Temperament and attachment disorders

Reviewed in this article is research on children with reactive attachment disorder (RAD) who exhibit specific patterns of socially aberrant behavior resulting from being maltreated or having limited opportunities to form selective attachments. There are no data explaining why 2 different patterns of the disorder, an emotionally withdrawn-inhibited pattern and an indiscriminate-disinhibited pattern, arise from similarly aberrant environments. In this article, we consider whether temperamental differences might contribute to the different manifestations of reactive attachment disorder (RAD) in the context of adverse environments. Although the association between attachment and temperament has been studied extensively and has been the subject of spirited debate within the field of child development, there are no extant data on the influence of temperament on the development of attachment disorders. We consider possible directions for research efforts designed to explore the biological underpinnings of the complex phenomenon of attachment disorders.