The Experts below are selected from a list of 246 Experts worldwide ranked by ideXlab platform
Helen Minnis - One of the best experts on this subject based on the ideXlab platform.
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autism and Attachment Disorder symptoms in the general population prevalence overlap and burden
Developmental Child Welfare, 2020Co-Authors: Helen Minnis, Claudiamartina Messow, Alex Mcconnachie, Paul Bradshaw, Andrew Briggs, Philip Wilson, Christopher GillbergAbstract:Background:Co-occurring trauma-related and neurodevelopmental problems are common in maltreated children. In population research and clinical practice, these tend to be considered separately. Overl...
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reactive Attachment Disorder in maltreated young children in foster care
Attachment & Human Development, 2019Co-Authors: Molly Bruce, David Young, Sue Turnbull, Maki Rooksby, Guy Chadwick, Catriona Oates, Rebecca Nelson, Genevieve Youngsouthward, Caroline Haig, Helen MinnisAbstract:Reactive Attachment Disorder (RAD) is one of the least researched and most poorly understood psychiatric Disorders. Very little is known about the prevalence and stability of RAD symptoms over time. Until recently it has been difficult to investigate RAD due to limited tools for informing a diagnosis. Utilising a newly developed observational tool along with the Disturbances of Attachment Interview. this short-term prospective longitudinal study explored RAD symptoms in maltreated young children in Scotland (n=100, age range =12-62 months) over 12 months. Children were recruited as part of The Best Services Trial (BeST?), in which all infants who came in to the care of the local authority in Glasgow due to child protection concerns were invited to participate. Prevalence of RAD was found to be 5.0% (n=5, 95% CI [0.7-9.3]) when children were first placed in to foster care. Following at least 1 year of improved care conditions, prevalence in the 76 children remaining in the study was 2.1% (n=2, 95% CI [below 0-4.7]). RAD was associated with some mental health and cognitive difficulties. While levels of carer-reported RAD symptoms decreased significantly over time, observed symptoms did not. Findings suggest that RAD resolved in a small majority of cases but further exploration in larger samples would be invaluable.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:BACKGROUND: Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. METHODS: Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. RESULTS: Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. CONCLUSIONS: Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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prevalence of reactive Attachment Disorder in a deprived population
British Journal of Psychiatry, 2013Co-Authors: Helen Minnis, David Young, Rachel Pritchett, Claire Davidson, Susan Macmillan, Brenda Wallace, John Butcher, Fiona Sim, Katie Baynham, Christopher GillbergAbstract:Background Reactive Attachment Disorder (RAD) is associated with early childhood maltreatment and has unknown population prevalence beyond infancy. Aims To estimate RAD prevalence in a deprived population of children. Method All 1646 children aged 6-8 years old in a deprived sector of an urban UK centre were screened for RAD symptoms. Parents of high and low scorers were interviewed using semi-structured interviews probing for psychopathology and individuals likely to have RAD were offered face-to-face assessment. Results Questionnaire data were available from 92.8% of teachers and 65.8% of parents. Assessments were conducted with 50% of those invited and missing data were imputed - based on the baseline data - for the rest. We calculated that there would be 23 children with definite RAD diagnoses, suggesting that the prevalence of RAD in this population was 1.40% (95% CI 0.94-2.10). Conclusions In this deprived general population, RAD was not rare.
Charles H Zeanah - One of the best experts on this subject based on the ideXlab platform.
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commentary increasing diagnostic precision in reactive Attachment Disorder a commentary on allen schuengel 2019
Child and Adolescent Mental Health, 2020Co-Authors: Charles H Zeanah, Katherine L GuyonharrisAbstract:: A study by Allen and Schuengel in this issue of the journal replicates and extends previous findings by Woolgar and Baldock (2015) indicating that community practitioners are far more likely to diagnose reactive Attachment Disorder in symptomatic children than are specialists using well-validated measures. We consider historic variability in how this Disorder is defined but note an emerging consensus in nosologies and among researchers. We consider how more systematic assessments might improve diagnostic efforts to specify the kinds of clinical phenomena that are associated with neglect and deprivation.
