Reactive attachment disorder

Reactive attachment disorder (RAD) is a rare but serious condition that affects young children who have experienced severe disruptions in their early relationships with caregivers. It is a disorder of emotional attachment that results when a child is unable to form a healthy bond with their primary caregiver, usually due to neglect, abuse, or frequent changes in caregivers during the critical early years of life.

Children with RAD show significant difficulties in social and emotional functioning. They often appear withdrawn and emotionally detached, failing to seek comfort when distressed or respond to caregivers' efforts to soothe them. Unlike typical children who use their caregivers as a source of safety and comfort, children with RAD may seem indifferent or resistant to these needs.

Without treatment, RAD can interfere with the child's ability to develop healthy relationships later in life, leading to emotional and behavioral challenges during childhood, adolescence, and adulthood.

RAD typically presents before the age of five. Key signs include:

These symptoms are distinct from those seen in autism spectrum disorder or other developmental conditions, which must be ruled out during diagnosis.

RAD arises primarily due to disruptions in early caregiving environments, especially during the first few years of life when the child's brain and emotional systems are rapidly developing. Common causes include:

Diagnosing RAD requires a thorough clinical evaluation by mental health professionals. The process includes:

The ICD-11 categorizes RAD as a disorder of social functioning with onset in childhood.