Signs & Symptoms of Reactive Attachment Disorder

Learn more about reactive attachment disorder

Reactive attachment disorder is a mental health condition with origins and causes rooted in infancy and early childhood. The early origins of this illness is the result of the fact that it is brought on by poor attachment from caregivers when a child is unable to care for him or herself due to age and hindered ability to meet one’s own needs. The bond between caregivers and their child or children during early development is crucial such that this is the phase of life when a person learns what it means to feel safe, emotionally connected, and physically cared for by another individual or individuals. When these elements are lacking or completely absent, an infant/young child learns that others cannot be relied on for care and comfort, and the resulting developmental impairments and behaviors are symptoms synonymous with reactive attachment disorder.

Also known as RAD, young people with this mental illness may fail to thrive and function in a healthy manner. Additionally, as a child ages, he or she may be unable to form meaningful relationships with others as rejection and/or hostility is the assumed response from other people. Care for this disorder, when it is sought and implemented, can help a young person learn new skills for social interactions and experience the benefits of having therapeutic relationships with others who will offer support in an advantageous way.  And while the circumstances or events that led to the development of this disorder cannot be erased, treatment can greatly improve the lives of RAD sufferers.

Reactive attachment disorder statistics

It is estimated that less than 10% of children and adolescents suffer from reactive attachment disorder. However, this estimate may not be fully accurate as RAD is extremely rare and the number of young people who receive treatment for this condition is scarce. What is known, however, is that children who have a history of early institutional living, in orphanages for example, are at an increased risk for developing reactive attachment disorder.

Causes and risk factors for reactive attachment disorder

Reactive attachment disorder is a rare mental illness. Because of this, extensive research is lacking on this disorder. However, researchers believe that the following causes and risk factors lead to the onset of RAD symptoms during childhood:

Genetic: Child development experts agree that a person’s environment is the biggest determinant for the development of reactive attachment disorder. However, there are certain genetic influences that can influence the onset of this disorder. For examples, if there is a family history of personality disorders, young children may present with severe symptoms of RAD as they age.

Physical: Poor attachment with caregivers can lead to hindered development in a child’s brain. Specifically in the area of the brain that is responsible for the formation of a person’s personality, the frontal lobe, children who suffer from reactive attachment disorder are known to have structural differences in their brains. This conclusion was made when the brains of young people with RAD were compared to children and adolescents who do not meet diagnostic criteria for this mental health condition.

Environmental: Mental health experts believe that environmental circumstances that take place early in a child’s life greatly influence whether or not a child will suffer from reactive attachment disorder. When a child is neglected in a manner than denies physical closeness, emotional connectivity, and care for basic needs, there is an increased likelihood for the development of RAD. Healthy and adequate attachment is necessary for a child to develop a sense of safety and security within him or herself. When a child lacks these elements, he or she may turn inward and be unable to form attachments and relationships with others. Furthermore, children who are abused or experience other extreme traumas are also at risk for developing RAD when they are not comforted in a nurturing way when fear is experienced.

Risk Factors:

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

Signs and symptoms of reactive attachment disorder

Depending on the circumstances that occurred early in a child’s development that led to the eventual onset of reactive attachment disorder symptoms, the signs of this condition can be vast and affect various aspects of a young person’s life in a number of ways. The listed behavioral, physical, cognitive, and psycho-social symptoms suggest a youth is struggling with RAD and often require care in order to improve the life of the child or adolescent with this mental illness.

Behavioral symptoms:

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

Physical symptoms:

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

Cognitive symptoms:

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

Psycho-social symptoms:

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

The effects of reactive attachment disorder

Because the symptoms of RAD can severely impact a young person’s social and emotional development, there are a number of effects that can occur if treatment is not sought and implemented to help a youth grappling with this mental health condition. The follow effects and consequences are examples of circumstances and hindrances that can take place when symptoms of this disorder remain unaddressed:

• Inability to develop or maintain significant interpersonal relationships
• Inability to relate interpersonally to adults or peers
• Extreme anger problems
• Lacking the ability to have genuine feelings of compassion towards others
• Underdeveloped conscience
• Developing a strong aversion to any kind of physical touch

Reactive attachment disorder and co-occurring disorders

Because the causes of reactive attachment disorder are similar to the causes of other mental health conditions, there are a number of other mental illnesses that can be diagnosed alongside RAD. Theses disorders can include language, cognitive, and behavioral impairments, of which are also symptomatic of reactive attachment disorder. The following co-occurring disorders are examples of such conditions that can be present at the same time as reactive attachment disorder:

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