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a prospective longitudinal study of reactive Attachment Disorder following early institutional care considering variable and person centered approaches
Attachment & Human Development, 2019Co-Authors: Katherine L Guyonharris, Charles A Nelson, Kathryn L Humphreys, Kathryn A Degnan, Nathan A Fox, Charles H ZeanahAbstract:Although the study of reactive Attachment Disorder (RAD) in early childhood has received considerable attention, there is emerging interest in RAD that presents in school age children and adolescents. We examined the course of RAD signs from early childhood to early adolescence using both variable-centered (linear mixed modeling) and person-centered (growth mixture modeling) approaches. One-hundred twenty-four children with a history of institutional care from the Bucharest Early Intervention Project, a randomized controlled trial of foster care as an alternative to institutional care, as well as 69 community comparison children were included in the study. While foster care was associated with steep reductions in RAD signs across development, person-centered approaches indicated that later age of placement into families and greater percent time in institutional care were each associated with prolonged elevated RAD signs. Findings suggest the course of RAD is variable but substantially influenced by early experiences.
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signs of Attachment Disorders and social functioning among early adolescents with a history of institutional care
Child Abuse & Neglect, 2019Co-Authors: Katherine L Guyonharris, Kathryn L Humphreys, Charles A Nelson, Charles H ZeanahAbstract:Abstract Background Institutional rearing is associated with increased risk for reactive Attachment Disorder (RAD) and disinhibited social engagement Disorder (DSED). Disorders of Attachment involve disturbances in children’s primary caregiving relationships, and are likely to disturb multiple domains of social functioning. Objective To examine associations between signs of RAD and DSED and social functioning in early adolescence. Participants and setting Our participants were 110 children with a history of institutional rearing and 50 community comparison adolescents from the Bucharest Early Intervention Project, based in Bucharest, Romania. Participants were assessed at age 12 years (M age in years = 12.80, SD = 0.71). Method Signs of RAD and DSED were obtained through caregiver report. Reports of social functioning were provided by caregivers and teachers. General and specific domains of social functioning were identified using bi-factor modeling. A general social functioning factor and four specific factors were revealed: peer conflict, caregiver views as victim, teacher views as victim, and social competence. Results Signs of RAD predicted poorer general social functioning (β=-0.36, p Conclusions Attachment Disorder signs in early adolescence are problematic for social functioning, although the manifestation of these social difficulties differs based on whether RAD or DSED signs are present.
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signs of reactive Attachment Disorder and disinhibited social engagement Disorder at age 12 years effects of institutional care history and high quality foster care
Development and Psychopathology, 2017Co-Authors: Kathryn L Humphreys, Charles A Nelson, Charles H ZeanahAbstract:: Two Disorders of Attachment have been consistently identified in some young children following severe deprivation in early life: reactive Attachment Disorder and disinhibited social engagement Disorder. However, less is known about whether signs of these Disorders persist into adolescence. We examined signs of reactive Attachment Disorder and disinhibited social engagement Disorder at age 12 years in 111 children who were abandoned at or shortly after birth and subsequently randomized to care as usual or to high-quality foster care, as well as in 50 comparison children who were never institutionalized. Consistent with expectations, those who experienced institutional care in early life had more signs of reactive Attachment Disorder and disinhibited social engagement Disorder at age 12 years than children never institutionalized. In addition, using a conservative intent-to-treat approach, those children randomized to foster care had significantly fewer signs of reactive Attachment Disorder and disinhibited social engagement Disorder than those randomized to care as usual. Analyses within the ever institutionalized group revealed no effects of the age of placement into foster care, but number of caregiving disruptions experienced and the percentage of the child's life spent in institutional care were significant predictors of signs of Attachment Disorders assessed in early adolescence. These findings indicate that adverse caregiving environments in early life have enduring effects on signs of Attachment Disorders, and provide further evidence that high-quality caregiving interventions are associated with reductions in both reactive Attachment Disorder and disinhibited social engagement Disorder.
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practice parameter for the assessment and treatment of children and adolescents with reactive Attachment Disorder and disinhibited social engagement Disorder
Journal of the American Academy of Child and Adolescent Psychiatry, 2016Co-Authors: Charles H Zeanah, Neil W Boris, Tessa L Chesher, Heather J Walter, Oscar G Bukstein, Christopher Bellonci, Scott R Benson, Regina Bussing, Allan K Chrisman, John D HamiltonAbstract:This Practice Parameter is a revision of a previous Parameter addressing reactive Attachment Disorder that was published in 2005. It reviews the current status of reactive Attachment Disorder (RAD) and disinhibited social engagement Disorder (DESD) with regard to assessment and treatment. Attachment is a central component of social and emotional development in early childhood, and Disordered Attachment is defined by specific patterns of abnormal social behavior in the context of "insufficient care" or social neglect. Assessment requires direct observation of the child in the context of his or her relationships with primary caregivers. Treatment requires establishing an Attachment relationship for the child when none exists and ameliorating disturbed social relatedness with non-caregivers when evident.
