Causes

Attachment disorders are related to INTERRUPTIONS or DISRUPTIONS that occur during the time and infant and primary caregiver are establishing a bond during the time the Trust Cycle (see Trust Cycle) is forming during, which is typically the first 6 months of life, but may extend into the first full year of life. Some speculate that disruptions and interruptions during the first three years of life might have significant impact on a child's behavior and attachment pattern.

In addition, factors related to the child and/or caregiver also have an effect on how the attachment forms. Factors related to Reactive Attachment Disorder (RAD) include:

INTERRUPTIONS

Adoption
- (52% have RAD symptoms)
Caregiver career
- frequently gone
Foster Care
- multiple placements
- (60-85% have RAD symptoms)
Hospitalization
Frequent Moves
Frequent changes in child care providers

DISRUPTIONS

Abuse/Neglect
- 80% have RAD
Divorce
Death
Inadequate day care

CHILD FACTORS

Temperament
- Difficult to comfort
- Aggressive/hyperactive
- Depressed
Chronic illness (earaches or colic)
Unable to regulate emotions
Interfering disability

CAREGIVER FACTORS

Temperament
- Doesn't match child's
Chronic illness
Interfering disability
Alcoholism in caregiver (typically the father)
Depression in caregiver (typically the mother)
Inadequate parenting skills
- unpredictable/inconsistent
- unresponsive
- insensitive
- pathological care

It is the combination of some of these factors that creates the problem. For example, a caregiver might have a career that requires being gone a lot, but if the child's temperament is that of being "easy going" and the substitute caregiver adequately meets the infant's needs, no disruption might occur. If, however, the caregiver is frequently gone, the infant is easily upset by changes in the environment and is shuffled around between caregivers in the absent of the parent, the child is at greater risk of having an attachment disorder.

Another example -- If the primary caregiver is mentally challenged or mentally ill and does not read the infant's cues of needing love, nourishment, or comfort, the trust cycle can be disrupted. Of most importance is the consistency in how the caregiver responds. If the mentally ill caregiver goes through periods of deep depression where s/he does not meet the child's needs for weeks at a time and then does take care of the child when his or her mood lifts, this change in interaction confuses the infant. The child must then figure out which interaction pattern to follow with the caregiver.