Reactive Attachment Disorder

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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, children with reactive attachment disorder have a tendency to have episodes of negative emotions including a period of fear, sadness, and irritability that cannot be explained. According to the DSM-5 (2013), reactive attachment disorder impairs children’s ability to relate on a personal level with adults or peers along with many other functional impairment in several domains during early childhood. The clinical disorder is likely to manifest in a child between the ages of nine months and five years (p. 267).

Historically, reactive attachment disorder (RAD) is considered to be a rare disorder (American Academy of Children and Adolescent Psychiatry (AACAP), 2011). Clinical disorders of attachment did not appear in the DSM until the third edition, published in 1980 (Zeanah et al., 2004). In the fourth edition of the DSM (text revision), reactive attachment disorder was described from two different perspectives: inhibited form and disinhibited form. It was suggested that the different forms of...

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... to be subjected with a poor prognosis due to future poor brain functioning considering their brain at a young age is still at its critical developing stage (Weinberg, 2010). As far as demographics are concerned, Pritchett, R., Pritchett, J., Marshall, Davidson and Minnis’s (2013) study suggests a gender difference in children diagnosed with RAD, 59.1 % were males whereas 40.1% were females. Culturally, at risk children are those who lived in a dysfunctional home where violence is present along with parents having a history of substance abuse. Research shows no significant relationship with gender, ethnicity or length of time in care (Zeanah et al., 2004).

Further research is advised to be done in this area considering there is limited of information supporting the prognosis and cultural differences in children diagnosed with reactive attachment disorder.

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