Reactive Attachment Disorder Signs & Symptoms

Learn about reactive attachment disorder

Reactive attachment disorder, also known as RAD, is a mental health condition that is widely believed to be caused by poor attachment during an individual’s formative years. Developmental specialists believe that a close bond with caregivers is necessary in order for an infant/toddler to develop a sense security and overall sense of wellbeing. Failing to experience these integral elements of early development can eventually cause a youth to have difficulty with forming, or being unable to form, close relationships with others.

Additionally, children with reactive attachment disorder often display behavioral problems and emotional disturbances as they age. Being able to understand social cues could also come with a great deal of difficulty as the default response when interacting with others includes hostility. Individuals who do not receive treatment for reactive attachment disorder are likely to experience a great deal of adversity over time. Academic functioning is likely to be hindered, occupational performance when a person is older will probably be ripe with obstacles, substance abuse problems could manifest, and the onset of symptoms synonymous with another mental health condition could become more apparent. Furthermore, individuals with reactive attachment disorder have an increased risk for interaction with the legal system as their low threshold for tolerance in most situations can result in risky and/or law-breaking behaviors. Fortunately, there are viable treatment options available that can provide sufferers of this disorder with the hope of a happy future.

Reactive attachment disorder statistics

Studies that have examined prevalence rates of reactive attachment disorder report that less that ten percent of young people who have experienced abuse and/or neglect meet diagnostic criteria for this mental illness. Additionally, these studies have concluded that young people most vulnerable to developing this mental illness are those with a history of early institutional living. Lastly, many mental health experts agree that further research on reactive attachment disorder is needed in order to fully realize how many youth are battling this serious disorder.

Causes and risk factors for RAD

Being that reactive attachment disorder is a rare mental health condition, the causes of this disorder are not fully known. However, researchers believe that there are certain contributing factors that influence the onset of this illness. The most agreed upon factors, as well as risks, are elaborated on in the following:

Genetic: While environmental influences are believed to be one of the greatest determinants for the development of reactive attachment disorder, many experts in the field of mental health agree that an individual’s genetics play a role as well. Should a person possess a family history of certain personality disorders, there is an increased likelihood that symptoms of reactive attachment disorder will manifest if trauma is experienced early in life. Furthermore, a youth with such a genetic history will also likely display more severe symptoms of this disorder.

Environmental: Developmental specialists and mental health professionals agree that the development of reactive attachment disorder can be caused by certain environmental influences. Healthy attachment with a caregiver(s) early in life is believed to impact a child’s temperament, as it can foster a sense of wellness and security within a child. Poor attachment, whether due to severe neglect (emotional and physical) or abuse, can unfortunately cause a youth to be unable to form healthy relationships with others and develop this mental health condition.

Risk Factors:

• Growing up in an institutional setting
• Being forcefully removed from an abusive or neglectful home
• Having a mother who suffers from severe postpartum depression
• Moving amongst multiple foster homes
• Experiencing significant changes with a primary caregiver
• Being socially neglected
• Going through other types of traumatic losses

Signs and symptoms of reactive attachment disorder

Since trauma precedes the onset of reactive attachment disorder symptoms, the severity of said symptoms can rely greatly on the severity of the preceding trauma. The telltale signs that a youth is grappling with this disorder can vary, yet there are a number of indicators that this condition is a factor in a young person’s life. The following behavioral, physical, cognitive, and psychosocial symptoms are those that parents and caregivers may observe and should be reported to a mental health professional if an evaluation for treatment is sought:

Behavioral symptoms:

• Refusing to interact with peers
• Presenting as calm when alone as opposed to when other people are present
• Turning or leaning away from someone who is trying to show affection
• Participating in self-soothing behaviors
• Inability to make, or refraining from making, eye contact
• Minimal social responsiveness to others

Physical symptoms:

• Failing to gain weight
• Appearing listless
• Not smiling
• Looking joyless

Cognitive symptoms:

• Cognitive delays
• Language delays
• Delayed responsiveness to stimuli
• Other developmental delays

Psychosocial symptoms:

• Anxiety
• Experiencing difficulty or is incapable of being comforted
• Lacking the ability to trust others
• Lacking a sense of belonging
• Feeling unwanted
• Ongoing feelings of being unsafe
• Low self-esteem
• Feelings of worthlessness
• Sadness

Effects of RAD

A youth’s social and emotional development can be hindered when reactive attachment disorder is present. The following effects are those that have the potential of occurring in the event that therapeutic interventions are not implemented via treatment in order to improve how a young person interacts and emotionally responds to others:

• Angry or emotional outbursts
• Lacking the ability to have genuine feelings of compassion towards others
• Underdeveloped conscience
• Poor impulse control
• Developing a strong aversion to any kind of physical touch
• Inability to develop close relationships with others
• Difficulty maintaining significant interpersonal relationships
• Inability to relate interpersonally to adults or peers

Reactive attachment disorder and co-occurring disorders

Young people who suffer from reactive attachment disorder often suffer from symptoms synonymous with another mental health condition. Many co-occurring disorders that exist alongside this condition are likely to involve cognitive impairments, language deficits, and behavioral concerns. Additionally some common diagnoses that can be received by a youth who has reactive attachment disorder often feature emotional disturbances and problems socializing with others. Below are examples of these disorders:

• Autism spectrum disorder
• Rumination disorder
• Anxiety disorders
• Depressive disorders
• Pica