What does Reactive Attachment Disorder (RAD) in teenagers look like? What are the symptoms, and what should parents do if they think their child has attachment issues? Read on to find out.
What is Reactive Attachment Disorder (RAD)?
Reactive Attachment disorder is a condition that impacts the ability for a child to form a healthy attachment with their caregivers.
Incidents of RAD are higher among children with experiences of out of home placements such as orphanages or foster care. While it is considered rare, attachment problems are on a continuum and many children who have experienced trauma have challenges with secure attachment.
Children with RAD display a chronic inability to attach with their primary caregivers. As young children, this can look like a lack of eye contact or becoming physically rigid when caregiver attempts to nurture the child.
As a mother of children with RAD, my most potent example when explaining the symptoms is to describe how my child will fall down, scrape their knee and run past me screaming “Mom” at the top of their lungs. Instead of seeking me out, or even allowing me to approach them to provide comfort and assistance, they literally run in the opposite direction and hide.
RAD impacts not only the child but every person in the family. Unfortunately, RAD is resistant to treatment and often continues into teen and young adulthood.
What are the Symptoms of Attachment Problems in Teens?
RAD symptoms in teens can often be very disruptive. It is developmentally appropriate for a child to turn away from their family and towards peers during teen years.
This time in development is supposed to be a testing and growing experience. Where young children often look to parents for guidance and self-exploration, teens typically look to peers for those same needs. When a child has a mental health disorder that impacts attachment, it makes this time of development even more complex and difficult.
The tool clinicians use to diagnose disorders is the DSM (Diagnostic Service Manual). There has long been controversy about diagnosing children with a personality disorder, in addition to other persistent disorders that will follow a person throughout their life.
This caution is understandable as youth is supposed to be a time where children can develop and change. Some argue that an “adult” label of personality disorder will cause undue bias or harm for a child who may still change.
I am not a clinician and do not have a strong opinion on diagnosis criteria for children. I leave that up to the experts. I do, however, have concerns with symptoms or behaviors that persist into teen years and young adulthood for children with RAD, and I know what it looks like because I live with it every day.
Symptoms of RAD in Teens
Here are warning signs of RAD for teenagers:
- A lack of desire to connect with peers – they may present as indifferent about friends.
- A lack of understanding empathy – he or she may have difficulty understanding anyone else’s point of view outside of their own.
- Difficulty managing or maintaining relationships of reciprocity – not understand the value in give and take.
- Difficulty regulating emotions such as anger or fear – they may have rages or outbursts when they fear they are being rejected by peers.
- Difficulty understanding personal responsibility – young person may struggle with understanding they are responsible for their actions and lack the ability to draw connections to their actions and the response of their peers.
While these symptoms are difficult, remember that it’s because of the underlying disorder. The child is not choosing to have these connections with peers. Instead, they lack the ability to attach in a healthy way with peer relationships, much like they did with their caregivers.
Behaviors in Teenagers with RAD
Here’s how this translations into behavior that parents and teachers may see:
- Selfishness – they may only be concerned about their needs and how to get them met.
- Relationship Violence – the teen may engage in verbal or physical violence when fearful of losing a relationship.
- Manipulative or transactional relationships with peers – he or she may be unable to understand why they should do anything if there is “nothing in it for me”. For example, why should I go to watch my friends play, if they won’t give me something for going.
- Continued inability to connect with caregiver or other family members – young person may have difficulty connecting and receiving nurturing with caregivers and other family members.
Treatment Available for Teens with Attachment Issues
There are a number of treatments available for teens who struggle with mental health issues.
One treatment I found helpful is Dialectic Behavioral Therapy (DBT). Check out the DBT article I wrote specifically about this treatment as I feel there are many tools for parents and teens provided within the DBT model.
It can be incredibly difficult to help a teenager with attachment problems. It can also be difficult to get others to provide support and understanding instead of offering advice such as, “all teenagers only care about themselves.”
While incidents of selfishness is a common occurrence in neurotypical teens, it is a persistent and destructive trait for children with complex trauma.
How to Help a Teenager with Attachment Problems
I am of the opinion that helping teenagers develop skills for future success is key.
Yet, it is also incredibly difficult. The teen may not have much buy-in and believe that everyone else is the problem. The teen may become dysregulated and violent when confronted.
Being a teenager is a difficult stage to navigate for any teen. Children with attachment problems need even more support, tools and guidance to develop healthy relationships and boundaries.
Don’t go it alone. Reach out to local mental health professionals, community mentors, teachers, or others who can help provide guidance or support.