Disturbances of attachment in young children adopted from institutions.

Charles H. Zeanah

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Child Welfare and Adoption Psychoanalysis and Psychopathology Research Attachment and Relationship Dynamics

Abstract

In this article, the author describes a discrepancy between popular media accounts of reactive attachment disorder (RAD) and its clinical and scientific description. The literature on serious disturbances of attachment in children adopted out of institutions is reviewed. The author concludes that children adopted from institutions are at dramatically increased risk for disturbances, although the majority of such children do not demonstrate problems. Both the duration of deprivation and the postinstitutional caregiving environment seem to be importantly related to outcome. Inhibited/withdrawn RAD is exceedingly uncommon in children adopted from institutions (at least after 1 or more years), but disinhibited/indiscriminate RAD is quite persistent. Long after children become attached to adoptive parents, a number of them continue to exhibit indiscriminate sociability. Three explanations for this divergence of recovery curves are considered. It is likely that future systematic studies will illuminate many areas that are unclear at this time.

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2011Practitioner Review: Clinical applications of attachment theory and research for infants and young children 2008The mouse communal nest: Investigating the epigenetic influences of the early social environment on brain and behavior development 2004NEUROCEPTION: A Subconscious System for Detecting Threats and Safety 2005Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder of Infancy and Early Childhood 2004Institutional care: associations between overactivity and lack of selectivity in social relationships 2009An exploratory study of the association between reactive attachment disorder and attachment narratives in early school‐age children 2002Adoption and the effect on children's development 2009Socially indiscriminate attachment behavior in the Strange Situation: Convergent and discriminant validity in relation to caregiving risk, later behavior problems, and attachment insecurity

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