Reactive Attachment Disorder: Literature Review

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The course of reactive attachment disorder is not well studied, but through reviewing literature, it is evident that a larger amount of individuals diagnosed with reactive attachment disorder are children who have experienced serious forms of neglect or abuse, or have been brought up in institutional settings, and consequently exhibit signs of reactive attachment disorder (Boris & Zeanah, 2005). The prevalence of reactive attachment disorder that has been studied in the general population was found to be prevailing in 1.4%. Being that this is a relatively higher number found within the general population, it is crucial to understand the additional needs of these children (Pritchett, Pritchett, Marshall, Davidson, & Minnis, 2013).
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Differential Diagnosis Considerations
When diagnosing reactive attachment disorder, it is important to take into consideration possible differential diagnoses that could better explain the symptoms the individual is experiencing. The DSM V (2013) states that criteria for reactive attachment disorder show that there is a pattern of emotional disturbance and irregular social behaviors in children who are withdrawn from adults charged with caring for them (APA, 2013). Similar to reactive attachment disorder is autism spectrum disorder, in both diagnoses, younger children can exhibit a reduced expression of positive emotions as well as delays
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As mentioned, developmental delays can occur in individuals that are diagnosed with reactive attachment disorder, but this should not be the only factor. Children who have an intellectual disability exhibit emotional and social abilities similar to their cognitive skills, and contrasting from children with reactive attachment disorder who exhibit a significant decrease in positive affect and their ability to regulate their emotions. An additional difference between the two diagnoses is that children with developmental delays who have reached a cognitive age of seven to nine months should be establishing selective attachments with caregivers in their life regardless of their chronological age, whereas children with reactive attachment disorder who have a cognitive age of at least nine months show a deficit in attaining those relationships (APA,
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