Table of ContentsView AllTable of ContentsRAD vs. DSEDWhat Is RAD?SymptomsChildren With RAD in AdulthoodDiagnosisCausesTreatmentPreventionCoping
Table of ContentsView All
View All
Table of Contents
RAD vs. DSED
What Is RAD?
Symptoms
Children With RAD in Adulthood
Diagnosis
Causes
Treatment
Prevention
Coping
Reactive attachment disorder, also known as RAD, is a mood or behavioral disorder that affects babies and children. RAD symptoms include difficulty with bonding and forming relationships and inappropriate social patterns. There is no intellectual disability or pervasive developmental disorder (such asautism) to explain these characteristics.
This article goes over the symptoms of reactive attachment disorder and how it is treated.
Verywell / Joules Garcia
Reactive Attachment Disorder vs. Disinhibited Social Engagement Disorder
Attachment disorders are sometimes described as being inhibited or disinhibited. These terms are used to describe the behaviors of babies and young children.
Children who fall into the category of “inhibited” struggle to regulate their emotions, do not prefer any specific adult or caregiver, do not seek caregiver comfort, do not show much affection, or display a combination of these behaviors.On the other hand, children who fall into the category of disinhibited may engage or overly engage with all adults evenly, including strangers, and they do not prefer primary caregivers.
Reactive attachment disorder is the inhibited type of attachment disorder. There used to be only one diagnosis for both inhibited and disinhibited attachment, but that has changed with more recent research. The disinhibited type of attachment disorder is called disinhibited social engagement disorder, or DSED.
The term “reactive attachment disorder” is sometimes shortened to “attachment disorder,” but reactive attachment disorder is actually a type of attachment disorder.
What Is Reactive Attachment Disorder?
Children with reactive attachment disorder behave in ways that show little or no attachment to parents or other caregivers. The condition is usually seen in babies and young children. Children with reactive attachment disorder are not able to bond with their parents or primary caregivers in a way that is healthy and secure.
RAD Symptoms in Children
Symptoms of RAD in children include:
What Happens When Children With RAD Become Adults?
RAD is considered a condition of childhood, however, children with RAD may continue to have problems when they reach adulthood.
Research has found that people who were diagnosed with RAD as children are more likely to develop mental health problems as adults. One recent study found that around 73% of those who had RAD as children will develop a substance use disorder as adults and around 29% will attempt suicide. The study also found high rates of psychiatric hospitalization in this group (around 71%).
Children with RAD are also less likely to become successful as adults. Rates of high school and college graduation are lower in this group than in the general population, and rates of unemployment are higher. People who had RAD as children are also more likely to have legal issues later in life.
Reactive Attachment Disorder Diagnostic Criteria
The diagnostic criteria for RAD are as follows:
What Causes Reactive Attachment Disorder?
The specific causes of reactive attachment disorder are not as straightforward as they may seem. While child abuse and neglect can lead to attachment disorders, there is more to it than that. Children who receive inconsistent care or who are placed with new primary caregivers are also at an increased risk of reactive attachment disorder.This can happen even when parents and other caregivers mean well and are doing their best.
Children may experience an event or challenge that is not overtly harmful, such as a geographical move, or something that cannot be avoided, such as the death of a family member. Even though they may be too young to understand what is happening, they may feel as though they are not loved, they are unsafe, or they are unable to trust their caregivers.
Potential causes of RAD include:
Signs of Complex PTSD
Treatment for Reactive Attachment Disorder
Treatment for reactive attachment disorder goes beyond the child alone. The entire family may be included in order to support healthy bonding. The process involves a combination oftalk therapy, other therapies, and education that benefit children as well as parents and other caregivers.
Treatment options for RAD include:
Mental Health ResourcesIf you or a loved one are struggling with reactive attachment disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.
Mental Health Resources
If you or a loved one are struggling with reactive attachment disorder, contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat800-662-4357for information on support and treatment facilities in your area.
Preventing Reactive Attachment Disorder
Coping With Reactive Attachment Disorder
Coping with reactive attachment disorder involves strategies to support both the child and the adults who interact with the child. This is because bonding between children and their caregivers involves two or more people, and their interactions can help to form a more secure attachment.
For this reason, coping includes support, self-care, andstressmanagement for adults, as well as healthy nutrition and adequate sleep and physical activity for both children and their caretakers.
Summary
Children with RAD are not bonded to their caregivers and may have emotional and behavioral problems that include tantrums, difficulty making eye contact, avoidance of touch, and inability to show remorse, among others.
