WHAT IS REACTIVE ATTACHMENT DISORDER (RAD)?

The term Reactive Attachment Disorder is used in both the World Health Organization's International Statistical Classification of Diseases and Related Health Problems and in the DSM-IV-TR, the revised fourth edition of the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders (DSM). What follows is a description of the problem:

In spite of a limited availability of information about Reactive Attachment Disorder, the problem has been described in clinical literature for many years. It is often described as a rare but severe form of Attachment Disorder that can affect children who have been traumatized and or separated from a parent, which causes a failure to attach in early life, or to complete the attachment process during the bonding phase of their development.

However, due to significant and traumatic societal changes such as staggering divorce rates, increased parental drug involvement, or multiple wars around the globe, which cause threats to the safety of children and families everywhere, the problem is no longer rare as the number of children affected by neglect or abuse seems to be rising exponentially.

Attachment Disorders arise from a failure to form normal attachments with primary caregivers. Such failures can result from severe and early experiences of neglect, abuse and/or abrupt separation from primary caregivers during the first thirty-three (33) months of life, including while in utero.  A severe problem can also occur as the result of frequent changes of caregivers or a lack of caregiver's responsiveness to a child's efforts to communicate with them in non-verbal and/or by verbal means.

RAD is characterized by significantly disturbed and developmentally inappropriate ways of relating socially in most contexts. It can take on many forms, including a persistent failure to initiate or respond to most social interactions in a developmentally appropriate way. Reactive Attachment Disorder can also present itself as indiscriminate sociability, characterized by excessive familiarity with relative strangers.

However, it is important to note, that not all young victims of neglectful or abusive experiences result in RAD or a less severe form of Attachment Disorder.  The ultimate affects on vulnerable individuals tend to be determined by a combination of the degree and duration of the neglect or abuse combined with the internal strength of the individual child.

Medical and Mental Health specialists who have received a specialized education can differentiate Reactive Attachment Disorder from other more common mental health conditions, such as ADHD, ADD, Bipolar Disorder, etc., which can occur with RAD, and mental retardation which can affect attachment behavior. The criteria for a diagnosis of a Reactive Attachment Disorder are more severe and pronounced than the criteria used in the assessment or categorization of other Attachment Disorder styles such as insecure or disorganized attachment.
 
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