Reactive Attachment Disorder

About Reactive Attachment Disorder

Reactive attachment disorder is a trauma and stressor related condition of early childhood. It describes a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, in which a child rarely seeks or responds to comfort when distressed, alongside limited positive emotion and episodes of unexplained irritability, sadness or fearfulness. The diagnosis requires a history of insufficient care, such as severe social neglect, repeated changes of primary caregiver, or upbringing in settings with few opportunities to form selective attachments. It is considered rare, even among children who have experienced neglect, and it is diagnosed only in children with a developmental age of at least nine months. DSM-5 separated it from disinhibited social engagement disorder. The central approach is ensuring a stable, responsive caregiving environment, with therapy that supports caregivers in building a secure relationship with the child, and many children show improvement when care improves.