Presented to
United Nations Convention on Child Rights
June 9, 1999,
by Nancy Faulkner, Ph.D
on behalf of
P.A.R.E.N.T.
and
Victims of Parental Child Abduction
© Nancy Faulkner 1999

Page 3

Reactive Attachment Disorder.

Attachment is the deep and enduring connection established between a child and caregiver in the first few years of life. It profoundly influences every component of the human condition, -- mind, body, emotions, relationships, and values. Children lacking secure attachments with caregivers often become angry, oppositional, antisocial, and may grow up to be parents who are incapable of establishing this crucial foundation with their own children (Levy & Orlans, 1999).

Children who lack permanence in their lives often develop a "one-day-at-a-time" perspective of life, which effects appropriate development of the cognitive-behavioral chain -- thoughts, feelings, actions, choices, and outcomes. "They think, 'I've been moved so many times, I'll just be moved again. So why should I care?'" (ACE, 1999).

Stringer (1999) and other experts on attachment disorder concur that the highest risk occurs during the first few years of life. This disorder is classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) as Reactive Attachment Disorder. According to Stringer, common causes of attachment problems are:

1. Sudden or traumatic separation from primary caretaker
   (through death, illness hospitalization of caretaker, or removal of child);
2. Physical, emotional, or sexual abuse;
3. Neglect (of physical or emotional needs);
4. Frequent moves and/or placements;
5. Inconsistent or inadequate care at home or in day care
   (care must include holding, talking, nurturing, as well as meeting basic physical needs); and
6. Chronic depression of primary caretaker.

It is evident that these causality factors would place at high risk children who are subjected to similar conditions in the circumstances of parental kidnapping.

Attachment is the reciprocal process of emotional connection. This fundamental and necessary developmental process influences a child's physical, cognitive, and psychological development. It becomes the basis for development of basic trust or mistrust, and shapes how the child will relate to the world, how the child will learn, and how the child will form relationships throughout life. "If this process is disrupted, the child may not develop the secure base necessary to support all future healthy development" (Stringer, 1999).

Stringer (1999), Van Bloem (1999), The Attachment Center (ACE, 1999), and criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV, 1994) identify a significant and troubling list of behaviors associated with problematic attachment:

1. Unable to engage in satisfying reciprocal relationships;
2. Superficially engaging, charming (not genuine);
3. Lack of eye contact;
4. Indiscriminately affectionate with strangers;
5. Lack of ability to give and receive affection on parents' terms (not cuddly);
6. Inappropriately demanding and clingy;
7. Poor peer relationships;
8. Low self esteem;
9. Affectionate with strangers or attempts to leave with strangers;
10. Refuses, resists, or is uncomfortable with affection on parental terms;
11. Incessant chatter or nonsense questions;
12. Hyperactive, over-active, or attention deficit;
13. Poor, underdeveloped, or no conscience;
14. Hoarding, gorging, eating abnormalities, or hiding food;
15. Intense control battles;
16. Significant learning problems or lags;
17. Fire setting, fire play, or fascination with fire;
18. Daily lying or lying in the face of the obvious;
19. Fascination with weapons, blood, or gore;
20. Destructive to self or others; and
21. Cruelty to animals, siblings, or others.

This unsettling list of disturbances and other constellations of behaviors exhibited by abducted children comprises criteria from various childhood disorder categories of the Diagnostic and Statistical Manual of Mental Disorders that might lead one to rule out the following diagnoses:

1. Reactive Attachment Disorder of Infancy or Early Childhood;
2. Separation Anxiety Disorder;
3. Overanxious Disorder of Childhood;
4. Attention-Deficit/Hyperactivity Disorder;
5. Conduct Disorder;
6. Disruptive Behavior Disorder;
7. Oppositional Defiant Disorder;
8. Eating Disorders;
9. Learning Disorder NOS;
10. Regression and Elimination Disorders: Encopresis and Enuresis; and
11. Post Traumatic Stress Syndrome.

