What Is Teen Reactive Attachment Disorder?

Reactive attachment disorder, commonly abbreviated as RAD, is a disorder that begins in early childhood and is diagnosed before the age of five. It occurs when a child experiences severe emotional neglect and can be caused by a variety of issues with the parents or caregivers. While the condition takes hold during early childhood, it can affect an individual throughout childhood, adolescence, and even adulthood. If you know an adolescent with teen reactive attachment disorder, read on to learn more about the condition, how it can affect the adolescent, and what to expect going forward.

Teen Reactive Attachment Disorder Begins During Child Development

Reactive attachment disorder stems from not having basic emotional needs met during infancy, toddlerhood, and the preschool years. New parents usually meet their babies’ needs by cuddling, soothing, rocking, and interacting. Moms and dads generally react with empathy when their babies or toddlers are upset, they celebrate with smiles and hugs when their little ones first walk and reach other milestones, and they meet physical needs by feeding their babies when they cry and changing diapers when they are soiled. All of these actions, along with countless others, show babies and toddlers that they are loved. As a result, they develop a strong bond with their parents and other caregivers and feel secure and content most of the time.

When a baby is ignored, neglected, and abused, however, emotional needs are not met. They might cry for hours and nobody answers. Or they might find that when they reach milestones, nobody reacts. They might have little to no interaction at all; this can be the case even when the parents or caregivers meet their physical needs. For example, a mother or father might feed the baby without making eye contact or holding them. Or they might bathe and dress their child without talking or playing.

When this occurs, the child will often not forge any bonds to his or her caregivers. They might feel stressed and sad most of the time. They don’t know how to communicate in a loving manner and they are anxious when they are in the company of their caregiver. When the main caregiver leaves, they don’t show any signs of separation anxiety, which is common in babies and young children. As time goes by, the child will grow up not knowing how to bond to others because they have not learned this vital skill during the earliest weeks, months, and years of their life. Note that RAD shares many of the same signs as autism. While the two conditions might present similarly in some ways, they are not related.

Learn more about the symptoms of reactive attachment disorder in teens.

Why Parents Do Not Bond With Their Babies

The reasons that a parent might not bond with his or her baby can vary. If the mother has been abused or neglected herself, she might not know how to show love to her baby. If she or the child’s father is using drugs or other substances, they both might be unable to meet the child’s emotional needs. Sometimes, a mental health disorder or a mental impairment on the part of the parent is the cause of the problem. Other times, the parents are abusive and neglectful for some other reason. Many children who suffer from RAD end up in the foster care system or are placed for adoption. Others, particularly those who are having their physical needs met and are not being physically abused, will continue to live with their parents.

How RAD Affects Teenagers

While reactive attachment disorder begins and is diagnosed prior to the age of five, its effects last for many years. Teens with the condition often have trouble bonding with their parents, their friends, and romantic partners. They often withdraw from and avoid others. When they are experiencing negative feelings, they are more likely to want to be alone and will usually not want to involve others or share their feelings with them. They often lack basic social skills and do not know how to show empathy to others. They might feel awkward and ill at ease in all social situations, including in the classroom and anywhere where they are part of a group.

Teens with RAD might be more prone to mental health conditions such as anxiety, depression, obsessive-compulsive disorder, and eating disorders. They are also more prone to substance abuse and addiction.

Treatments for Teen Reactive Attachment Disorder

Treatment for RAD centers around therapy for both the teen and his or her current caregivers. If the teen is living with his or her parents, the parents will often need parenting classes to help them learn how to communicate and bond with their teenager. If the teen is living with other family members, an adoptive family, or foster parents, those adults will also need guidance as they learn how to help the teen create bonds and develop social skills. Cognitive behavioral therapy for the teen is a must so he or she can learn how to cope with negative feelings and communicate with others in effective ways.

Teens who have RAD along with substance addiction or an additional mental health disorder will need to have treatment for the coexisting disorder as well. For example, an adolescent with teen reactive attachment disorder might need inpatient rehabilitation for an alcohol or drug addiction or a different type of therapy or medication for anxiety, depression, or post-traumatic stress disorder. A full evaluation is necessary to make sure that the clinician knows what conditions are affecting the teen so a treatment plan can be created.

Understanding and coping with the behaviors of an adolescent who has teen reactive attachment disorder can be difficult for caregivers, so individual therapy for the adults involved can be helpful. With love and consistency, your teen can get past his or her rough start and go on to have a fulfilling life complete with relationships with family members, friends, and even romantic partners. Talk to your adolescent’s pediatrician or family doctor about the treatments available for reactive attachment disorder. He or she can refer your family to the appropriate behavioral health specialist.

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What Is Teen Reactive Attachment Disorder?

