Pathological attachment: characteristics of psychological alterations

We understand by attachment the affective bond that is created between a living being and another individual of the same species, for example a child and his mother, which has the purpose of seeking contact and communication to achieve support sure.

There are different types of attachment that depend to a greater extent on how the caregiver meets the needs of the child. Likewise, alterations in this bond can give rise to a pathological attachment, classifying this into two different types. On the one hand, reactive attachment disorder, characteristic for showing inhibited, depressive and withdrawn behavior; and on the other, disinhibited social relationship disorder, where excessively familiar behavior with unknown adults is observed.

In this article we will see what is the concept of pathological attachment, explaining the different types of attachment that exist and what disorders are related to a pathological bond.

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What do we understand by attachment?

Attachment, or attachment in English, is the emotional bond that appears between a person or animal and another living being of the same species. The main objective of this link is to provide security to the child, who seeks physical contact and communicate with her attachment figure. This process begins at 12 months of life and persists throughout life.

One of the main representatives of the study of attachment was John Bowlby, who pointed out that the child is especially sensitive to separation from the security figure between 6 months and 2 years, which can generate different physiological and psychological effects if it happens This greater vulnerability coincides with the period of attachment establishment that goes from 7 to 24 months, the bond intensifies and greater discomfort appears in the face of separation and anguish in the face of strangers.

Soon after separation, the child may show stress, agitation, and depressive symptoms. First, there is a phase of protest against the game, then there is the phase of ambivalence before the new caregivers and before the old one if he returns and finally the phase of acceptance of the new link. In the long term, when the lack of attachment lasts, the effects that a bad separation are more serious as intellectual deficit, problems in social interactions or even death.

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types of attachment

Another relevant author in the study of attachment was Mary Ainsworth, who carried out an experiment known as a strange situation, which poses different situations such as the presence of a strange, the separation from the mother or the return of the attachment figure, it is this last situation that Ainsworh gives special importance to determine what type of attachment each presents. child.

In the same way also The sensitivity shown by the mother to the needs of the baby will be essential, thus providing security to be able to explore. With the results he obtained, he proposed three basic types of attachment, present in all cultures: insurance, which is More prevalent, the child groans at mother's departure but is comforted on her return and explores when she is Present.

On the other hand, the two insecure ones are: the avoidant or elusive one, where there is no perceived discomfort in the face of separation, the child ignores the mother when she returns and is very sociable with the stranger; and the ambivalent or resistant type, in which the child shows great discomfort at the separation and cannot be comforted when the mother returns, resists it.

Later, he signed up another type known as disorganized or disoriented, which consists of a mixture of the two insecure, presenting inconsistent and contradictory behaviors, is the least secure.

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Attachment disorders and pathological attachment

Now that we know how attachment is defined and what types of attachment exist, it will be easier to understand the disorders that can appear if there are alterations in the bond. As we have already pointed out, Bowlby considers the first years to be fundamental for the correct establishment of attachment, in particular, the social neglect, which refers to a lack of a caregiver during childhood, is decisive for the development and diagnosis of attachment pathological.

The fifth edition of the Diagnostic Manual of the American Psychiatric Association classifies attachment disorders within the chapter of disorders related to trauma and stressors. Likewise, pathological grief is divided into two diagnostic categories: reactive attachment disorder, which stands out for presenting internal symptoms such as depressive or withdrawal symptoms and disinhibited social relationship disorder, characteristic for showing externalized symptoms, with greater disinhibition

1. reactive attachment disorder

In reactive attachment disorder withdrawn and inhibited behavior towards the environment and even towards the attachment figure is shown, accompanied by two main symptoms. Thus, when the child feels stressed or distressed, he does not seek or ask for comfort, and if he is comforted or reassured, the child does not show a response.

As well social and emotional disturbance is observed that is expressed by two or more of the following symptoms: minimal emotional and social response to others, low positive affect or feeling of sadness, irritability, shyness that appears even before the figure of support.

Another criterion to meet is the presence of a pathological upbringing due to one of the following characteristics: the adult fails to meet or ignores the child's basic emotional needs; neglect of the basic physical needs of the child or repeated changes in the figure of support which makes it difficult to form the appropriate bond.

The prevalence of reactive attachment disorder is unknown, but it is suspected that it is rare., since in situations where the child has not received adequate care it only occurs in less than 10% of the subjects. It is believed that if the child with this alteration does not receive adequate intervention, the symptoms tend to persist.

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2. Disinhibited social relationship disorder

Disinhibited social relationship disorder is another alteration linked to pathological attachment, this is characterized by a pattern of behavior where the child interacts with strange adults and is excessively sociable, plus two or more of the following symptoms: shows no reluctance to approach strangers, shows excessively familiar with strangers, does not check or value the caregiver's opinion when approaching the stranger, or leaves with an unfamiliar adult without doubt it.

The behaviors that are observed are disinhibited, but they are not due only to impulsiveness. There must be at least one of the alterations in the care mode: the basic emotional needs are not covered, they are not stimulated or comforted; repeated changes of caregivers; or parenting in unusual places that make bonding difficult, such as institutions where the number of caregivers is insufficient. Disinhibited behavior alterations are due to impairments in bond formation.

It is also noted that the child must be at least 9 months old, so that the development of attachment has begun. It can be specified if it is persistent in case of showing symptoms for more than 12 months and the current severity of the disorder, it is serious when all the symptoms are present with an affectation elevated.

Unusual social behavior is typical considering the culture of the subject, where the child continuously tries to call the attention and both emotional and behavioral alterations can occur, with difficulties in relating to their same.

Although we can jointly make the diagnosis of disinhibited social relationship disorder and the Attention deficit disorder and hyperactivity (ADHD), it is necessary to differentiate them. In the case of disinhibited disorder, despite being able to show impulsive behaviors, we will not observe attention deficit or hyperactivity.

As in the other pathological attachment disorder, the prevalence of disinhibited disorder is unknown, although it is believed to be rare. even in situations with inadequate parenting styles, only about 20% of the subjects show this alteration.

Regarding the course of the psychological alteration, it remains stable with some variations depending on the age of the subject. For example, when he is two years old, he shows sticky behavior of non-selective bonding, that is, without differentiating between known and unknown subjects; at 4 years old they seek affection indiscriminately; during middle childhood they require constant affection and in adolescence they express disinhibited behaviors and interpersonal conflicts. This condition has not been observed in adults.