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Reactive attachment disorder typically develops in children who were emotionally neglected at a young age. Symptoms of reactive attachment disorder depend on the age of the child, and those as young as a year old can show signs, such as refusing food and not responding to offered interaction. Older children often demonstrate stubbornness, defiance, and difficulty in relating to and interacting with others, even close family members.
Many diagnosed individuals will display symptoms of reactive attachment disorder throughout their lifetimes. Since the individual typically begins as being neglected by parents or caregivers or being shuffled from one foster family to another, his or her abilities to form long-lasting and meaningful relationships are severely compromised from the beginning. Infants and children of only a few years old often show the first signs, including being uninterested in the activities of nearby people, failing to participate in games or play, not smiling, and not fussing when left alone.
As the child develops, these symptoms of reactive attachment disorder can continue into a melancholy and withdrawn personality. Children suffering from reactive attachment disorder typically prefer being left alone, and can become agitated or angry when forced to interact with those of a similar age. Many of these children watch from outside a social circle and avoid all physical contact with others, and this typically continues through the school and adolescent years. Children can also become extremely manipulative, with no regard for others, and will often lie or issue false accusations to get out of trouble or get what they want.
Teenagers who continue through the condition without assistance frequently find solace in drugs or alcohol. Those who know they are having difficulty with illegal activities such as stealing and vandalism, or with school, will rarely ask for help, and are openly distrusting of parents, teachers, or other authority figures. When forced into social situations, they are obviously uncomfortable talking with and relating to others, and are largely incapable of forming lasting friendships or even passing acquaintances. Often, they will watch groups of friends interacting in a social way, but will not think to approach the group or speak to any of the individuals.
In high school years, the individual will typically seem to be behind his or her peers in developing on an emotional level, and may show one of two types of symptoms of reactive attachment disorder. This can manifest in two distinctly different ways. There may be problems with acting out, that is, irrational or inappropriate behavior designed to get attention. Other individuals can withdraw completely and shy away from any attention. Both types may be unable to understand the emotions felt by others, and may display violent behavior when met with those who do not understand them.
A few good references are: "Creating Capacity for Attachment," edited by Arthur Becker-Weidman and Deborah Shell (2005/2008)
"Attachment Parenting" edited by the same two (2010).
A few books about Dyadic Developmental Psychotherapy, which is an effective, evidence-based, and empirically validated treatment:
Becker-Weidman, A., (2010) "Dyadic Developmental Psychotherapy: Essential Practices & Methods." Lanham MD: Jason Aronson
"The Dyadic Developmental Psychotherapy Casebook" (2011)
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