Reactive attachment disorder following early maltreatment: systematic evidence beyond the institution.
نویسندگان
چکیده
Reactive Attachment Disorder (RAD) remains one of the least evidence-based areas of DSM and ICD nosology. Recent evidence from severely deprived institutional samples has informed review of RAD criteria for DSM-V; however, this data is not necessarily generalizable to expectable child environments in the developed world. We provide the first systematic study of this important syndrome in maltreated non-institutionalized adolescents from a high-income country. 153 high-risk adolescents in English out-of-home Looked After Care (LAC: mean age 174 months, SD 23, 52 % male) and 42 low-risk (LR) community controls (mean age 168 months, SD 18, 38 % male) were assessed for RAD behaviors. Data on maltreatment and care history were collected from social work reports and concurrent psychopathology from caregiver report. Triangulated data sources informed independent researcher ratings of adaptive functioning. LAC adolescents showed high prevalence of RAD behaviors. Factor analysis showed four symptom groups; Disinhibited Indiscriminate, Attention Seeking, Superficial Relationships and Unpredictability. RAD was associated with multiple maltreatment experience, earlier entry to care and increased rates of psychopathology. Superficial Relationships and Attention Seeking factors showed strong independent association with particularly pervasive functional impairment. Disinhibited RAD behaviors are identifiable with high prevalence in non-institutionalized high-risk adolescents. They are strongly associated with psychopathology and functional impairment. Retention of this subtype in DSM-V is supported. Findings on the inhibited subtype in adolescence are less persuasive. RAD behavior is a relevant marker of developmental impairment, has significant clinical implications and is deserving of further study within non-institutionalized risk populations.
منابع مشابه
Cortisol secretion in children with symptoms of Reactive Attachment Disorder
Maltreated children with Reactive Attachment Disorder (RAD) have severe problems with social relationships and affect regulation. An association between early maltreatment and changes in the daily rhythm of cortisol secretion has already been reported for maltreated toddlers. We sought to find out whether such changes were apparent in school-age children with symptoms of RAD, who had experience...
متن کاملCortisol secretion in children with symptoms of reactive attachment disorder.
Maltreated children with reactive attachment disorder (RAD) have severe problems with social relationships and affect regulation. An association between early maltreatment and changes in the daily rhythm of cortisol secretion has already been reported for maltreated toddlers. We sought to find out whether such changes were apparent in school-age children with symptoms of RAD, who had experience...
متن کاملThe report of the APSAC Task Force on Attachment Therapy, Reactive Attachment Disorder, and Attachment Problems.
متن کامل
Mentalization Mediates the Relationship between Early Maltreatment and Potential for Violence in Adolescence.
AIM The present study investigates the role of attachment representation and mentalization as possibly protective factors in the relationship between early maltreatment and potential for violence in adolescence. METHODS For the current study, 161 adolescents, aged 14-21 years, were recruited from high schools and youth psychiatry. Early maltreatment was assessed by the Childhood Experiences o...
متن کاملAn exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children.
OBJECTIVE To explore attachment narratives in children diagnosed with reactive attachment disorder (RAD). METHOD We compared attachment narratives, as measured by the Manchester Child Attachment Story Task, in a group of 33 children with a diagnosis of RAD and 37 comparison children. RESULTS The relative risk (RR) for children with RAD having an insecure attachment pattern was 2.4 (1.4-4.2)...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Journal of abnormal child psychology
دوره 41 4 شماره
صفحات -
تاریخ انتشار 2013