European Child & Adolescent Psychiatry

, Volume 15, Issue 6, pp 336–342 | Cite as

Reactive attachment disorder—a theoretical model beyond attachment

  • Helen MinnisEmail author
  • Helen Marwick
  • Julie Arthur
  • Alexis McLaughlin


Despite its importance in public health, reactive attachment disorder (RAD) is an under-researched and little used clinical category. Abnormalities of social relatedness have long been documented in children who have been abused, neglected or institutionalised, but there have been more recent efforts to define these behaviours within the psychiatric nosology. There has been an implicit assumption that the central deficit in RAD is in the attachment system, but this has caused controversy and may have blocked research. We propose that RAD is better construed within the framework of intersubjectivity, which has a central role in the development of core brain and social functions and may also have had an important role in the evolution of a key human characteristic—complex social functioning. This broader framework may potentially explain apparently diverse symptoms such as indiscriminate friendliness and negative or unpredictable reunion responses. Finally, we suggest that a change of name may be useful in progressing the field, but accept that this may be difficult until there is better agreement in the clinical and scientific communities about the core features and aetiology of this disorder.


foster care service use costs 



We are grateful to Christine Puckering, Joyce Minnis, Chris Gillberg, Danya Glaser, Amanda Burston and Valerie Murray for comments on earlier drafts.


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Copyright information

© Steinkopff Verlag Darmstadt 2006

Authors and Affiliations

  • Helen Minnis
    • 1
    Email author
  • Helen Marwick
    • 2
  • Julie Arthur
    • 1
  • Alexis McLaughlin
    • 1
  1. 1.University of Glasgow Section of Psychological MedicineCaledonia House, Yorkhill HospitalGlasgowUK
  2. 2.Dept. of Childhood and Primary StudiesUniversity of Strathclyde, National Centre for Autism StudiesGlasgowUK

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