Adult Separation Anxiety Questionnaire (ASA-27)

The Adult Separation Anxiety Questionnaire (ASA-27) is a widely used, psychometrically validated clinical tool designed to measure separation anxiety…

Questions: 27
Duration: 10 min
Original title: ASA-27 — Adult Separation Anxiety Questionnaire
Adaptation: Adult Separation Anxiety Questionnaire (ASA-27)
Authors: Manicavasagar, V., Silove, D., Wagner, R., & Drobny, J.
Created: 2003

The Adult Separation Anxiety Questionnaire (ASA-27) is a widely used, psychometrically validated clinical tool designed to measure separation anxiety symptoms persisting into or emerging during adulthood. Initially viewed as a childhood condition, separation anxiety is now recognized as a distinct presentation in adults, characterized by excessive distress upon separation from home or major attachment figures, pervasive worry about harm coming to loved ones, and avoidance behaviors.

By mapping directly to core diagnostic criteria, the ASA-27 helps clinicians quantify the severity of these symptoms, differentiating separation anxiety from panic disorder or generalized anxiety. It is highly valuable during initial intake to establish a baseline, or throughout treatment to monitor clinical change.

Providing both a dimensional severity score and empirically established clinical thresholds, this self-report measure offers clinicians a structured way to investigate attachment-related distress. It ensures that critical symptoms (such as separation-triggered panic, somatic complaints, and excessive dependence) are reliably identified and tracked across therapeutic interventions.

Example result

Fictitious result, computed from a sample set of answers.

Overall score

39/ 81

The ASA-27 is a 27-item self-report questionnaire for adults (aged 18 and older) that assesses adult separation anxiety symptoms: anticipated or actual distress upon separation from attachment figures, excessive worries regarding their safety, physical symptoms, difficulty sleeping alone, avoidance behaviours, and excessive clinging. Developed from DSM diagnostic criteria for separation anxiety disorder, it is primarily used as a screening tool for adult separation anxiety disorder and to evaluate symptom severity, particularly in clinical populations or in individuals exhibiting moderate to high levels of adult separation anxiety disorder (ASAD). ASAD is also referred to by the acronym SEPAD (Separation Anxiety Disorder in Adults).

0–15

Low or no separation anxiety

16–21

Some separation anxiety

22–81

Probable adult separation anxiety disorder

Indicates the presence of severe and pervasive symptoms of separation anxiety that involve avoidance behaviours, dependency, excessive worry about harm to attachment figures, and difficulty functioning independently.

généralefemales · general population · n = 482 · Finsaas et al. (2020)

081

M = 10.34 ± 9.61

généralemales · general population · n = 407 · Finsaas et al. (2020)

081

M = 8.1 ± 8.46

cliniquemixed · pathology: mood and anxiety disorders · n = 509 · Pini et al. (2021)

081

M = 29.11 ± 15.6

Scoring

Sum of items (unidimensional score), total score ranging from 0 to 81, each item is scored on a 4-point scale (from 0 to 3).

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What the test measures

The ASA-27 evaluates the severity of separation anxiety in adulthood by assessing specific cognitive, emotional, and behavioral responses to actual or anticipated separation. The questionnaire maps the core dimensions of separation distress:

Anticipatory anxiety: intense distress, worry, or physical symptoms occurring before leaving home or separating from a loved one.
Excessive worry: persistent fears that serious harm will befall major attachment figures, often resembling traits of health anxiety.
Separation panic: sudden rushes of anxiety triggered specifically by distance from close individuals.
Avoidance behaviors: reluctance to be alone, reliance on safety objects, or disrupted routines that function as automatic behaviors to maintain proximity.
Sleep difficulties: trouble sleeping away from home or requiring a loved one's presence to sleep.

This instrument is intended for adults (aged 18 and older) presenting with anxiety, dependency, or attachment-related distress.

When and why to use it

The ASA-27 is a practical tool for clinicians mapping how symptoms manifest across the anxiety experience, particularly when separation distress is misidentified. It is highly useful in the following clinical situations:

Intake screening: identifying adult separation anxiety when a patient presents with broad anxiety, dependency, or panic symptoms.
Differential support: distinguishing separation-triggered panic from spontaneous panic attacks or agoraphobia.
Treatment planning: pinpointing specific behavioral targets (such as safety behaviors or reassurance-seeking) to address in exposure work.
Monitoring change: tracking symptom severity over time to measure the effectiveness of psychotherapeutic or pharmacological interventions.

Using a validated scale adds precision to the clinical impression, providing a quantifiable severity score that clarifies whether attachment-related distress exceeds normative adult functioning.

