Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) Symptomatology in a High-Risk Clinical Sample.

This article focuses on the prevalence and clinical significance of reactive attachment disorder (RAD) and disinhibited social engagement disorder (DSED) symptoms in a high-risk sample of internationally adopted children. While full diagnoses of RAD and DSED were rare (1% and 8.1%, respectively), over half of the children exhibited subclinical symptoms associated with these attachment disorders, particularly difficulties in emotional regulation and caregiver-child interactions. The study highlights that DSED symptomatology was significantly linked to parent-reported physical aggression and that delayed mental health intervention correlated with increased behavioral concerns. Findings underscore the importance of early mental health screening—such as using the Disturbance of Attachment Interview (DAI)—and timely, attachment-focused interventions to support adopted children and their families, even when full diagnostic criteria are not met.