Attachment disorders: Disinhibited attachment behaviours and secure base distortions with special reference to adopted children

This paper suggests that the behaviours associated with the formal diagnosis of the “disinhibited” form of reactive attachment disorder (RAD) might be seen as a functional adaptation rather than a mental health problem, a facultative response enhancing the probability of survival that is triggered by certain conditions. Although disinhibited RAD is most commonly observed in institutionalised children, similar behaviours may also be a part of the emotional difficulties displayed by some fostered and adopted children (the latter includes those once institutionalised), and these may demonstrate not so much a discrete attachment disorder as either the need to fend for oneself following loss of dedicated caregiving or a lack of opportunity to build specific intimate relationships with dedicated caregivers. In many cases this may be inextricably mixed with the neurobiological and psychological seqelae of maltreatment. Indiscriminate attachment behaviour, from this proposed evolutionary perspective, is less a syndrome of mental ill-health than an astute survival manoeuvre following being orphaned, abandoned or fecklessly reared. Such a response, allied to the innate facility to access caregiving from different adults, could be expected to be initiated by specific events as are the other attachment configurations. Classing disinhibited RAD as an adaptation has implications for helping children brought up under extreme duress when their caregiving environment has changed for the better.