Attachment disorder Flashcards
What are attachment disorders?
Patterns of behaviour result of a lack of development of normal bonds with a primary caregiver in early childhood
What can cause attachment difficult?
Normal connection with parent figure not there due to neglect, abuse, institutionlisation or disruption of care
When do attachment disorders present?
Before 5, cant be diagnosed before the age of 1 year
Why cant attachment disorders be diagnosed before the age of 1 year?
Potential autism diagnosis
Capacity for selective attachments may not be developed
What may a history of grossly insufficient care include?
Persistent disregard for childs basic emotional needs for comfort, stimulation and affection
Persitent disregard for childs basic physical needs
Repeated changes of primary caregivers eg fostering
Rearing in iunusual settings eg institutions that prevent stable selective attachements
Maltreatment
What is reactive attachment disorder?
grossly abnormal attachment behaviours in early childhood, occurring in the context of a history of grossly inadequate child care (e.g., severe neglect, maltreatment, institutional deprivation). Even when an adequate primary caregiver is newly available, the child does not turn to the primary caregiver for comfort, support and nurture, rarely displays security-seeking behaviours towards any adult, and does not respond when comfort is offered.
What are the essential features for reactive attachment disorder?
A history of grossly insufficient care
Markedly abnormal attachment behaviours towards adult caregivers in a child, characterized by a persistent and pervasive pattern of inhibited, emotionally withdrawn behaviour including both of the following
The grossly insufficient care is presumed to be responsible for the persistent and pervasive pattern of inhibited, emotionally withdrawn behaviour.
The symptoms are evident before the age of 5.
The child has reached a developmental level by which the capacity to form selective attachments with caregivers normally develops, which typically occurs at a chronological age of 1 year or a developmental age of at least 9 months.
The abnormal attachment behaviours are not better accounted for by Autism Spectrum Disorder.
The abnormal attachment behaviours are not confined to a specific dyadic relationship.
Abnormal attachment behaviours in children towards careivers in children with reactive attachmet disorder
a persistent and pervasive pattern of inhibited, emotionally withdrawn behaviour including both
Minimal seeking of comfort when distressed.
Rare or minimal response to comfort when it is offered.
How is maltreatment characterised?
Non accidental acts of physical force which result or have reasonable potential to result in physical harm or evoke significatn fear
Sexual acts invilving a child for gratification of adult
Non accidental verbal or symbolic acts that results in signifcatnt psychological harm
What are children with reactive attachment disorder espcially at risk of getting?
PTSD or complex PTSD
Who do the behaviorus of a child with RAD have to include?
All caregivers - not just dyadic (with one person)
Causes of Reactive attachment disorder
Child maltreatemnet
Multiple care placements
Insititutionalsiation
Separation from primary aregiver
dRUG AND ALCOHOL ABSUE
Conditions causing children to seek asylum
When are clear specific attatchment bonds normally formed
6-9 months
How does a cler specific atachment bond present in an infant
Prefer one individual to give comfort
Express distress when spearated
Normal wariness of strangers
Signs of attachment disorder
Neglectful behaviour by primary caregiver - not comforting in distress, not respsonding to needs eg changing nappy or hunger
Innapropriate interaction caregiver and child eg hostil, insensitive, neglectful, unresponsive
Lack smile or responsiveness in babay or child
Does not seek attention or comfort
Avoidance of touch or gestures of affection
Lack of distress in situations that should distress
Indiscriminate excessive frinedliness towards healthcare workers
Inconsolable crying
Emotional and behavioural difficulties - anxiety, depression, socila withdrawal, somatisation, aggression, challenging behaviour