As a relatively new diagnosis to the Diagnostic and Statistical Manual of Mental Disorders, Reactive Attachment Disorder (RAD), also known as Attachment Disorder (AD), is often misunderstood, and relatively unknown (ACE, 1999). Although the official DSM-IV diagnosis may be overlooked by some professionals, the phenomenon of attachment disorder was observed 50 years ago by Rene Spitz in the well known monkey studies. Spitz reported that infant monkeys may actually die if they are not played with, talked to, held, stroked, and tended. Some species of young monkeys die when abandoned. Even a brief separation of infant monkeys from their mothers is seen two years later, causing the infants to be more timid, clingy, and relate poorly to others.

Humans are social animals. If abandoned as an infant or young child, we may first protest by screaming, then quietly withdraw; finally, we become detached and apathetic. Abandoned, we may joylessly play some with others, but there is no emotional involvement (Tucker-Ladd, 1960).

The DSM-IV (1994) defines Reactive Attachment Disorder (RAD) as markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age five. According to Van Bloem (1999), inexperienced professionals often misdiagnose Reactive Attachment Disorder (RAD) as Oppositional Defiant Disorder, Attention Deficit Disorder, Depression, Autism, Post-Traumatic Stress Disorder, Bipolar Disorder, or Attention-Deficit/Hyperactivity Disorder. Other experts in RAD estimate that this disorder has been misdiagnosed as Bi-Polar Disorder or Attention Deficit Disorder in 40 to 70 percent of the cases (ACE, 1999).

Bloem (1999) suggests that Reactive Attachment Disorder is often accompanied by other diagnosis listed above, but that Attachment Disorder most often needs to be the primary diagnosis and the focus of early intervention. Some professionals may mildly disagree with Bloem's preferred diagnostic perspective; however, most would agree that the resultant trauma to a child, -- who in a moment was stolen away from his or her entire world of familiarity, -- is emotionally, developmentally, and psychologically devastating.

Van Bloem (1999) reports that for a child "it is not possible to develop true self-esteem and find peace without resolving differences and emotional pain due to stressed or damaged emotional ties to parents and family." According to Van Bloem, attachment helps the child to:

1. Attain full intellectual potential;
2. Sort out perceptions;
3. Think logically;
4. Develop a conscience;
5. Become self-reliant;
6. Cope with stress and frustration;
7. Handle fear and worry;
8. Develop future relationships; and
9. Reduce jealousy (Van Bloem, 1999).

The words "attachment" and "bonding" are used interchangeably. These bonding impaired individuals typically fail to develop a conscience and do not learn how to trust. With Attachment Disorder, individuals have difficulty forming intimate lasting relationships (ACE, 1999). Children with attachment disturbance often project an image of self-sufficiency and charm, while masking inner feelings of insecurity and self hate. Unfortunately, such children do not respond well to traditional parenting or therapy, since both rely on the child's ability to form relationships (Stringer, 1999).

Adult survivors of abuse may experience long term or chronic lifetime symptoms resulting from childhood trauma. For example, a person who has been physically abused might suffer from depression or anxiety. A victim of childhood sexual abuse might exhibit symptoms of Posttraumatic Stress, or other disorders as evidenced in the DSM-IV criteria of adult mental health disorders, such as:

1. Agoraphobia
2. Post traumatic Stress Disorder
3. Dissociative Identity Disorder
4. Dysthymic Disorder
5. Substance Abuse or Dependency
6. Generalized Anxiety Disorder
7. Major Depressive Disorder
8. Panic Attacks or Panic Disorder
9. Borderline Personality Disorder

All too often, children suffering from Reactive Attachment Disorder go untreated and become adults without conscience (Antisocial Personality Disorder) and without concern for anyone but themselves. "Parental dreams are lost, and they grow up uncaring and without social conscience" (ACE, 1999).

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