《婴儿与儿童早期反应性依赖障碍的儿童和青少年患者的评价和治疗指南》内容预览:

This parameter reviews the current status of reactive attachment disorder with regard to assessment and treatment. Attachment is a central component of social and emotional develop-ment in early childhood, and disordered attachment is defined by specific patterns of abnormal social behavior in the context of “pathogenic care.” Clinically relevant subtypes include an emotionally withdrawn/inhibited pattern and a socially indiscriminate/disinhibited pattern. As-sessment requires direct observation of the child in the context of his/her relationships with pri-mary caregivers. Treatment requires establishing an attachment relationship for the child when none exists and ameliorating disturbed attachment relationships with caregivers when they are evident. Coercive treatments with children with attachment disorders are potentially dangerous and not recommended. Key Words: attachment, reactive attachment disorder, indiscriminate behavior, practice parameter, practice guideline.

This parameter was developed by Neil W. Boris, M.D., and Charles H. Zeanah, M.D., and the Work Group on Quality Issues: William Bernet, M.D., and Oscar G. Bukstein, M.D., Co-Chairs, and Valerie Arnold, M.D., Joseph Beitchman, M.D., R. Scott Benson, M.D., Joan Kinlan, M.D., Jon McClellan, M.D., Jon Shaw, M.D., and Saundra Stock, M.D. AACAP staff: Kristin Kroeger Ptakowski. The following individuals reviewed and submitted comments on an earlier draft of this document: Lucy Berliner, Ph.D., Robert J. Harmon, M.D., Tom O’Connor, Ph.D., and Carlo Schuengel, Ph.D.

This parameter was reviewed at the member forum at the 2003 annual meeting of the American Academy of Child and Adolescent Psychiatry.During October to December 2004 a consensus group reviewed and finalized the content of this practice parameter. The consensus group consisted of representatives of relevant AACAP components as well as independent experts: William Bernet, M.D., Chair; Neil W. Boris, M.D., and Charles H. Zeanah, M.D., authors of the parameter; R. Scott Benson, M.D., and Ulrich Schoettle, M.D., representatives of the Work Group on Quality Issues; Michael Houston, M.D., and Rachel Z. Ritvo, M.D., representatives of the AACAP Council; Syed Naqvi, M.D., and Mary W. Roberts, M.D., representatives of the AACAP Assembly of Regional Organizations;Robert J. Harmon, M.D., and Helen Link Egger, M.D., independent expert reviewers; and Kristin Kroeger Ptakowski, Director of Clinical Affairs, AACAP.

This practice parameter was approved by AACAP Council on February 1, 2005.This practice parameter is available on the Internet (www.aacap.org). Reprint requests to the AACAP Communications Department, 3615 Wisconsin Ave., NW, Washington, D.C. 20016..2005 by the American Academy of Child and Adolescent Psychiatry.sociated with aberrant social behaviors in young children. Reactive attachment disorder (RAD) is the clinical disorder that defines distinctive patterns of aberrant behavior in young children who have been maltreated or raised in environments that limit opportunities to form selective attachments. Although there are few studies of children diagnosed with RAD using the DSM-IV-TR (APA, 2000) criteria, there is growing consensus about both principles of assessment of RAD and safe and effective treatments for RAD. This parameter describes the assessment and treat-ment of reactive attachment disorder......

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