, 2005b). Parallel to the above outcomes, Mayseless and Scher, (2000), reported that maternal separation anxiety had no relation to fearful temperament among 97 infants. This indicates that there are discrepancies among the literature on the level of anxiety among children separated from their parents.

Child Vulnerability Factors
The factors contributing to child vulnerability are outlined by the Organization for Economic Co-operation and Development [OECD] (2019) in the document titled "Changing the Odds for Vulnerable Children: Building Opportunities and Resilience." The factors include, but are not limited to: • Disability: regardless of the fact that the conditions of children with disabilities have increased over the last few decades, it is still a contributing factor to child vulnerability. Children whose personal functioning is limited by communication, sensory impairments, intellectual, physical, or chronic conditions are more susceptible to negligence and maltreatment compared to other children without disabilities.
• Parents' educational level: the level of parents' education has a great role to play in a child's developmental milestones and the child's educational achievements. Studies have shown that among the OECD countries, children with (at least one) educated parent have a 60% likelihood of attempting tertiary education, while children of parents with upper secondary and below upper secondary education have 41% and 42%, respectively. Another study indicates that parents' educational level has a significant effect on adult literacy and numeracy skills, as 25% of adult participants whose parents had below-average upper secondary education recorded the lowest scores compared to participants whose parents had tertiary education. This implies that the educational level of a child's parents plays a significant role in how successful or vulnerable such a child will be.
• Mental health status: the level of poor mental health among children and younger adults is becoming alarming these days. Children who live in low socio-economic backgrounds or who experienced life-threatening events early in life are more susceptible to being vulnerable compared to children with a high socio-economic background and those who never witnessed any life-threatening events. Losing parents early in life, being displaced due to war or insurgency, or the recent CVID-19 pandemic are all triggers of poor mental health that may push children to be more vulnerable than others.
• Maltreatment: Maltreatment may fall under environmental factors in terms of living in a poor neighborhood, poverty, substance abuse by parents, overcrowded housing, and intimate partner violence. Maltreatment has been found to trigger long-lasting economic consequences in society.
• Constant parental violence: violence among intimate partners affects children negatively. It leads to low birth weight and/or preterm delivery. During early childhood, violence among parents has a great impact on the child's social and emotional development.

Preventing Child Vulnerability
Different factors have been found to contribute to child vulnerability over time. Multilevel approaches are needed to continually tackle these issues. Take, for instance, children who live in a low-income family (LIF), who may as well live in a high-income family (HIF) located in an environment with poor social capital and social cohesion (Wikle, 2018). Also, children living in low-income families (LIFs) are more likely to lack good social and family support, adequate living space, and access to high-quality education (Ellenbogen et al., 2014). Therefore, it becomes imperative that all laws and policies at international and national levels be geared towards building child resilience, which can serve as a good coping strategy.
• Parental support: This covers developing a program that helps families reduce their exposure to stressors. E.g., developing good parenting skills and providing financial aid will go a long way in helping families and homes achieve a better quality of life.
• Emotional and social well-being programs: Emotional and social well-being programs will help individuals (especially the disadvantaged ones) develop good emotional functioning and social connections too. The school, for instance, plays a vital role in supporting children's emotional and social well-being by identifying children who have special needs. Creating equal opportunities for accessing physical and mental health institutions, providing adolescent mentoring programs, and organizing sensitization programs all go a long way toward improving emotional and social well-being.
• Child protection: Countries around the world should pay more attention to child protection and make offices accessible to families and children in need. Child protection laws always target child maltreatment, poverty, and discrimination, improves the well-being of children placed in out-of-home care, and support adolescents aging out of the care system. ijps.ccsenet.org International Journal of Psychological Studies Vol. 15, No. 2; • Health: Creating equal opportunities should also transcend access to family planning services and health insurance. In terms of child mortality, access to healthcare institutions reduces the risk of preterm birth and low-birth-weight babies.

Area of Focus
• Orphans in general and children made vulnerable by HIV/AIDS in particular • Children associated with armed groups and other children made vulnerable by armed conflict • Street children.
• Children are involved in the worst forms of child labor.
• Children living with disabilities • Children affected by natural disasters

Discussion
The role of parents in preventing child vulnerability can never be overemphasized; this is why Ezaka et al., (2020) describe their roles as tedious, diverse, and yet complex, in that entire societies are affected when they go wrong. Although parents are regarded as the first form of protection for the child, a number of factors have been found to subject children to life without parents, some of which include separation of parents, poverty, negligence, abuse, being displaced, trafficking, or the death of parents (Calis, 2022). More so, these children are exposed to so many psychosocial dangers, such as a higher risk of abuse, exploitation, neglect, and being barely cared for, and this unwarranted exposure can impact negatively on the child's social and psychological development and expose them to physical and sexual abuse (UNICEF, 2013). Due to irregularities in the number of children living without parental care in some countries, there should be harmonized international law in this regard, for instance, the United Nations Convention on the Rights of the Child, which will go a long way in preventing child vulnerability. On the other hand, separation anxiety is a required distress response to being separated from one's caregivers during infancy and is critical to the child's emotional or psychological development (Blatt, 2004;. When a child is separated from his or her loved ones or familiar environment, it has a heavy impact on his or her developmental milestones. In this study, disability, parents' educational level, mental health status, maltreatment, and constant parental violence were found to be child vulnerability factors. Parental support, emotional and social well-being programs, child protection, and health are better ways to prevent child vulnerability. This study further suggests that, apart from the physical and economic challenges faced by children without parents, some psychological challenges (e.g., separation anxiety) predispose them to being vulnerable.

Author's contributions:
All authors had full access to all of the information in the study, studied it, and approved the final manuscript. The first author is responsible for the conceptualization and design of the study, while the second author is responsible for the review of related literature and discussion.

Funding:
No external funding is received for this study.

Declaration of interest:
The authors declare that they have no competing interests.
Ethics approval: not applicable. Consent to participants: not applicable.