Reactive Attachment Disorder: Symptoms, Causes And Treatment

Sad blond boy.

A kiss, a hug, a caress… All of this has something in common: In most cases they are carried out with love, and most of us awaken feelings of warmth and affection. Let’s imagine for a moment that we have never received any in childhood. Or that we have done it, but without any affection or emotion having been expressed in it. Let’s also imagine that we have always felt secondary, unimportant to our close ones. How would we feel? How would we relate to others?

It would not be unusual for this to cause us severe limitations, which would mark and hinder our development as people and our social relationships. This is what happens to those people with reactive attachment disorder Let’s see what it consists of.

Reactive attachment disorder: main symptoms

Reactive attachment disorder is one of the disorders related to trauma and stress factors It is also a new disorder included in the latest version of the reference manual of clinical psychology and psychiatry, the DSM 5.

Reactive attachment disorder is characterized by the presence in children over nine months of age of a behavioral pattern in which a high emotional and affective inhibition is manifested towards their caregivers, not seeking and even avoiding contact and comfort in them even when some stimulus or situation occurs that scares you or causes pain or concern. In general, the subject feels unimportant and valued, and does not have a powerful emotional bond with them.

This pattern of inhibition is maintained not only with their caregivers but also at a social level, expressing difficulties in reacting emotionally to the social environment and frequently expressing irritability, sadness or fear of caregivers even in situations that do not pose a threat to them. They often express few positive feelings or emotions in social interaction

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The symptoms described above can be observed before the age of five, and it is important to keep in mind that it can only be diagnosed if the diagnostic criteria for autism are not met. In this sense, it is easy observe a certain similarity between some aspects of the symptomatology of both disorders, but there are big differences. One of them is its cause, which in the case of reactive attachment disorder has been identified and is in fact part of its diagnostic criteria.


The causes of reactive attachment disorder, a requirement in fact for it to be diagnosed, are mainly found in insufficient care during the first years of life. The subject has not received enough affection or met his or her emotional needs and care, affection and protection and/or basic physiological ones.

It is more common in families in which parents have poor parenting skills, or in which they tend not to express feelings. It is common for it to occur in unstructured families, which do not offer or meet the basic needs of the minor.

It is also possible that domestic violence has occurred, whether or not it is physical or whether or not it is directed at the minor in question, or sexual abuse. However, this does not mean that it cannot occur in families without great difficulties at the socioeconomic level, the defining factor being the fact that they have not satisfied or have not been able to sufficiently satisfy the affection needs, or have been excessively ambivalent in the expression of affectivity towards the subject in question.

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Minors who have gone through several changes in primary caregivers (due to custody issues) may also have this disorder, or those who have been educated in institutions and contexts such as orphanages or foster care in which they have not been given enough time or cared for sufficiently. their emotional needs. It must be taken into account that The experience of these circumstances does not have to cause a disorder


The treatment of reactive attachment disorder is complex and requires a multidisciplinary approach where professionals from psychology, medicine, social assistance, education and the field can come together.

It is necessary that the subject be able to establish a solid connection with a reference caregiver to provide emotional support For this reason, subjects with this type of disorder will often benefit from the use of family therapy, in order not only to treat the subject but also to ensure that appropriate educational guidelines are established in cases where there is a deficit in parenting skills.

It is essential to work on the emotional component with the minor. In this sense it will be very useful the use of therapies dedicated to strengthening the subject’s self-esteem, as well as training in social skills. Cognitive restructuring will make it possible to change the dysfunctional cognitions that the subject may have regarding social relationships.

It must also be taken into account that some cases occur in a context of severe neglect of the minor’s needs, with circumstances that even pose a danger to the subject’s life. such as the existence of drug dependence on the part of the parents. In this aspect The withdrawal of guardianship or custody by a judge may be necessary whether temporarily or permanently.

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