Psychiatric Illness: Reactive Attachment Disorder

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Reactive Attachment Disorder (RAD) is a psychiatric illness that is characterized by problems with emotional attachments and usually presents itself around the age of five (Reactive attachment disorder, 2013). Parents or caregivers might notice that the child has emotional attachment issues by the age of one though (Reactive attachment disorder, 2013). The DSM-IV goes on to describe RAD as also including the first or second category (American Psychiatric Association, 2000). The first category describes a failure to interact in developmentally appropriate ways while the second category describes an inability discriminate appropriate attachments to different groups of people (American Psychiatric Association, 2000). Boekamp (2008) describes these two forms of RAD that have been identified by the DSM as disinhibited and inhibited. Part of understanding RAD requires studying the perspective that children with RAD have. Tobin, Wardi-Zonna, and Yezzi-Shareef (2007) gathered data about the recollections that children had with RAD and some important themes were feelings of being alone, or abandonment, emotional needs that the felt were not met, as well as feeling sad or having fear. An important question to explore before delving deeper into RAD is what exactly attachment is. Attachment is the bond between a primary caregiver and the child which usually develops during the first year in which the child is born (Fonagy, Steele, & Steele, 1991). This bond is crucial for the formation of the other attachment relationships that the child will form (Horner, 2008; Lyons, 2007). There are several theories on attachment that have been studied extensively. Bowlby was a psychiatrist who worked on attachment theory. His theory describes how a child... ... middle of paper ... ...aws into question the accuracy of a child’s self-assessment. One question to ask is if children with RAD really perceive parental warmth accurately, or do they not feel that warmth. That is why further studies need to be conducted on RAD in order to help kids and families. Increasing research on the areas of the brain that play a role with RAD should also be a priority. The cortisol study by Kocovska, Wilson, Young, Wallace, Gorski, Follan, and Minnis (2013) was an interesting study that can be further researched. The hypothalamic-pituitary-adrenal (HPA) axis is crucial in stress regulation and further research can possibly find how children with RAD differ in cortisol production when compared to a control (Brand, Brennan, Newport, Smith, Zachary, 2010 ; Caldji, Diorio, Meaney, 2000). Areas important to attachment, like the amygdala can also be researched further.

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