Date on Master's Thesis/Doctoral Dissertation


Document Type

Doctoral Dissertation

Degree Name

Ph. D.

Department (Legacy)

Department of Educational and Counseling Psychology

Committee Chair

Kirby, Kathleen M.

Author's Keywords

Education; Psychology; Reactive attachment disorder; Attachment disorder; Community mental health; Clients


Attachment disorder in children--Diagnosis


Attachment Disorder (AD) in children has been characterized by particularly alarming behaviors, yet the identification of this disorder for clinicians in community mental health agencies is problematic. The only available diagnosis that addresses attachment problems is the DSM-IV diagnosis of Reactive Attachment Disorder (RAD), a diagnosis that does not include the more severely disturbed behaviors that have been associated with attachment-disordered children. This dissertation examined the frequency with which CMHA child clients were diagnosed with RAD, as well as the actual occurrence of attachment problems and Attachment Disorder as measured by the Randolph Attachment Disorder Questionnaire (RADA). The Personality Inventory for Children, Second Edition (PIC-2) was used as another measure to explore behavior problems in this population. Results of this study indicated that less than one percent of 662 CMHA child clients had received a diagnosis of RAD. However, a total of 41% of participants in the study had attachment problems (23% with AD) as measured by the RADQ. Additional study results indicated that there was no significant difference in RADQ scores between children currently living with their birth parents and those living in other arrangements. However, as the number of caregivers for children increased, so did RADA scores, indicating there was an increase in attachment-disordered behavior problems. Significant correlations were found between the RADQ scores and the PIC-2 scales of Delinquency, Cognitive Impairment, Impulsivity/Distractibility, Reality Distortion, Psychological Discomfort, and Social Skills Deficits. No relationship was found between RADQ scores and the PIC-2 scale scores of Family Dysfunction, Somatic Concerns, and Social Withdrawal. Interviews of CMHA clinicians revealed confusion and concern regarding the DSM-IV diagnosis of Reactive Attachment Disorder and what specialists in the field refer to as Attachment Disorder. Most of the clinicians reported having had very little exposure to this diagnosis in their graduate schools' programs, and seldom assigned a diagnosis of RAD due to confusion over the criteria and concern over treatment issues.