DSM V – Reactive Attachment Disorder


Do you know about this?  Do you have any idea what it is?  Is there anyone you may know that may have adopted out of foster care who may be suffering in their home?  It’s not just for adoptive and foster families, but this real mental health issue exists and wreaks havoc in homes in your neighborhood.  It would help us Reactive Attachment Disorder Parents out if more people knew about it and made an effort to understand the disorder that is impossible to understand.  We’d like you to try to make sense out of this disorder that makes no sense.  Please read and try to understand…if you have any questions, don’t be afraid to ask.

The DSM is a Diagnostic and Statistical Manual of Mental Disorders (DSM) is the handbook used by health care professionals in the United States and much of the world as the authoritative guide to the diagnosis of mental disorders. It is like the check sheet that you need to have to get a diagnosis and you need to get a diagnosis so that you can get the help and services you need.  AKA – how insurance will pay and how much they will pay depending on diagnosis.

DSM-5 Criteria for Reactive Attachment Disorder (RAD)

The DSM-5 gives the following criteria for Reactive Attachment Disorder:

A. A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers,(NOTE THE WORD CAREGIVERS – That means to everyone else this child may appear helpful, polite and pretty typical) manifested by both of the following:

  • The child rarely or minimally seeks comfort when distressed.(Is used to taking care of himself, so will do so even if he doesn’t know how.)
  • The child rarely or minimally responds to comfort when distressed.(Doesn’t respond appropriately to any kind loving attention….again….from the caregivers….he’ll let everyone else love on him, just not the ones who love him the most.)

B. A persistent social or emotional disturbance characterized by at least two of the following:

  • Minimal social and emotional responsiveness to others (might care about you, might not.)
  • Limited positive affect (refers to the extent to which an individual subjectively experiences positive moods such as joy, interest, and alertness.  Looks very distant and isn’t really joyful at typical times like birthdays, holidays, etc.)
  • Episodes of unexplained irritability, sadness, or fearfulness that are evident even during nonthreatening interactions with adult caregivers. (Just ticked for no apparent reason and the more you try to help, the more irritable he gets. At home will rage since home is his most threatening environment for him.)

C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:

  • Social neglect or deprivation in the form of persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caring adults (Babies need someone to respond to their cries.)
  • Repeated changes of primary caregivers that limit opportunities to form stable attachments (e.g., frequent changes in foster care) Something needs to be done about this to help prevent this disorder!!!!!
  • Rearing in unusual settings that severely limit opportunities to form selective attachments (e.g., institutions with high child to caregiver ratios)

D. The care in Criterion C is presumed to be responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the lack of adequate care in Criterion C).

E. The criteria are not met for autism spectrum disorder.

F. The disturbance is evident before age 5 years.

G. The child has a developmental age of at least nine months.

Specify if Persistent: The disorder has been present for more than 12 months.

Specify current severity: Reactive Attachment Disorder is specified as severe when a child exhibits all symptoms of the disorder, with each symptom manifesting at relatively high levels.

Thank you for your interest in reading this post to the end and learning a little bit about this very real, very disruptive diagnosis.  

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Filed under Adoptive, Parenting, Trauma-mama, Uncategorized

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