Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) Symptomatology in a High-Risk Clinical Sample

Clin Pediatr (Phila). 2023 Jul;62(7):760-768. doi: 10.1177/00099228221143810. Epub 2022 Dec 14.

Abstract

Attachment relationships are broadly considered foundational to child development as such attachment disorders, reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED), pose a severe threat to children's safety and developmental trajectory. This study examined the prevalence of full diagnosis and symptoms of RAD and DSED in a high-risk sample of adopted children (n = 98; mean age: 46.26 months; range: 16.09 months-6.51 years). Consistent with existing literature, a full diagnosis of RAD and DSED was rare, 1% (n = 1) and 8.1% (n = 8), respectively. However, over half of the sample presented with at least one clinically concerning symptom of RAD or DSED. Given the nature of attachment disorders and the level of concern associated with symptoms, these findings emphasize the need for effective mental health screening, sensitivity beyond just a full diagnosis, and early interventions for adopted children.

Keywords: adoption; attachment disorders; disinhibited social engagement disorder; mental health screening; reactive attachment disorder.

MeSH terms

  • Child
  • Child Development
  • Child, Preschool
  • Early Intervention, Educational
  • Humans
  • Problem Behavior*
  • Reactive Attachment Disorder* / diagnosis
  • Reactive Attachment Disorder* / epidemiology
  • Reactive Attachment Disorder* / psychology
  • Social Participation