Development and Validation of a Measure of Attachment Disorders Based on DSM-5 Criteria: The Early TRAuma-Related Disorders Questionnaire (ETRADQ)

Abstract

Background:

A review of the scientific literature showed few valid tools for assessing reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED), two diagnostic entities traditionally grouped under “attachment disorders.” The Early TRAuma-related Disorders Questionnaire (ETRADQ), a caregiver report, was developed to assess attachment disorders in school-age children based on the Diagnostic and Statistical Manual of Mental Disorders–Fifth edition criteria. This study sought to validate this instrument.

Method:

Caregivers of school-age children from the community (n = 578) and caregivers of at-risk children adopted or in out-of-home care (n = 245) completed a sociodemographic questionnaire, the ETRADQ, the Relationship Problem Questionnaire, the RADA (RAD and DSED Assessment) interview, and the Barkley Functional Impairment Scale for Children and Adolescents.

Results:

Confirmatory factor analysis of the ETRADQ items supported the expected organization of the measure, that is, two second-order factors and five subfactors: (1) RAD scale (three subscales: Low selective attachment, Low social and emotional responsiveness, Emotional unpredictability) and (2) DSED scale (two subscales: Interactions with unfamiliar adults, Social disinhibition). All scales showed excellent internal consistency, test–retest reliability, convergent validity, and known-group validity.

Conclusions:

Results support the reliability and validity of the ETRADQ.

Keywords

reactive attachment disorder disinhibited social engagement disorder attachment disorders questionnaire maltreatment out-of-home care child protective services

Get full access to this article

View all access options for this article.

References

Allen

(2018). Misperceptions of reactive attachment disorder persist: Poor methods and unsupported conclusions. Research in Developmental Disabilities, 77(June), 24-29. https://doi.org/10.1016/j.ridd.2018.03.012

American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Author.

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author.

Atkinson

(2019). Reactive attachment disorder and attachment theory from infancy to adolescence: Review, integration, and expansion. Attachment & Human Development, 21(2), 205-217. https://doi.org/10.1080/14616734.2018.1499214

Barkley

R. A.

(2012). Barkley Functional Impairment Scale for children and adolescents. Guildford Press.

Blunch

N. J.

(2013). Introduction to structural equation modelling using SPSS and Amos. Sage.

Boris

N. W.

Zeanah

C. H.

Larrieu

J. A.

Scheeringa

M. S.

Heller

(1998). Attachment disorders in infancy and early childhood: A preliminary investigation of diagnostic criteria. American Journal of Psychiatry, 155(2), 295-297. https://doi.org/10.1176/ajp.155.2.295

Bruce

Young

Turnbull

Rooksby

Chadwick

Oates

Nelson

Young-Southward

Haig

Minnis

(2019). Reactive attachment disorder in maltreated young children in foster care. Attachment & Human Development, 21(2), 152-169. https://doi.org/10.1080/14616734.2018.1499211

Byrne

B. M.

Stewart

S. M.

(2006). Teacher’s Corner: The MACS approach to testing for multigroup invariance of a second-order Structure: A walk through the process. Structural Equation Modeling: A Multidisciplinary Journal, 13(2), 287–32. https://doi.org/10.1207/s15328007sem1302_7

10.

Cadman

Diamond

P. R.

Fearon

(2018). Reassessing the validity of the Attachment Q-Sort: An updated meta-analysis. Infant and Child Development, 27(1), e2034. https://doi.org/10.1002/icd.2034

11.

Chen

F. F.

Sousa

K. H.

West

S. G.

(2005). Teacher’s corner: testing measurement invariance of second-order factor models. Structural Equation Modeling: A Multidisciplinary Journal, 12(3), 471–492. https://doi.org/10.1207/s15328007sem1203_7

12.

Corval

Belsky

Baptista

Mesquita

Soares

(2019). Development and validation of an observational measure of symptoms of reactive attachment disorder. Attachment & Human Development, 21(2), 111-131. https://doi.org/10.1080/14616734.2018.1499209

13.

Davidson

O’Hare

Mactaggart

Green

Young

Gillberg

Minnis

(2015). Social relationship difficulties in autism and reactive attachment disorder: Improving diagnostic validity through structured assessment. Research in Developmental Disabilities, 40(May), 63-72. https://doi.org/10.1016/j.ridd.2015.01.007

14.

