Chapter 22: Reactive Attachment Disorder

Question 1

Reactive Attachment Disorder (RAD)

Answer 1

difficulties in forming emotional attachments with others

Question 2

Understanding the Disorder

Answer 2

• children who have not been afforded consistent and nurturing presence early in their lives become either anxiously attached or detached in relation to others
• infants and children diagnosed with attachment disorders have usually endured neglect and/or maltreatment or have experienced severe trauma

Question 3

The children who are at risk

Answer 3

• those within foster care and international and domestic adoption system who have previously been abandoned or abused
• disrupted early attachment; infants with mothers with postpartum depression or mental illness may not have had the opportunity to bond and attach healthily

Question 4

Signs + Symptoms

Answer 4

-marked disturbance in ability to relate socially, manifesting either:
>emotional withdrawal or inhibition
-inability to seek or accept warmth from others
-inability to show or respond to affection
>marked disinhibition
-indiscriminate willingness to seek comfort even from strangers
-excessive trust of strangers
-infants with serious insecure attachments may exhibit severe feeding difficulties not r/t a physiological cause

Question 5

Diagnosis

Answer 5

by parental report and observing how the child interacts around parents an strangers

Question 6

Prevention

Answer 6

• educating parents and providing them with mental health services prior to becoming parents
• adoptive parents should be aware of the difficulties that may have been experienced by their children prior to adoption

Question 7

Nursing Care

Answer 7

-create an opportunity to experience a caring relationship
-developing trust through meeting the child’s basic needs or responding to cried or tantrums or listlessness with patience and consistency
>child with RAD had no true concept about which basic needs will be met
-refer for psychotherapy

Question 8

Education/Discharge

Answer 8

• parents need a great deal of support
• educated about attachment ad bonding and how to deal with a child who has difficulty making interpersonal connections
• support groups with other parents who have children with RAD