An Overview Of Reactive Attachment Disorder

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An Extensive Overview of Reactive Attachment Disorder Reactive attachment disorder, also known as RAD, is characteristic of children who have developmentally inappropriate attachment behaviors. As mentioned in the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (2013), “The essential feature (of reactive attachment disorder) is absent or grossly underdeveloped attachment between the child and putative caregiving adults” (p. 266). This underdeveloped attachment is in response to a child being neglected or deprived of emotional and social comfort (American Psychiatric Association, 2013). In the following section, the diagnostic criteria for reactive attachment disorder will be discussed.
Reactive Attachment Disorder
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A history of neglect must also be present, which may include any of the following: lack of basic emotional needs for comfort, stimulation and affection on behalf of the caregiver(s), repeated changes of primary caregivers, and/or rearing in unusual settings. An extremely important factor when diagnosing RAD is that all disruptions explained in diagnostic criteria A and B must be a result of this pattern of neglect and deprivation of comfort and care. Additional diagnostic criteria include that the disturbances in the child/caregiver relationship much be noticeable before 5 years of age, the child must be a developmental age of at least 9 months, and the criteria for autism spectrum disorder are not met. It is important that the clinician specify whether the disorder is persistent, lasting more than 12 months, and whether it is severe, which is when the child exhibits all the symptoms of the disorder and the symptoms are displayed at relatively high levels (American Psychiatric Association, 2013). Understanding the etiology and the basics of attachment theory are essential to understanding the disruptive relationships seen in reactive attachment disorder.
The Etiology of Reactive Attachment Disorder Attachment theory was developed by John Bowlby in the 1960s and suggests that infants are primed to form a close, dependant bond with a primary caregiver beginning in the first moments of life. Hardy (2007) writes,
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