Reactive Attachment Disorder: Symptoms & Treatment

Instructor: Yolanda Williams

Yolanda has taught college Psychology and Ethics, and has a doctorate of philosophy in counselor education and supervision.

In this lesson, we will discuss reactive attachment disorder. Learn about its symptoms, how reactive attachment disorder is treated, and more. Then test your knowledge with a quiz.

Reactive Attachment Disorder and Mia

Karen and Henry are a married couple who decided to adopt a child. After a lengthy process and careful consideration, Karen and Henry adopted four-year-old orphan Mia. Because very little was known about Mia's family background, Karen and Henry were advised to keep a close eye on her development and report any concerns. They noticed that Mia did not seek out their comfort when she was hurt, and any attempts that Karen and Henry made to comfort Mia were met with confusion. For example, when Karen attempted to hug Mia and pick her up after Mia bruised her knee at the park, Mia responded by not hugging Karen back and giving her a confused look. Mia had very little interest in playing with toys or peek-a-boo. Mia also appeared sad most of the time and did not engage in activities with Karen or Henry very much. Karen and Henry voiced their concerns to Mia's psychiatrist. Soon after, Mia was diagnosed with reactive attachment disorder.

Definition and Symptoms

Reactive attachment disorder is a mental disorder in which a child does not develop healthy attachment bonds with primary caregivers or parents. If a child does not receive the nurture, care, protection, or support that it needs from its primary caregiver, reactive attachment disorder is likely to result. Repeatedly changing primary caregivers in such a way that it limits the opportunities for a child to form secure attachments, i.e. moving an infant through several foster homes, can lead to reactive attachment disorder, Reactive attachment disorder is commonly seen in children who have been neglected or abused, or in children who are orphans. Still, reactive attachment disorder is extremely rare, only occurring in less than 10 percent of children who have been extremely neglected. Reactive attachment disorder usually starts somewhere between infancy and five years of age. There is not much literature on reactive attachment disorder beyond this age group, and it is unknown whether children over the age of five have reactive attachment disorder.


Mia was an orphan, which increased her chances of having reactive attachment disorder. She did not seek out comfort of a caregiver when she was hurt, nor did she like playing with toys. Both of these are symptoms of reactive attachment disorder. Mia exhibited unexplained withdrawal from her primary caregivers and sadness. She was also confused by Karen's attempt to comport her and did not respond appropriately to being hugged. Other symptoms of reactive attachment disorder include not exhibiting positive emotions while having regular interactions with a primary caregiver (i.e. not laughing or smiling), not asking for support from primary caregiver when needed, emotional withdrawal, and fear of social interactions.

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