1139 – Reactive Attachment Disorder: Effects And Limits On Treatment Options

Abstract

The failure to bond with a caring adult can lead to failed bonding in future relationships throughout life. This inability to relate or connect to others may affect the child's development. More and more children are being diagnosed with reactive attachment disorder due to affective instability related to their inability to make secure attachments. The diagnosis is complex and treatments are limited which presents a challenge for providers and patients alike.

Objectives

Describe cases related to reactive attachment disorder.

Describe diagnosis of reactive attachment disorder and its limitations.

Describe treatment options for reactive attachment disorder.

Aims

Be familiar with diagnosis of reactive attachment disorder.

Be familiar with treatment options.

Be familiar with challenges in complex scenarios.

Methods

Case of a 15 year old black female with history of neglect, legal issues, school truancy, witness to domestic and community violence who presents with escalating aggressive behavior and affective instability.

Literature review focusing on treatments options in complex scenarios.

Results

Many children are suffering from “maltreatment” and there are difficulties with making an appropriate diagnosis due to co-occurring symptoms and potential differential diagnoses; therefore treatments are limited.

Conclusions

The disorder warrants further research especially in addressing the timing and critical period for an intervention. The disorder necessitates a multi-modal approach in particular a collaborative approach involving in home services with the child and caregiver. The disorder becomes even more complex when dealing with patient populations with intergenerational adversity and the patterns of disordered attachment are evident.