Causes Of Attachment Disorder In Children: Symptoms & Treatment

Attachment disorders in children are psychiatric illnesses wherein they go through emotional attachment issues. They usually develop these symptoms in early childhood. Most children with attachment issues have trouble building healthy relationships, and the symptoms may remain the same or worsen as the child grows older if not treated on time. In most cases, caregivers or psychologists can notice the signs of attachment disorders once the child attains the age of one. The most evident sign is either overfriendliness with strangers or total disengagement with people (1).

Read on to know about the types, symptoms, causes, risk factors, treatment, and ways that might help prevent attachment disorders in children.

Types Of Attachment Disorders In Children

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) classifies attachment disorders into reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) (1) (2).

1. Reactive attachment disorder (RAD): RAD is most commonly seen in children who were neglected before they received any foster care or raised in boarding homes/institutions. Children with RAD like to be on their own and do not seek an adult’s comfort when upset. They may not show any emotion while interacting and often come off as unhappy, irritable, aggressive, or scared.

2. Disinhibited social engagement disorder (DSED): DSED is marked by overfriendliness with strangers. Children with DSED are extremely friendly and do not understand the distance they need to maintain with unfamiliar people. As a result, they are at risk of wandering away with a stranger without informing the parents or caregivers.

Symptoms Of Attachment Disorder In Children

Some of the most common symptoms of attachment disorder in young children include (2) (3)

• Not smiling often
• Rejecting efforts to calm them
• Anger management issues
• Being excessively controlling
• Difficulty making eye contact
• Crying inconsolably
• Lack of interest in engaging and interactive activities
• Aversion to physical touch
• Difficulty in showing guilt or regret (RAD)
• Over friendliness with strangers (DSED)
• Little to no genuine affection towards parents (DSED)

Causes Of Attachment Disorder In Children

The exact cause of attachment disorders in children is not known. However, experts suggest that it often stems from inadequate caregiving. This could happen due to several factors (1) (3) (4).

1. If the child was separated from the parents during infancy or early stages of childhood, they may feel detached. It develops as separation anxiety and can lead to attachment disorders.

2. A frequent change in caregivers can lead to inconsistency, and the child may struggle to develop a bond with any of them.

3. Parents with a mental illness or who abuse substances may fail to attend to the child more regularly, thus increasing the child’s risk for attachment disorders.

4. If a child is not sure about what to expect due to inconsistency in the mood of the caregiver, they may feel insecure and emotionally withdrawn. This may happen when the child receives different reactions from a caregiver for doing the same thing.

5. Children who face trauma or physical or emotional abuse may later develop attachment disorders. This often causes trust issues and anxiety in the child as they are unable to get over the negative experience from the past.

6. When parents do not respond to or comfort the child when they experience distress, it makes them feel unattended and neglected.

7. Some children realize that they get the attention they crave only when they throw tantrums or act difficult. Thus, they may resort to these drastic measures to receive what they want from their parents. Such children may develop attachment problems as they grow older.

Risks Factors And Complications Of Attachment Disorders

Certain factors can lead to a higher risk of developing attachment disorders in children. These include (2)

• Inconsistent availability of caregivers.
  • Institutional care: Children who spend most of their time at daycare centers or in boarding institutions may develop attachment problems due to the lack of bonding time with their parents.
  • Changes in foster care placements: When the child is sent from one place to another, which often involves a change of caregivers, it may lead to the onset of attachment disorders.
  • Loss of the primary caregiver: Children who suffer the loss of a parent due to death or separation between the parents can develop separation anxiety, further leading to attachment disorders.

• Inability of the caregiver to meet the child’s needs due to
  • Self-absorption.
  • Mental illness.
  • Substance abuse.
  • Domestic violence.
  • Physical disability.
  • A separation or divorce.
  • Child maltreatment, such as sexual abuse, physical abuse, emotional abuse, and neglect.

Attachment disorders can give rise to the following complications if not managed well (4).

• Delayed mental development
• Delayed physical growth
• Emotional detachment, anxiety, depression, and anger outbursts
• Eating disorders
• Substance abuse later in life
• Poor academic performance
• Relationship issues
• Self-harm behaviour

Treatment For Attachment Disorder In Children

A pediatric mental health professional may treat a child with attachment disorder adopting any of the following options (2).

1. Dyadic interactive therapy: This therapy is designed for the child and caregiver. It is often used to treat social and behavioral issues seen in RAD.

2. Psychopharmacological intervention: Children with comorbid disorders such as ADHD, anxiety, or mood disorder may benefit from the medications prescribed by a healthcare professional. Medication along with therapy is often a good approach to treat attachment disorder accompanied by comorbid disorders.

3. Limiting contact with unfamiliar people: This is useful for children with DSED to reduce indiscriminate behavior and over-friendliness with strangers.

Prevention Of Attachment Disorder In Children

You can help prevent attachment disorder in your child by (4).

• Ensuring they form healthy bonds with the caregivers or parents. This encourages the child to be more interactive and social outside the house too.

• Showing them that family relationships are consistent and secure. Children feel more comfortable and at ease when they are secure about their relationship with their parents.

• Making the child feel loved and cared for. This gives children the confidence to turn to their parents in any difficult situation.

• Supporting the child through the years of development and catering to their various developmental needs.

• Keeping calm and tackling instances of bad behavior more patiently, particularly once they step closer towards puberty.

• Consistently validating them and spending more time together.

• Being a good role model

How To Help Children With Attachment Disorders?

To help children manage attachment disorders, you may consider following these steps (5).

• Do not overwhelm the child with your expectations.

• Be patient as the child may not show improvement instantly. It takes time for a young child to come out of attachment issues; thus, you may create a safe space for the child and allow them to confide in you.

• Share the happy and sad times. Laughter can go a long way in building strong bonds, and sharing it with your child will help them open up to you.

• Be optimistic and sensitive towards your child’s feelings. A positive approach in helping the child overcome the disorder will fetch good results in the long run.

• Ask for support from family members, friends, teachers, or even peers of the child when required. This will give your child multiple opportunities to feel more involved socially.

Attachment disorder can worsen with time if left untreated. Hence, early diagnosis and treatment can help the child have a good-quality life. You can also enroll your child in special educational programs—this can help develop certain skills that improve academic performance and control behavioral issues.

References

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Reviewer

Dr. Neha Bhave SalankarMD

 

Dr. Neha Bhave Salankar is a consultant psychiatrist at Bhave Institute of Mental Health based in Nagpur and has around 11 years of experience in the field. Having been a meritorious student throughout, she bagged the prestigious gold medal for medicine in MBBS and MD psychiatry.

Read full bio of Dr. Neha Bhave Salankar