200 likes | 606 Views
Childhood Disorders. Reactive Attachment Disorder of Infancy & Early Childhood Carolyn R. Fallahi, Ph. D. Common Associated Diagnoses. Axis I: Reactive Attachment disorder of infancy & early childhood. Attention Deficit Hyperactivity Disorder Major Depressive Disorder Dysthmic Disorder
E N D
Childhood Disorders Reactive Attachment Disorder of Infancy & Early Childhood Carolyn R. Fallahi, Ph. D.
Common Associated Diagnoses Axis I: Reactive Attachment disorder of infancy & early childhood. Attention Deficit Hyperactivity Disorder Major Depressive Disorder Dysthmic Disorder Adjustment Disorder Posttraumatic Stress Disorder Obsessive-Compulsive Disorder Oppositional Defiant Disorder Conduct Disorder Antisocial Personality Disorder
Behavioral Definitions • Brought into family through adoption after coming from an abusive, neglectful biological family. • Consistent pattern of failing to initiate or respond to social interactions. • Pattern of becoming too friendly too quickly with strangers. • Pattern of showing indiscriminate affection to strangers.
Behavioral Definitions • Resists accepting care from others. • Hoarding or gorging food. • Aggressive behavior. • Frequent lying. • Stealing. • No signs of a conscience.
Behavioral Definitions • Excessive clinginess. • Persistent disregard for emotional or physical needs. • Subjected to frequent changes in caregivers.
History of Attachment • History of Attachment • John Bowlby • Stages: Protest, Despair, Detachment • Mother-child bond adaptive & important for survival • Karl Lorenz & imprinting
Critical period for the development of attachment • Age range? • Model for future relationships.
Mary Ainsworth’s Research Model • The Strange Situation • 8 episodes measuring 4 behaviors • Willingness to explore • Separation anxiety • Stranger anxiety • Reunion behavior
Infant Characteristics that promote attachment • “kewpie doll” appearance • Rooting, sucking, grasping reflexes • Cooing, babbling • Smiling • Crying • Responsiveness to social overtures
Infant & Mother characteristics that hinder attachment • Physically unattractive • Reflexes weak • Irritable • Little pleasant vocalization • Easily over stimulated • Maternal depression • Abused mother • Mother insensitive to baby’s cues • Several children in family • Marital problems
Schaffer & Emerson Stages in Social Attachment • Asocial stage – 0-6 weeks • Indiscriminate attachment stage – 6 weeks to 6-7 months • Specific attachment stage – 7-9 months • Multiple attachment stage – shortly after stage 3
Theories of Attachment • Psychoanalytical • Learning • Ethological
Types of Attachment • Secure attachment • Insecure attachment (anxious/resistant) • Insecure attachment (anxious/avoidant) • Insecure attachment (disorganized/disoriented)
Ainsworth’s Caregiving Hypothesis • Quality of attachment • Inconsistent caregiving • Impatient caregiving • Abusive caregiving
Kagan’s Temperament Hypothesis • Easy temperment • Difficult temperment • Slow to warm up temperment
Reactive Attachment Disorder • Infancy & early childhood • Older children & adolescents • adults
Therapy • Holding therapy – controversial. • Failure-to-thrive cases. • Therapy techniques. • Adolescents & adults.
Long-term goals • Establish & maintain bond. • Form healthy connections with others. • Has a desire for & initiates connections with others. • Tolerates reasonable absence from caregiver.