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Lucy Nguyen

Lucy Nguyen, LMFT
Clinical Reviewer

Lucy Nguyen is the Executive Director at Paradigm Treatment, overseeing all clinical treatment programs across the organization's southwestern region. Her extensive experience includes working with young adults in private practice, serving as a therapist for children and teens with emotional and behavioral needs, and acting as a behavior interventionist for teens with developmental disorders. Lucy integrates cognitive-behavioral approaches with mindfulness and compassion in her work, and she is also EMDR-trained. She holds a Master of Science in Counseling from California State University, Fullerton, and a Bachelor’s degree in Psychology and Social Behavior from the University of California, Irvine.

Reactive attachment disorder, commonly abbreviated as RAD, is a disorder that begins in early childhood and is diagnosed before the age of five. It occurs when a child experiences severe emotional neglect and can be caused by a variety of issues with the parents or caregivers. While the condition takes hold during early childhood, it can affect an individual throughout childhood, adolescence, and even adulthood. If you know an adolescent with teen reactive attachment disorder, read on to learn more about the condition, how it can affect the adolescent, and what to expect going forward.

Teen Reactive Attachment Disorder Begins During Child Development

Reactive attachment disorder stems from not having basic emotional needs met during infancy, toddlerhood, and the preschool years. New parents usually meet their babies’ needs by cuddling, soothing, rocking, and interacting. Moms and dads generally react with empathy when their babies or toddlers are upset, they celebrate with smiles and hugs when their little ones first walk and reach other milestones, and they meet physical needs by feeding their babies when they cry and changing diapers when they are soiled. All of these actions, along with countless others, show babies and toddlers that they are loved. As a result, they develop a strong bond with their parents and other caregivers and feel secure and content most of the time.

When a baby is ignored, neglected, and abused, however, emotional needs are not met. They might cry for hours and nobody answers. Or they might find that when they reach milestones, nobody reacts. They might have little to no interaction at all; this can be the case even when the parents or caregivers meet their physical needs. For example, a mother or father might feed the baby without making eye contact or holding them. Or they might bathe and dress their child without talking or playing.

When this occurs, the child will often not forge any bonds to his or her caregivers. They might feel stressed and sad most of the time. They don’t know how to communicate in a loving manner and they are anxious when they are in the company of their caregiver. When the main caregiver leaves, they don’t show any signs of separation anxiety, which is common in babies and young children. As time goes by, the child will grow up not knowing how to bond to others because they have not learned this vital skill during the earliest weeks, months, and years of their life. Note that RAD shares many of the same signs as autism. While the two conditions might present similarly in some ways, they are not related.

Learn more about the symptoms of reactive attachment disorder in teens.

Why Parents Do Not Bond With Their Babies

The reasons that a parent might not bond with his or her baby can vary. If the mother has been abused or neglected herself, she might not know how to show love to her baby. If she or the child’s father is using drugs or other substances, they both might be unable to meet the child’s emotional needs. Sometimes, a mental health disorder or a mental impairment on the part of the parent is the cause of the problem. Other times, the parents are abusive and neglectful for some other reason. Many children who suffer from RAD end up in the foster care system or are placed for adoption. Others, particularly those who are having their physical needs met and are not being physically abused, will continue to live with their parents.

How RAD Affects Teenagers

While reactive attachment disorder begins and is diagnosed prior to the age of five, its effects last for many years. Teens with the condition often have trouble bonding with their parents, their friends, and romantic partners. They often withdraw from and avoid others. When they are experiencing negative feelings, they are more likely to want to be alone and will usually not want to involve others or share their feelings with them. They often lack basic social skills and do not know how to show empathy to others. They might feel awkward and ill at ease in all social situations, including in the classroom and anywhere where they are part of a group.

Teens with RAD might be more prone to mental health conditions such as anxiety, depression, obsessive-compulsive disorder, and eating disorders. They are also more prone to substance abuse and addiction.

Treatments for Teen Reactive Attachment Disorder

Treatment for RAD centers around therapy for both the teen and his or her current caregivers. If the teen is living with his or her parents, the parents will often need parenting classes to help them learn how to communicate and bond with their teenager. If the teen is living with other family members, an adoptive family, or foster parents, those adults will also need guidance as they learn how to help the teen create bonds and develop social skills. Cognitive behavioral therapy for the teen is a must so he or she can learn how to cope with negative feelings and communicate with others in effective ways.

Teens who have RAD along with substance addiction or an additional mental health disorder will need to have treatment for the coexisting disorder as well. For example, an adolescent with teen reactive attachment disorder might need inpatient rehabilitation for an alcohol or drug addiction or a different type of therapy or medication for anxiety, depression, or post-traumatic stress disorder. A full evaluation is necessary to make sure that the clinician knows what conditions are affecting the teen so a treatment plan can be created.

Understanding and coping with the behaviors of an adolescent who has teen reactive attachment disorder can be difficult for caregivers, so individual therapy for the adults involved can be helpful. With love and consistency, your teen can get past his or her rough start and go on to have a fulfilling life complete with relationships with family members, friends, and even romantic partners. Talk to your adolescent’s pediatrician or family doctor about the treatments available for reactive attachment disorder. He or she can refer your family to the appropriate behavioral health specialist.

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