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Causes
By Mayo Clinic staffTo feel safe and develop trust, infants and young children need a stable, caring environment. Their basic emotional and physical needs must be consistently met. For instance, when a baby cries, his or her need for a meal or a diaper must be met with a shared emotional exchange that may include eye contact, smiling and caressing.
A child whose needs are ignored or met with emotionally or physically abusive responses from caregivers comes to expect rejection or hostility. The child then becomes distrustful and learns to avoid social contact. Emotional interactions between babies and caregivers may affect development in the brain, leading to attachment problems and affecting personality and relationships throughout life.
Most children are naturally resilient, and even those who've been neglected, lived in orphanages or had multiple caregivers can develop healthy relationships and strong bonds. It's not clear why some babies and children to develop reactive attachment disorder and others don't.
- Reactive attachment disorder of infancy or early childhood. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 23, 2009.
- Reactive attachment disorder. In: Moore DP, et al.: Handbook of Medical Psychiatry. 2nd ed. Philadelphia, Pa.: Mosby; 2004. http://www.mdconsult.com/das/book/body/145545363-3/0/1243/32.html?tocnode=52436085&fromURL=32.html#4-u1.0-B0-323-02911-6..50032-4_311. Accessed June 23, 2009.
- Newman L, et al. Recent advances in the theories of and interventions with attachment disorders. Current Opinion in Psychiatry. 2007;20:343.
- Haugaard JJ, et al. Recognizing and treating uncommon emotional disorders in children and adolescents who have been severely maltreated: Reactive attachment disorder. Child Maltreatment. 2004;9:154.
- Cornell T, et al. Clinical interventions for children with attachment problems. Journal of Child and Adolescent Psychiatric Nursing. 2008;21:35.
- Hanson RF, et al. Reactive attachment disorder: What we know about the disorder and implications for treatment. Child Maltreatment. 2000;5:137.
- Report of the American Professional Society on the Abuse of Children Task Force on Attachment Therapy, RAD and Attachment Problems. American Psychiatric Association. http://www.apa.org/divisions/div37/RADTaskForceManuscript.pdf. Accessed July 1, 2009.
- Coercive interventions for reactive attachment disorder. Association for Treatment and Training in the Attachment of Children. http://www.attach.org/apsac.htm. Accessed July 1, 2009.
- Child Abuse and Neglect Committee. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/cs/root/policy_statements/coercive_interventions_for_reactive_attachment_disorder. Accessed June 29, 2009.