Del Giudice

. (2019). Sex differences in attachment styles. Current Opinion in Psychology, 25(February), 1-5. https://doi.org/10.1016/j.copsyc.2018.02.004

15.

Dobrova-Krol

N. A.

Bakermans-Kranenburg

M. J.

van Ijzendoorn

M. H.

Juffer

(2010). The importance of quality of care: Effects of perinatal HIV infection and early institutional rearing on preschoolers’ attachment and indiscriminate friendliness. Journal of Child Psychology and Psychiatry, 51(12), 1368-1376. https://doi.org/10.1111/j.1469-7610.2010.02243.x

16.

Enders

C. K.

(2001). A primer on maximum likelihood algorithms available for use with missing data. Structural Equation Modeling, 8(1), 128-141. https://doi.org/10.1207/S15328007SEM0801_7

17.

Gleason

M. M.

Fox

N. A.

Drury

S. S.

Smyke

A. T.

Nelson

C. A.

Zeanah

C. H.

(2014). Indiscriminate behaviors in previously institutionalized young children. Pediatrics, 133(3), e657-e665. https://doi.org/10.1542/peds.2013-0212

18.

Hall

S. E. K.

Geher

(2003). Behavioral and personality characteristics of children with reactive attachment disorder. Journal of Psychology, 137(2), 145-162. https://doi.org/10.1080/00223980309600605

19.

Hanson

R. F.

Spratt

E. G.

(2000). Reactive attachment disorder: What we know about the disorder and implication for treatment. Child Maltreatment, 5(2), 137–145.

20.

Bentler

P. M.

(1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling: A Multidisciplinary Journal, 6(1), 1-55. https://doi.org/10.1080/10705519909540118

21.

Jackson

D. L.

Gillaspy

J. A.

Purc-Stephenson

(2009). Reporting practices in confirmatory factor analysis: An overview and some recommendations. Psychological Methods, 14(1), 6-23. https://doi.org/10.1037/a0014694

22.

JASP Team. (2020). JASP (Version 0.13.1) [Computer software]. https://jasp-stats.org/2020/07/21/jasp-0-13-1-small-fixes/

23.

Jonkman

C. S.

Oosterman

Schuengel

Bolle

E. A.

Boer

Lindauer

R. J.

(2014). Disturbances in attachment: Inhibited and disinhibited symptoms in foster children. Child and Adolescent Psychiatry and Mental Health, 8, Article 21. https://doi.org/10.1186/1753-2000-8-21

24.

Kay

Green

(2013). Reactive attachment disorder following early maltreatment: Systematic evidence beyond the institution. Journal of Abnormal Child Psychology, 41(4), 571-581. https://doi.org/10.1007/s10802-012-9705-9

25.

Kay

Green

Sharma

(2016). Disinhibited attachment disorder in UK adopted children during middle childhood: Prevalence, validity and possible developmental origin. Journal of Abnormal Child Psychology, 44(7), 1375-1386. https://doi.org/10.1007/s10802-016-0131-2

26.

Kazdin

A. E.

(1998). Research design in clinical psychology (3rd ed.). Allyn & Bacon.

27.

Kliewer-Neumann

J. D.

Zimmermann

Bovenschen

Gabler

Lang

Spangler

Nowacki

(2018). Assessment of attachment disorder symptoms in foster children: Comparing diagnostic assessment tools. Child and Adolescent Psychiatry and Mental Health, 12, Article 43. https://doi.org/10.1186/s13034-018-0250-3

28.

Kočovská

Puckering

Follan

Smillie

Gorski

Barnes

Wilson

Young

Lidstone

Pritchett

Hockday

Minnis

(2012). Neurodevelopmental problems in maltreated children referred with indiscriminate friendliness. Research in Developmental Disabilities, 33(5), 1560-1565. https://doi.org/10.1016/j.ridd.2012.02.016

29.

Lalande

Cyr

Dubois-Comtois

Losier

Paquette

Emery

(2014). Les comportements d’attachement indiscriminé chez les enfants de mères adolescentes: Étiologie et facteurs de risque [Indiscriminate attachment behavior among infants of adolescent mothers: Etiology and risk factors.]. Canadian Journal of Behavioural Science/Revue canadienne des sciences du comportement, 46(2), 73-83. https://doi.org/10.1037/a0027426

30.

