Development of a brief, clinically relevant, scale for measuring attachment disorders

Area of Science:

• Child Psychology
• Developmental Psychology
• Clinical Psychology

Background:

• Reactive attachment disorder (RAD) is a serious condition affecting children's emotional and social development.
• Accurate assessment tools are crucial for identifying RAD and its subtypes in vulnerable populations like foster children.
• Previous research highlights the impact of early adversity on attachment patterns.

Purpose of the Study:

• To develop and validate a reliable questionnaire for assessing reactive attachment disorders (RAD) in children.
• To explore the relationship between RAD subtypes and specific adverse childhood experiences.
• To investigate the association between RAD symptoms and behavioral/emotional problems in foster care.

Main Methods:

• Development of a 17-item questionnaire for RAD.
• Administration to 182 Scottish children in foster care.
• Assessment of test-retest and inter-rater reliability (ICC values of 0.78 and 0.81, respectively).
• Cluster analysis to identify child groupings and RAD subtypes.
• Statistical analysis of questionnaire scores against behavioral problems and abuse history.

Main Results:

• The RAD questionnaire demonstrated good reliability.
• Cluster analysis identified three groups, aligning with two RAD subtypes.
• High RAD scores were significantly linked to conduct problems, emotional difficulties, hyperactivity, peer issues, and lower pro-social behavior.
• High RAD scores were associated with a history of sexual abuse, but not physical abuse.
• The disinhibited RAD subtype was specifically associated with a history of neglect.

Conclusions:

• The developed questionnaire is a reliable tool for assessing RAD in foster children.
• RAD symptoms are strongly associated with significant behavioral and emotional challenges.
• Specific RAD subtypes may be linked to distinct forms of early adversity, particularly sexual abuse and neglect.