Furthermore, attachment disorder symptoms are more common with children being exposed to abuse or neglect or being separated from prior caregivers. Thus, the less sensitive an environment is the more common attachment disorder symptoms of both categories are. It has been shown that attachment disorder behaviors are linked to the duration of deprivation, sensitivity of the environment and quantity of caregivers. Several studies showed significant correlations between institutional care and attachment disorder symptoms. Hall and Geher describe positive caregiver child interaction leading to bonding and attachment, whereas the absence may lead to attachment disorder symptoms. Both DSM and ICD describe poor caregiving as the core factor for the development of attachment disorder symptoms. reported 4.11% of RAD and 20% of DSED in a population of previously institutionalized children. found a prevalence of 1.4% in a deprived population of school-aged children and Gleason et al. In a sample of 300 preschoolers aged between 2 and 5 years, no child met the diagnostic criteria for an attachment disorder. Both RAD and DSED are exceedingly rare in low-risk samples and occur in a minority of children, raised under extreme conditions. ![]() Recently considerable research on disturbances of attachment has been done, but there is little empirical data regarding the prevalence of the disorders. The criteria for attachment disorders have been revised several times and the recent DSM-5 divides the reactive attachment disorder (RAD), referring to the inhibited symptoms, and the disinhibited social engagement disorder (DSED), referring to the disinhibited symptom pattern. ![]() Later studies of children who experienced institutional care in Romanian orphanages identified similar disorder symptoms. These two behavioral patterns provided the foundation for picturing reactive attachment disorders in the DSM-III for the first time. Most of these children showed emotional withdrawal, and unresponsiveness or indiscriminate behavior, friendliness and, overly familiar behavior. Studies focusing on children raised under extreme conditions of caregiving, like the first major longitudinal study by Tizard and Rees found deviant social behavior within a group of children raised in institutions. ![]() Inadequate care like maltreatment, neglect or severe deprivation in terms of no consistent caregiver, is known leading to behavior that can be diagnosed as attachment disorders.
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