Reactive Attachment Disorder and Its Relationship to Psychopathology: A Systematic Review

Abstract

This study aimed to determine, through a systematic review, the relationship between Reactive Attachment Disorder (RAD) and the presence of psychopathology in children and adolescents, and to determine the existence of differences in terms of internalising and externalising psychological problems between the RAD group and groups with other disorders or with typical development. Following the PRISMA methodology, a search was carried out in the Web of Science, PubMed and Scopus databases. The search yielded 770 results, of which only 25 met the inclusion criteria. The results indicate a relationship between the presence of RAD and/or disinhibited social engagement disorder (DSED), with the presence of internalising and externalising problems. These difficulties are more present in children with RAD compared to children without personal difficulties, or children with DSED, children with autism, children with intellectual disabilities or children with hyperactivity. It can be concluded that the presence of RAD has negative consequences on the mental health of children and adolescents, with these being greater in the inhibited group than in the disinhibited group, and with respect to children with autism or hyperactivity.

A Systematic Review on Assessing Assessments: Unveiling Psychometric Properties of Instruments for Reactive Attachment Disorder and Disinhibited Social Engagement Disorder in Minors under Protective Measures

“…Our research endeavors to enhance the clinical practices of professionals by offering insights into the appropriateness and characteristics of RAD/DSED assessment instruments. Given the association of RAD or DSED with a higher prevalence of mental health issues in children [10,12,15,17,22,47], especially in children where protective measures have been taken at a younger age [14,48], there is a compelling rationale for implementing RAD/DSED assessments within the realm of child protection.…”

“…These children often display self-soothing behaviors, discomfort in social interactions, and aggression toward peers [8]. Additionally, they commonly exhibit other associated personal, developmental, emotional, social, and behavioral difficulties [9,10]. Indeed, the experience of suffering from DSED or RAD is associated with a higher likelihood of presenting other emotional or behavioral difficulties [10] including anxiety, depression, emotional insecurity, attentiondeficit/hyperactivity disorder, oppositional defiant disorder, a deficit in social skills, and an increased probability of being a victim or perpetrator of bullying [11][12][13][14][15][16][17][18][19].…”

“…Additionally, they commonly exhibit other associated personal, developmental, emotional, social, and behavioral difficulties [9,10]. Indeed, the experience of suffering from DSED or RAD is associated with a higher likelihood of presenting other emotional or behavioral difficulties [10] including anxiety, depression, emotional insecurity, attentiondeficit/hyperactivity disorder, oppositional defiant disorder, a deficit in social skills, and an increased probability of being a victim or perpetrator of bullying [11][12][13][14][15][16][17][18][19]. DSED and RAD can also influence the way the child interacts with peers and caregivers, thereby complicating the child's adaptation to the new family context.…”