Master of Social WorkL.
Attachment theory and attachment disorder Pediatricians are often the first health professionals to assess and raise suspicions of RAD in children with the disorder. The initial presentation varies according to the child's developmental and chronological age, although it always involves a disturbance in social interaction.
Infants up to about 18—24 months may present with non-organic failure to thrive and display abnormal responsiveness to stimuli. Laboratory investigations will be unremarkable barring possible findings consistent with malnutrition or dehydrationwhile serum growth hormone levels will be normal or elevated.
This can manifest itself in three ways: Indiscriminate and excessive attempts to receive comfort and affection from any available adult, even relative strangers older children and adolescents may also aim attempts at peers. This may often times appear as denial of comfort from anyone as well.
Extreme reluctance to initiate or accept comfort and affection, even from familiar adults, especially when distressed. Actions that otherwise would be classified as conduct disordersuch as mutilating animalsharming siblings or other family, or harming themselves intentionally.
However, the instances of that ability are rare. Often a range of measures is used in research and diagnosis. Recognized assessment methods of attachment styles, difficulties or disorders include the Strange Situation Procedure devised by developmental psychologist Mary Ainsworth   the separation and reunion procedure and the Preschool Assessment of Attachment,  the Observational Record of the Caregiving Environment,  the Attachment Q-sort  and a variety of narrative techniques using stem storiespuppets or pictures.
For older children, actual interviews such as the Child Attachment Interview and the Autobiographical Emotional Events Dialogue can be used. Caregivers may also be assessed using procedures such as the Working Model of the Child Interview.
This method is designed to pick up not only RAD but also the proposed new alternative categories of disorders of attachment. Causes[ edit ] Although increasing numbers of childhood mental health problems are being attributed to genetic defects reactive attachment disorder is by definition based on a problematic history of care and social relationships.
Abuse can occur alongside the required factors, but on its own does not explain attachment disorder. The issue of temperament and its influence on the development of attachment disorders has yet to be resolved.
RAD has never been reported in the absence of serious environmental adversity yet outcomes for children raised in the same environment are the same. The subsequent development of higher-order self-regulation is jeopardized and the formation of internal models is affected.
Consequently, the "templates" in the mind that drive organized behavior in relationships may be impacted. The potential for "re-regulation" modulation of emotional responses to within the normal range in the presence of "corrective" experiences normative caregiving seems possible.
There is little systematic epidemiologic information on RAD, its course is not well established and it appears difficult to diagnose accurately. The signs or symptoms of RAD may also be found in other psychiatric disorders and AACAP advises against giving a child this label or diagnosis without a comprehensive evaluation.
Attachment behaviors used for the diagnosis of RAD change markedly with development and defining analogous behaviors in older children is difficult. There are no substantially validated measures of attachment in middle childhood or early adolescence.
The two classifications are similar and both include: ICD states in relation to the inhibited form only that the syndrome probably occurs as a direct result of severe parental neglect, abuse, or serious mishandling.Score my Questionnaire and you will receive a brief summary.
It is recommended that you share this questionnaire with a physician or mental health professional who can perform a complete evaluation and can determine whether you are experiencing depression and/or depersonalization.
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Totally, 2 rounds of Delphi.