By attachment, we mean the affective bond that is created between a living being and another individual of the same species, for example a child and its mother, the purpose of which is to seek contact and communication to ensure support.
There are different types of attachment that depend to a large extent on how the caregiver meets the needs of the child. Also, alterations of this link can lead to pathological attachment, which is classified into two different types. On the one hand, reactive attachment disorder, characterized by inhibited, depressed and withdrawn behavior; and on the other hand the disorder of the uninhibited social relationship, where one observes an overly familiar behavior with unknown adults.
In this article we will see what the concept of pathological attachment isexplaining the different types of attachment that exist and what disorders are linked to pathological attachment.
What do we mean by attachment?
Attachment, or attachment in English, is the emotional bond that appears between a person or animal and another living being of the same species. The main purpose of this bond is to ensure the safety of the child, who seeks physical contact and communicates with his attachment figure. This process begins at 12 months of age and continues throughout life.
One of the main exponents of the study of attachment was John Bowlby, who pointed out that the child is particularly sensitive to the separation of the security digit between 6 months and 2 years, which can lead to various physiological and psychological if given. This greater vulnerability coincides with the period of establishment of the attachment which goes from 7 to 24 months, the bond intensifies and appears a greater discomfort in front of the separation and anguish in front of the strangers.
Shortly after the separation, the child may experience stress, restlessness and depressive symptoms. First there is a phase of protest before the departure, then there is the phase of ambivalence in front of the new carer and before the old one if he returns and finally the phase of acceptance of the new bond. In the long term, when the lack of attachment persists, the effects that can lead to a bad separation are more serious, such as intellectual deficit, problems in social interactions or even death.
Another relevant author in the study of attachment was Mary Ainsworth, who carried out an experiment known as the strange situation, which raises different situations such as the presence of a stranger, separation from the mother or the return of the attachment figure, is this last situation for which Ainsworh attaches particular importance to the determination of the type of attachment of each child.
In the same way too The mother’s sensitivity to the needs of the baby will be crucial, thus providing security to be able to explore. With the results he obtained, he raised three basic types of attachment, present in all cultures: assurance is the most widespread, the child complains of the mother’s departure but is comforted when he comes back and explores when present.
On the other hand, the two insecurities are: the evasive or elusive, where no embarrassment is perceived before the separation, the child ignores the mother on his return and is very sociable with the stranger; and the ambivalent or resistant, in which the child shows great discomfort at the separation and does not feel comforted when the mother returns, resists it.
Later he enrolled another type called disorganized or disorientedwhich consists of a mixture of the two precarious, exhibiting inconsistent and contradictory behaviors, is the least safe.
Addiction disorders and pathological addiction
Now that we know how attachment is defined and what types of attachment there are, it will be easier to understand the disorders that can arise if the bond is altered. As we have already pointed out, Bowlby considers that the early years are essential for the correct establishment of attachment, in particular social neglect, which refers to a lack of caregiver during childhood, is decisive for the development and diagnosis of pathological attachment.
The fifth edition of the American Psychiatric Association’s Diagnostic Manual classifies attachment disorders in the chapter on trauma-related disorders and stressors. Pathological grief is also divided into two diagnostic categories: Reactive Attachment Disorder, characterized by internal symptoms such as depression or withdrawal, and Uninhibited Social Relationship Disorder, characterized by the presentation of externalizing symptoms. with greater disinhibition.
1. Reactive Attachment Disorder
In Reactive Attachment Disorder he shows a withdrawn and inhibited behavior towards the environment and even towards the attachment figure, accompanied by two main symptoms. Thus, when the child feels stressed or distressed, he does not seek or ask for comfort, and if he is comforted or reassured, the child shows no response.
Also social and emotional impairment is observed which is expressed by two or more of the following symptoms: minimal emotional and social response to others, weak positive affection or feeling of sadness, irritability, shyness which appears even before the support figure.
Another criterion to be met is the presence of pathological parenting due to any of the following: the adult fails to meet or ignores the child’s basic emotional needs; rejection of the child’s basic physical needs or repeated changes in the support figure that make it difficult to form the right bond.
The prevalence of reactive attachment disorder is unknown, but it is not uncommon, since in situations where the child has not received adequate care, it occurs only in less than 10% of subjects. It is believed that if the child with this disorder does not receive adequate intervention, the symptoms tend to persist.
2. Uninhibited Social Relationship Disorder
Disinhibited social relations disorder is another disorder related to pathological attachment, it is characterized by a pattern of behavior where the child interacts with strange adults and is overly sociableplus two or more of the following symptoms: Shows no reluctance to approach strangers, Shows excessively familiar behavior with strangers, Does not check or value caregiver’s opinion when approaching strangers or going with a unknown adult without hesitation.
The behaviors observed are uninhibited, but they are not solely due to impulsivity. At least one of the caring mode alterations must be present: basic emotional needs are not met, they are neither stimulated nor comforted; repeated changes of caregivers; or parenting in unusual places that make bonding difficult, such as institutions with insufficient numbers of caregivers. Alterations in uninhibited behavior are due to impaired bond formation.
It is also noted that the child must be at least 9 months old, so the development of attachment began. It can be specified as persistent if the symptoms have been present for more than 12 months and the current severity of the disorder is severe when all the symptoms with severe involvement are present.
Abnormal social behavior is typical given the culture of the subject, where the child constantly tries to get attention and emotional and behavioral alterations may occur, with difficulty establishing relationships with peers.
Although uninhibited social disorders and attention deficit hyperactivity disorder (ADHD) can be diagnosed together, it is necessary to differentiate between them. In the case of an uninhibited disorder, despite the possibility of exhibiting impulsive behaviors, attention deficit and hyperactivity will not be observed.
As in the other pathological attachment disorder, the prevalence of the disorder uninhibited is unknown, although thought to be uncommon. even in situations where parenting styles are inadequate, only about 20% of subjects exhibit this alteration.
Concerning the evolution of the psychic disorder, it remains stable with some variations according to the age of the subject. For example, when he is two years old, he manifests a sticky behavior of non-selective bonding, that is to say without differentiation between known and unknown subjects; at the age of 4 years, they seek affection indiscriminately; during early childhood, they need constant affection and in adolescence, they express uninhibited behaviors and interpersonal conflicts. This condition has not been observed in adults.