title: Disturbances in attachment: inhibited and disinhibited symptoms in foster children.
abstract: BACKGROUND
  Previous DSM-versions recognized an inhibited and a disinhibited subtype of the Reactive Attachment Disorder (RAD). The current DSM-5 distinguishes two different disorders, instead of two subtypes of RAD. This study examined whether a split-up of the subtypes is valid.
  
  
  METHODS
  In 126 foster children, attachment disorder symptoms were assessed with the Disturbances of Attachment Interview. Forms of pathogenic care were identified based on dossier analyses. Associations between symptoms of attachment disorder with internalizing and externalizing problems (Child Behavior Checklist and Teacher Report Form) were examined.
  
  
  RESULTS
  Omnibus tests showed no significant association between type of symptoms and type of pathogenic care. Exploratory analyses did reveal an univariate association between disinhibited symptoms and history of physical abuse. Disinhibited symptoms were associated with more internalizing and externalizing problems (d's < 0.50).
  
  
  CONCLUSIONS
  The distinction of inhibited and disinhibited subtypes of RAD seems valid regarding their emotional and behavioral correlations. Whereas inhibited symptoms lack a correlation, disinhibited symptoms seem to have an externalizing and internalizing correlation.
  
  
  BACKGROUND
  NTR1747.
authors: Department of Child and Adolescents Psychiatry, Academic Medical Center, University of Amsterdam and with De Bascule, Academic Center for Child and Adolescents Psychiatry, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands.
authors: Caroline S
authors: CS
authors: Jonkman
authors: Department of Clinical Child and Family Studies and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
authors: Mirjam
authors: M
authors: Oosterman
authors: Department of Clinical Child and Family Studies and the EMGO Institute for Health and Care Research, VU University Amsterdam, Amsterdam, The Netherlands.
authors: Carlo
authors: C
authors: Schuengel
authors: Department of Child and Adolescents Psychiatry, Academic Medical Center, University of Amsterdam and with De Bascule, Academic Center for Child and Adolescents Psychiatry, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands.
authors: Eva A
authors: EA
authors: Bolle
authors: Department of Child and Adolescents Psychiatry, Academic Medical Center, University of Amsterdam and with De Bascule, Academic Center for Child and Adolescents Psychiatry, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands.
authors: Frits
authors: F
authors: Boer
authors: Department of Child and Adolescents Psychiatry, Academic Medical Center, University of Amsterdam and with De Bascule, Academic Center for Child and Adolescents Psychiatry, Meibergdreef 5, Amsterdam 1105 AZ, The Netherlands.
authors: Ramon Jl
authors: RJ
authors: Lindauer