Reactive Attachment Disorder Symptoms in Teenagers

Symptoms of reactive attachment disorder in teenagers can include behavioral and social issues.

Reactive attachment disorder is a mental health disorder that occurs when a child’s emotional and physical needs aren’t met by their caregivers. The symptoms of reactive attachment disorder in teens can include behavioral issues, trouble forming relationships with others, and avoiding physical affection.

Although serious, this disorder can be treated. Appropriate treatment can help children and teens with reactive attachment disorder form healthy, stable bonds with others.

Children and teens can develop reactive attachment disorder if they don’t form healthy bonds with their caregivers. The disorder usually occurs when children are abused or neglected — emotionally or physically — at an early age. When left untreated, the condition can prevent them from forming healthy bonds with their caregivers.

The symptoms of reactive attachment disorder in teens may include:

• aggressive behavior
• angry outbursts
• avoiding physical affection
• avoiding caregivers and other family members
• behavioral problems at school, home, or both
• control issues, including wanting to control friends
• difficulty forming close bonds with others
• difficulty making friends
• difficulty regulating their emotions
• hypervigilance
• ignoring or not engaging with close family
• irritability
• lacking trust in caregivers and other adults
• low self-esteem
• not asking for help or comfort
• not engaging in social interaction
• not responding to affection or comfort
• observing others closely but rarely reacting or engaging
• harmful behavior (such as substance use, sex not protected by condoms or other barrier methods, criminal behavior)
• withdrawn, sad disposition

Teens with reactive attachment disorder are likely to also have other mental health conditions, according to recent research .

Although these are typical symptoms of reactive attachment disorder, it’s important to have your teenager assessed by a professional. Some of these symptoms may be caused by other conditions, including autism, post-traumatic stress disorder (PTSD), and depression.

Early symptoms of an attachment disorder

The symptoms of an attachment disorder might be noticeable before your child reaches adolescence. In fact, the symptoms are often present during infancy.

The early symptoms of an attachment disorder include:

• avoiding eye contact
• crying inconsolably
• never (or rarely) smiling
• not laughing or making sounds
• not showing interest in interactive games like peekaboo
• not reaching for caregivers
• rejecting or ignoring attempts to bond
• seeming unaffected when left alone
• rarely looking for comfort when distressed

Of course, the above symptoms must be assessed in relation to your child’s age. Depending on their age, it might be developmentally typical for them to not laugh or smile (yet).

If you suspect your child has reactive attachment disorder, the first step is to talk with your pediatrician. They’ll be able to advise you on whether your child’s behavior is atypical. If necessary, they can refer you to another specialist, such as a psychiatrist or psychologist, for assessment.

At what age does reactive attachment disorder typically occur?

Reactive attachment disorder usually occurs at a young age — sometimes even younger than 1 year old. The symptoms of reactive attachment disorder may be noticeable before your child turns 5 years old, although they may receive a diagnosis at a later stage.

Reactive attachment disorder occurs when a child’s emotional or physical needs aren’t met by their caregivers. This lack of care can make it difficult for young children to form healthy bonds with their caregivers, and they might find it difficult to trust or rely on others.

Teenagers are more likely to have reactive attachment disorder if, in their early years, they:

• had a caregiver or parent who died, left, or abandoned them
• had caregivers or parents whose parenting was affected by mental health problems, physical illness, substance abuse, incarceration, or other major stressors
• had multiple caregivers (due to living in a children’s home, frequently changing foster homes, moving from one family member to the next, etc.)
• have prolonged separation from parents or other caregivers due to repeated out-of-home placement, hospitalization, or death of a primary caregiver
• were abused or neglected by their parents or caregivers
• were separated from parents or caregivers for a prolonged period of time (due to hospitalization, illness, or incarceration)

But not every child who experiences the above situations will develop a reactive attachment disorder.

Although reactive attachment disorder is a serious disorder, it can be treated. Typically, the condition is treated through therapy that involves the child as well as their caregiver or caregivers.

Your teenager might benefit from the following types of therapy:

• Individual therapy: There are many types of therapy. Some of the most common include cognitive behavioral therapy (CBT), dialectical behavioral therapy (DBT), and psychodynamic therapy.
• Family therapy: This can involve the teenager, caregivers, and other family members.
• Group therapy: The group will include a group of teenagers and, in some cases, their caregivers.

Often, a combination of individual and family therapy is necessary.

The following might also be helpful:

• Social skills intervention: This is a type of therapy that can assist your teenager in learning to have healthy interactions with friends, family members, and others.
• Remedial education: In some cases, teenagers with reactive attachment disorder may also experience developmental delays and behavioral problems that can affect their school career. Educational programs can assist them with schoolwork.
• Complementary therapies: Along with psychotherapy, complementary activities like art therapy, equine therapy, mindfulness training, and yoga can also be healing for your teen.
• Medication: Although no medication is prescribed specifically for reactive attachment disorder, they may benefit from medication if they have another condition (for example, depression) that can be treated through medication.

Every person with reactive attachment disorder is different, and the treatment plan you use will depend on your teenager’s individual situation. If you’re not sure where to start, speaking with a mental health professional is a good first step.

Do children grow out of reactive attachment disorder?

No, reactive attachment disorder is a lifelong disorder. Although it can be treated and managed through therapy and other programs, children don’t “grow out” of it on their own.

It’s important to get help if you believe your child has an attachment disorder or another mental health condition. The earlier you act, the better.

If your child or teenager has reactive attachment disorder, appropriate support can help improve their confidence and enable them to form healthy relationships and learn better social skills.

As a parent or caregiver, you can help them by:

• Creating stability: A stable, consistent living situation can help your teenager feel safer. Although instability is sometimes unavoidable, prioritizing their sense of safety is important.
• Educating yourself: Understanding their disorder can help you understand your teenager and their behavior.
• Taking parenting skills classes: These classes can help you learn techniques to effectively parent your child while creating a healthy bond with them.

Other ways to support teenagers with reactive attachment disorder can include:

• helping them establish healthy, consistent routines to provide them with a sense of stability and consistency
• introducing them to healthy stress-relief tools, like mindfulness, journaling, and exercise, which can help them regulate their emotions
• modeling emotional regulation for them by showing them how you manage and process your emotions
• doing activities (including sports, crafts, games, volunteering, or hobbies) with your teenager to facilitate bonding and encourage them to pursue their interests and build skills
• giving them consistent love and attention, even when it doesn’t feel like they engage

Reactive attachment disorder forms when a child’s needs aren’t met by their caregivers. This disorder can make it difficult for children to bond with their caregivers. In teenagers, reactive attachment disorder can lead to social and behavioral issues.

Although it’s a lifelong disorder, it can be treated. There are numerous treatment options for teenagers with reactive attachment disorder. You can start by contacting a mental health professional who has experience working with teenagers.

Last medically reviewed on March 24, 2023