Parental Evaluations of Separation Anxiety Symptoms: The Role of Socialization Norms and Stigma in China and Germany

Separation anxiety disorder (SAD) is a prevalent mental health issue in childhood with long-term negative consequences. As primary gatekeepers to professional help and treatment, parents play a crucial role in identifying and responding to children’s SAD symptoms. The threshold hypothesis posits that cultural socialization norms influence how parents evaluate SAD symptoms by shaping expectations for child behaviors. However, recent work suggests that stigma could explain cross-cultural differences in such parental evaluations. This study used an experimental vignette design to examine the role of cultural norms and stigma in shaping parental responses to SAD in China and Germany. A total of 295 parents of children aged 7 to 13 participated. The experimental manipulation of norm salience did not pass the manipulation check or affect parental evaluations. Perceived seriousness of SAD symptoms did not differ between the two groups. However, Chinese parents reported higher levels of help-seeking intentions, parental distress, and more shame in response to SAD symptoms, despite perceiving symptom severity similarly to German parents. These findings suggest that while cognitive appraisals of SAD symptoms may be similar across cultures, behavioral and emotional responses differ. Stigma-related distress appears to drive cultural differences in help-seeking, challenging the threshold hypothesis.