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Attachment Disorder

Question:

I’m a teacher. I have a student diagnosed with attachment disorder. My question is – does attachment disorder also mean conduct conduct disorder? He can become violent by kicking, hitting, blurting out while other times he totally shuts down. He also seeks my constant attention. When he has a good day the class and me have a good day; when he has a bad day we all have a bad day. Please help if you can. I am exhausted! Thank you for this consideration and website.

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Answer:

All diagnoses are human-made constructs that don’t actually exist in reality. Diagnoses change over time, and there are political as well as scientific processes that shapes how they change. In the current psychiatric bible, (the Diagnostic and Statistical Manual of Mental Disorders, 4th edition, Text Revision) Attachment Disorder and Conduct Disorder are considered distinct entities. Are they really? Well, yes, I think so in many cases, but I don’t doubt that there is a subset of Attachment Disordered kids who are also Conduct Disordered. Your young student may possibly have the distinction of meriting both diagnoses.

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p> Attachment Disorder (really, ‘Reactive Attachment Disorder of Childhood’) has as its criteria inappropriate social relatedness manifesting in either inhibited or disinhibited behavior towards others (which could include hostility, aggression and self-centeredness, but could also manifest as intense shyness and avoidance), and evidence of a disruption in the normal infant-caregiver relationship (e.g., abuse and/or neglect). Attachment Disorder can be thought of as a ’cause and effect’ or ‘theoretical’ disorder definition in that troubled behavior is being observed, and it is being related backwards to early developmental problems which are thought to be the causative factors in producing the troubled behavior. Conduct Disorder, on the other hand, is simply marked by signs of anti-social behavior displayed at a young age which can include: aggression towards people and/or animals, property destruction, lying and stealing, and other serious violations of social rules. Conduct disorder is always marked by disinhibited behavior, but not so Attachment Disorder which can be expressed as disinhibited or inhibited behavior.

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