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Is your teen struggling with issues associated with Reactive Attachment Disorder (RAD)? We have information regarding Reactive Attachment Disorder Treatment that can help. Complete the form on the right.

Many residential treatment programs work with teens who struggle with RAD. These teens sometimes exhibit complex problems. Does your child exhibit any of the following behaviors?

Reactive Attachment Disorder Awareness: Does Your Teenager Struggle With Any of the Following?

• Avoidant Behavior
• Distant or Aloof Behavior
• Anxious Clinging Behavior
• Depression
• Anxiety
• Difficulty Coping with Stress
• Poor Relationships with Others

Have there been symptoms or diagnoses of this or other disorders?

• Family Conflict, Argumentative, Abusive Behavior
• Blatant Disregard of Rules
• Can't Accept "No" For an Answer
• Abrupt Change in Personality
• Never at Fault - Shifts Blame to Others
• Uncontrollable Anger - Poor Emotional Control
• Can't Accept Feedback - "Above the Law"
• Manipulative - Pits Parents Against Each Other
• Lying - Stealing - Sneaky Behaviors
• Lack of Motivation - Lazy - Resists Tasks
• "I hate you," attitude
• "You can't make me," attitude
• Substance Abuse - Alcohol or Drugs
• Skips School - Truancy
• School Suspensions - Authority Problems
• Grades Have Fallen - Academic Problems
• Can't Keep Friends - Peer Problems
• Danger to Self or Others
• Runs Away or AWOL
• Conduct Disorder - Diagnosed or Observed?
• Poor Choice of Friends - Easily Misled
• Oppositional Defiant Disorder (ODD)
• Bipolar Disorder - Diagnosed or Observed?
• Low Self-Esteem or Poor Self-Image
• Attention Deficit Disorder (ADD)
• Attention Deficit Hyperactive Disorder (ADHD)
• Depression - Diagnosed or Observed?
• Attempted or Threats of Suicide (Ideation)
• Drug Abuse or Addiction
• Alcohol Abuse or Addiction
• Smoking or other Tobacco Use
• Sexually Active - Risky Behavior
• Cutting - Self-Harm or Mutilation
• Adoption Issues - Associated with RAD
• Reactive Attachment Disorder (RAD)
• Eating Disorder (Anorexia, Bulimia)
• Learning Disabilities - Diagnosed?

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Attachment Theory and Reactive Attachment Disorder: Theoretical Perspectives and Treatment Implications

Journal of Child and Adolescent Psychiatric Nursing, Feb 2007 by Hardy, Lyons T

TOPIC: Attachment theory and reactive attachment disorder (RAD).

PURPOSE: To highlight current perspectives on attachment theory, RAD, and treatment implications using a case study of an 8-year-old patient with RAD.

SOURCES: Selected multidisciplinary literature related to attachment theory and RAD.

CONCLUSIONS: The literature provides a body of work that substantiates the importance of early attachment relationships to human development and highlights gaps in our knowledge related to treatment of children with RAD. The quality of early attachment relationships is correlated with future personality and brain development. Attachment disturbances are associated with psychopathology in childhood and adulthood. Although evidence for the effective treatment of children with attachment disorders is minimal and inconclusive, the two major perspectives, developmental psychology and neuropsychoanalysis, offer guidelines for practice.

Attachment theory was developed by John Bowlby in the 1960s. Bowlby was a psychoanalyst who began to focus on a child's early relationship with the primary caregiver as the most important predictor of the child's future personality development. This position contrasted with the classic Freudian psychoanalytic view, which generally looked backward from adult neurosis to determine the instinctual conflicts that had originated in childhood. Bowlby was the first to suggest that information about a person's future interpersonal relationships could be predicted by looking forward from the early ones. Ainsworth, Blehar, Waters and Wall (1978) state that Bowlby's ideas constituted a paradigm shift in developmental psychology, and indeed, attachment theory has been extremely influential on current thought in psychiatry, psychology, and related fields.

Attachment theory suggests that infants are evolutionarily primed to form a close, enduring, dependent bond on a primary caregiver beginning in the first moments of life. The vulnerability of the infant requires that care be provided by an adult, and the infant's behaviors and inherent faculties ensure that a bond will be created. Infants attend to human voices, recognize human faces, and gaze into parents' eyes when being fed. They look to the attachment object for cues when faced with novel stimuli. The fulfillment of their physiological needs requires close and frequent physical contact throughout infancy (Carlson, Sampson, & Sroufe, 2003). As they develop the capacity for locomotion and intentional movement, they attempt to maintain physical proximity to the caregiver and frequently return for "refueling" when they are involved in an individual activity (Ainsworth et al., 1978). Since infants are intrinsically driven to form attachments, they will attach to the primary caregiver regardless of the type of interactions that occur. Thus, attachment status is classified according to quality rather than quantity (Main, 1996).

Four infant attachment styles have been identified: secure, avoidant, resistant-ambivalent, and disorganized-disoriented. Infants with a secure pattern of attachment typically protest when they are separated from their caregiver, and they attempt to regain closeness to the caregiver upon reunion. The avoidant attachment style involves behaviors that resemble rejection. Infants with this pattern tend to ignore the caregiver's departure and return and actively avoid the caregiver's attempts to regain contact. The resistant-ambivalent pattern is characterized by a preoccupation or fixation on the caregiver in which the caregiver is alternately sought for comfort and rejected. The disorganized style of attachment is typically seen in infants who have been maltreated by their attachment figure. They exhibit conflicted behaviors such as simultaneously reaching for and turning away from the caregiver. This is most likely related to the inherent conflict between the attachment object being both the cause of distress and the infant's only potential source of comfort from distress. The disorganized attachment style is thought to be most correlated with psychopathology (Main, 1996).

There are two major theoretical perspectives that inform our understanding of the process of attachment. According to the developmental psychology perspective, the early relationship with the attachment object causes an infant to form internal working models for relationships that will influence interpersonal relationships throughout life. These working models consist of representational structures that define one's perception of self and others and contribute to the internal processes that define one's selective experience of the external world (Pietromonaco & Barrett, 2000). Working models are believed to operate unconsciously. Fonagy (2003) adds another conceptualization called the internal interpretive mechanism. He contends that this mechanism undergoes maturation during the attachment process and comprises the neurocognitive processes that are used to interpret all new experiences throughout life. The psychoanalytic perspective maintains that self and object representations form as a result of early childhood experiences and that these representations will influence all future affective exchanges. Similarly, these processes function from the unconscious mind (Schore, 2002). Although there are some differences in the construction and application of the developmental psychology and psychoanalytic perspectives, they seem to differ primarily in semantics.

(To continue this article, see: Reactive Attachment Disorder Treatment)

(For additional information relating to Reactive Attachment Disorder Treatment, see: Attachment Disorder Adoption, Attachment Disorder Treatment Centers, Attachment Disorder Treatment Options, RAD Programs, RAD Schools, RAD Treatment, Reactive Attachment Disorder in Teens, Reactive Attachment Disorder Therapy, and Reactive Attachment Disorder Treatment)

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