Lawler

J. M.

Koss

K. J.

Doyle

C. M.

Gunnar

M. R.

(2016). The course of early disinhibited social engagement among post-institutionalized adopted children. Journal of Child Psychology and Psychiatry, 57(10), 1126–1134. https://doi.org/10.1111/jcpp.12606

31.

Lehmann

Breivik

Heiervang

E. R.

Havik

O. E.

(2016). Reactive attachment disorder and disinhibited social engagement disorder in school-aged foster children: A confirmatory approach to dimensional measures. Journal of Abnormal Child Psychology, 44(3), 445-457. https://doi.org/10.1007/s10802-015-0045-4

32.

Lehmann

Havik

O. E.

Havik

Heiervang

E. R.

(2013). Mental disorders in foster children: A study of prevalence, comorbidity and risk factors. Child and Adolescent Psychiatry and Mental Health, 7, Article 39. https://doi.org/10.1186/1753-2000-7-39

33.

Lehmann

Monette

Egger

Breivik

Young

Davidson

Minnis

(2018). Development and examination of the reactive attachment disorder and disinhibited social engagement disorder assessment interview. Assessment, 27(4), 749-765. https://doi.org/10.1177/1073191118797422

34.

McLaughlin

Espie

Minnis

(2010). Development of a brief waiting room observation for behaviours typical of reactive attachment disorder. Child and Adolescent Mental Health, 15(2), 73-79. https://doi.org/10.1111/j.1475-3588.2009.00549.x

35.

Minnis

Green

O’Connor

T. G.

Liew

Glaser

Taylor

Follan

Young

Barnes

Gilberg

Pelosi

Arthur

Burston

Sadiq

F. A.

(2009). An exploratory study of the association between reactive attachment disorder and attachment narratives in early school-age children. Journal of Child Psychology and Psychiatry, 50(8), 931-942. https://doi.org/10.1111/j.1469-7610.2009.02075.x

36.

Minnis

Macmillan

Pritchett

Young

Wallace

Butcher

Sim

Baynham

Davidson

Gillberg

(2013). Prevalence of reactive attachment disorder in a deprived population. British Journal of Psychiatry, 202(5), 342-346. https://doi.org/10.1192/bjp.bp.112.114074

37.

Minnis

Rabe-Hesketh

Wolkind

(2002). Development of a brief, clinically relevant, scale for measuring attachment disorders. International Journal of Methods in Psychiatric Research, 11(2), 90-98. https://doi.org/10.1002/mpr.127

38.

Müller

J. M.

Furniss

(2013). Correction of distortions in distressed mothers’ ratings of their preschool children’s psychopathology. Psychiatry Research, 210(1), 294-301. https://doi.org/10.1016/j.psychres.2013.03.025

39.

Muthén

L. K.

Muthén

B. O.

(2017). Mplus user’s guide (8th ed.). Muthén & Muthén.

40.

O’Connor

T. G.

Bredenkamp

Rutter

& The English and Romanian Adoptees (ERA) Study Team. (1999). Attachment disturbances and disorders in children exposed to early severe deprivation. Infant Mental Health Journal, 20(1), 10-29. https://doi.org/10.1002/(SICI)1097-0355(199921)20:1<10::AID-IMHJ2>3.0.CO;2-S

41.

Oosterman

Schuengel

(2008). Attachment in foster children associated with caregivers’ sensitivity and behavioral problems. Infant Mental Health Journal, 29(6), 609-623. https://doi.org/10.1002/imhj.20198

42.

Pears

K. C.

Bruce

Fisher

P. A.

Kim

H. K.

(2010). Indiscriminate friendliness in maltreated foster children. Child Maltreatment, 15(1), 64-75. https://doi.org/10.1177/1077559509337891

43.

Putnick

D. L.

Bornstein

M. H.

(2016). Measurement invariance conventions and reporting: The state of the art and future directions for psychological research. Developmental Review, 41(September), 71-90. https://doi.org/10.1016/j.dr.2016.06.004

44.

Randolph

E. M.

(2000). Manual for the Randolph Attachment Disorder Questionnaire (3rd ed.). Attachment Center Press.

45.

Ringoot

A. P.

van der Ende

Jansen

P. W.

Measelle

J. R.

Basten

Jaddoe

V. W. V.

Hofman

Verhulst

F. C.

Tiemeier

(2015). Why mothers and young children agree or disagree in their reports of the child’s problem behavior. Child Psychiatry & Human Development, 46(6), 913-927. https://doi.org/10.1007/s10578-014-0531-x

46.

