RAD is one of the least researched disorders in DSM and it difficult to diagnose accurately (Chaffin et al, 2006). There is also difficulty in distinguishing between consequences of maltreatment, disorganized attachment and attachment disorder (Prior & Glaser, 2006). In the United Kingdom, according to British Association for Adoption and Fostering (BAAF), only psychiatrists can diagnose RAD and any assessment regarding RAD must include a comprehensive evaluation of child’s family history and individual history (BAAF, 2006). There are other disorders that share many symptoms with RAD and they are often co-morbid or confused by RAD, such as anxiety disorder, Post Traumatic Syndrome Disorder (PTSD), social phobia and conduct disorder (Sadock, 2004).
The developmental psychopathology models which are going to be evaluated in this essay are: psychodynamic model and the family systemic model.
Psychodynamic Model
Psychodynamic model was developed by Sigmund Freud to describe the process of mind as flows of libido (psychological energy) in brain (Bowlby, 1999). In Psychology, Psychodynamics is the study of the inter-relationship between several areas of the mind, personality, or psyche, as they relate to mental, emotional or motivational focuses, emphasising on the dynamism of unconsciousness (Freud, 1923; Hall, 1954). Psychodynamics, basically, focuses on the formation of psychic energy (Hall, 1954) and its distribution over the human system and development by the virtue of interaction among ‘id’, ‘ego’ and ‘superego’ (Freud, 1923). Some of the key believes of psychodynamic are discussed here.
Firstly, Freud believed that the mind is like an iceberg (Freud, 1953) , mostly hidden, and that free association would ultimately ...
... middle of paper ...
...of this point of view the member of family could understand the patient’s situation and they can help them to be treated properly, and the patient have the support of the family.
On the other hand, stressing too much on the family and not seeing other issues around the patient could be a weakness. The disorder may be caused by a medical issue or genetic and the approach could be criticising to be reductionist from this aspect.
Conclusion
In conclusion, from my point of view family systemic model seems to be better to justify and explain the attachment disorder. As attachment disorder is directly grounded in the family and the child’s relationship to caregiver (Bowlby, 1980), investigating on the family system to improve and treat the disorder can be seen more logically better and also the patient can have the family support around and rebuild the relationship.
Sigmund Freud’s theories on the construction of the mind are simple, but fundamentally changed the field of psychology. He proposed, among other things, that the human mind is composed of three parts: the conscious, preconscious, and unconscious. The preconscious consists of information, such as a telephone number, that is “accessible to consciousness without emotional resistance” (Schellenberg 21). In Freud’s estimation, the unconscious is the most important area of the mind. The information stored within it has “very strong resistances” to becoming conscious (Freud 32). Residing in the unconscious is the id, which “contains everything…that is present at birth… – above all, therefore, the instincts which originate from somatic organization” (14). From birth, all action is instinctual, from the id. The id recognizes and entertains no desires but its own and is impatient to have its needs met. This phase lasts until a part of the id changes “under the influence of the real external world” (14). This changed portion b...
Treating the patient and family as one, can have improved outcomes, decrease hospital stays, increased patient satisfaction, and improved reimbursements for the hospital. Developing a relationship with not only the patient, but family as well, can pay off in the long run by providing better communication, better quality of care, and trust. The patient and family can be strong advocates for improved performance improvement efforts. Including family in the treatment of the patient treats the “whole” patient through their hospitalization. Involving the family can enhance the patients care.
Mary Main was Ainssowrth student. She therefore introduced another fourth category of attachment styles with her attachment studies with adults. During her longitudinal research project alongside her colleague Goldwyn on middle class children’s attachment styles, they found that about 79% of the time attachment styles remained constant from 18 months to 6 years of age (in Brandell & Ringel, 2007,). However in their observations about 5%) that did not fit into Ainsworth’s classification of attachment styles, which they called ‘disorganized/disoriented attachment’ (Main & Solomon, 1986, 1990). These children were fearful and engaged in repetitive or aggressive behaviors. Their behaviors at reunion were unpredictable. They displayed contradictory behavior patterns such as approaching and then suddenly avoiding or exhibiting misdirected behavior patterns such as crying when the stranger leaves or stereotypical behaviors such as rocking, hair pulling or freezing. The mothers of these children were either depressed or had unresolved grief due to early loss of own parents (Main & Solomon, 1986). In this type of attachment, there is no or very little organized strategy to cope with stress and to form an attachment relationship with the caregiver, because here, the attachment figure is the direct cause of distress or fear. An abusive, abandoned and frightening caregiver is the source of fear and the protector at the same time. The infant shows signs of distress and displays avoidant and inconsistent reactions in the presence of the caregiver (Bakermans-Kranenburg & van IJzendoorn, 2007; Stams et al, 2002).
In addition to Freud’s stages of development his best-known concepts are those of the id, ego, and superego (Crain, p. 268). The id personality called ‘the unconscious” is the personality that focuses on maximizing pleasure and minimizing pain through reflexes and drives such as hunger or bladder tensions (Crain, pp. 268-269). The id concept is impulsive, chaotic and unrealistic.
