Reactive Attachment Disorder (RAD)

Symptoms | Causes | Diagnostic Criteria | Treatments

Reactive attachment disorder (RAD) is a rare condition that is found in children where they experience a great deal of emotional dysfunction. It develops due to the child experiencing abuse or neglect from their caregiver early on in their lives.

This truly hinders the natural bond that is developed between them. After this occurs for a significant amount of time, reactive attachment disorder can develop.

Children who are raised in orphanages or foster-care facilities have a higher risk for developing this disorder. Other factors that may heighten the risk for a child to develop this illness are if their parents or caregivers engage in high quantities of alcohol or recreational drugs, if their caregivers suffer from major depression, or if they are merely uncaring and apathetic toward their children, among many other factors.


According to the DSM-5, the prevalence of reactive attachment disorder is unknown, but the disorder is seen relatively rarely in clinical settings. The disorder has been found in young children exposed to severe neglect before being placed in foster care or raised in institutions. However, even in populations of severely neglected children, the disorder is uncommon, occurring in less than 10% of such children.

Symptoms of Reactive Attachment Disorder

Some common symptoms of inhibited reactive attachment disorder are feelings of detachment, excessively holding back emotions, resistant to comforting, and behaving in a withdrawn manner. Some common symptoms of dis-inhibited RAD are being inappropriately selective in the decision making process of choosing attachment figures and exercising poor social judgement.

Their behaviors may look similar to that of a younger child. They may lie, steal, argue, throw temper tantrums, blame others for their mistakes, and have trouble regulating their emotions, among many other things. Essentially, their brains are hard-wired to “stay put.” Here are some other common symptoms of RAD:

  • Failure to reach out when picked up
  • Unexplained withdrawal
  • Having a sad appearance
  • Watching others closely but not engaging in social interaction
  • Not seeking comfort
  • Failure to smile or appear happy
  • Failing to ask for support when its needed
  • No interest in playing fun, interactive games

Causes of Reactive Attachment Disorder

There are many different causes of this condition. One of the most prevalent causes for a child to develop this disorder is when there is an interruption with the natural attachment that is developed between a child and their caregiver. Such an interruption could be due to many different factors, such as the one’s previously mentioned. Nevertheless, this would have to occur for a significant period of time for the child to develop reactive attachment disorder.

Consistent and persistent efforts to avoid their child or lack of effort to engage with them over a significant period of time can possibly cause this mental disorder to develop. Other causes could be if the child is in foster care. This may make it very difficult for them to develop a meaningful relationship with their caregiver. This may lead to the child developing reactive attachment disorder, as well as other mental illnesses such as depression or anxiety.

It is unclear whether this mental disorder occurs in older children and, if so, how it differs from its presentation in young children. Because of this, the diagnosis should be made with caution in children older than 5 years, according to the DSM-5.


Diagnostic Criteria

To get properly diagnosed with RAD, you will need to go through a psychiatric evaluation with your psychiatrist, psychologist, or other accredited mental health professional who can legally diagnose mental disorders. Psychiatric evaluations typically entail getting asked questions about your symptoms, such as how intense and frequent you experience them.

Some specific diagnostic criteria, according to the DSM-5, is a consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers, manifested by both of the following:

  1. The child rarely or minimally seeks comfort when distressed.
  2. The child rarely or minimally responds to comfort when distressed.

Additional criteria is as follows: The child has experienced a pattern of extremes of insufficient care as evidenced by: Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults. For more information about this disorder’s diagnostic criteria, it is recommended to read the DSM-5.


Treatments for Reactive Attachment Disorder

Like most mental disorders, there are no treatment methods that can cure reactive attachment disorder. According to Mayo Clinic, there is no standard treatment for reactive attachment disorder. Nevertheless, it should still involve both the child and primary caregivers.

Some strategies for treating this mental illness in therapy are to encourage the child’s development, providing a positive, stimulating and interactive environment for the child, as well as to address the child’s medical, safety and housing needs, according to Mayo Clinic.

If you think you may be suffering from some of the symptoms of this condition, then you may benefit from therapy. Feel free to reach out to your doctor or local mental health clinic to see what your available options are and to see if there is any sort of discount or promo code available to help you with the costs of treatment, as well as if your health insurance will cover treatment costs.


  • Diagnostic and Statistical Manual of Mental Disorders (DSM-5)

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