Reactive Attachment Disorder Symptoms in Adults with Intellectual Disabilities

Abstract

Background Studies with children suggest that reactive attachment disorder (RAD) is associated with pathogenic early care. Little is known about RAD in adults with intellectual disabilities, many of whom experience adversity and abuse in early life. We investigated whether RAD symptoms occur in this population, and explored whether hypothesized risk factors are associated with higher RAD symptom scores. Method Fifty adults with intellectual disabilities residing in long-stay hospitals and their carers participated in a questionnaire survey of RAD symptoms, childhood experiences, and disabilities. Results Reactive attachment disorder symptoms were present in this sample, and symptom scores were independently associated with early childhood adversity, diminished with age, but were not associated with cognitive ability, gender, other disabilities, nor number of childhood years in institutional care.Conclusions As with children with RAD, it is possible that some maltreated adults with intellectual disabilities fail to develop stranger anxiety by the usual developmental age. Over decades, they may gradually learn.

Assessing attachment status in adults with intellectual disabilities: the potential of the Adult Attachment Projective Picture System

“…Our results show some connection to the study by Minnis et al (2010) in that, although they approached their sample from the lens of RAD, these researchers also observed a high level of attachment trauma in their sample. It is possible that unintegrated trauma and pathological mourning as described in our results is an alternative explanation of their findings.…”

“…Minnis et al (2010) modified a questionnaire designed to identify symptoms of reactive attachment disorder (RAD) in children in a study of 50 adults with varying degrees of intellectual disabilities. RAD is a severe and atypical form of attachment disorder observed in children who experience severely compromised care Plymouth Community Healthcare (CIC) was formerly part of NHS Plymouth.…”

Psychiatric diagnostic screening of social maladaptive behaviour in children with mild intellectual disability: differentiating disordered attachment and pervasive developmental disorder behaviour

“…In fact, children with ID (many of whom are diagnosed with PDD) may be at heightened risk for experiencing such environments and be more vulnerable for the effects (Schuengel & Janssen ; Minnis et al . ). Therefore, the need exists for effective and research‐based screening instruments and diagnostic rules, because both disorders are in the domain of social functioning while having highly different probable aetiological pathways and highly different treatment implications.…”

“…Minnis et al . () administered the Relationship Problems Questionnaire (RPQ) to the professional caregivers of 50 institutionalised adults (mean age 48 years; 56% profound ID). Symptoms of RAD were negatively associated with increasing age and positively associated with childhood adversity (childhood experience of abuse, severe neglect, or other serious adverse experience).…”

Child Maltreatment, Adolescent Attachment Style, and Dating Violence: Considerations in Youths with Borderline-to-Mild Intellectual Disability

“…There is preliminary research to suggest that early attachment relationships in people with ID, even those with severe ID, can influence subsequent relationship trajectories in adulthood. For example, reactive attachment disorder symptoms in adults with ID, characterized by severely inappropriate social relating to caregivers and peers as a result of pathogenic care have been correlated with a history of childhood adversity and maltreatment (Minnis et al, 2010). Because of their increased level of dependency across the lifespan, adults with severe ID who live in residential settings (i.e., group homes) are likely to develop attachment relationships with their paid caregivers, and insecurely attached persons are more likely to demonstrate challenging behaviors with their caregivers in times of stress (Clegg and LansdallWelfare, 1995;Janssen et al, 2002).…”