Reactive Attachment Analysis

In the earliest stages of development, emotions are diffuse and infants have little control over their behavioral expression, relying instead on the dyadic regulation provided by their caregivers’ responses to behavioral signals. Attachment disorders form in infancy and early childhood as a result of instability in the child-caregiver relationship. Attachment-disordered children typically have experienced abusive or neglectful care, multiple changes between caregivers and environments, or the sudden loss of a parent or parents.

Reactive Attachment Disorder (RAD) was first introduced just over 20 years ago, with the publication of DSM-III (American Psychiatric Association, 1980). In the DSM-IV. The disorder is defined by aberrant social behavior that appears in early childhood and is evident cross contextually(1994). The disorder describes aberrant social behaviors in young children that are believed to derive from being reared in caregiving environments lacking species-typical nurturance and stimulation, such as in instances such as maltreatment or institutional rearing. (First, M., & Tasman, A. 2010) . In cases of RAD two major types of abnormalities have been cited; these include an emotionally withdrawn/inhibited type and an indiscriminately social/disinhibited pattern (First, M., & Tasman, A. 2010).Conditions in in foreign orphanages and institutions such as, multiple caregivers, maltreatment, abuse, neglect, and others contribute to the inability for internationally adopted children to form secure attachments. All of these factors contribute to internationally adopted children being at a higher risk to develop attachment disorders such as RAD and other behavioral problems.

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,

Ainsworth (1978) developed the Strange Situation Theory, which is how one is able to view the different levels of attachment (Groh, Roisman, Booth-LaForce, Flaley, Owen, Cox, & Burchinal, 2014). The first attachment is secure attachment, which is when a child is able to greet and seek out contact with the caregiver upon arrival after a stressful separation (Haltigan & Roisman, 2015). The next is anxious-avoidant/resistant (insecure) attachment, when the child has no want to contact with the caregiver while showing signs of resistance upon the return (Haltigan & Roisman, 2015). The last and the most crucial to child development is disoriented/ disorganized attachment; conflicting responses from the child which show hostile and aggressive behavior toward the caregiver (Haltigan & Roisman, 2015). All of these attachements show the different types of ways that a child can communicate with their caregiver. These actions are the representations of their early attachment and experiences with the caregiver (Siebert & Kerns, 2015). If there are no changes toward the environment, the attention

Munchausen by Proxy Syndrome is a very dangerous disorder. This disorder came about to identify a parent who intentionally causes harm to their child. This disorder was named after Baron von Munchausen who discovered it. Symptoms are hard to identify because many do not believe a parent could harm their own child. The main symptom is that the child only becomes sick or is harmed in the presence of their parent. The parent tries to maintain a relationship with the doctor of the child because this disorder is based on the parents need for attention from the doctor, other parents, and their child. MBPS is caused by a need for attention and sympathy of the parent for “helping” their child. The only treatment known for this disorder is extensive psychotherapy. Munchausen by Proxy is a very rare behavioral disorder. “This form of abuse claims the life of nine percent of children that fall victim to it.”

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 a disorder that impairs a child’s social skills before the age of five. (Shi, 2014) Children diagnosed with reactive attachment disorder have a hard time getting close to others. They are ones who are neglected, abused or constantly changing caregivers. It is hard for these children to get close to others when all they know is negative things about personal relationships. If a child is raised not knowing how to trust or be close to anyone, they will have issues with relationships.

Treatment strategies are not as well established for disorganized attachment as they are with other attachments. However, there is a critical need to develop these strategies as this particular population struggles immensely with issues such as self-regulation, the development and maintenance of relationships, as well as many other conditions that affect their daily lives. An important and critical time for treatment is during early childhood, as the longer a person struggles with disorganized attachment, the more difficult it is to treat and correct that attachment. There are a number of different treatments that may be utilized, and researchers are in the process of determining their effectiveness. There have been some case studies that have discussed the potential for individual therapies that have a focus on both emotional regulation and the growth of relational abilities through non-directive play according to Zilberstein (2010, p.89) Other studies have instead choose to focus on the changes that are elicited through the basic parent-child

