REACTIVE ATTACHMENT DISORDER
Attachment is defined as the affectional tie between two people. It begins with the bond between the infant and mother. This bond becomes internally representative of how the child will form relationships with the world. Bowlby stated “the initial relationship between self and others serves as blueprints for all future relationships.” (Bowlby, 1975)
Attachment Disorder is defined as the condition in which individuals have difficulty forming lasting relationships. They often show nearly a complete lack of ability to be genuinely affectionate with others. They typically fail to develop a conscience and do not learn to trust.
According to the different studies consulted, this disorder of attachment could arise from the exposure of the baby to experiences of rejection, neglect, abuse or abandon, it is regularly believed that it is the mother or the first caregiver who produces these traumatic experiences. Freud describes the relation of the infant with his mother (or the first caregiver), as the first relation of love and the prototype of later relationships. (Paul says in Colossians 3:14 that love is the perfect bond)
Psychologist John Cacioppo of the University of Chicago says that isolation is detrimental because humans depend on social stimulation to shape the mind ... Since during the first 3 months of life of the infant, the brain grows and develops significantly facilitating the basic abilities of the neurological development, for the psychological and emotional functions.
As we can see the brain scan shows the changes produced by the detachment of a child with their parents or first caretakers. The experiences are part of the learning of a human being that are organized in an impressive way, it is said that for the 4 years the brain has changed by 80% its structure. This will influence for good or for bad in the functions of the brain according to the experiences accumulated during these first years.
To be able to be diagnosed the child should have more than 9 months, and until the age of 5 years.
Attachment Disorder is a psychiatric illnesses according with DSM-5.
Parents need to bring their child to the doctor, if he or she presents one or more of the following symptoms:
- severe colic and/or feeding difficulties
- failure to gain weight
- minimal social and emotional response to others
- difficulty being comforted
- preoccupied and/or defiant behavior
- inhibition or hesitancy in social interactions
- being too close with strangers
The DMS-5 considers Attachment Disorder to be a single diagnosis, but it also divides that diagnosis into two types of the disorder: Reactive Attachment Disorder and Disinhibited Social Engagement Disorder.
Reactive Attachment Disorder (RAD) signs and symptoms
- Children less likely to interact with other people because of negative experiences with adults in their early years.
- They have difficulty calming down when stressed and do not look for comfort from their caregivers when they are upset.
-These children may seem to have little to no emotions when interacting with others.
-They may appear unhappy, irritable, sad, or scared while having normal activities.
Disinhibited Social Engagement Disorder (DSED)
Children with DSED do not appear appropriately cautious when meeting someone for the first time. They may be overly friendly, walk up to strangers to talk or even hug them.
Younger children may allow strangers to pick them up, feed them, or give them toys to play with.
When these children are put in a strang situation, they do not check with their parents or caregivers, and will often go with someone they do not know.
Complications of attachment disorder :
-Defiant behavior, refusal to cooperate, pervasive anger and resentment, cognitive and language delays, stereotypes, conduct disorder, difficulties in social settings.
The criteria used by the DMS-5 for make diagnosis of RAD and DSED is not based on laboratory tests or, others ways, nevertheless it has specific points to follow and, if the symptoms persist for more than 12 months, the disorder is consider to be severe.
Treatment of RAD/DSED
Children with signs of RAD/DSED should be treated individually by a mental health professional, such as a psychiatrist or psychologist.
Is It is very important that the practitioner involves the child's parents and other family members, or the child's primary caregiver.
Most adoption agencies have parent support classes to aid in development of healthy attachment. These should include skills and activities to be implemented by the whole family.
There are three essential ingredients in the therapeutic process that will help parents and caregivers of children suffering from RAD or DSDE:
SECURITY - Sense of psychological security
STABILITY - Keep the attachment figure
SENSITIVITY - emotional abilities
Reactive Attachment Disorder and Disinhibited Social Engagement Disorder are serious clinical conditions. However, close and ongoing collaboration between the child's family and the treatment team will increase the likelihood of a successful outcome.