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Causes
By Mayo Clinic staffTo feel safe and develop trust, infants and young children need a stable, caring environment. Their basic emotional and physical needs must be consistently met. For instance, when a baby cries, his or her need for a meal or a diaper must be met with a shared emotional exchange that may include eye contact, smiling and caressing.
A child whose needs are ignored or met with emotionally or physically abusive responses from caregivers comes to expect rejection or hostility. The child then becomes distrustful and learns to avoid social contact. Emotional interactions between babies and caregivers may affect development in the brain, leading to attachment problems and affecting personality and relationships throughout life.
Most children are naturally resilient, and even those who've been neglected, lived in orphanages or had multiple caregivers can develop healthy relationships and strong bonds. It's not clear why some babies and children develop reactive attachment disorder and others don't.
- Reactive attachment disorder of infancy or early childhood. In: Diagnostic and Statistical Manual of Mental Disorders DSM-IV-TR. 4th ed. Arlington, Va.: American Psychiatric Association; 2000. http://www.psychiatryonline.com. Accessed June 9, 2011.
- Haugaard JJ, et al. Recognizing and treating uncommon emotional disorders in children and adolescents who have been severely maltreated: Reactive attachment disorder. Child Maltreatment. 2004;9:154.
- Horner G. Reactive attachment disorder. Journal of Pediatric Health Care. 2008;22:234.
- Reactive attachment disorder. American Academy of Child and Adolescent Psychiatry. http://www.aacap.org/cs/root/facts_for_families/reactive_attachment_disorder. Accessed June 9, 2011.
- Newman L, et al. Recent advances in the theories of and interventions with attachment disorders. Current Opinion in Psychiatry. 2007;20:343.
- Boris NW, et al. Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder of infancy and early childhood. American Academy of Child and Adolescent Psychiatry. http://aacap.browsermedia.com/galleries/PracticeParameters/rad.pdf. Accessed June 9, 2011.
- Cornell T, et al. Clinical interventions for children with attachment problems. Journal of Child and Adolescent Psychiatric Nursing. 2008;21:35.
- Report of the APSAC task force on attachment therapy, reactive attachment disorder, and attachment problems. Association for Treatment and Training in the Attachment of Children. http://www.attach.org/apsac.htm. Accessed June 9, 2011.
- Coercive interventions for reactive attachment disorder. American Academy of Child & Adolescent Psychiatry. http://www.aacap.org/cs/root/policy_statements/coercive_interventions_for_reactive_attachment_disorder. Accessed June 9, 2011.
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