Christopher Gillberg - One of the best experts on this subject based on the ideXlab platform.
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autism and Attachment Disorder symptoms in the general population prevalence overlap and burden
Developmental Child Welfare, 2020Co-Authors: Helen Minnis, Claudiamartina Messow, Alex Mcconnachie, Paul Bradshaw, Andrew Briggs, Philip Wilson, Christopher GillbergAbstract:Background:Co-occurring trauma-related and neurodevelopmental problems are common in maltreated children. In population research and clinical practice, these tend to be considered separately. Overl...
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:BACKGROUND: Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. METHODS: Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. RESULTS: Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. CONCLUSIONS: Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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prevalence of reactive Attachment Disorder in a deprived population
British Journal of Psychiatry, 2013Co-Authors: Helen Minnis, David Young, Rachel Pritchett, Claire Davidson, Susan Macmillan, Brenda Wallace, John Butcher, Fiona Sim, Katie Baynham, Christopher GillbergAbstract:Background Reactive Attachment Disorder (RAD) is associated with early childhood maltreatment and has unknown population prevalence beyond infancy. Aims To estimate RAD prevalence in a deprived population of children. Method All 1646 children aged 6-8 years old in a deprived sector of an urban UK centre were screened for RAD symptoms. Parents of high and low scorers were interviewed using semi-structured interviews probing for psychopathology and individuals likely to have RAD were offered face-to-face assessment. Results Questionnaire data were available from 92.8% of teachers and 65.8% of parents. Assessments were conducted with 50% of those invited and missing data were imputed - based on the baseline data - for the rest. We calculated that there would be 23 children with definite RAD diagnoses, suggesting that the prevalence of RAD in this population was 1.40% (95% CI 0.94-2.10). Conclusions In this deprived general population, RAD was not rare.
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social use of language in children with reactive Attachment Disorder and autism spectrum Disorders
European Child & Adolescent Psychiatry, 2012Co-Authors: Fareeha Amber Sadiq, Christopher Gillberg, Louise Slator, David Skuse, Helen MinnisAbstract:Children with a diagnosis of reactive Attachment Disorder (RAD) appear to show difficulties in social understanding. We aimed to compare the pragmatic language functioning of children with (RAD) and autism spectrum Disorder (ASD). Assessments were made in three groups of children aged 5–8 years, with verbal IQ estimates in the normal range: 35 with a RAD diagnosis, 52 with an ASD diagnosis and 39 with typical development. The Children’s Communication Checklist (CCC) was used to compare their pragmatic language skills, and ADI-R algorithms were used to compare autistic symptomatology, according to parent report. According to the CCC, the RAD group demonstrated significant problems in their use of context, rapport and social relationships with a degree of severity equivalent to children in the ASD comparison group. More than 60% of the group with RAD met ADI-R clinical criteria on the Use of Language and Other Social Communication Skills subscale, 46% on the Reciprocal Social Interaction subscale, and 20% had significant repetitive and stereotyped behaviours. Children with RAD appear to be at least as impaired as children with ASD in certain domains of social relatedness, particularly in their pragmatic language skills.
Jonathan Green - One of the best experts on this subject based on the ideXlab platform.
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disinhibited Attachment Disorder in uk adopted children during middle childhood prevalence validity and possible developmental origin
Journal of Abnormal Child Psychology, 2016Co-Authors: Catherine Kay, Jonathan Green, Kishan SharmaAbstract:We investigate the prevalence, specificity and possible aetiology of Disinhibited Attachment Disorder (DAD) in adopted children without a history of institutional care. Sixty children adopted from UK out-of-home care (AD; mean age 102 months, 45 % male); 26 clinic-referred children with externalizing Disorder (ED; mean age 104 months, 77 % male) but no history of maltreatment or disrupted care; and 55 matched low-risk comparison controls (LR; mean age 108 months, 49 % male) were assessed for DAD using a triangulation of parent, teacher, and research observations. Maltreatment history and child psychiatric symptoms were obtained from parent report and child language development was assessed. DAD was identified in 49 % of AD, 4 % of ED and 6 % of LR children. Seventy-two percent of AD children had suffered maltreatment. DAD was not associated with degree of risk exposure, demographics, or language. A significant association with ADHD did not explain variance in DAD prevalence across groups. DAD was significantly more common in children first admitted to out-of-home care between 7 and 24 months, independent of maltreatment severity, age at adoption and number of care placements. Implications for developmental theory, adoption policy and clinical application are discussed.
