Essay On Attachment Disorder In Children

Reactive Attachment Disorder is a common infancy/early childhood disorder. Reactive attachment disorder is located under the trauma- and stressors-related disorder section of the Diagnostic and Statistical Manuel of Mental Disorders (DSM-5), Fifth Edition. It is normally diagnosed when an infant or child experience expresses a minimal attachment to a figure for nurturance, comfort, support, and protection. Although children diagnosed with reactive attachment disorder have the ability to select their attachment figure, they fail to show behavioral manifestation because they had limited access during the early developmental stage. Some disturbed behaviors include diminished or absence of positive emotions toward caregiver. In addition,

The Strange Situation is meant to be a snapshot of the relationship between infant and caregiver, and provide insight into the dyadic patterns that define this bond. Securely attached children are thought to have a primary caregiver who is sensitive, available and receptive to their infants needs. Insecure-avoidant children have primary caregivers who are intrusive, controlling and hurtful. These caregivers may be present in the infant’s life but unable to understand their infants needs, and provide the correct response. Caregivers of insecure-ambivalent infants have been found to be unresponsive to the needs of the infant, and very often unavailable. The effect of this treatment is that the infant is starved for affection and attention. The infant also feels the need to amplify their needs in an effort to reach their caregiver (Barnett & Vondra, 1999).

The importance of a healthy attachment in early childhood development can lead to a better adult development and skills for daily life. A secure and healthy attachment to the caregiver in infancy to adolescence showcases the importance of building strong relationships and coping skills during periods of stress and anxiety. The research that has been found, goes into detail about the different types of attachments that infants and children can develop as well as what negative and positive aspects come along with the attachments.

Attachment disorder is the result of a bonding process that occurs between a child and caregiver during the first couple years of the child’s life. From the view of Mary Ainsworth, Harry Harlow, John Bowlby and Rene Spitz attachment disorder does severe damage depending on the child and the abuse level. This attachment break severely damages the heart and mind. It stops the child’s ability to care, love or trust. When a child

Reactive attachment disorder is described (Kress & Paylo, 2014) as a disorder in which the child received extreme neglect by the primary caregiver and as a result does not form emotional bonds with others. Recent studies, state Kress & Paylo (2014), show that all children in order to develop emotional bonding with others need their basic physical and emotional requirements met. This was also the case with the little girl in the HBO &

This paper is a review of how attachment disorders were first defined in the Diagnostic Statistical Manual of Mental Health Disorders (DSM) in 1980, and how the descriptions have evolved over the past 30 years of research efforts which have provided new insights into the disorder. The main attachment disorder discussed is Reactive Attachment Disorder (RAD), that has recently been expanded to include a new diagnosis term called DSED – Disinhibited Social Engagement Disorder. In order to provide effective therapeutic interventions to children who may suffer from RAD, the professionals they come in contact with on a regular basis must be provided the skills to recognize the common indicators of the disorder as early as possible in a child’s development. RAD, if left undiagnosed, can have devastating effects throughout the lifespan for the individuals who suffer from it.

Attachment is defined as a deep, affectionate, and enduring emotional bond that forms between two people, namely an infant and a caregiver. It is developed during the first years of an infant’s life and has four types depending on the quality of the attachment: secure, ambivalent, avoidant, and disorganised. It has been reported that approximately only 60 to 65 percent of children form secure attachment to their caregivers. Research indicates that the early attachment relationship is an essential foundation for later development. Insecurely attached infants are more likely to grow into aggressive, defiant and hyperactive individuals with lower academic skills compared to securely attached children, they are also more prone to psychiatric disorders and other problems. In contrast, individuals who form a secure attachment in their infancy are more resilient to depression, parental stress, family instability, and poverty compared to those who form an insecure attachment. Given the prevalence and consequences, it is important to educate parents on the impacts that attachment quality can have on a child’s development and later life.

This paper explores the psychological disorder known as Reactive Attachment Disorder (RAD). It will investigate how a child diagnosed with RAD will have an inefficient connection with his or her caregiver during an early age. RAD is considered a serious disorder which affects infant and young children who have difficulties establishing healthy relationship with their caregiver or parents. The flawed relationship will affect the child’s ability to establish normal affiliation with other human being. Thus, a child’s rapport was a major determinant in the etiology of

According to Bowlby, the founder of attachment theory, a dependable, safe, and caring relationship with a primary caregiver is vital to an infant’s psychological health (Bowlby, 1951). In particular, children lacking a secure attachment with their primary caregivers are at risk of developing emotional and behavioral issues (Blakely & Dziadosz, 2015). Unfortunately, the human bonds normally formed in infancy are fractured in neglected and abused children suffering from RAD (Shi, 2014). As a result, these children become withdrawn, distrustful, and fearful of the world (Shi, 2014).

