Disorders of Infancy and Attachment Flashcards
(10 cards)
What is attachment?
The enduring emotional bond between a child and a specific caregiver.
People develop internal working models which guide future relationships.
What are different patterns of attachment?
Securely attached
Insecurely attached
What are the 2 attachment disorders in the DSM?
Reactive attachment disorder (RAD)
Disinhibited social engagement disorder (DSED)
What is the diagnostic criteria for RAD?
A. Consistent pattern of inhibited, emotionally withdrawn behavior towards adult caregivers, manifested by both of the following:
- rarely seeks comfort
- rarely responds to comfort
B. A persistent social and emotional disturbance characterized by at least 2 of the following:
- minimal responsiveness
- limited positive affect
- episodes of unexplained irritability, sadness, or fear with nonthreatening interactions with adult
C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:
- social neglect, deprivation of emotional needs
- repeated changes of primary caregiver
- rearing in unusual settings
D. Criteria C is responsible for behavior in A.
What are the cautions of RAD?
Must be 9 months developmental age. Caution diagnosing after 5 y/o
What is the diagnostic criteria for DSED?
A. Pattern of behavior in which a child actively approaches and interacts with unfamiliar adults and exhibits at least two of the following:
- reduced reticence in approaching unfamiliar adults
- overly familiar behavior with unknown adults
- diminished checking back with caregiver after venturing away
- willingness to go off with unfamiliar adult
B. Behaviors in A are not limited to impulse (as in ADD/ADHD) but include socially disinhibited behavior
C. The child has experienced a pattern of extremes of insufficient care as evidenced by at least one of the following:
- social neglect, deprivation of emotional needs
- repeated changes of primary caregiver
- rearing in unusual settings
D. Criteria C is responsible for behavior in A.
What is a caution of DSED?
The child has a developmental age of at least 9 months.
What is the differences between attachment disorders and insecure attachment?
Attachment disorders are rare, clinically diagnosable conditions caused by severe early deprivation or neglect, leading to pervasive difficulties in forming attachments at all.
Insecure attachment refers to less optimal but common patterns of relating (anxious, avoidant, disorganized) that stem from inconsistent caregiving and may cause relationship problems, but do not constitute a mental disorder.
All individuals with attachment disorders have insecure attachment, but not all people with insecure attachment have an attachment disorder.
What can we do for children with RAD or DSED?
No empirically supported treatments for RAD or DSED.
Make sure child is in safe, stable environment.
Educate caregivers.
Use treatments which are empirically supported for childhood trauma.
What is the Bucharest Early Intervention Project?
A major study that tested whether placing young children from Romanian orphanages into foster care would improve their development. It was the first randomized controlled trial to compare foster care with continued institutional care (CAUG), and found that children in foster families had better brain, emotional, and social development than those who stayed in institutions.
