Aggression in Children With Reactive Attachment Disorder: A Sign of Deficits in Emotional Regulatory Processes?

ABSTRACT

Children diagnosed with reactive attachment disorder (RAD) have been reported to exhibit a multitude of symptoms and behaviors that are not captured by the Diagnostic and Statistical Manual of Mental Disorders criteria. One behavior in particular that has been the source of much argument and controversy is aggression. Although limited research on this topic does support an association between aggression and RAD behaviors, the exact nature of this link remains unclear. This study aims to fill this gap by reporting data from a study that examined the behavioral processes that occur in adopted children with RAD. Guided by the principles of grounded theory, this study employed a multi-stage semi-structured interview design. The sample consisted of 5 adoptive families, and included both adult and child participants, including the adopted children with RAD. The findings revealed 5 prominent themes: The adopted children are reported to engage in extreme and prolonged tantrums, known as rages; children were often inconsolable during these rages; these rages are perceived as uncontrollable by children with RAD; these rages are directed toward a discriminate caregiver; and the impetus for these rages appears to be associated with difficulties in adapting to environmental demands. An in-depth discussion that draws a theoretical connection between these rages and possible deficits in brain-based processes responsible for emotional regulation is presented.

KEYWORDS:

• Adoption
• attachment theory
• emotional regulation
• families
• neglect
• reactive attachment disorder
• regulation theory
• trauma

Notes

1. Mina’s adoptive parents noted that when they were in China for Mina’s adoption, they heard conflicting reports about the quality of the orphanage she came from, including the strong possibility that the infant-caregiver ratio was much higher than was being reported by the adoption officials.