In the Newman, Newman book two types of expressions are defined, emotional withdrawn/inhibited type and indiscriminately social/uninhibited type. These expressions were defined in the Diagnostic and Statistical Manual-IV. In the new Diagnostic and Statistical Manual-5 (DSM-5), reactive attachment disorder is found under the Trauma-and Stress-related disorders section. The two expressions are now categorized as distinct disorders, reactive attachment disorder and disinhibited social engagement disorder. Both of these disorders are the result of social neglect or other situations that limit a young child’s opportunity to form selective attachments. Although sharing this etiological pathway, the two disorders differ in important ways. Because of dampened positive affect, reactive attachment disorder more closely resembles internalizing disorders; it is essentially equivalent to a lack of or incompletely formed preferred attachments to caregiving adults. In contrast, disinhibited social engagement disorder more closely resembles ADHD; it may occur in children who do not necessarily lack attachments and may have established or even secure attachments (American Psychiatric Association,

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.

While improper attachment between the care provider and the child may put the latter at risk of developing psychosocial problems, not every child with unsafe attachment develops reactive attachment disorder (Kennedy & Kennedy, 2004). A couple of variants of reactive attachment disorder have been discovered. Restrained reactive attachment disorder develops in a child who is aloof and socially and emotionally detached, shows resistance towards love and holds back the emotions. Unrestrained reactive attachment disorder involves the child showing impartial sociability and expressing more friendliness towards unknown persons than the primary care

Reactive attachment disorder is a unique disorder in its onset, impact on all aspects of life, and diversity of subtypes. In the Diagnostic and Statistical Manual – IV (DSM- IV), reactive attachment disorder was characterized by two subtypes; the disinhibited and the inhibited subtypes. The inhibited subtype was identified as being withdrawn, unemotional, and having difficulty forming any sort of significant relationship with others. The disinhibited subtype’s most defining characteristic was indiscriminate friendliness, and overwhelming trust for strangers. While the two subtypes seem like completely different disorders that have no relation, the reason they were originally put together in the DSM-IV was their origins. These disorders originate from severe maltreatment in childhood, and are fairly rare because of the level of severity necessary for the disorder to develop. Their common origin hints at a problem within the attachment relationship as a potential source of difficulties. The name itself is derived from a reaction to pathogenic care in early childhood.

Barbara M. Newman and Philip R. Newman (2009) stated, “Infants who show an anxious-avoidant attachment avoid contact with their mothers after separation or ignore their efforts to interact” (pg. 153). Children will show less distress at being alone than other children, resulting with rejecting others. As the child get older, they will become distant and avoid connections with peers, and have a harder time forming relationships. Children with resistant attachment explore very little in their surroundings, and is very suspicious in front of strangers. Barbara M. Newman and Philip R. Newman (2009) stated, “Infants who show an anxious-resistant attachment are very cautious in the presence of the stranger” (pg. 153).

The definition of attachment involves an affectional bond that infants need to form with a differentiated and preferred individual that becomes an attachment figure, consisting in a sustained nurturing relationship with the sensitive caregiver (Bowlbly, 1979). Attachment is conceptualized as an evolutionary feature: individuals can create a secure base around which one is able to explore and gain independence as well as a safe haven to which individuals can return and be reassured in a situation of distress or danger (Ainsworth et al., 1978; Bowlby, 1969). On the contrary, unresponsive or atypical ways of parenting can lead to aberrant behaviours or, if others risk factors are present, to psychopathology (Jacobsen, Edelstein, Hoffman, 1994; Schaffer, 1996). Secure attachment with the primary caregiver is necessary for social and emotional regulation as well as cognitive and resilience abilities(Bowlby, 1982; Ainsworth & Bell,1970); insecure attachment affects individuals’ life in many aspects, especially the ability to face distress (Macbeth et al., 2011), and not too rarely the aftermaths of an insane attachment can culminate in personality disorders (Crawford et al.,