Attachment Disorders

Most people, as infants, develop stable emotional attachments to their caregivers at an early age. They display healthy anxiety when their caregiver is not present, and they express relief when they’re reunited.

Some infants, nonetheless, develop attachment disorders because their caregivers weren’t available to meet their needs. They’re incapable of bonding with their caregivers, and they struggle to establish any type of emotional attachment.

Attachment disorders are treatable, but early diagnosis is crucial to treatment.  If not treated, children with attachment disorders may experience ongoing problems throughout their lifetime.

Attachment theory

Attachment theory involves the way a person forms emotional bonds with others. John Bowlby, A psychologist, formulated the theory while studying why babies became very upset when separated from a parent.

Babies depend on parent or caregiver to take care of their essential needs. Bowlby discovered that they used what he called attachment behaviours, such as holding on to their parent, crying or trying to prevent separation or to attract the attention of a lost parent.

Bowlby’s study of attachment in children is the basis for later research on attachment in adults.

As a person ages, one can develop a personal attachment style, based mostly on the attachment behaviours one internalized as a child. This attachment style can have an enormous impact on how one to form relationships as an adult.

Research also indicates that a person’s attachment style can affect one’s overall happiness and day-to-day life.

Attachment styles

A persons attachment style involves one’s behaviours and interactions with others and how one’s form relationships with people they meet. Attachment theory holds that these styles are significantly determined during early childhood.

Secure vs insecure

Attachment styles are considerably classified as being either secure or insecure.

If one’s needs as a child are usually met right away by the caregiver, the child can become a secure attachment style. As an adult, they will likely feel confident in their close relationships and trust that the other person will be there when one needs them.

If one’s caregiver failed to meet the needs of a child or was slow to respond to them, they can develop an insecure attachment style. As an adult, they might find it difficult to establish intimate bonds with others.

They may also find it difficult trusting other persons close to them. There are different subtypes of insecure attachment styles in adults.

Anxious-preoccupied attachment

If one has an anxious-preoccupied attachment style, they might:

  • Have a heightened need to feel desired
  • expend a lot of time thinking about their relationships
  • Have a predisposition to experience jealousy or idolize romantic partners
  • Require constant reassurance from those close to them that they care about them, and when the need for reassurance isn’t met, they can begin to develop doubts about how their loved ones feel about them. When they are in a relationship, they might often think their partner is upset with them and wants to leave even when it’s not true.
  • These anxieties can make them more sensitive to how people behave around them, as some of their actions might be interpreted as proof that what they were worried about is real.

Dismissive-avoidant attachment

If one’s attachment style is dismissive-avoidant, they might:

  • Have a hard time relying on their partners or other persons around them
  • Prefer to be on their own
  • Feel like intimate relationships aren’t worth the trouble
  • Become concerned that establishing close bonds with others will make them less independent and vulnerable
  • These behaviours may make it difficult for others to support or feel close to or feel close to them. Moreover, if someone does put in additional effort to draw get them closer, they might react by shutting themselves down. Keep in mind that these behaviours aren’t about lacking empathy for others. Rather it’s more about protecting oneself and keeping a sense of independence. 

Fearful-avoidant attachment

If one has a fearful-avoidant attachment style, they might:

  • Have antagonistic feelings about relationships and intimacy.
  • Crave romantic relationships but scared that their partner will hurt or leave them, or both.
  • Push aside feelings and emotions to try to avoid experiencing them
  • Fear one isn’t good enough for the kind of relationship one would like to have

While one might be able to suppress emotions for some time, they tend to come out in bursts. This can feel overwhelming and develop a habit of highs and lows in their relationships with others.

The Importance of Attachment

Continuous positive experiences with the caregiver help the infants to develop a secure attachment. When an adult reacts to a baby’s cries by feeding, changing, or comfort, the baby, learns they can trust the adult to protect them and to provide their needs.

Secure Attachments

Children who are securely attached tend to:

  • Form better relationships with others
  • Adopt a more positive attitude to problems
  • Usually adventurous and tend to explore independently
  • Ability to cope better in strenuous conditions

Insecure Attachments

Children who are experiencing negative or difficult to predict responses from a care provider may cultivate an insecure style of attachment.

They may consider adults unreliable and may not easily trust them. Children with insecure attachments may:

  • Refuse to engage with others
  • Avoid people
  • Get easily distressed
  • Display anxiety, anger, and fear


Indications that a child may have an attachment disorder include:

  • Self-destructive behaviours
  • Anxiety
  • Lack of eye contact
  • Bullying other kids
  • Extreme clinginess
  • Failure to smile
  • Intense bursts of anger
  • Lack of fear of strangers
  • Not affectionate toward caregivers
  • Oppositional behaviours
  • Poor impulse control
  • Observing others playing and interacting without joining
  • Withdrawn or listless moods

Types of Attachment Disorders

The DSM-5 approves two different attachment disorders: disinhibited social engagement disorder and reactive attachment disorder.

Disinhibited Social Engagement Disorder

The key indicator of disinhibited social involvement disorder (DSED) is over-friendliness with strangers. A child may seek the comfort of a stranger, sit on a stranger’s lap, and demonstrate no distress when a caregiver is not present.

Children with DSED also have little intention or desire to check in with authority figures before they leave a safe place and enter a situation that is strange or even endangering.

Kids with this condition show a scant preference for trusted adults over strangers and may actively seek out affection from people they’ve never met. 

Reactive Attachment Disorder

Reactive attachment disorder is childhood or early childhood disorder that involves an inability to seek comfort from a caregiver. A child with a reactive attachment may resist the caregiver’s physical support, avoid eye contact, and be constantly vigilant.  

