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Thursday, 23 February 2023

Reactive attachment disorder(Attachment Disorder in Adult) part- III

                    Reactive attachment disorder
Reactive attachment disorder (RAD) is a psychiatric condition wherein people have difficulty forming attachments with others. It is usually the result of early childhood trauma. 

About Reactive attachment disorder (RAD):

 RAD is a rare condition in which a child or adolescent experiences difficulties forming attachments with others. According to the diagnostic and statistical manual 5th edition, RAD is the result of a trusted source of experiencing neglect or abuse during early childhood. 

Reactive attachment disorder (RAD) can develop in children who do to form a predictable and nurturing bond with a trusted parent or caregiver. This may happen as a result of:

- Growing up in an overcrowded orphanage

- Frequently changing foster homes

- Having a parent or caregiver who has mental or physical health issues.

- Being taken away from a primary caregiver after establishing a bond with them.

- Experiencing long periods of hospitalization. 

     Being unable to form early emotional bonds can cause a child to stop engaging with others emotionally and develop behavioral problems. 

     Reactive attachment disorder (RAD) tends to develop in early childhood and typically affects children and adolescents. However, the symptoms may also extend into adulthood for some people. 

Reactive attachment disorder (RAD) in children

   A child can develop RAD following early life trauma that prevents them from forming may consistent emotional bonds with others. 

 Some children may develop RAD as a result of early neglect, such as being left crying, wet, or hungry for hours and having no one to interact with. Others may develop RAD following emotional or physical abuse. 

  Neglect or abuse can cause feelings of isolation, abandonment, and fear. Children who develop RAD tend to stop trying to form consistent emotional bonds with others. 

  This can extend into adolescence and adulthood. For example, some people may have difficulty trusting others and forming close personal relationships. 

Signs and symptoms

 Children with RAD may display some or all of the following signs and symptoms trusted source:

- Rarely seeking comfort when distressed

- Not responding to comfort when distressed 

- Minimal emotional or social responses, such as avoiding eye contact and not smiling 

- Persistent low mood and crying 

- Unexplained episodes of irritability, anxiety, or fearfulness

- A lack of interest in interacting or playing with others.

- A lack of social skills

- Cognitive problems

- Hyperactivity 

- Repetitive movements, such as rocking back and forth or hand flapping 

 These symptoms must occur before the age of 5 years in order for the child to receive a diagnosis of RAD. 

Patterns: 

When children with RAD grow a little older, their symptoms usually fall into one of two general patterns: inhibited RAD symptoms or disinhibited RAD symptoms. 

The following sections will discuss these in more detail. 

Inhibited RAD symptoms

  With this pattern, children are usually aware of what happens around them, but they do not respond typically to outside stimuli. 
children showing inhibited RD symptoms are often withdrawn and emotionally unresponsive. They may not show or seek affection from caregivers or others, instead preferring to keep to themselves. 

Disinhibited RAD symptoms

 With this pattern, children may be overly friendly toward strangers. Also, they may not prefer their primary caregiver over other people. 
In most cases, these children act younger than others' age and may seek affection from others in a potentially unsafe way. 

Reactive attachment disorder (RAD) in adolescents and adults:

 Without treatment, a child who develops RAD may continue to experience issues throughout adolescence and adulthood. 
 These issues may include:

- Avoidance of physical contact

- Difficulty displaying affection or care for others
- A lack of empathy
- Poor social skills
- Difficulty forming stable 
- Relationships with others
- Cognitive problems, such as poor memory or problem-solving skills
- Anger problems
- Control issues
- Academic or workplace problems
- Engaging in risky behaviors, such as substance abuse
- Mental health problems, such as depression or anxiety

Complications:

RAD can cause complications in children, adolescents, and adults. 

Children with RAD may be at increased risk of developmental delays and delayed growth. 

Older children and adolescents may be at increased risk of:

- Anger management issues

- Difficulties in school

- Depression

- Anxiety 

- Eating disorders

- Drug and alcohol abuse

If a person does not receive treatment for RAD during childhood or adolescence, the above complications may occur.

Diagnosis:

 A doctor or therapist will diagnose according to the DSM-5 guidelines. These guidelines trusted source state that a child must meet the following criteria in order to receive a diagnosis of RAD:

- A consistent pattern of emotionally withdrawn behavior toward a parent or caregiver, as evidenced by the child rarely seeking or responding to comfort when distressed

- A consistent emotional or social disturbance, as characterized by at least two of the following behaviors: 

- Minimal social and emotional responsiveness to other people 

- Limited displays of positive emotion.

- Episodes of unexplained irritability, sadness, or fearfulness even during nonthreatening interactions with adult caregivers 

- A traumatic experience that consists of one or more of the following:

- Social neglect or deprivation

- Repeated changes to the child's primary caregiver

- Rearing in a setting that severely limits the child's ability to form selective attachments. 

