Attachment refers to the ability to form emotional bonds and empathic, enjoyable relationships with other people, especially close family members.

Insecure attachment early in life may lead to difficulty forming relationships throughout life, and, if not checked, this continues into adulthood and may develop into an attachment disorder.

attachment disorder

Reactive attachment disorder can negatively affect all areas of a child or adolescent’s life and development. There are two main types of reactive attachment disorder: inhibited and disinhibited. Not much research has been done on the signs and symptoms of this disorder beyond early childhood, however as children grow older they may develop either inhibited or disinhibited behavior patterns. In some cases an adolescent will display symptoms of both types. Some common signs and symptoms may include:

Inhibited type:

  • Detached
  • Unresponsive or resistant to comforting
  • Withdrawn
  • Avoidant
  • Shuns relationships with everyone

Disinhibited type:

  • Indiscriminate sociability
  • Inappropriately familiar or selective in choice in attachment figures
  • Seeks attention from anyone
  • Displays inappropriate childish behavior
  • Frequently asks for help doing things
  • Violates social boundaries

Additional symptoms:

Relationships: In relationships, a person who has RAD may be bossy, untrusting, manipulative, and controlling. They may have challenges giving or receiving genuine love and affection. Their unstable peer relationships are tenuous at best, as children and teens with RAD blame others for their mistakes or challenges.

Behavioral: Destructive, irresponsible, impulsive, and defiant behaviors. Children or teens with RAD may steal, lie, abuse others, start fires, behave cruelly to animals, or act in a self-destructive manner. They also may avoid physical contact with others, and engage in drug or alcohol abuse.

Moral:  Teens with RAD may lack faith, compassion, and remorse for their actions.

Emotional: Children who have RAD may feel sad, moody, fearful, anxious, depressed, and hopeless. These children may display inappropriate emotional reactions.

Thoughts: Children and teens who have RAD may have negative beliefs about themselves, life, and other relationships. These children and teens are unable to understand the concept of cause and effect. Additionally, they may experience inattention and challenges with learning.

The DSM-V recognizes two distinct attachment disorders:

Disinhibited social engagement disorder

A classic sign of disinhibited social engagement disorder is overfriendliness with strangers. A child may seek comfort from a stranger, sit on a stranger’s lap, and not exhibit any distress when a caregiver isn’t present.

Reactive attachment disorder

Reactive attachment disorder is a disorder of infancy or early childhood that involves a failure to seek comfort from a caregiver. A child with reactive attachment may resist physical comfort from a caregiver, avoid eye contact, and be hypervigilant. Most children with reactive attachment disorder display a variety of problematic behaviours.

In the majority of cases, attachment disorder usually develops by the age of five, and is typically caused by some form of neglect or abuse from a primary caregiver. Any situation where a child has been unable to form a bond, or has been separated from their parents, can lead to attachment issues.

Examples of children that are most at risk of attachment disorder include:

  • Children who have been neglected or abused
  • Children who have been placed in care institutions
  • Children who have moved between a series of different carers or adoptive parents
  • Children who have been separated from their parents
  • Children whose parents abuse drugs or alcohol

A child inherently desires love and affection, as well as being able to build a trust and reliance on their caregivers to provide them with their basic needs. The negative impact of ignoring or neglecting a baby or child’s cries of hunger or nappy changing can leave them feeling abandoned. This may lead to fear that the world is an insecure place for them, without developing the understanding of attachment they need to forge strong relationships in the future.

Your attachment style involves your behaviors and interactions with others and how you form relationships with them. Attachment theory holds that these styles are largely determined during early childhood.

Secure vs. insecure

Attachment styles are broadly categorized as being either secure of insecure.

If your needs as a child were usually met right away by your caregiver, you probably developed a secure attachment style. As an adult, you most likely feel secure in your close relationships and trust that the other person will be there when you need them.

If your caregiver failed to meet your needs as a child — or was slow to do so — you may have an insecure attachment style. As an adult, you might find it hard to form intimate bonds with others. You may also have a hard time trusting those close to you.

There are several subtypes of insecure attachment styles in adults.

Anxious-preoccupied attachment

If you have an anxious-preoccupied attachment style, you might:

  • have an increased need to feel wanted
  • spend a lot of time thinking about your relationships
  • have a tendency to experience jealousy or idolize romantic partners
  • require frequent reassurance from those close to you that they care about you

If you’re need for reassurance isn’t met, you might start doubting how your loved ones feel about you. If you’re in a romantic relationship, you might frequently believe that your partner is upset with you and wants to leave.

These fears can make you more sensitive to the behaviors of those close to you. You might interpret some of their actions as proof that what you’ve worried about (them leaving) is actually happening.

Dismissive-avoidant attachment

If your attachment style is dismissive-avoidant, you might:

  • have a hard time depending on partners or other people close to you
  • prefer to be on your own
  • feel like close relationships aren’t worth the trouble
  • worry that forming close bonds with others will make you less independent

These behaviors can make it hard for others to support you or feel close to you. Moreover, if someone does put in extra effort to draw you out of your shell, you may react by closing yourself off.

Keep in mind that these behaviors don’t stem from not caring about others. Instead, it’s more about protecting yourself and maintaining a sense of self-sufficiency.

Fearful-avoidant attachment

If you have a fearful-avoidant attachment style, you might:

  • have conflicting feelings about relationships and intimacy
  • want to develop romantic relationships but worry that your partner will hurt you, leave you, or both
  • push aside your feelings and emotions to try to avoid experiencing them
  • fear you aren’t good enough for the kind of relationship you’d like to have

While you might be able to suppress your emotions for a period of time, they tend to come out in bursts. This can feel overwhelming and create a pattern of highs and lows in your relationships with others.

Treatment for attachment disorder focuses on repairing and/or creating emotionally healthy family bonds. It aims to strengthen relationships between children and their caretakers in a way that can later help the child to develop other healthy relationships

Both children and parents benefit from tailored treatment plans. Treatment may incorporate:

  • Psychotherapy/Counseling. A mental health provider works with the child and parents in a variety of ways, sometimes one-on-one with the child, sometimes with just caretakers, and sometimes in combination, to build skills and reduce problematic patterns of behavior.
  • Family therapy. This therapy involves working together with the primary caretakers and child to develop ways to interact in healthy ways.
  • Social Skills Intervention. This therapy teaches the child how to interact more appropriately with other similar–aged children in typical social settings. Parents are usually also involved to help the child to use the skills they learn.
  • Special education. If a child qualifies, these are school-based programs that help children learn skills to succeed both academically and socially.
  • Parenting skills classes. In these sessions parents may learn more effective ways of managing their child’s challenges. This can be particularly beneficial as managing discipline for children with attachment disorder can be more difficult.
  1. Peterson, T. (2016, February 5). Reactive Attachment Disorder in Adults, HealthyPlace. Retrieved on 2019, August 4 from

Seeking Help

If you feel that attachment disorder is impacting on your ability to enjoy life, a Mind Health Clinician may be able to help.

  • Mind Health are highly trained and qualified professionals, skilled in providing effective interventions for a range of mental health concerns, including attachment disorders.
  • A Mind Health Clinician can help you to identify and address factors that might be contributing to your insecure attachment and the most effective ways to address attachment issues using techniques based on best available research.
  • Mind Health usually see clients individually, but can also include family members to support treatment where appropriate.

   A medical check-up with a GP might also be helpful to see if there is an underlying health issue.