Reactive Attachment Disorder (RAD) In Adults

Medically reviewed by Majesty Purvis, LCMHC
Updated May 16, 2024by BetterHelp Editorial Team
Please be advised, the below article might mention trauma-related topics that include suicide, substance use, or abuse which could be triggering to the reader.
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Attachment theory suggests that forming a close and loving bond early in life is essential for good mental health outcomes. But what happens when an infant or child doesn’t form this bond with their primary caregiver? One possible outcome is reactive attachment disorder (RAD), a rare condition that can be diagnosed in infants, children, and adults. 

Psychologists believe that RAD may result from childhood trauma or unmet emotional or physical needs. RAD affects children in many ways and may cause them to feel anxious or fearful around their caregivers or have trouble managing their emotions. RAD is more often observed in children under five, but it can persist into adolescence and even adulthood if not properly addressed. Fortunately, reactive attachment disorder can be treated in both children and adults.

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Do I have reactive attachment disorder from childhood trauma?

Criteria for reactive attachment disorder

According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), the criteria for diagnosing someone with reactive attachment disorder include the following:

  • The presence of persistent social and emotional disturbance
  • A consistent pattern of inhibited, emotionally withdrawn behavior toward adult caregivers
  • A pattern of extremes of insufficient care
  • The child has a developmental age of at least nine months
  • The disturbance is evident before the age of five years
  • The criteria for autism spectrum disorder are not met

Symptoms of RAD

Reactive attachment disorder affects the development of healthy bonds and attachment to others and impacts overall mental health. It can cause people to believe they must provide for themselves, even if they don’t have the means or knowledge to do so. If not identified and treated effectively in childhood, RAD can persist into adulthood, significantly affecting adult relationships.

The effects of RAD vary depending on age. Children with RAD may experience the following symptoms:

  • Difficulty forming emotional attachments
  • Decreased ability to experience positive emotions
  • Difficulty accepting emotional or physical closeness
  • Extreme reactions  when cuddled or held, including violence, rage, or self-injury
  • Exhibit unpredictable behavior
  • Are difficult to console and discipline
  • Erratic mood swings

Some children with RAD may have a strong need to control their environment and may not cope well with spontaneous changes in routine. 

As children with RAD reach adolescence and adulthood, they are more likely to engage in high-risk behaviors, like substance use, high-risk sexual behavior, and gambling, and are more likely to be incarcerated.

Adults with RAD can have various symptoms, including distrust of others, control issues, and anger issues. They may deny personal responsibility for their behavior and feel helpless due to a lack of personal relationships. Adults with RAD often have trouble with complex emotions, like trust, compassion, remorse, and empathy, making it extremely hard to develop healthy adult relationships. These feelings may lead to isolation, anger, and depression.

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Treatment for reactive attachment disorder

Early intervention may improve the outcome of treatment for people with RAD. Children with RAD are believed to be able to form attachments, but their early experiences have hindered their ability to do so. Most young children are resilient; even those severely neglected can develop healthy attachments in a safe, stable, caring environment. There is no textbook treatment for RAD, but treatment goals usually focus on ensuring the child has a stable and safe home and has positive interactions with parents and caregivers to encourage the development of a healthy bond.

Adults with reactive attachment disorder may experience sadness and fear of the unknown. Although they may not admit it or may appear to hide behind their attachment issues, these adults often crave love and affection from others, but their inability to form healthy attachments often causes them to avoid reaching out. Because adults with RAD have trust issues and difficulty connecting with their emotions, talk therapy is frequently a first step in treatment.

If you are an adult experiencing symptoms of reactive attachment disorder, seeking professional help from a licensed therapist can help you work through any childhood trauma that may be contributing to your symptoms and take the first steps toward developing deep, meaningful, loving adult relationships. One study found that psychological therapy can increase attachment security and decrease attachment anxiety across therapeutic approaches and therapy settings.

Online therapy has many benefits for adults with RAD. It’s a convenient approach to treatment for an attachment disorder and many other mental health conditions. Many people with RAD may have difficulty asking for help and may not feel comfortable talking about their feelings face-to-face, but online therapy makes it easy to find and connect with a qualified counselor right from the comfort of home.

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Do I have reactive attachment disorder from childhood trauma?

Studies show that online therapy is just as effective as in-person therapy and may even be more so. Research also suggests that people are just as satisfied with online treatment as they are with in-person therapy. Talk therapy can help adults with RAD work through their attachment issues and learn how to build strong, meaningful adult relationships.

Takeaway

Reactive attachment disorder starts in childhood, but the effects are long-lasting if the condition is not identified or properly treated. If you are an adult and think you are experiencing symptoms of RAD due to unresolved attachment issues from childhood, talking to a therapist online can help.
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