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Reactive Attachment Disorder is a severe developmetal disorder primarily caused by early chronic maltreatment within a care-giving relationship. The American Psychiatric Association's DSM-IV describes two subtypes:
Inhibited (if there is a persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifested by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses.)
Disinhibited (if there is diffuse attachments as manifested by indiscriminate sociability with marked inability to exhibit appropriate selective attachments.
These problems cannot be accounted for by mental retardation and do not meet the criteria for Pervasive Developmental Disorder.
The DSM requires that there has been pathogenic care (child abuse, neglect, or prolonged institutional care).
Treatment for this condition is complex and requires specialized care, for example Dyadic Developmental Psychotherapy, which is an evidence-based, effective, and empirically supported treatment (Becker-Weidman, A., & Hughes, D., (2008) "Dyadic Developmental Psychotherapy: An evidence-based treatment for children with complex trauma and disorders of attachment," Child & Family Social Work, 13, pp.329-337.)
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