Scheffer

(2002). Dealing with missing data. Research Letters in the Information and Mathematical Sciences, 3, 153-160. https://mro.massey.ac.nz/handle/10179/4355

47.

Seim

A. R.

Jozefiak

Wichstrøm

Kayed

N. S.

(2019). Validity of reactive attachment disorder and disinhibited social engagement disorder in adolescence. European Child & Adolescent Psychiatry. https://doi.org/10.1007/s00787-019-01456-9

48.

Smyke

A. T.

Dumitrescu

Zeanah

C. H.

(2002). Attachment disturbances in young children. I: The continuum of caretaking casualty. Journal of the American Academy of Child & Adolescent Psychiatry, 41(8), 972-982. https://doi.org/10.1097/00004583-200208000-00016

49.

Sonuga-Barke

E. J. S.

Kennedy

Kumsta

Knights

Golm

Rutter

Maughan

Schlotz

Kreppner

(2017). Child-to-adult neurodevelopmental and mental health trajectories after early life deprivation: The young adult follow-up of the longitudinal English and Romanian Adoptees study. Lancet, 389(10078), 1539-1548. https://doi.org/10.1016/S0140-6736(17)30045-4

50.

van Ijzendoorn

M. H.

Vereijken

C. M. J. L.

Bakermans-Kranenburg

M. J.

Riksen-Walraven

J. M

. (2004). Assessing attachment security with the Attachment Q Sort: Meta-analytic evidence for the validity of the observer AQS. Child Development, 75(4), 1188-1213. https://doi.org/10.1111/j.1467-8624.2004.00733.x

51.

Vervoort

De Schipper

Bosmans

Verschueren

(2013). Screening symptoms of reactive attachment disorder: Evidence for measurement invariance and convergent validity. International Journal of Methods in Psychiatric Research, 22(3), 256-265. https://doi.org/10.1002/mpr.1395

52.

West

S. G.

Taylor

A. B.

(2012). Model fit and model selection in structural equation modeling. In Hoyle

R. H.

(Ed.), Handbook of structural equation modeling (pp. 209-231). Guilford Press.

53.

Woolgar

Baldock

(2015). Attachment disorders versus more common problems in looked after and adopted children: Comparing community and expert assessments. Child and Adolescent Mental Health, 20(1), 34-40. https://doi.org/10.1111/camh.12052

54.

World Health Organization. (1992). ICD-10 classification of mental and behavioural disorders: Clinical descriptions and diagnostic guidelines. Author.

55.

Zeanah

C. H.

Chesher

Boris

N. W.

Walter

H. J.

Bukstein

O. G.

Bellonci

Benson

R. C.

Bussing

Chrisman

Hamilton

Hayek

Keable

Rockhill

Siegel

Stock

(2016). Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder. Journal of the American Academy of Child & Adolescent Psychiatry, 55(11), 990-1003. https://doi.org/10.1016/j.jaac.2016.08.004

56.

Zeanah

C. H.

Gleason

M. M.

(2015). Annual research review: Attachment disorders in early childhood—clinical presentation, causes, correlates, and treatment. Journal of Child Psychology and Psychiatry, 56(3), 207-222. https://doi.org/10.1111/jcpp.12347

57.

Zeanah

C. H.

Humphreys

K. L.

Fox

N. A.

Nelson

C. A.

(2017). Alternatives for abandoned children: Insights from the Bucharest Early Intervention Project. Current Opinion in Psychology, 15(June), 182-188. https://doi.org/10.1016/j.copsyc.2017.02.024

58.

Zeanah

C. H.

Scheeringa

Boris

N. W.

Heller

S. S.

Smyke

A. T.

Trapani

(2004). Reactive attachment disorder in maltreated toddlers. Child Abuse & Neglect, 28(8), 877-888. https://doi.org/10.1016/j.chiabu.2004.01.010

59.

Zimmermann

Iwanski

(2019). Attachment disorder behavior in early and middle childhood: Associations with children’s self-concept and observed signs of negative internal working models. Attachment & Human Development, 21(2), 170-189. https://doi.org/10.1080/14616734.2018.1499212

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.46 MB

0.51 MB