Reactive Attachment Disorder - Symptoms, Causes, Diagnosis and Treatment

What Is Reactive Attachment Disorder?

Reactive attachment disorder (RAD) is a severe and rather uncommon disorder whereupon an infant or child seems to lose any interest in forming a healthy bond with their parents or parental figures, resulting from a childhood history of abuse or neglect. Children suffering from reactive attachment disorder have issues expressing and managing their emotions (later on in life) along with forming a productive relationship with anyone in their lives.

When noticed around their parents or parental figures, the child portrays signs of being uncomfortable, anxious, and fear being left alone with them. Reactive attachment disorder may develop due to abandonment issues, or the child’s basic needs for comfort and affection are not met or are declined. The absence of a bond or relationship with the parent or a parent figure can leave a negative impact on the child’s life. Reactive attachment disorder is flagged off as a developmental disorder that later impacts the personal and professional life of the child.

What Are the Types of Reactive Attachment Disorder?

Reactive attachment disorder is divided into two types:

• Inhibited reactive attachment disorder.

• Disinhibited reactive attachment disorder.

The difference between the two lies in the symptoms of inhibited and disinhibited reactive attachment disorders.

1. Signs and Symptoms of Inhibited Reactive Attachment Disorder Include:

• Feeling of detachment.

• Unresponsive behavior.

• The tendency to hold back emotions.

• Symptoms of withdrawal from the parent or parental figure.

• Tendency to avoid any relative or parent.

• Failure in seeking affection.

• A tendency to be on guard (to keep to themselves).

• Feeling of detachment.

2. Signs and Symptoms of Disinhibited Reactive Attachment Disorder Include:

• No sense of familiarity with a parent or parental figures.

• Tendency to behave like a child.

• Attention-seeking tendencies.

• Self-harming tendencies or behavior.

• Inappropriate unfamiliar behavior with the parent or parental figure.

• Violates social boundaries.

What Causes Reactive Attachment Disorder?

There is so specific or known cause for reactive attachment disorder to occur. However, abandonment or childhood trauma has proven the prime factor behind the development of reactive attachment disorder. Some of the other causes of reactive attachment disorder are:

• Childhood abuse.

• Lack of child safety.

• Orphan (usually, a child living in an orphanage has a higher chance of developing RAD).

• Continuous change in parental figures.

• Positive history of medical illness (history of hospitalization).

• History of sexual or verbal abuse.

• Positive history of parents with mental illness or substance abuse (drug or alcohol).

• Often seen in children with mothers who suffer from postpartum depression.

• Borderline personality disorder.

• Post-traumatic stress disorder (PTSD).

What Are the Symptoms of Reactive Attachment Disorder?

RAD affects different aspects of a child’s life. Symptoms of RAD are different in each case. Some of the common symptoms of RAD are:

• Reserve behavior.

• Have difficulty interacting with others.

• Avoids eye contact.

• Comfortable showing temper tantrums (in public).

• Positive symptoms of withdrawal from a parent or other relative.

• Not an interactive personality.

• Lack of emotions and conscience (remorse, guilt, and regret).

• Avoids all physical touch.

• Disobedient child or adult.

• Argumentative behavior.

• Symptoms of depression.

• Usual signs of unhappiness and sadness without a said cause.

• Signs of conduct disorder.

• Self-harming tendencies and behaviors.

• Unlikely tendencies such as manipulative, controlling, and untrusting behaviors.

• Unstable peer or professional relationship.

• Unstable, irresponsible, impulsive, and destructive behaviors.

• May suffer from learning or attention disorder (such as attention deficit learning disorder).

How to Diagnose Someone With Reactive Attachment Disorder?

A licensed healthcare professional asks questions about the child’s past and their parent's history to officially diagnose the child. Judging the past medical history, symptoms, and the parent’s medical history, a more informative and official medical diagnosis is made.

If the child seems to be suffering from RAD, the patient is then referred to a pediatrician or a psychologist, or a psychiatrist for the treatment needed. The official diagnosis is made based on the child’s behaviors, attitude, symptoms (showing as well as being told by parents), and talking to the parents.

What Is the Treatment for Reactive Attachment Disorder?

The focal point of the treatment for reactive attachment disorder is to provide a safe environment to the child (in case of an abused home) and to create an emotionally stable and healthy bond with the parent figure or parent to repair the fearful, damaged, and uncomfortable bond formed due to childhood abuse or trauma. The treatment aims to strengthen the child emotionally so the child can develop more productive relationships in their respective future. The treatment is aimed at both the child and the parent (or parent figure); treatment includes -

1. Psychotherapy: The branch of psychological treatment that aims to help the child talk and discuss their fears, weaknesses, and thoughts. Different types of psychotherapies are:

• Family therapy.
• Social skill intervention.

Therapy interacts with the patient and the parent so as to help develop a bond that is emotionally stable and strong so the patient does not suffer from long-term complications. Parents are often involved in helping the child use the skills they learn during the therapy. Counseling addresses the issues, situations, and conditions faced by the child and the parent.

What Are the Complications of Reactive Attachment Disorder?

The physical, mental, and emotional stress a child goes through that later develops into reactive attachment disorder. In avoidance of the treatment, there are complications. Some of them are:

• Developmental delay (mentally and physically).

• Behavioral and emotional troubles like depression, anxiety, anger issues, post-traumatic stress disorder, and personality disorders.

• Eating disorder (as a result of neglect from home).

• Substance misuse (alcohol or drugs).

• Social rejection (isolation from peers at school).

• Relationship issues (with peers, parents, adults, or later with personal relationships).

• Self-harming tendencies.

Without treatment, reactive attachment disorder continues for several years and may leave lifelong consequences or complications.

Conclusion:

Reactive attachment disorder is a rare but fatal disorder wherein the child is unable to develop a healthy and stable bond with their parents or parental figure. Children growing up in neglected and abused homes often tend to suffer from developmental disorders, reactive attachment disorder being one of them. Children suffering from this disorder have difficulty trusting, forming relationships, and seeking comfort. Treatment for reactive attachment disorder is therapy. Treatments for reactive attachment disorder include psychological counseling, parent or caregiver counseling, and education. Therapy aims to mold an individual and the parent to make the relationship better and to understand the developmental growth of both the child and the parent. Therefore, reactive attachment disorder is a preventable condition for the better relationship between the child and the parent.