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Reactive Attachment Disorder is listed in the DSM-5 under Trauma- and Stressor-Related Disorders. A child with this disorder lacks the ability to form meaningful relationships with others as a result of the child’s basic needs not being met during infancy, often times due to extreme neglect or abuse. When upset, the child will not look to their primary caregiver for support, nurturance, comfort, or protection, and is unlikely to respond to the caregivers efforts to provide these.

Reactive Attachment Disorder is characterized by inhibited, emotionally withdrawn behavior toward caregivers in that the child rarely seeks comfort nor responds to comfort when distressed. There are persistent social and emotional disturbances illustrated by minimal social and emotional responsiveness to others, limited positive affect, and episodes of unexplained irritability, sadness, or fearfulness during nonthreatening situations. Additionally, the child must have experienced extreme insufficient care, prior to symptoms listed previously, which is typified by persistent emotional neglect, continued change of primary care givers that does not allow opportunity for attachment, or rearing in a setting with severely limited opportunity to attachment to form.

A child with reactive attachment disorder must not meet the criteria for autism spectrum disorder. Past history of trauma, neglect, or abuse is often the differentiating factor of the two.

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Attachment Disorder: Diagnosis and Treatment