Mental health articles

It has long been recognised that infants and children exposed to disturbed and
traumatising early care may have long-term difficulties in emotional interaction
and relationships. Only recently, however, have there been attempts to describe
the mechanisms involved in some of the observed longer term difficulties, or to
describe and classify types of attachment disorders. One of the ongoing
discussions in the theoretical literature relates to the nature of these proposed
disorders and at what point an infant or child can be said to have an individual
disorder that lies within, particularly when the origins of the problem can be
identified in the attachment relationship itself. Also, it is unclear how attachment
disorders relate to the classification of insecure attachment, given that insecure
attachment occurs in ‘normal’ populations and is not seen as a disorder, nor does
it usually result in an attachment disorder. Recent work on the developmental
implications of early disorganised attachment may help clarify this question, as
it suggests that attachment disorganisation rather than attachment insecurity
can disrupt relationship and personality development, and is related to
psychological disorder in later life.
Early studies of attachment difficulties resulting from traumatic early care
included the descriptions of indiscriminate sociability in institutionalised
children during the Second World War (such as the studies of Burlington &
Freud, 1944). Bowlby (1944) was also interested in the effects of early
deprivation of care and described a form of emotional detachment and avoidance
of interaction in children who had experienced separation from attachment
figures. These two varieties of attachment abnormality are sometimes described
as disinhibited and inhibited patterns and this is reflected in the current DSM
classification system, which first included attachment disorder in the 1980
DSM-III (American Psychiatric Association [APA], 1980).

Tags: attachment, disorders