Reactive Attachment Disorder in Teens
Adolescence and young adulthood can be a time period when teens test their parents by pushing boundaries. But teenagers with reactive attachment disorder are highly unique.
Learn more about reactive attachment disorder in teenagers, the types of mental health treatment available to teens and how to get your child the help he or she needs.
What Is Reactive Attachment Disorder?
Reactive attachment disorder is a rare mental health disorder that can challenge the resolve of a parent whose teen suffers from this complex type of attachment disorder.
Reactive attachment disorder occurs during a developmental time in early childhood as a result of being subjected to abuse, neglect or a protracted or permanent separation from a primary caregiver. The effects of reactive attachment disorder increase as the child gets older; its effects can cause severe dysfunction into adolescence and even the young adult years.
For parents who are adopting or raising a teen with reactive attachment disorder, having access to experts in attachment disorder that can provide guidance, responsiveness, support and treatment to establish healthy relationships, is essential.
Reactive Attachment Disorder in Teens
Reactive attachment disorder is a mental illness that affects about 1% of children and teenagers. The outward signs of reactive attachment disorder in a child are similar to autism spectrum disorder, so care must be taken to arrive at an accurate diagnosis. Generally, the risk factors and symptoms of reactive attachment disorder will be present prior to age five.
Reactive attachment disorder is also the most severe among the attachment disorder category of mental disorders.
Reactive attachment disorder features an inability to bond with the significant people in their life. This is due to the child’s emotional needs going unmet in early childhood, or due to serious abuse or neglect. As a result, the child doesn’t experience normal bonding with caregivers or parents at this early age, which can cause lifelong psychological harm.
What Causes Reactive Attachment Disorder?
According to the American Academy of Child and Adolescent Psychiatry (AACAP), the early infant experience provides the foundation for lifelong functioning. When those early months or years of child development are disrupted by abandonment, abuse or emotional neglect, it can severely impair the child’s future ability to connect emotionally with a caregiver or parent.
Reactive attachment disorder is the resulting mental health disorder that reflects a child’s damaging and disrupted early life experience.
The situations that can lead to reactive attachment disorder are diverse:
- A parent may not be able to attach to their baby due to their own struggles with a mental health disorder or a substance use disorder. These conditions thwart a parent’s ability to provide affection and normal interactions for their child.
- A parent may have died, thus leaving the young child without the normal parent-child attachment process.
- Some children experience frequent changes moving throughout numerous foster care or foster home settings, where they are unable to form any consistent attachment with caregivers.
- Some children spent their early months and years in an institution and were deprived of comfort and physical touch.
- Some young children are abused physically or sexually by a caregiver.
All of these early childhood experiences cause a prevalence of attachment issues, a sense of deep distrust and a lack of emotional safety, which can result in reactive attachment disorder.
The Symptoms of Reactive Attachment Disorder
A loved one with reactive attachment disorder will exhibit symptoms in childhood or adolescence such as:
- Avoids eye contact
- Cries inconsolably
- Doesn’t notice when someone leaves them or is present
- Doesn’t reach out arms to be picked up
- Has no interest in playing games or with toys
- Rarely or never smiles
- Rocks themselves as a means of self-comforting
Older children display symptoms such as:
- Angry outbursts or tantrums
- May be argumentative or disobedient
- Passive-aggressive behaviors
- Shows aversion to being touched
- Show little to no affection toward parents
As your child with reactive attachment disorder ages, their symptoms will fall into one of two groups, referred to as inhibited and disinhibited. The symptoms of each are as follows:
Inhibited reactive attachment disorder:
- A lack of emotional expression, emotionally detached
- Appearing uncomfortable or unresponsive when being soothed or comforted
- Avoidant behavior
- Avoids relationship behaviors
- Is extremely withdrawn
Disinhibited reactive attachment disorder:
- Act immature for their age
- Are extremely dependent
- Seeks attention all the time
- Treats strangers the same as parents
- Violates social boundaries
- Will seek comfort from anyone, may form inappropriate attachments
Help for Parents of Teens With Reactive Attachment Disorder
When a child with reactive attachment disorder enters their teenage years, it poses daunting challenges for caregivers and their parenting skills.
Your child's needs may appear normal, yet they will experience behavioral problems and developmental delays. Emotionally, their development will often be that of a young child. The particular struggles that you will face will depend on whether your teen daughter or son with reactive attachment disorder shows inhibited or disinhibited features.
Some of the ways reactive attachment disorder can cause impairment in functioning and interpersonal relationships include:
- Anger issues and behavior problems can lead to issues within peer relationships and issues at school.
- Low self-esteem can result, which causes the teen to withdraw or avoid social situations.
- The teen may have difficulty functioning in the school environment and may have a learning impediment.
- The teen may engage in inappropriate sexual behavior.
- In relationships, the teen will seek to maintain control at all costs, which can drive friends away.
- Disordered eating habits may result in slowed physical growth or malnutrition.
- Without a feeling of a healthy attachment to a parent, the teen will be vulnerable to following a peer’s influence.
- The teen may engage in reckless behaviors.
- The teen will not feel remorse for their bad choices, which can include cruelty to animals or illegal acts.
- The teen may engage in substance abuse.
Because the teen with reactive attachment disorder has the emotional development of a young child, there is a need for calm and consistent disciplining and parenting. Teens with reactive attachment disorder will require close monitoring, which for parents can be exhausting and stressful. In most cases, the teen should not be allowed to drive a car, and their online activities will need to be very limited if allowed at all.
Mental Health Treatment for Reactive Attachment Disorder
While outpatient support can be helpful to a degree, a teen with reactive attachment disorder can learn how to manipulate the therapy sessions and avoid making any substantive lasting behavioral changes.
The residential setting provides a safe, structured setting where the teen can receive ongoing care over an extended period. This level of care is especially useful when the teen has a co-occurring disorder, like that of reactive attachment disorder and attention deficit hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder (ODD), post-traumatic stress disorder (PTSD), etc.
According to the American Psychiatric Association (APA), treatment elements for teens with reactive attachment disorder include:
- Dyadic Developmental Psychotherapy
- Emotional Focused Therapy
- Family Systems Therapy
- Complementary activities, such as art therapy, equine therapy or yoga
Within a nurturing residential setting, the teen can practice co-regulation with adult caregivers and new behavior and thought patterns that will better equip him or her for managing the effects of early attachment insecurity in daily life.
Embark Behavioral Health Provides Treatment for Teens With Reactive Attachment Disorder
Embark Behavioral Health is a family of mental health treatment programs that specialize in treating adolescents and young adults. We provide comprehensive treatment solutions for teens that struggle with reactive attachment disorder, including those with co-occurring mental health or substance use issues.
Our clinical and mental health professionals understand the unique needs of adolescents with reactive attachment disorder and assist both the teenager and their families in effective management techniques to create stable attachments.