ACE Centre - Our research / Measures
What is Attachment Disorder (AD)?
AD is a serious disorder affecting social functioning in children who have experienced abuse and/or neglect. There are two subtypes: an Inhibited Type (thought to be very rare) in which children are emotionally withdrawn, fearful or "hypervigilant" and unpredictable in their social responses and a Disinhibited Type (called Disinhibited Social Engagement Disorder (DSED) in DSM-5) in which children are indiscriminately friendly and do not recognise social boundaries. Children with AD (whether Inhibited or Disinhibited) have difficulties developing intimate relationships and this can have a profound effect on their ability to settle into a foster or adoptive placement and on their friendships.
In materially deprived populations, about 1% of pre-school and early school-age children have an Attachment Disorder and this prevalence is much higher in children in the care system. The great majority of children with AD have a complex presentation with at least one other psychiatric diagnosis, often Attention Deficit Hyperactivity Disorder (ADHD) or Conduct Disorder. We do not know the pervalence in the teenage years or in adulthood, but indiscriminate friendliness can persist into adult life.
AD is believed to be caused by abuse and/or neglect but not all abused and/or neglected children develop RAD. There appear also to be genetic risk or resilience factors for AD (in the context of abuse or neglect), but we do not yet know what these are.
Attachment Disorder (AD)
- Emotional withdrawal
- Failure to seek comfort
- Unpredictable responses, especially on reunion
Disinhibited Social Engagement Disorder (DSED)
- Indiscriminate friendliness
- Wandering off without checking back (in younger children)
- Cuddliness with strangers (in younger children)
- Attention seeking or asking personal questions of strangers (in older children)
Other symptoms sometimes associated with AD
- Controlling behaviour
- Self-stimulating behaviour (e.g. rocking, headbanging)
- Gorging or scavenging for food.
Measuring AD symptoms
We have developed various measures for assessing the symptoms of AD and DSED. On this website you can find various papers that describe our work and also copies of measures themselves that you are free to download and use. We only ask that, if you are using the measures in research, you let us know that you are doing so. If you have any questions about the measures, please don't hesitate to contact us - firstname.lastname@example.org
If you want to make a diagnosis based on the measures we recommend that you use the ICD or DSM classification systems and simply use the measures to identify whether or not the key symptoms are present.
If you would like to use the measures to make research diagnosis, we recommend that you use the method described in the article - 2013 Prevalence of RAD in a deprived population
- Observational Schedule for RAD
- Reactive Disorder and Disinhibited Social Engagement Disorder Assessment (RaDA)
- RPQ Netherlands
- RPQ Parent Swedish
- RPQ Parents Spanish
- RPQ Professional Spanish
- RPQ Teacher Dutch
- RPQ - English - Parent
- RPQ - English - Teacher
- 2017 - A study of Attachment Disorders in young offenders attending specialist..
- 2015 Social relationship difficulties in autism and RAD: improving ...
- 2013 Maltreatment-associated psychiatric problems: An example ...
- 2013 Prevalence of RAD in a deprived population
- 2012 Social use of language in children with RAD and ASD
- 2012 Neurodevelopmental problems in maltreated children ...
- 2011 Discrimination between ADHD and RAD in school age children
- 2010 Development of a brief waiting room observation ...
- 2010 RAD symptoms in adults with intellectual disabilities
- 2010 Forty-four juvenile thieves revisited: from Bowlby to RAD
- 2009 A qualitative exploration of children's understanding of indiscriminate ...
- 2009 An exploratory study of the association between RAD and attachment ...
- 2002 Development of a brief, clinically relevant scale for measuring ...