Improved functioning in children diagnosed with reactive attachment disorder after SSRI therapy.
Year: 2010
Type: article
Study design: Case Report
Abstract: The process of secure attachment between child and parent during early childhood is requisite for laying the foundation for later normative psychosocial and emotional development. Failure to establish a nurturing and reciprocal attachment between the young child and caretaker can have profound and sometimes irreversible effects on the child’s later social emotional development, and may result in the development of Reactive Attachment Disorder (RAD). Moreover, there is literature that describes the potential neurobiological deficits that can occur to the developing brain if a child is exposed to early maltreatment (Schore, 2001). The absence of responsive and consistent caretaking can subject the developing brain to an inordinate amount of physiological stress, leading to increased cortisol production and consequential inefficiencies in the serotonin and the growth-hormone releasing systems. Although neurotransmitter deficiencies are a possible result of early childhood maltreatment, treatment of these children is usually limited to psychosocial interventions that focus on remediating the core attachment deficits and other comorbid conditions. Pharmacological interventions may have efficacy in treating comorbid conditions (e.g., depression, ADHD, PTSD), but there is no literature supporting the use of pharmacological treatment to address the core attachment deficit. This deficit reflects the child’s inability to form a secure and enduring relationship with their primary caregiver, which consequently impairs their future social adaptation in the areas of affect regulation, stress modulation and behavioural organization.
The following two case studies will illustrate the use of SSRI therapy in children with RAD who have other comorbid conditions, and discuss these outcomes in the context of early neurobiological and social development.
Source: PubMed
Author: Harvey A Weinberg
Institution: Gundersen Health System
Language: English
Subfield: Clinical Psychology
Field: Psychology
Domain: Social Sciences
Open Access status: green
OpenAlex ID: W289521100