Attachment issues develop when children are over/under attached to others.  Often, attachment disorders can present by a child lacking a secure, calm attachment to their parents/caregivers.  Attachment disorders can be present when a child lacks boundaries with strangers.  Although attachment issues typically develop before the age of 5, symptoms of these disorders can carry into adulthood if not addressed earlier in life.  The two predominant attachment disorders that develop in childhood are Reactive Attachment Disorder and Disinhibited Social Interaction Disorder.  Children with Reactive Attachment Disorder adversely interact with or avoid typical interactions with others as a result of negative experiences in their early years.  In Disinhibited Social Interaction Disorder, children are overly friendly with strangers, often allowing themselves to be in dangerous positions because they do not fear unknown people.

Often, attachment issues stem from inconsistent parenting.  When children spend significant time in foster homes, or when a child’s parents are absent/distracted, children can begin to withdraw from others as well.  Children can also begin to develop attachment issues when parents are gone for long periods, such as with hospitalizations.  Children with avoidant, ambivalent, or disorganized attachment styles will eventually begin to disengage from adults as well as other children.

Diagnosis

If children exhibit symptoms of Reactive Attachment Disorder or Disinhibited Social Interaction Disorder, it is important for them to have a comprehensive psychological evaluation.  An evaluation can help rule out other conditions with potentially similar symptoms, such as Autism Spectrum Disorder.  Teaching children healthy and productive interpersonal boundaries can lessen the symptoms of attachment issues later in life.  Common symptoms of an attachment disorder in children include failure to trust adults in authority, the need to control or manipulate, and lying.  These children can often display impulsivity and superficial charm.

Though attachment issues are often observed in childhood, adults can also show symptoms of Reactive Attachment Disorder.  Often these symptoms include difficulty in handling conflict with other adults, controlling/manipulating others, feelings of isolation, and feelings of being blamed.  Attachment issues/disorders are serious and should be addressed by a mental health professional as soon as possible to avoid progression of interpersonal issues.

Treatment

Both individual and family therapy may be necessary when attachment issues are present. The therapist will focus on understanding the relationships of the client and the family of origin, and strengthening these relationships.  Therapy alone is often not sufficient to relieve symptoms of attachment disorders in children; stable housing and consistent parenting are required for a child to begin developing healthy attachments. If treatment is not sought for a child with Reactive Attachment Disorder, they have a much greater chance at developing issues such as borderline, histrionic, antisocial, narcissistic, dependent, or obsessive-compulsive personality disorders later in life.

“Repetition compulsion,” the tendency to recreate relationship styles of the past, can be dangerous for adults that suffer from attachment issues that stem from childhood. In these instances, family/couples therapy can be beneficial to differentiate between current and past relationships.  Therapy can also help those suffering from attachment issues to process what is healthy in a relationship from what is not healthy in a relationship.

Additional Resources:

American Academy of Child and Adolescent Psychiatry: Attachment Disorders

American Association of Marriage and Family Therapy: Adult Attachment Relationships

Institute for Attachment and Child Development

Mayo Clinic: Attachment Disorders

Article By: Sarah Warner, MS