Reactive Attachment Disorder Symptoms & Effects

Learn about reactive attachment disorder

Reactive attachment disorder (RAD) is a rare mental illness that develops when infants or children are not provided with the necessary opportunity to establish healthy bonds with parents, guardians, or other types of caregivers. The attachment that is developed between infants and their caregivers occurs at a critical point in their overall development, so when children are denied that emotional bond during these important years, they are going to suffer negative consequences. In order for children to truly learn how to trust others and to develop the sense of safety that they need in order to thrive, it is essential that they be surrounded by a safe, secure, caring, compassionate, and nonthreatening environment. When this environment is not provided, and when a child’s needs go unmet, they inherently feel unsafe and lack the ability to develop a sense of trust in others. As they grow, they continue to expect that all relational interactions are only going to be met with the same hostility or rejection that they experienced from their caregivers during early development. For these children, this is all that they know to expect from others, so they react accordingly. This reaction can then result in the onset of reactive attachment disorder.

Reactive attachment disorder statistics

Due to the rarity of reactive attachment disorder, along with the fact that it is scarcely seen in clinical settings, its true prevalence remains unknown. Psychiatrists have noted that, even within the population of children who have been the victims of severe abuse and neglect, less than 10% go on to develop RAD.

Causes and risk factors for reactive attachment disorder

The rarity of reactive attachment disorder causes research on the condition to be significantly lacking. Therefore, specific causes and risk factors as to why some children develop RAD while others do not is not conclusive. However, the following descriptions have been noted as likely to impact the development of reactive attachment disorder:

Genetic: While there is no specific genetic link tied to the onset of RAD, genetic influences are cited as playing a significant role in the development of other attachment disorders, so many professionals in the field have hypothesized that genetic influences impact the development of reactive attachment disorder as well.

Physical: The way in which infants and their mothers or other primary caregivers interact has an impact on how the brain develops. When emotional interaction is lacking or nonexistent, an alteration in brain development occurs which can, in turn, affect the molding of one’s personality. This affects how a child views and experiences interpersonal relationships, which can further determine whether or not the onset of RAD will occur.

Environmental: It is a common belief amongst professionals in the field of psychology that the onset of reactive attachment disorder is primarily the result of the environment in which a child is raised. Being denied a healthy, emotional, and affectionate relationship with a caregiver can greatly hinder a child’s successful mental health development. Additionally, when children are raised in homes where they are abused, they will inevitably recognize fear as the primary emotion that they are capable of experiencing. The concept of attachment is foreign to them, so they will unconsciously avoid any situation that might lead to its development.

Risk Factors:

• Being socially neglected
• Growing up in an institutional setting (e.g. an orphanage)
• Moving amongst multiple foster homes
• 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 or significant changes with a primary caregiver

Signs and symptoms of reactive attachment disorder

The signs and symptoms that are displayed by a child who is suffering from reactive attachment disorder will vary depending on the specific circumstances that impacted the child’s early development. Examples of various symptoms that may present in these children can include:

Behavioral symptoms:

• Inability to, or purposely refraining from, making eye contact
• Refusing to interact with peers
• Presenting as calm when alone as opposed to when other people are present
• Participating in self-soothing behaviors, such as stroking one’s arms or consistently rocking back and forth
• Turning or leaning away from someone who is trying to show affection
• Minimal social responsiveness to others

Physical symptoms:

• Failing to gain weight
• Never smiling
• Looking joyless
• Appearing listless

Cognitive symptoms:

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

Psychosocial symptoms:

• Experiences difficulty or is incapable of being comforted
• Ongoing feelings of being unsafe
• Drastically low self-esteem
• Feeling “empty” inside
• Feelings of worthlessness
• Lacking the ability to trust others
• Lacking a sense of belonging
• Feeling unwanted
• Chronic, overwhelming feelings of sadness
• Chronic, overwhelming feelings of anxiety

Effects of reactive attachment disorder

There are countless long-term ramifications that can result if you don’t address and receive treatment for reactive attachment disorder. Examples of such effects may include:

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

Reactive attachment disorder and co-occurring disorders

There are a number of conditions that have been known to co-occur with reactive attachment disorder. According to the American Psychiatric Association, these conditions typically involve neglect, including cognitive delays, language delays, and repetitive or ritualistic movements, such as body rocking. The specific disorders that have been cited as occurring alongside reactive attachment disorder include:

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