The impact of reactive attachment disorder on adoptive family functioning

Adopted children with special needs can experience a multitude of developmental, emotional, and behavioral issues as a result of pre-adoption maltreatment. On rare occasions, maltreated children can display behaviors severe enough to fit the criteria of reactive attachment disorder (RAD). Children with RAD are known to engage in self-destructive behavior, talk of killing others or themselves, verbal and physical aggression toward peers and adults, and a lack of discernment between parental figures and strangers. Given the uniqueness of these behaviors, the rarity of the disorder, and the lack of research in this area, further exploration is warranted. Therefore, the purpose of this study is to explore the effects an adopted child with reactive attachment disorder (RAD) has on family functioning.

Due to their being little research on RAD in the context of families, an exploratory approach was determined to be the best fit for this study. Kathy Charmaz's constructivist grounded theory guided this qualitative inquiry. Her approach, coupled with the use of semi-structured interviews, allowed for rich, descriptive information to be obtained, while allowing the researcher to include aspects of his experience in working with children with RAD. The relevant data collected included five families from the Midwest, and consisted of a total of 28 participants, with 14 adults and 14 children. The adopted children's mental health assessments, individual education plans, and the researcher's field notes were also included. Data analysis consisted of the constant comparative method.

RAD behaviors were found to manifest themselves on a developmental continuum, with two dominant forms of thinking and behaviors identified. These behaviors are characterized as control-based, and are often perpetuated by high levels of anxiety. When this anxiety becomes unmanageable for the child, it is released in the form of rages toward those caregivers who are deemed as safe and for whom the child as the strongest relational bond. Traditional child therapies and behavior modification techniques were found to do little to change the course of these behaviors. Since children with RAD had no physical sign of a disorder, this commonly led the public to perceive their behaviors as being the result of parental incompetency. Parents who continually experienced public criticism found themselves purposefully withdrawing from society. This withdrawal was related to an increased sense of isolation, which was related to increased levels of stress, somatic complaints, and marital discord. Possible neurobiological factors involved in the development of RAD are discussed, along with practice and policy implications for families who adopt children with RAD.