Psychology Facts

▲ Reactive Attachment Disorder ▲

》Reactive attachment disorder (RAD) is described in clinical literature as a severe and relatively uncommon disorder that can affect children. It often occurs in children who have been subject to extreme neglect or abuse or experienced repeated changes in caregivers that gave them limited opportunities to form selective attachments.

》Here are some examples of times when a child may not be able to form a secure attachment to a primary caregiver:

A child's mother is incarcerated off and on. The child resides with various relatives while she is in jail and the baby is never in the same home long enough to form a strong bond with any adults.

A child is removed from their birth parents and placed in foster care. They live in several different foster homes over the course of a year. They don't form secure relationships with any caregivers.

A mother has depression. Consequently, she struggles to care for her child. She is not responsive to the child when they cry and doesn't show them much affection.

A baby is placed in an orphanage. There are many different caregivers but the baby is rarely held or consoled when they cry. They spend most of their time in a crib.

A young mother doesn't understand child development basics. She lacks the knowledge to care for her child physically and emotionally. The child doesn't bond with the mother because she isn't responsive to the baby's needs.

Two parents have serious substance abuse problems. Under the influence of drugs and alcohol, they aren't able to provide their child with adequate care

》Reactive attachment disorder is a relatively new diagnosis. It was first introduced in the DSM in 1980.

》Diagnosis is limited to children between the ages of 9 months and 5 years who do not meet the criteria for autism spectrum disorder, but it is a lifelong condition that causes significant difficulties interacting with both adults and peers.

》In 2010, a study in Denmark found that less than 0.4% of children had reactive attachment disorder.

》A 2013 study estimated about 1.4% of children living in an impoverished area in the United Kingdom had an attachment disorder.

》A 2013 study of children in foster care in Romania found that about 4% exhibited reactive attachment disorder at 54 months of age.

》Researchers estimate that 52% of juvenile offenders have an attachment disorder or borderline attachment disorder. The vast majority of those teens had experienced maltreatment or neglect early in life.

》Symptoms :

Limited positive affect or smiling

Unexplained episodes of irritability

Sad, fearful, inhibited, or withdrawn behavior towards caregivers

Failure to respond to comfort when offered

Attempts to nurture or soothe oneself during times of distress as opposed to seeking comfort from caregivers, often calming down more quickly without the presence of an adult

Lack of reaction to caregivers' attempts to
interact or to others moving about a room

Failure to engage in interactive activities or motions such as reaching out when picked up or responding to a game of peek-a-boo

Superficially engaging and charming

Lack of eye contact

Indiscriminately affectionate with strangers

Lack of ability to give and receive affection on parents' terms – not cuddly

Inappropriately demanding and clingy

Persistent nonsense questions and incessant chatter

Poor peer relationships

Low self-esteem

Extreme control problems—may attempt to control openly or in sneaky ways

Difficulty learning from mistakes

Learning problems—disabilities, delays

Poor impulse control

Abnormal speech patterns

Abnormal eating patterns

Chronic "crazy" lying

Stealing

Destructive to self, others, property

Cruel to animals

Preoccupied with fire, blood, and gore

》Sometimes, children with reactive attachment disorder experience comorbid conditions. Research shows that children with attachment disorders experience higher rates of attention-deficit hyperactivity disorder (ADHD), anxiety disorders, and conduct disorders.

》The first step in treating a child with reactive attachment disorder usually involves ensuring the child is given a loving, caring, and stable environment.

》Therapy won't be effective if a child continues moving from foster home to foster home or if he continues living in a residential setting with inconsistent caregivers.