Reactive attachment disorder--a theoretical model beyond attachment

Area of Science:

• Child Psychology
• Developmental Psychiatry
• Clinical Neuroscience

Background:

• Reactive attachment disorder (RAD) is a clinically significant but under-researched condition.
• Abnormal social relatedness in children stems from abuse, neglect, or institutionalization.
• Previous research focused on attachment deficits, causing controversy and hindering progress.

Purpose of the Study:

• To propose a new framework for understanding Reactive Attachment Disorder (RAD).
• To reframe RAD within the concept of intersubjectivity.
• To explore how intersubjectivity can explain diverse RAD symptoms and guide future research.

Main Methods:

• Conceptual analysis of existing literature on RAD, attachment theory, and intersubjectivity.
• Theoretical integration of intersubjectivity framework with observed RAD symptomatology.
• Review of psychiatric nosology and clinical definitions of attachment-related disorders.

Main Results:

• The attachment system framework may be too narrow for RAD.
• Intersubjectivity offers a broader perspective, encompassing core social and brain functions.
• This framework potentially explains varied symptoms like indiscriminate friendliness and unpredictable reunion behaviors.

Conclusions:

• Reframing RAD within intersubjectivity may facilitate research and clinical understanding.
• A potential name change for RAD could aid field progression.
• Further consensus on RAD's core features and etiology is needed for clinical and scientific advancement.