Reactive Attachment Disorder In Partial Fulfillment of the Requirements for the Degree of Master of Arts in Marriage and Family Therapy Presented By: Renae Frederick Facts about Reactive Attachment Disorder • Attachment is a term used as a strong emotional bond that develops between children and their caregiver. • Reactive Attachment Disorder otherwise known as (RAD) is a mental health disorder in which the child is unable to form healthy relationships, particularly with their primary caregiver. • Many children with RAD have been physically or emotionally abused or neglected. • RAD is commonly seen with children who have experienced a form of trauma before the age of 5. (Hardy, 2007) Facts about Reactive Attachment Disorder • It is thought to result from a lack of consistent care and nurturing in early years. • Maltreatment such as abuse or neglect may compromise development and cause social, cognitive, emotional, and behavioral problems as the child grows. Reactive Attachment Disorder • Some children with RAD have experienced inadequate care in an institutional setting, or other out-of-home placement such as residential programs, foster care or orphanages. • Attachment Disorder may impact the way one views themselves and future relationships. (Nichols, M., Lacher, D., & May, J. 2010) DSM-IV-TR and Reactive Attachment Disorder According to the DSM-IV-TR there are 2 different types of presentation to Reactive Attachment Disorder. Inhibited Type – is characterized by a predominate failure to initiate and respond to most social interaction in a developmentally appropriate way for their age. Disinhibted Type – is characterized by a pattern of diffuse attachment. The child shows indiscriminate sociability or lack of selectivity in their choices of attachment figure. 313.89 Reactive Attachment Disorder of Infancy or Early Childhood Please see handout provided DSM Diagnostic Criteria Characteristics of Inhibited Type RAD Inhibited Type RAD is also referred to as Ambivalent. Children can present but are not limited to the following: • Will push affection away to keep control • Are angry, defiant and can be violent • Destructive both with their own belongings and others • Difficult children to parent because they sabotage or destroy almost everything positive that happens to them • Manipulative • When they want something they act very affectionate (Hardy, 2007) Additional Characteristics of Inhibited Type RAD • Have few friends if any, although they will say they do, listing several acquaintances • Lack the ability to give and receive love • Lack empathy for others •Poor impulse control •Lying for no apparent reason •Developmental /learning delays •Problems with food; either hoarding or refusing to eat Characteristics of Disinhibited Type of RAD Children can present but are not limited to the following: • Tend to be overly clingy, showing extreme separation anxiety when separated from their caretaker • Appear to be eager to please and are superficially compliant • Lack an understanding of social boundaries, often in others personal space • Attention seeking • Chronic anxious appearance • Exaggeration of needs for assistance • Can be perceived as shallow (Hardy, 2007) Characteristics of Disinhibited Type of RAD • Are often passive aggressive. Constantly doing little things wrong, but never doing anything really bad. • These children have a higher risk to go off with strangers because they fail to distinguish between people that want to help them and people that want to harm them. • Poor Impulse control