How the Body Reacts to Stress
7 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychological Association.Reactive attachment disorder.Jonkman CS, Oosterman M, Schuengel C, Bolle EA, Boer F, Lindauer RJ.Disturbances in attachment: inhibited and disinhibited symptoms in foster children.Child and Adolescent Psychiatry and Mental Health. 2014;8(1):21. doi:10:1186/1753-2000-8-21Betcher HK, Bommersbach TJ, Perossa BA, et al.Adult outcomes of children with reactive attachment disorder in a non-institutionalized sample.J Clin Psychiatry. 2023;84(6):23m14994. doi:10.4088/JCP.23m14994Lehmann S, Monette S, Egger H, et al.Development and examination of the reactive attachment disorder and disinhibited social engagement disorder assessment interview.Assessment. 2020;27(4):749-765. doi:10.1177/1073191118797422National Library of Medicine.Reactive attachment disorder of infancy or early childhood.Hornor G.Attachment disorders.J Pediatr Health Care. 2019;33(5):612-622. doi:10.1016/j.pedhc.2019.04.017Cleveland Clinic.Reactive attachment disorder.
7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.American Psychological Association.Reactive attachment disorder.Jonkman CS, Oosterman M, Schuengel C, Bolle EA, Boer F, Lindauer RJ.Disturbances in attachment: inhibited and disinhibited symptoms in foster children.Child and Adolescent Psychiatry and Mental Health. 2014;8(1):21. doi:10:1186/1753-2000-8-21Betcher HK, Bommersbach TJ, Perossa BA, et al.Adult outcomes of children with reactive attachment disorder in a non-institutionalized sample.J Clin Psychiatry. 2023;84(6):23m14994. doi:10.4088/JCP.23m14994Lehmann S, Monette S, Egger H, et al.Development and examination of the reactive attachment disorder and disinhibited social engagement disorder assessment interview.Assessment. 2020;27(4):749-765. doi:10.1177/1073191118797422National Library of Medicine.Reactive attachment disorder of infancy or early childhood.Hornor G.Attachment disorders.J Pediatr Health Care. 2019;33(5):612-622. doi:10.1016/j.pedhc.2019.04.017Cleveland Clinic.Reactive attachment disorder.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
American Psychological Association.Reactive attachment disorder.Jonkman CS, Oosterman M, Schuengel C, Bolle EA, Boer F, Lindauer RJ.Disturbances in attachment: inhibited and disinhibited symptoms in foster children.Child and Adolescent Psychiatry and Mental Health. 2014;8(1):21. doi:10:1186/1753-2000-8-21Betcher HK, Bommersbach TJ, Perossa BA, et al.Adult outcomes of children with reactive attachment disorder in a non-institutionalized sample.J Clin Psychiatry. 2023;84(6):23m14994. doi:10.4088/JCP.23m14994Lehmann S, Monette S, Egger H, et al.Development and examination of the reactive attachment disorder and disinhibited social engagement disorder assessment interview.Assessment. 2020;27(4):749-765. doi:10.1177/1073191118797422National Library of Medicine.Reactive attachment disorder of infancy or early childhood.Hornor G.Attachment disorders.J Pediatr Health Care. 2019;33(5):612-622. doi:10.1016/j.pedhc.2019.04.017Cleveland Clinic.Reactive attachment disorder.
American Psychological Association.Reactive attachment disorder.
Jonkman CS, Oosterman M, Schuengel C, Bolle EA, Boer F, Lindauer RJ.Disturbances in attachment: inhibited and disinhibited symptoms in foster children.Child and Adolescent Psychiatry and Mental Health. 2014;8(1):21. doi:10:1186/1753-2000-8-21
Betcher HK, Bommersbach TJ, Perossa BA, et al.Adult outcomes of children with reactive attachment disorder in a non-institutionalized sample.J Clin Psychiatry. 2023;84(6):23m14994. doi:10.4088/JCP.23m14994
Lehmann S, Monette S, Egger H, et al.Development and examination of the reactive attachment disorder and disinhibited social engagement disorder assessment interview.Assessment. 2020;27(4):749-765. doi:10.1177/1073191118797422
National Library of Medicine.Reactive attachment disorder of infancy or early childhood.
Hornor G.Attachment disorders.J Pediatr Health Care. 2019;33(5):612-622. doi:10.1016/j.pedhc.2019.04.017
Cleveland Clinic.Reactive attachment disorder.
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