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What Is Reactive Attachment Disorder?


Reactive Attachment Disorder written out

Reactive attachment disorder (RAD) is a rare, but serious condition in which a young child, or infant, does not form a healthy, secure emotional bond to his or her primary caretakers. According to the American Academy of Child and Adolescent Psychiatry (AACAP), attachment disorders are defined as “psychiatric illnesses that can develop in young children who have problems in forming emotional attachments to others.” The exact cause behind why a young person develops RAD remains unknown. However, according to the Cleveland Clinic, “researchers believe that lack of an appropriate level of loving and consistent caretaking contributes to the development of RAD.” Young people with RAD typically find it difficult to manage their emotions, and are often unable to form meaningful connections with other people. Reactive attachment disorder rarely develops in people over the age of five, though without treatment its symptoms can persist indefinitely.

Signs and Symptoms

There are several common signs and symptoms that may be indicative of a teenager suffering from reactive attachment disorder. The Mayo Clinic provides a list of symptoms, some of which include the following examples: 

  • Appear constantly anxious
  • Lacks eye contact 
  • Dislike being touched
  • Difficulty expressing anger
  • Self imposed social isolation
  • Displays little affect
  • Avoids interacting with peers
  • Physically withdrawn
  • Constant need for control
  • Bullying 
  • Unable to show affection
  • Exaggerate distress
  • Lacks remorse
  • Seeks affection from strangers
  • Emotionally withdrawn

The combination and severity of symptoms will vary. It is important to note that not all young people that exhibit one or more of the above examples necessarily has reactive attachment disorder. 


A pediatric psychiatrist or psychologist will conduct an in-depth examination to diagnose RAD. Most evaluating mental health professionals will rely on the diagnostic criteria provided in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), which includes:

  • A consistent pattern of emotionally withdrawn behavior toward caregivers, shown by rarely seeking or not responding to comfort when distressed
  • Persistent social and emotional problems that include minimal responsiveness to others, no positive response to interactions, or unexplained irritability, sadness or fearfulness during interactions with caregivers
  • Persistent lack of having emotional needs for comfort, stimulation and affection met by caregivers, or repeated changes of primary caregivers that limit opportunities to form stable attachments, or care in a setting that severely limits opportunities to form attachments (such as an institution)
  • No diagnosis of autism spectrum disorder

In order to secure the most effective treatment a young person must be thoroughly evaluated by a qualified mental health professional so as to obtain an accurate diagnosis.  

For Information and Support

Seeking help is never easy, but you are not alone! If you or someone you know is in need of mental health treatment, we strongly encourage you to reach out for help as quickly as possible. It is not uncommon for many mental health difficulties to impact a person for the long term. The earlier you seek support, the sooner you and your loved ones can return to happy, healthy and fulfilling lives.

Our admissions team is available to answer any general questions regarding mental health issues, treatment, and/or specific questions about the program at Pacific Teen Treatment and how we might be able to help your family. We can be reached by phone 24/7 at 800-531-5769. You can also contact us via email at

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