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social cognitive deficits and biases in maltreated adolescents in uk out of home care relation to disinhibited Attachment Disorder and psychopathology
Development and Psychopathology, 2016Co-Authors: Catherine Kay, Jonathan GreenAbstract:Children entering out-of-home (OoH) care have often experienced multiple forms of maltreatment and are at risk of psychiatric Disorder and poor long-term outcome. Recent evidence shows high rates of disinhibited Attachment Disorder (DAD) among maltreated adolescents in UK OoH care (Kay & Green, 2013). This study aimed to further understand the mechanisms of outcome in this group through investigation of social cognitive functioning. Patterns of theory of mind (ToM) and social information processing were assessed alongside DAD behavior and psychopathology in 63 adolescents in UK OoH care (mean age = 176 months, SD = 22; 48% male; 89% White British) and 69 low-risk comparison adolescents (mean age = 171 months, SD = 17; 46% male; 87% White British). Compared to low risk, OoH adolescents showed a hostile attribution bias and ToM deficit, but this was confounded by language ability. ToM was associated with reduced hostile attribution and responding biases and increased social competence, which was further associated with lower levels of externalizing psychopathology. There was no association between social cognition and core features of DAD. Social cognitive deficits and biases may play a role in the high rates of externalizing psychopathology and relationship functioning difficulties in maltreated samples. Future research should assess alternative cognitive mechanisms for DAD.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:BACKGROUND: Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. METHODS: Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. RESULTS: Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. CONCLUSIONS: Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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reactive Attachment Disorder following early maltreatment systematic evidence beyond the institution
Journal of Abnormal Child Psychology, 2013Co-Authors: Catherine Kay, Jonathan GreenAbstract:Reactive Attachment Disorder (RAD) remains one of the least evidence-based areas of DSM and ICD nosology. Recent evidence from severely deprived institutional samples has informed review of RAD criteria for DSM-V; however, this data is not necessarily generalizable to expectable child environments in the developed world. We provide the first systematic study of this important syndrome in maltreated non-institutionalized adolescents from a high-income country. 153 high-risk adolescents in English out-of-home Looked After Care (LAC: mean age 174 months, SD 23, 52 % male) and 42 low-risk (LR) community controls (mean age 168 months, SD 18, 38 % male) were assessed for RAD behaviors. Data on maltreatment and care history were collected from social work reports and concurrent psychopathology from caregiver report. Triangulated data sources informed independent researcher ratings of adaptive functioning. LAC adolescents showed high prevalence of RAD behaviors. Factor analysis showed four symptom groups; Disinhibited Indiscriminate, Attention Seeking, Superficial Relationships and Unpredictability. RAD was associated with multiple maltreatment experience, earlier entry to care and increased rates of psychopathology. Superficial Relationships and Attention Seeking factors showed strong independent association with particularly pervasive functional impairment. Disinhibited RAD behaviors are identifiable with high prevalence in non-institutionalized high-risk adolescents. They are strongly associated with psychopathology and functional impairment. Retention of this subtype in DSM-V is supported. Findings on the inhibited subtype in adolescence are less persuasive. RAD behavior is a relevant marker of developmental impairment, has significant clinical implications and is deserving of further study within non-institutionalized risk populations.
David Young - One of the best experts on this subject based on the ideXlab platform.
