title: Disinhibited Attachment Disorder in UK Adopted Children During Middle Childhood: Prevalence, Validity and Possible Developmental Origin.
abstract: We investigate the prevalence, specificity and possible aetiology of Disinhibited Attachment Disorder (DAD) in adopted children without a history of institutional care. Sixty children adopted from UK out-of-home care (AD; mean age 102 months, 45 % male); 26 clinic-referred children with externalizing disorder (ED; mean age 104 months, 77 % male) but no history of maltreatment or disrupted care; and 55 matched low-risk comparison controls (LR; mean age 108 months, 49 % male) were assessed for DAD using a triangulation of parent, teacher, and research observations. Maltreatment history and child psychiatric symptoms were obtained from parent report and child language development was assessed. DAD was identified in 49 % of AD, 4 % of ED and 6 % of LR children. Seventy-two percent of AD children had suffered maltreatment. DAD was not associated with degree of risk exposure, demographics, or language. A significant association with ADHD did not explain variance in DAD prevalence across groups. DAD was significantly more common in children first admitted to out-of-home care between 7 and 24 months, independent of maltreatment severity, age at adoption and number of care placements. Implications for developmental theory, adoption policy and clinical application are discussed.
authors: Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK. catherine.kay@manchester.ac.uk.|Room 3.316, Jean McFarlane Building, University of Manchester, Oxford Road, Manchester, England, M13 9PL, UK. catherine.kay@manchester.ac.uk.
authors: Catherine
authors: C
authors: Kay
authors: Institute of Brain Behaviour and Mental Health, University of Manchester, Manchester, UK.
authors: Jonathan
authors: J
authors: Green
authors: Pennine Care NHS Foundation Trust, Manchester, UK.
authors: Kishan
authors: K
authors: Sharma
mesh_terms: D000300:Adoption / Q000523:psychology*; D000367:Age Factors; D002648:Child; D002649:Child Abuse / Q000523:psychology; D005260:Female; D006801:Humans; D008297:Male; D011599:Psychopathology; D019962:Reactive Attachment Disorder / Q000453:epidemiology* / Q000209:etiology / Q000523:psychology; D006113:United Kingdom / Q000453:epidemiology
keywords: Adoption; Attachment disorder; Externalizing psychopathology; Maltreatment