Reactive attachment disorder manifests before the age of five and affects how a child is able to attach to their guardians, teachers, friends, authority figures, and any other person in their lives. There are two recognized types of reactive attachment disorder. The inhibited type and the disinhibited type (Rhodes, 2016). The inhibited type is “emotionally withdrawn” (Roberds & Davis, 2011). They do not initiate social relations or respond developmentally appropriately. The disinhibited type could also be called “indiscriminate” (Roberds & Davis, 2011). They will look for comfort or interaction from strangers or caregivers indiscriminately. They can also be “described as shallow and attention seeking” (Roberds & Davis, 2011). Some of the symptoms of reactive attachment disorder, or RAD, could stem from other disorders such as post-traumatic stress disorder. “Children with RAD may lack empathy, may intentionally harm themselves or others, and may be hypervigilant. Children with RAD have also been observed to exhibit impulsive and self-endangering behaviors. They may generally struggle with emotional and behavioral regulation. Children diagnosed with RAD may have related issues stemming from abuse and neglect that are not part of RAD that also need professional attention. These include unattended medical conditions, as well as trouble with speech or language” (Roberds & Davis, 2011). Some sources also include trouble understanding cause and effect as well as a problem with

In relating the details of Munchausen Syndrome by Proxy (MSBP), the initial reaction is usually shock, followed quickly by fascination. The reason for the latter is that the medical community has yet to make up their minds about what exactly MSBP is. The debate: psychiatric disorder v. child abuse. Essentially the arguments for both create a divide between the brain and behavior, though not relating the two.

Childhood abuse may be our number one public health issue (Wylie 1). Munchausen By Proxy is a type of child abuse, where the perpetrator is most commonly a parent or guardian of a small child. The parent will purposely neglect and abuse their child to receive attention from doctors and other individuals. This leads us to question, what leads a parent to mistreat their children in the first place?

Munchausen syndrome by proxy is a mental illness and form of child abuse that claims the lives of 9% of its victims (Heffner, 2004). It is defined as, “a psychological disorder in which a parent, typically a mother, harms her child (as by poisoning), falsifies the child 's medical history, or tampers with the child 's medical specimens in order to create a situation that requires or seems to require medical attention” (Merriam-Webster, 1977). In most cases, the mother is the abuser and plagues the life of her child and/or children by making them ill in order to receive attention, affection, and love. They thrive on feeling important and needed, and feel accomplished when they succeed in making their child/children ill (Meadow, 1989).

Most often Munchausen’s by proxy is between mother and child, or caregiver and child. The perpetrators of this form of Munchausen’s receive the attention they crave by playing the hero role or ultra-caring parent while also assuming the sick or injured role by proxy. Munchausen’s by proxy is often undetected because it appears as a form of neglect or child abuse. Munchausen’s syndrome by proxy may sometimes be described as a mental disorder or simply as abusive behavior. In regards to either form of Munchausen’s syndrome, neither appear in the “Diagnostic and Statistical Manual of Mental Disorders” (“DSM-IV-TR”) under that name but are categorized under “Factitious disorder.” Because of the complexity in diagnosing Munchausen’s syndrome by proxy, doctors under suspicion sometimes attempt a “separation test.” In this test the doctor will observe the proxy victim in absence of the care giver. Quite often the symptoms will disappear. Care must be taken when conducting such tests because if the doctors assumptions are wrong, the seriousness of the child’s illness may have been compromised putting the child’s life further at

Facilitating Developmental Attachment by Daniel A Hughes is an in depth look at the work of Dr Hughes, a clinical psychologist who specialises in child abuse and neglect, attachment and works with children in foster care or adoption. Hughes discusses every facet of his practice including the theory and research surrounding attachment, the qualities and expectations required by each of the people involved in the therapeutic process as well as including four case studies. Hughes states the book is written for those working with children who have “…severe forms of attachment problems that correspond to

Attachment theory is a concept that explores the importance of attachment in respect to direct development. “It is a deep and enduring emotional bond that connects one person to another across time and space” (Bowlby, 1969; McLeod, 2009). It is the relationship that develops within the first year of the infant’s life between them and their caregiver. The theory also relates to the quality of the attachment that is shown in the behavior of the infant (Rieser-Danner, 2016). Attachment theory shows that infants need a close nurturing relationship with their caregiver in order to have a healthy relationship. Lack of response from the caregiver