Reactive attachment disorder

Reactive attachment disorder, often shortened to RAD, is an attachment disorder marked by disturbed and developmentally inappropriate ways of relating socially in most contexts. It mainly affects children, although the difficulties occasionally persist into adulthood. It can take the form of a persistent failure to start or respond to most social interactions in a developmentally appropriate way, called the inhibited form, and in the DSM-5 the disinhibited form is a separate diagnosis named disinhibited social engagement disorder. The disorder arises from a failure to form normal attachments to primary caregivers in early childhood, which can follow severe neglect, abuse, abrupt separation from caregivers, frequent changes of caregiver or a lack of caregiver responsiveness. Mainstream treatment and prevention programs aim to raise the responsiveness and sensitivity of the caregiver or, if that is not possible, to place the child with a different caregiver, and the diagnosis and the controversial attachment therapy have drawn significant criticism.