- Not meeting the diagnostic criteria for an autism spectrum disorder

- Experiencing signs of RAD before the age of 5 years

- Having a developmental age of at least 9 months. 

     Some of the signs and symptoms of RAD overlap with those of other conditions, such as intellectual disabilities or attention deficit disorders. A doctor will want to rule out these conditions before diagnosing RAD.


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Thursday, 2 February 2023

Attachment Disorder in Adults(Avoidant attachment) part- II

                      Avoidant attachment 



    An attachment style is the pattern of behaviors a person exhibits in response to relationships and bonds. Developing an avoidant attachment style as a child can lead to difficulties in forming close relationships as an adult.

  Avoidant attachment is one of three attachment styles trusted sources that Mary Ainsworth and Barbara Wittin developed in 1970. 

The Four attachment styles are:

 Secure

   Secure attachment develops in children with a parent or caregiver who is sensitive and responsive to their needs. Securely attached children have confidence that a parent or caregiver will be available to meet their needs and comfort them when they are distressed. 

Avoidant, or insecure-avoidant:
 
   Avoidant attachment develops in children who do not experience sensitive responses from a parent or caregiver to their needs or distress. Children with an avoidant attachment may become very independent, both physically and emotionally. 

Anxious, or insecure-anxious

  Children with anxious attachment do not have consistent responses to their needs from a parent or caregiver. Children with an anxious attachments may be clingy around their caregiver while insecure in themselves or in their interactions with others. 

Fearful, or Disorganized:

 Disorganized attachment occurs when a child wants love and care from their parent or caregiver but is also afraid of them. Disorganized attachment can develop if a parent or caregiver responds to a child seeking comfort by ignoring, yelling at, or punishing them in some way. 

Strange situation procedure:

  In the 1970s, Mary Ainsworth did an experiment called the " strange situation procedure". In this experiment, parents or caregivers left the room as their child played with a trained observer nearby. The researchers observed and documented the child's response to their parent or caregiver leaving the room. Children with a secure attachment style would cry when their parent or caregiver left the room but go to them and quickly become soothed on their return. 

 Children with an avoidant attachment style would be calm when their parent or caregiver left the room. Once they returned, the child would avoid or resist the child would avoid or resist having contact with them. 

Causes: 

  Infants and children generally need to form a close bond with their parents or caregiver. The repeated rejection of attempts to form this secure attachment may result in a child learning to suppress their desire for comfort when distressed or upset. 

  Avoidant attachment develops when an infant or young child has a parent or caregiver who is consistently emotionally unavailable or unresponsive to their needs. Infants with an avoidant attachment style may also have faced repeated discouragement from crying or expressing outward emotion. 

 The parent or caregiver of a child who has avoidant attachment may: 

- Lack of knowledge on how to support their child
- Lack empathy
- Feel overwhelmed by parenting 
- Responsibilities
- Not have developed a sense of commitment
- Have an avoidant attachment style themselves

 Children with an avoidant attachment may also disconnect from their own needs and feelings. These children may learn to self-soothe and feel as though they can only rely on themselves. As a result, they have little motivation or trust to seek help or support from others. 

Signs and symptoms

   A child with an avoidant attachment style may show no outward display of desire for closeness, affection, or love. However, internally, the child will feel the same stress and anxiety attachment when they are in stressful situations. 

 These children may also want to be near their primary caregiver but not interact with them. They may also reject physical contact with their caregiver. 

 Attachment styles and their associated behaviors can last into adulthood. As an adult, a person with an avoidant attachment style may experience the following: 

- Avoiding emotional closeness in a relationship
- Feeling as though their partners are being clingy when they simply want to get emotionally closer. 
- Withdrawing and coping with difficult situations alone
- Suppressing emotions
- Avoiding complaining, preferring to sulk or hint at what is wrong. 
- Suppressing negative memories
- Withdrawing, or tuning out, from unpleasant conversations or sights 
- Fearing rejection
- Having a strong sense of independence 
- Having feelings of high self-esteem while having a negative view of others 
- Being overly focused on their own needs and comforts. 

 Avoidant attachment can also affect older adults. A study from Hong Kong found that in older married couples, a male partner with an avoidant attachment style experienced more detrimental effects on their well-being than a female partner. 

Prevention:

  A parent or caregiver can prevent their child from developing an avoidant attachment style by being sensitive to their needs and feeling while encouraging them to express their wants and emotions. It is also important for a person to let their child know that they are safe and cared for through both actions and words. 

    Parents or caregivers should also be mindful to avoid making their children feel ashamed if they make a mistake or are afraid, Instead, they should soothe and comfort their children as often as possible when they are distressed or scared. 

   If a parent or caregiver finds that they are struggling with parenting and suspects that they may not consistently be meeting the emotional needs of their child, they should seek help from a mental health professional who specializes in working with people with these issues. 

 Anyone with concerns about how their child is developing, including their attachment style, may also find speaking with a pediatrician or child psychologist helpful.

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