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Reactive Attachment Disorder of Infancy or Early Childhood

Diagnostic criteria or 31.89 Reactive Attachment Disorder of Infancy or Early Childhood

A. Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2):

(1) persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses (e.g., the child may respond to caregivers with a mixture of approach, avoidance, and resistance to comforting or may exhibit frozen watchfulness)
(2) diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures)

B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder.

C. Pathogenic care as evidenced by at least one of the following:
(1) persistent disregard of the child's basic emotional needs for comfort, stimulation, and affection
(2) persistent disregard of the child's basic physical needs
(3) repeated changes of primary caregiver that prevent formation of stable attachments (e.g., frequent changes in foster care).

D. There is a presumption that the care in Criterion C is responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C).

(1994) American Psychiatric Association: Diagnostic And Statistical Manual of Mental Disorders, Fourth Edition, Washington, DC, American Psychiatric Association

Links to Reactive Attachment Disorder (RAD) websites:

  • Attachment Home Page
  • Kuddle Kids Korner
  • Reactive Attachment Disorder - It's Time To Understand . . .
  • Kathi's Mental Health Review
  • ARIA: Parenting a Poorly Attached Child: Understanding and Bonding
  • Heal the Hearts Foundation
  • Attachment Disorder Site
  • Attachment Disorder Network
  • Reactive Attachment Disorder - It's Time To Understand . . .
  • Attachment Disorder Site
    The Attachment Center at Evergreen
    Taming the Tiger While itís a Kitten
  • Attachment Disorder Support Group
  • Attachment Disorder Network
  • The Kay Foundation
  • Dr. Foster Cline's Website
  • Attachment Disorder: Useful resources
  • A list of books and articles on Attachment
  • Children at risk for reactive attachment disorder: assessment, diagnosis and treatment.
  • Adopted Child Newsletter
  • Adoption Policy Resource Center
  • Whole Family Attachment Parenting Association
  • Alaska Attachment and Bonding Associates
  • Attachment
  • EEG Spectrum
  • Utah Parents' Support Group
  • Dianne Craft's Website
    The Attachment Disorder Support Group
  • Bonding and Attachment in Maltreated Children
  • The Attachment Center at Evergreen
  • Association for Treatment and Training in the Attachment of Children
  • Attachment Disorder
  • Attachment Disorder Home Page
  • Attachment Disorder Network
  • Attachment Disorder Theory, Parenting and Therapy
  • Attachment Disorder:† Attachment and Bonding Center of PA
  • Attachment Holding Therapies: Harmful? Or Rather Beneficial!
  • Attachment Issues
  • Attachment as a Context for Development: Challenges and Issues
  • Behavior Change as Reported by Caregivers of Children Receiving Holding Therapy
  • Bonding and Attachment - When it Goes Awry Part 2
  • Bonding and Attachment - When it Goes Right Part 1
  • Reactive Attachment Disorder: From Awareness to Growth
  • Correlation Between Reactive Attachment Disorder and Bipolar Disorder
  • Dear Friends and Family...RAD FAQs
  • Deborah's Page: Attachment Disorder Specialist
  • Depression and Parenting a Child with Attachment Difficulties
  • Donna Gould's Family Therapy
  • Dr. Federici - Home Page
  • Evergreen Psychotherapy Center
  • Evolution of Attachment Therapy
  • Family Attachment Center of Minnesota
  • Fighting to be a Family
  • Focus Adolescent Services
  • Full of Woe
  • Heal The Hearts Foundation
  • Hope to Tell
  • Martha G. Welch Center
  • Nancy Thomas
  • Older Child Adoption...Hannah and Her Mama
  • Parenting RAD Children ....... a Balancing Act
  • Post Traumatic Stress (PTS) In Families With Attachment Disordered Children
  • Power Tools for Attachment
  • Reactive Attachment Disorder Parenting Tips
  • Reactive Attachment Disorder - It's Time To Understand
  • Reactive Attachment Disorder Mailing List
  • Reactive Attachment Disorder: A Case Study
  • Stony Brook: Attachment Research and Theory
  • Tapestry Books
  • Taplink
  • The Attachment Center West
  • The Attachment Disorder Support Group (ADSG)
  • The Enemy Within
  • The PA Attachment Disorder Support Group
  • Trauma and Attachment
  • Treatment of Attachment Disorder
  • Understanding Bonding
  • What Is Holding Time?
  • Wisconsin Attachment Resource Network
  • Choosing to Use Confrontative Therapies with Attachment Disordered Children



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    ** Please use caution when reading any of the disorders listed above.
    Do not panic because you find a couple of symptoms that match a specific personality disorder.
    We all have symptoms that can apply to one or another disorder
    but what makes it a disorder is a "pervasive pattern"
    and that is how the psychiatrists and psychologists
    determine if it is a specific disorder.**
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