Attachment theory is the idea that a child needs to form a close relationship with at least one primary caregiver. The theory proved that attachment is necessary to ensure successful social and emotional development in an infant. It is critical for this to occur in the child’s early infant years. However, failed to prove that this nurturing can only be given by a mother (Birns, 1999, p. 13). Many aspects of this theory grew out of psychoanalyst, John Bowlby’s research. There are several other factors that needed to be taken into account before the social worker reached a conclusion; such as issues surrounding poverty, social class and temperament. These factors, as well as an explanation of insecure attachment will be further explored in this paper.
An embryo forms in the uterus of a soon-to-be mother. Already the organism is dependent on its mother and is physically attached to her through the formation of the umbilical cord. After birth, the interactions between the child and its caregivers determine whether this attachment continues on a healthy path or begins to become disturbed. When the latter occurs, children may develop reactive attachment disorder (RAD) Being that this disorder is fairly misdiagnosed and misunderstood, there is not much empirical data as pertains to its etiological bases and epidemiology. The Diagnostic and Statistical Manual of Mental Disorders characterizes RAD has a disorder that occurs when a child has experienced repeated insufficient care. Moreover, children with this disorder really concentrate on attention and attachment that they perceive from the world around them, whether they avoid it (inhibited type) or crave it (disinhibited type). Further research is needed in the years to come in order for RAD to become more recognized and understood.
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...
Freud, S., Strachey, J., Freud, A., Rothgeb, C., & Richards, A. (1953). The standard edition of the complete psychological works of Sigmund Freud (1st ed.). London: Hogarth Press.
The most common tool to diagnose an attachment disorder is the Diagnostic and Statistical Manual (DSM) but other assessment tools include The Child Behavior Checklist (CBCL), The Reactive Attachment Disorder Scale (RADS), The Attachment Disorder Symptoms Checklist (ADSCL), The Child Behavior Rating Scale (CBRS), and The Randolph Attachment Disorder Questionnaire (RADQ) (Abel, 2009). Abel (2009) examines “the relationship between childhood traumatic events and the presence of behaviors related to the attachment disorder diagnosis as defined by the Randolph Attachment Disorder Questionnaire (RADQ) assessment tool (see comments from Cappelletty, 2005, below about the assessment tool and its effectiveness). Abel (2009) utilizes the ARC model (Attachment, Self-Regulation, and Competency) which relies heavily on theories and empirical knowledge about the effect of trauma on the child (p. 36). This intervention takes into account the effects of trauma on multiple domains including attachment, self-regulation, and the development of competencies. The ARC model insists that treatment of children affected by trauma needs to focus on six main goals: safety, self-regulation, self-reflection, information processing, traumatic experience integration, relational engagement or attachment, and positive affect enhancement (p. 36). This model works in phases and emphasizes building different skills, making the child
In this essay I intend to discuss two psychological theories of development; The psychodynamic approach and the behavioural approach. In order to do this, I will outline each theory and explain how it accounts for psychological development, health and behaviour of the individual. In addition to this, I will explain how an understanding of these theories relates to care and would help a care professional to support an individual in a care setting.
It is through these resources that an individual or family gets the help required to overcome their health care obstacles. This approach understands that family is a small segment of a larger group and that these segments interact on an ongoing basis. This approach is mainly used in the community nurse setting.
Attachment patterns of a child are developed by the use of strange situation protocol where the attachment of a child is assessed between 12 months and 20 months of the child development. This procedure is not clinical and is used only to supplement the clinical diagnosis procedure called Reactive Attachment Disorder (RAD), which will be discussed at a later stage of this essay. In the strange situation protocol, a child, and the caregiver are put in an environment with varying conditions and the attachment behaviour of the child is observed. Through this protocol there are there organized attachment categories, which are observed in a child, which include secure attachment, avoidant/attachment and resistant/
The psychodynamic theory focuses on the unconscious mind. Freud’s credence is that different mental forces operate in the mind. The unconscious mind can be described as being like an iceberg. The tip of the iceberg represents the part of the mind that is conscious, everyday thoughts. The iceberg just below the water’s surface represents the pre conscious, thoughts and information that can be retrieved easily. And finally the base of the iceberg is the unconscious part of the mind where fears, traumas and bad experiences are contained, almost impossible to retrieve.
Freud’s conception of the mind is characterized by primarily by dynamism, seen in the distribution of psychic energy, the interplay between the different levels of consciousness, and the interaction between the various functions of the mind. The single function of the mind, which brings together these various aspects, is repression, the maintenance of what is and what isn’t appropriately retained in the conscious mind.
Personality is an individual’s characteristic pattern of feeling, thinking and acting. Psychodynamic theories of personality view human behavior as a dynamic interaction between the conscious mind and unconscious mind, including associated motives and conflicts (Myers & Dewall, pg# 572, 2015). These theories focus on the unconscious and the importance of childhood experiences. Psychodynamic theories are descended from Sigmund Freud’s psychoanalysis, which is his ideology of personality and the associated treatment techniques. Psychoanalysis attributes thoughts and actions to unconscious motives and conflicts. This theory also includes the techniques used in treating psychological disorders by seeking to expose and interpret unconscious tensions. He proposed that childhood sexuality and unconscious motivations influence personality. Freud’s historically significant psychoanalytic theory became part of the human cultural legacy.