Most children with reactive attachment disorder exhibit a wide range of problematic behaviours. Such behaviours may include mood swings, withdrawal, lack of warmth, not engaging with other children, and avoiding physical contact. 

Related Conditions

Attachment disorders go further than having to refuse to establish a close relationship with carers. Children with attachment disorders are likely to have academic, social, behavioural and emotional difficulties.

They are also at increased risk of having legal issues during adolescent development. 

Children with attachment disorders generally have lower IQs and are at increased risk of developing language problems. They are also more prone to have psychiatric disorders. A 2013 study examining children with attachment disorders discovered that: 

Overall, as well as having an attachment disorder, 85 per cent of the children had another psychiatric condition.

  • 14% had an autism spectrum disorder
  • 29% had conduct disorder
  • 19% had PTSD
  • 52% had ADHD
  • 29% had the oppositional defiant disorder
  • 14% had a specific phobia
  • 1% had a tic disorder

Link to Personality Disorders in Adulthood

Children do not grow out of attachment disorders on their without treatment.

Their symptoms may change as they grow older, but if left untreated, they are likely to continue to experience ongoing problems in adulthood, including difficulty in regulating their emotions.

Attachment disorders may also be associated with psychiatric traits. A 2018 study discovered that children with attachment disorders were more liable to exhibit callous and unemotional features.

While there is evidence that the two are linked, there is no evidence that attachment disorders cause an individual to develop an antisocial personality disorder. 


No one understands precisely why some children develop attachment disorders, while others may not develop attachment disorders in the same environment.

However, researchers agree that there is a link between attachment disorders and considerable neglect or deprivation, repetitive changes in primary caregivers, or childhood in institutional settings. 

Some other possible risk factors for attachment disorders include:

  • Frequent changes in care providers
  • Parental neglect
  • Prenatal exposure to alcohol or drugs
  • Abuse (physical, emotional, or sexual)
  • Caregivers with poor parenting skills
  • Institutional care
  • Parental anger issues
  • Parents with psychiatric conditions
  • Attachment disorders are relatively rare in the general population. However, foster children or children who have been institutionalized are at highest risk. 

These conditions are often identified around the first birthday of a child. Early warning signs often include failure to thrive or lack of interest in interaction. Populations most at risk include:

  • Children who were taken from a primary carer after building a healthy bond
  • Children who have had numerous different foster care providers
  • Children who spend their childhood in an orphanage
  • Children who have suffered multiple traumatic events


A stable, healthy environment is the most important aspect of helping a child develop a secure attachment.

A child who is continually moved from from from one foster home to another, or a child who resides in an orphanage, is unlikely to develop a healthy relationship with a caregiver. 

And even if a child with attachment disorder is placed in a loving home with a consistent caregiver, the symptoms will not be easily resolved.

They tend to drive away their carers, and behavioural problems often repulse those around them. They tend to require intensive ongoing treatment. 

Treatment typically involves:

  • Psychotherapy: Psychotherapy for attachment disorders aims at identifying specific problems and curbing problematic behaviours. This can be done via counselling sessions with a therapist, but it could also involve caregivers. 
  • Social skills training: development of social skills which can help children learn how to interact with other children in academic and social settings effectively. Kids can try practising these skills with their psychiatrist and caregivers to help them gain trust and experience.
  • Family therapy: Family therapy can help children, caregivers and other family members learn new ways to interact and respond. Mental health treatment involving caregivers can help children learn how to develop more secure attachments. The conditions of the Comorbid should also be treated. 

Getting Help

If you see an indication that your child may have an attachment disorder, talk to your child’s doctor about an assessment, diagnosis, or referral to a child’s mental health specialist.

The earlier the treatment, the more likely the child will experience a positive outcome. Another step you can take to help a child with an attachment issue is to take a parenting class.

Children with attachment issues require special care, so learning how to respond correctly can help your baby build a healthy and secure bond with care providers. 

Talk to a paediatrician if you have reasons to be concerned about your child’s attachment. Your paediatrician can do an initial assessment and can rule out any medical problems. You and your child might then be referred for a psychological evaluation.

Mental health professionals have different ways they can use to evaluate a child’s attachment and determine whether there may be an attachment disorder and what are the best treatment options for the child. 

There is no formal diagnosis of attachment disorder in adults. But in adulthood, you can undoubtedly experience attachment issues. For some, these may be persistent symptoms of RAD or DSED that have gone undiagnosed in childhood.

While you may not have much say about attachment behaviours that you develop as a child, as an adult, there are steps that can help to develop a more secure attachment style.

Learn more about why you feel and think the way you do it is key to overcoming unsafe attachment styles. Start by looking for a therapist with whom you feel comfortable talking.

They can help you unpack the traumatic childhood experiences, Recognize patterns that keep appearing in your relationship and develop new ways to connect with others and create intimate relationships. 

Finding a Therapist

Finding a therapist may feel daunting, but it doesn’t have to be that way. Start by asking yourself some basic questions: 

What are the issues you want to address? These might be specific or vague. 

Are there any special features that you would like to have in a therapist? For instance, are you more comfortable with someone who shares your gender? 

How much can you realistically afford to spend on a session? Would you like someone to offer sliding-scale prices or payment plans? 

Where’s the therapy going to fit your schedule? Do you need a therapist to see you on a specific day of the week? Or someone who ‘s having sessions at night? 

Next, start making a list of therapists in your area if you live in the United States, head over to the American Psychological Association’s therapist locator.