Re: reactive attachment disorder

[<FrampD@xxxxxxx>]

We just recently tried a case in Charleston, S.C. involving a diagnosis of
Reactive Attachment Disorder.  According to the DSM4 (Code 313.89), "The
essential feature of Reactive Attachment Disorder is markedly disturbed and
developmentally inappropriate social relatedness in most contexts that begins
before age 5 years and is associated with grossly pathological care . . . ."
(Emphasis added).  There are 2 main subtypes:  (1) inhibited type, where the
child has difficulty "bonding" or interacting in social situations, and (2)
disinhibited type, where the child indiscriminately "bonds" or attaches to
persons in his or her environment.  In our case, the child was removed after a
pattern of neglect and severe abuse "tantamount to torture" (in the words of
the Family Court Judge), and, from the admitting nurse to the foster parent,
called every female "mommy."  I don't know of any current literature or
research on this disorder, but the consideration of this as a differential
diagnosis in many cases of maltreatment to young children seems to be
appropriate in light of the quoted language from the DSM.

Frampton Durban, Jr.
Chief Legal Counsel
Charleston County DSS
3366 Rivers Avenue
North Charleston, S. C. 29405
(843) 740-0625
FAX (843) 740-0629