Reactive attachment disorder (RAD) is a disorder of infancy and early childhood characterized by disturbed attachment patterns and developmentally inappropriate attachment behaviors resulting from disrupted caregiving environments during infancy. Inconsistent care as an infant, such as [Page 2800]emotional and social deprivation, causes an individual to distrust his or her caregiver. RAD is commonplace in environments of neglect and maltreatment, where deprivation experiences are frequent, such as foster, residential, or shelter care environments.

Treatment for this disorder is controversial, and recently, the American Professional Society on the Abuse of Children (APSAC) and the American Academy of Child and Adolescent Psychiatry (AACAP) have each assigned task forces to explore the assessment, diagnosis, and treatment of RAD. Recommendations from the APSAC group include careful assessment of RAD symptomatology, taking ...