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The questions

The following statements refer to symptoms that you might have experienced as an adult (over the age of 18 years). For each item, indicate how often you have experienced this symptom. Please remember to answer all questions.
1. Have you felt safer at home when you are with people close to you?
Evaluates the subjective sense of safety derived from the physical presence of attachment figures.
- Never
- Occasionally
- Fairly often
- Very often
2. Have you had difficulty staying away from home for several hours at a time?
Probes behavioral difficulty and distress associated with prolonged absence from the home environment.
- Never
- Occasionally
- Fairly often
- Very often
3. Have you gotten into the habit of carrying something in your bag or wallet that gives you a feeling of security or comfort?
Assesses reliance on transitional or safety objects to mitigate anxiety.
- Never
- Occasionally
- Fairly often
- Very often
4. Have you felt extreme stress before leaving home to go on a long trip?
Measures anticipatory anxiety and stress specifically linked to leaving home for extended periods.
- Never
- Occasionally
- Fairly often
- Very often
5. Have you had nightmares or dreams in which you are separated from a loved one?
Explores the intrusion of separation themes into sleep and dream content.
- Never
- Occasionally
- Fairly often
- Very often
6. Have you felt extreme stress before leaving a loved one when going on a trip?
Evaluates anticipatory distress when facing an impending separation from a key attachment figure.
- Never
- Occasionally
- Fairly often
- Very often
7. Have you become very upset when your usual daily routine is disrupted?
Assesses rigidity and emotional reactivity when daily routines are unexpectedly altered.
- Never
- Occasionally
- Fairly often
- Very often
8. Have you been worried about the intensity of your relationship with loved ones, for example, feeling that you are too strongly attached to them?
Probes metacognitive awareness of and preoccupation with the intensity of one's attachments.
- Never
- Occasionally
- Fairly often
- Very often
9. Have you experienced symptoms such as headaches, stomachaches, or nausea (or others) before leaving for work or for another regular activity outside the home?
Checks for somatization symptoms triggered by routine daily separations like work or errands.
- Never
- Occasionally
- Fairly often
- Very often
10. Do you find that you talk a lot in order to keep people close to you?
Evaluates excessive talking as a compensatory behavior to maintain engagement and proximity.
- Never
- Occasionally
- Fairly often
- Very often
11. Have you been particularly worried about where your loved ones go when you are separated from them (for example, when you leave them to go to work or out of the house)?
Assesses hypervigilance and tracking of a loved one's whereabouts during routine separations.
- Never
- Occasionally
- Fairly often
- Very often
12. Have you had difficulty sleeping alone at night (for example, do you sleep better when a loved one is in the house)?
Probes nighttime separation anxiety and the inability to sleep without the presence of a loved one.
- Never
- Occasionally
- Fairly often
- Very often
13. Have you noticed that you fall asleep more easily if you can hear the voices of loved ones or the sound of the TV or radio?
Explores the use of auditory simulation as a coping mechanism for nighttime solitude.
- Never
- Occasionally
- Fairly often
- Very often
14. Have you become very distressed at the thought of being away from your loved ones?
Measures cognitive distress and rumination focused on the concept of being apart from attachment figures.
- Never
- Occasionally
- Fairly often
- Very often
15. Have you had nightmares or dreams in which you are far from home?
Checks for sleep disturbances centered specifically around themes of geographical displacement or being away from home.
- Never
- Occasionally
- Fairly often
- Very often
16. Have you worried a lot that serious harm might come to your loved ones, for example, a car accident or a fatal illness?
Evaluates catastrophic worry regarding the health and safety of major attachment figures.
- Never
- Occasionally
- Fairly often
- Very often
17. Have you become very upset by changes in your usual daily routine when they interfere with your contact with loved ones?
Assesses distress when routine disruptions specifically impede access or connection to loved ones.
- Never
- Occasionally
- Fairly often
- Very often
18. Have you worried a lot about the people who matter to you leaving you?
Probes the core fear of abandonment by significant individuals.
- Never
- Occasionally
- Fairly often
- Very often
19. Have you found that you sleep better when the lights are left on in the house or in your bedroom?
Measures reliance on environmental modifications (like lighting) to manage nighttime anxiety.
- Never
- Occasionally
- Fairly often
- Very often
20. Have you tried to avoid staying home alone, especially when your loved ones are out?
Assesses active avoidance of solitude within the home environment.
- Never
- Occasionally
- Fairly often
- Very often
21. Have you had sudden bouts of anxiety or panic attacks (e.g., sudden shaking, sweating, shortness of breath, racing heart) when thinking about leaving your loved ones or the thought of them leaving you?
Evaluates severe physiological panic responses triggered by thoughts of abandonment or separation.
- Never
- Occasionally
- Fairly often
- Very often
22. Have you found that you become anxious if you don't talk to your loved ones on the phone regularly (e.g., every day)?
Probes the need for constant digital or telephonic reassurance to regulate anxiety.
- Never
- Occasionally
- Fairly often
- Very often
23. Have you been afraid that you wouldn't be able to cope, or couldn't carry on, if someone who matters to you were to leave you?
Explores beliefs about self-efficacy and the anticipated inability to survive a loss or separation.
- Never
- Occasionally
- Fairly often
- Very often
24. Have you had sudden bouts of anxiety or panic attacks (e.g., sudden shaking, sweating, shortness of breath, racing heart) when you were separated from your loved ones?
Checks for actual panic attacks occurring during instances of physical separation.
- Never
- Occasionally
- Fairly often
- Very often
25. Have you worried a lot about events that could separate you from your loved ones (e.g., work obligations)?
Measures worry regarding external circumstances, such as work, that could enforce separation.
- Never
- Occasionally
- Fairly often
- Very often
26. Have loved ones ever pointed out to you that you 'talk a lot'?
Evaluates interpersonal feedback regarding hyper-verbal behaviors used to maintain connection.
- Never
- Occasionally
- Fairly often
- Very often
27. Have you worried that your relationships with certain people are so close that it might cause problems for them?
Probes awareness of the relational burden caused by overly enmeshed or dependent behaviors.
- Never
- Occasionally
- Fairly often
- Very often