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reactive Attachment Disorder in maltreated young children in foster care
Attachment & Human Development, 2019Co-Authors: Molly Bruce, David Young, Sue Turnbull, Maki Rooksby, Guy Chadwick, Catriona Oates, Rebecca Nelson, Genevieve Youngsouthward, Caroline Haig, Helen MinnisAbstract:Reactive Attachment Disorder (RAD) is one of the least researched and most poorly understood psychiatric Disorders. Very little is known about the prevalence and stability of RAD symptoms over time. Until recently it has been difficult to investigate RAD due to limited tools for informing a diagnosis. Utilising a newly developed observational tool along with the Disturbances of Attachment Interview. this short-term prospective longitudinal study explored RAD symptoms in maltreated young children in Scotland (n=100, age range =12-62 months) over 12 months. Children were recruited as part of The Best Services Trial (BeST?), in which all infants who came in to the care of the local authority in Glasgow due to child protection concerns were invited to participate. Prevalence of RAD was found to be 5.0% (n=5, 95% CI [0.7-9.3]) when children were first placed in to foster care. Following at least 1 year of improved care conditions, prevalence in the 76 children remaining in the study was 2.1% (n=2, 95% CI [below 0-4.7]). RAD was associated with some mental health and cognitive difficulties. While levels of carer-reported RAD symptoms decreased significantly over time, observed symptoms did not. Findings suggest that RAD resolved in a small majority of cases but further exploration in larger samples would be invaluable.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:BACKGROUND: Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. METHODS: Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. RESULTS: Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. CONCLUSIONS: Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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social relationship difficulties in autism and reactive Attachment Disorder improving diagnostic validity through structured assessment
Research in Developmental Disabilities, 2015Co-Authors: Claire Davidson, Jonathan Green, David Young, Christopher Gillberg, Anne Ohare, Fiona Mactaggart, Helen MinnisAbstract:Autism Spectrum Disorder (ASD) versus Reactive Attachment Disorder (RAD) is a common diagnostic challenge for clinicians due to overlapping difficulties with social relationships. RAD is associated with neglect or maltreatment whereas ASD is not: accurate differential diagnosis is therefore critical. Very little research has investigated the relationship between the two, and it is unknown if standardised measures are able to discriminate between ASD and RAD. The current study aimed to address these issues. Fifty eight children with ASD, and no history of maltreatment, were group matched on age with 67 children with RAD. Group profiles on multi-informant measures of RAD were investigated and group differences explored. Discriminant function analysis determined assessment features that best discriminated between the two groups. Although, according to parent report, children with ASD presented with significantly fewer indiscriminate friendliness behaviours compared to the RAD group (p<0.001), 36 children with ASD appeared to meet core RAD criteria. However, structured observation clearly demonstrated that features were indicative of ASD and not RAD for all but 1 of these 36 children. Children with RAD and children with ASD may demonstrate similar social relationship difficulties but there appears to be a difference in the social quality of the interactions between the groups. In most cases it was possible to differentiate between children with ASD and children with RAD via structured observation. Nevertheless, for a small proportion of children with ASD, particularly those whose difficulties may be more subtle, our current standardised measures, including structured observation, may not be effective in differentiating RAD from ASD.
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prevalence of reactive Attachment Disorder in a deprived population
British Journal of Psychiatry, 2013Co-Authors: Helen Minnis, David Young, Rachel Pritchett, Claire Davidson, Susan Macmillan, Brenda Wallace, John Butcher, Fiona Sim, Katie Baynham, Christopher GillbergAbstract:Background Reactive Attachment Disorder (RAD) is associated with early childhood maltreatment and has unknown population prevalence beyond infancy. Aims To estimate RAD prevalence in a deprived population of children. Method All 1646 children aged 6-8 years old in a deprived sector of an urban UK centre were screened for RAD symptoms. Parents of high and low scorers were interviewed using semi-structured interviews probing for psychopathology and individuals likely to have RAD were offered face-to-face assessment. Results Questionnaire data were available from 92.8% of teachers and 65.8% of parents. Assessments were conducted with 50% of those invited and missing data were imputed - based on the baseline data - for the rest. We calculated that there would be 23 children with definite RAD diagnoses, suggesting that the prevalence of RAD in this population was 1.40% (95% CI 0.94-2.10). Conclusions In this deprived general population, RAD was not rare.
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genetic environmental and gender influences on Attachment Disorder behaviours
British Journal of Psychiatry, 2007Co-Authors: Helen Minnis, Joanne Reekie, David Young, Thomas G Oconnor, Angelica Ronald, Alison Gray, Robert PlominAbstract:Background Despite current interest in Attachment Disorder, there is concern about its discrimination from other Disorders and an unproven assumption of an environmental aetiology. Aims To test whether behaviours suggestive of Attachment Disorder are distinct from other childhood behavioural and emotional problems and are solely environmentally determined. Method In a community sample of 13 472 twins, we carried out factor analysis of questionnaire items encompassing behaviours indicative of Attachment Disorder, conduct problems, hyperactivity and emotional difficulties. We used behavioural genetic model-fitting analysis to explore the contribution of genes and environment. Results Factor analysis showed clear discrimination between behaviours suggestive of Attachment Disorder, conduct problems, hyperactivity and emotional problems. Behavioural genetics analysis suggested a strong genetic influence to Attachment Disorder behaviour, with males showing higher heritability. Conclusions Behaviours suggestive of Attachment Disorder can be differentiated from common childhood emotional and behavioural problems and appear to be strongly genetically influenced, particularly in boys.