Reactive Attachment Disorder and Attachment Narrative among Children

Reactive Attachment Disorder and Attachment Narrative among Early School-Aged Children

Attachment disorders in early school-aged childrenpresentations have been a critical interest for many years, and the reason the article was selected. In psychology, attachment development in children is essential for the proper development of character. According to the study by Minnis et al. (2009), inadequate caregiving environments hinder such development. Despite scholars thoroughly exploring various attachment conditions, the reactive attachment disorder (RAD) is neglected where it remains an inadequately understood phenotype. The article by Minnis et al. (2009) titled “An exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children” extensively explores the attachment narratives among kids with RAD. From the study, it is evident that RAD has never been similar to attachment uncertainty, as many have thought for many years. Despite the research, questions remain on how attachment study reveals the clinical exploration and especially on attachment issues. The main intent of this paper is to explore Minnis et al. (2009) article’s methodology, interpretation of the results, general discussion points, critique analysis of the work’s originality, evaluation, and insight. While the article produced significant results indicating that RAD is linked to attachment narrate, more research is imperative to explore the neurobiological mechanism underlying RAD.

Methodology

From the article’s, it is evident that the DSM-IV tool was used where RAD was considered as a disorder with two main subtypes. Apart from the DSM-IV, the ICD-10 was used in basing the sample recruitment. With the lack of a preexisting measuring tool that would have been used to measure RAD behaviors, a new protocol was introduced. In this case, the participants were observed outside the clinical waiting room where the teacher and the parent interview happened. The interview that followed allowed the diagnostic consensus. 

Sample

The study firstly selected 47 participants, where 66% (n=31) were boys. After a clinical assessment, 38% of them were considered to have RAD. However, 5 of them refused to fill the forms, which resulted in a sample of 33. The comparison group, on the other hand, had 37 children who never matched the RAD criteria. In terms of consent, all the adults signed the consent form while the children offered verbal consent. The sampling was aimed at producing children that had RAD behaviors. A comparison sample of low RAD risk was attained from society. 

For this study, a Parental Semi-Structured Interview (CAPA-RAD) that has 28 questions was used. Additionally, the observation data collection method was used where participants were observed in their clinical waiting area, as mentioned earlier. In terms of the verbal IQ, the British Picture Vocabulary Scale (BPVS) was used. BPVS also assisted in checking the participant’s comprehension. The authors also utilized the Relationship Problems Questionnaire (RPQ), and the attachment illustrations were done by the help of The Manchester Child Attachment Story Task (MCAST). RAD diagnosis was arrived at after the use of the above tools, observation, and interviews from parents, teachers, and the participants. 

Concerning the procedure, the study requested the participants to attend two sessions with their caregivers. During the first visit, the researchers studied the caregiver and the participants in the hospital waiting room. In this case, the waiting room observation (WRO) was used. The children were also requested to fill the BPVS or MCAST assessment while their parents filled the CAPA modules. During the second visit, the caregivers were requested to fill the 3di semi-structured interview, and the children filled the MCAST. 

Results Description and Summary

The study indicated that pre-school children have secure attachment patterns even when they have RAD risk of developing insecure relationships. Another finding is the fact that RAD symptoms are effectively-evident in school going kids. However, co-morbid symptoms that include ADHD are familiar. Kids diagnosed with RAD were approximately double at risk of getting apprehensive relations. 

From the results, it was evident that the comparison participants had a higher number of secure patterns. On the other hand, the RAD cluster was spread across attachment patterns in an even manner. The attachment outline includes secure that had 30%, insecure-avoidant 27 %, insecure ambivalent 15%, and disorganized 27%. For the comparison group, secure had 73%, insecure-avoidant 19%. Insecure ambivalent 8% and 0% disorganized. The study confirmed that RAD participants had a higher risk of developing insecure attachment in the future. The early disruption of children tends to affect the way they develop attachments in the future. 

In MCAST, six elements were considered, including narrative coherence, anxiety (arousal), self-care, conflicted behavior, carer sensitivity & warmth, and carer intrusiveness & control. The RAD group and the controlling group performed differently. In the narrative coherence, for instance, the RAD group got 4.90 while the non-RAD got 6.13. In terms of arousal and self-care, the RAD group performed 6.80 and .95, while non-RAD received 7.40 and .55. The conflicted behavior also had a significant difference where the RAD got 2.25 and 1.00 for the non-RAD. Lastly, the carer sensitive & warmth and instructiveness & control had differences. The sensitivity had 3.44 for the RAD and 5.30 for the non-RAD. For the warmth, RAD had 2.66, while the non-RAD had 3.82. From the above presentation, participants in the control group attained a higher chance of developing healthy relationships with the carers and the community at large. The disorder also exposed the RAD participants to poor communication, sensitivity among other elements that exposed them to developing unhealthy behaviors in the future.

Article Critique

According to the study by Minnis et al. (2009), the researchers have explored the link between RAD and attachment narrative in school-aged participants. Through the abstract presented at the beginning of the article, readers get the whole idea of the article before going into details. Additionally, the study effectively selected the sample and the controlling group. The researchers considered various elements when choosing the participants, including the element of consent and availability. Participants who disagreed on filling out the consent form were removed from the study. Apart from the above strengths, the authors also used adequate instruments in measuring the element of RAD in participants. On examining the literature review, the article has consulted many peer-reviewed articles that ensure the study’s richness. The literature review gives the reader a glimpse of what has been documented and the study gaps. 

 Despite the above much strength, the article used a small population (sample size). With such a small size, it becomes a challenge to generalize to the larger society. The power of the study can be attained by obtaining a larger sample size. Additionally, the study presents numerous potential threats to internal validity, which needs to be addressed in future studies. Lastly, the study used many tools/ assessments, including WRO, BPVS, MCAST, RPQ, and BPVS, that can confuse the reader. From the above analysis, it is evident that future researchers have an important task of exploring the element of attachment in the context of RAD. RAD has, for many years, confided a is a pervasive disorder of social impairment in the nosology. The study majorly adds my understanding of RAD and how it is connected to attachment narratives and especially in school-age children. In this case, the non-RAD sample seemed to have secure and healthy relationships as expected. Lastly, I came to realize that RAD is not the same as attachment security.

In conclusion, the study findings reinforced the conclusion of the literature review that RAD is a different phenomenon, and especially when it comes to attachment specific behaviors. With the 33 RAD participants that the study used, it was evident that the nature of disruption that the RAD group of participants went through had severe impacts on their attachments. RAD has a higher chance of disrupting children’s social development. On analyzing the comparison group (non-RAD), they had a healthy attachment that made them effectively deal with their parents, carers, and teachers. Apart from the extensive research that Minnis et al. (2009) conducted, many studies regarding the element of RAD should be conducted. The studies will provide a better comprehension of attachment among RAD individuals. Such an account includes the possibility of distinctions in behavior even in the secure category. RAD has for many years considered as a pervasive disorder that affects social impairments and especially in the nosology. The two main priorities that future researchers should focus on include the neurobiological mechanism surrounding RAD. Additionally, they should explore the association that RAD has with developmental phenomenology.

References

Minnis, H., Green, J., O’Connor, T., Liew, A., Glaser, D., & Taylor, E. et al. (2009). An exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children. Journal of Child Psychology and Psychiatry, 50(8), 931-942. Doi: 10.1111/j.1469-7610.2009.02075.x