Reactive Attachment Disorder (RAD) is a psychological condition that is controversial and somewhat ambiguous regarding symptoms and treatment. Some experts are calling for clarification of the requirements for diagnosis of RAD, especially in light of research.
Commonly believed to be a disorder of abused, neglected and abandoned children, Reactive Attachment Disorder is most often seen in adopted children. The increased rate of RAD in foreign adoption cases, whereby American parents adopt babies and young children from other countries around the world, helped to bring RAD to light.
Reactive Attachment Disorder in Children Adopted from Foreign Countries
Children adopted from European countries such as Romania were not developing as expected and were severely psychologically damaged. They were full of rage and unable to trust or to love the adults in their lives, especially their primary caregivers. The term attachment disorder was coined to describe the condition these and other children displayed.
Some of the behaviors exhibited by the children suffering from RAD included:
- Little or no conscience
- Lack of eye contact (except when lying)
- Inability to give and receive affection (or indiscriminately affectionate – hugging strangers)
- Extreme control issues
- Food issues – hoarding food, stealing food, refusing to eat
- Destructive to self, others, animals, or property
- Impulse control problems
- Demanding
- Discipline problem for mother, less so for father, can behave very well for others
Handling and Treating the Problem of Reactive Attachment Disorder
Adoptive parents sought help from therapists and psychiatrists, only to find that no one was equipped to handle the damage that had been done to the children.
Over time and as the demand rose, therapists and experienced parents came to the fore to help other adoptive and foster parents struggling with attachment disorders in the children they loved.
What Causes Reactive Attachment Disorder?
The International Classification of Diseases (ICD 10) published by the World Health Organization, indicates that the syndrome "probably" occurs as a direct result of parental abuse or neglect. The Diagnostic and Statistical Manual IV Revised (DSM-IV TR), the manual used by mental health professionals in the United States, goes further than the ICD and states that there must be a history of pathogenic care.
The DSM requires that a child have an abusive parent or caregiver in order to receive a diagnosis of Reactive Attachment Disorder. For foster and adoptive parents, it is easy to believe that the child must have been abused and neglected before the child came to them. For biological parents who know that the child has not been abused, this implication is disheartening at best.
Research May Vindicate Biological Parents
Helen Minnis, et al, published research results that indicate that children who have RAD do not necessarily have an abusive parent. She found that attachment disorder is heritable, and that males were more likely than females to inherit the condition. This research was published in the British Journal of Psychiatry 2007, under the title, "Genetic, environmental and gender influences on attachment disorder behaviours."
This information clearly conflicts with the DSM criteria, and with the common view of RAD as a disorder of attachment – caused by conditions in an infant’s external environment. If the research of Minnis, et al is valid, then RAD’s etiology may be an expression of genetics, an inborn personality trait that was not caused by environment. In layman’s terms, the parents may not be to blame after all.
Jennifer Harshman - With more than 20 years of experience and education in her fields, she's also read more than one book for every day she has lived.
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