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Accueil arrow L'adoption en Russie arrow Santé et éducation arrow psychologie arrow Reactive Attachment Disorder (RAD): Dispelling the Myths
Reactive Attachment Disorder (RAD): Dispelling the Myths
27-08-2011
by Monica Pignotti, PhD on August 24, 2011

Yesterday, adoptive parent Jessica Beagley was found guilty in an Alaskan court of child abuse for punishing her Russian adopted child by giving him hot sauce and forcing him to take cold showers. Although unfortunately this form of abuse is thought to be common, what made this case unusual was the fact that she made a video of this that aired on the Dr. Phil show and that brought her abuse to the attention of authorities who then pressed charges. Beagley did not lose custody of her children.

The punishment of hot saucing and cold showers was not part of any kind of Attachment Therapy treatment, as the mom and children were not in any kind of therapy at the time. However, attachment therapy, along with all its myths, did enter the picture when so-called “experts” testified at the trial that the child was suffering from RAD and that this explained his alleged behavior problems, thus mitigating what the mom did. The problem is, that the behavior problems they attributed to RAD are nowhere in the DSM diagnosis of RAD, nor is there sound evidence that they have anything to do with attachment problems. No doubt, the publicity of this case is now going to be accompanied by more spreading of these myths that children with attachment problems lie, cheat, steal, are violent and will grow up to be sociopaths and the only thing that can stop this from happening is the harsh disciplinary measures associated with so-called “attachment therapy” which is what I consider to be abuse in the name of therapy.

This case is a prime example of why more states need to adopt Daubert, which would require experts to produce actual scientific evidence for that statements. That did not appear to be the case here. Even though Beagley was deservedly convicted, these therapists were allowed in as “experts” to testify to symptoms that have no basis in scientific evidence.

I thought that this would be an appropriate time to cite a table in a recent publication of mine, a systematic review of the literature on RAD and international adoption. The table clarifies the difference between what is in the DSM-IV-TR and the symptoms made up by “attachment therapists” that have no basis. For emphasis, I have placed the latter in red font for this posting (of course, in the actual publication, it is not in red). For even more such symptoms, see  Nancy Thomas’ article   Jean Mercer has just coined the term MAD (Misunderstood Attachment Disorder) to describe these symptoms that are repeated far and wide as legitimate when they are not.

From:

Pignotti, M. (2011). Reactive attachment disorder and international adoption: A systematic research synthesis. The Scientific Review of Mental Health Practice, 8, 30-49. (p.33)

Table 1. DSM Definition of RAD vs. Symptoms not in DSM Attributed to Attachment Problems

DSM-IV-TR Criteria 313.89 (American Psychiatric Association, 2000)

Reactive Attachment Disorder of Infancy or Early Childhood

A. Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2):
(1) persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hypervigilant, or highly ambivalent and contradictory responses (e.g., the child may respond to caregivers with a mixture of approach, avoidance, and resistance to comforting, or may exhibit frozen watchfulness)
(2) diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures)

B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder.

C. Pathogenic care as evidenced by at least one of the following:

(1) persistent disregard of the child’s basic emotional needs for comfort, stimulation, and affection
(2) persistent disregard of the child’s basic physical needs
(3) repeated changes of primary caregiver that prevent formation of stable attachments (e.g., frequent changes in foster care)

D. There is a presumption that the care in Criterion C is responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C).

(American Psychiatric Association, 2000, p. 128).

 Symptoms Outside the DSM-IV Definition Attributed to Attachment Disorders [red emphasis added]

Reference Symptoms
Coleman, 2003 Physical aggression, shallow, emotionally deficient social behavior, tantrums, recklessness, risk taking, bullying, stealing, abuse of pets, hoarding food, deception, emotional insatiability, need to control others, defianceFamily of RAD child symptoms:  loss of executive parental power, decreases in spousal interaction in parents of RAD children, parentification of siblings.
Howe, 2003 Aggression towards mother, crazy lying [lying about the obvious], poor eye contact, obsession with violence and bloody imagery, inability to anticipate consequences of behavior, compulsion to be in control and fear of being controlled, aggressive behaviors.
Hughes, 2003 Aggression, dissociation, affect and behavioral disregulation, impulsivity, alterations in consciousness, loss of meaning, somatization, inability to differentiate facial expressions, lack of eye contact with caregivers, discomfort with touch, shame.
http://phtherapies.wordpress.com/2011/08/24/reactive-attachment-disorder-rad-dispelling-the-myths/
 
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