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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