When I had a psychological evaluation in 2010, it included a questionnaire about attachment styles. Attachment is the bond an infant first forms with their parents or primary caregivers. When a child was traumatized early in life, insecure attachment or attachment disorders may occur. In the diagnostic criteria for reactive attachment disorder (RAD), this trauma is to be either abuse or being away from the primary caregiver for a prolonged time. Children adopted from orphanages are the most well-known population to be at risk for RAD, but insecure attachment can occur in milder cases of early childhood trauma too.
Attachment disorders in children are characterized by markedly inappropriate relatedness to others in most contexts (so not just with parents). There are two types of attachment disorders. One, which is called reactive attachment disorder in DSM-5, is characterized by abnormally inhibited or hypervigilant interactions with others. The child has developed an ambivalent/anxious attachment style. A child who has developed this attachment style will react with suspicion and mistrust to their parents, while at the same time being overly clingy. Adults who exhibit this pattern of attachment will alternate between rejection of and dependency on others.
My evaluation report said I tended towards the anxious attachment style as well as the preoccuped attachment style. Children who grew up with ambivalent attachments often later develop into adults displaying the preoccupied attachment style. This means they constantly seek approval of others, are overly self-critical, and constantly worry that important people in their lives are going to reject them. As a result, they act overly dependent.
The other type of attachment disorder is called disinhibited social engagement disorder or disinhibited attachment disorder. In this type of attachment disorder, the child is overly sociable, friendly with strangers, nonselective in their interactions and may display attention-seeking behaviors. They also often have co-existing behavioral or emotional disturbances. Kids with disinhibited attachment disorder often do not see the consequences of their behavior. For example, when a child lies, they often do not realize that it will cost them their believeability.
Children with attachment disorders need just the right balance in parenting between affective availability and consistency in response to misbehavior. It is recommended that parents do not show strong emotions when they respond to the attachment-disordered child’s misbehavior. It is also important that the child learns to accept the consequences of their behavior, so parents should not come to the child’s rescue when they get into trouble.
Adults with reactive or disinhibited attachment disorder or attachment issues are often diagnosed with narcissistic, antisocial or borderline personality disorder. Some people say that it is important to disninguish between personality disorders and adult attachment disorders, because adults with attachment disorders need to have their trauma recognized. I believe that, if there is evidence of trauma, of course a person needs to have this recognized and get appropriate treatment. Then again, this does not mean that a person should not face the consequences of their actions. I honestly believe that the key determiner of the right intervention for anyone displaying disturbed behavior should be what works, not what is thought to be the underlying cause of their behavior. After all, we cannot pick at people’s brains and tell whetehr it was childhood trauma, genetics, or “free will” determining the behavior.