Reactive Attachment Disorder, Causes, Signs and Symptoms, Diagnosis and Treatment.

Reactive Attachment Disorder (RAD) is a rare but serious condition where a child under five fails to form normal attachments with parents or caregivers. Attachment develops when a child's needs are consistently met, leading to trust, emotional awareness, and healthy relationships. Emotional deprivation in early years can lead to difficulties connecting with emotions, low self-worth, and anger.

As children with RAD grow, they develop either an inhibited or disinhibited pattern. In the inhibited pattern, the child is emotionally detached, withdrawn, and unresponsive to comfort, pushing others away or becoming aggressive. In the disinhibited pattern, the child shows no preference for parents over strangers, seeks attention indiscriminately, displays inappropriate childish behavior, and may appear anxious.

RAD is caused by problematic caregiving and social relationships, often due to detachment between a young child and their primary caregiver. Reasons include constant disregard of basic physical or emotional needs, living in institutions, frequent changes in foster homes, parents with severe mental problems, separation due to long-term hospitalization, or experiencing physical, sexual, or verbal abuse.

Symptoms in infants include unresponsiveness to comforting, withdrawal, sadness, irritability, failure to smile, lack of social engagement, crying inconsolably, and not reaching out to be picked up. In young children, symptoms include anger problems, aversion to physical affection, control issues, difficulty showing genuine care, lack of guilt or remorse, and shunning relationships.

Diagnosis involves a thorough examination including direct observation, assessment of behavioral patterns, home situation details, and interactions with caregivers. Doctors rule out other psychiatric disorders and follow criteria from the DSM. Treatment aims to ensure the child's safety and help them develop healthy relationships through psychosocial support for the family, psychotherapeutic intervention, parenting classes, and nurturing care.