Review Reactive Attachment Disorder (RAD)

Abuse, Violence, Trauma, and Stressor Related Disorders > Mental Health

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Reactive Attachment Disorder (RAD)

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Question 1:

A nurse is assessing a child with reactive attachment disorder (RAD). What are some common psychological signs of RAD?

A. Aggression and violence. B. Lack of trust and empathy. C. Growth retardation and malnutrition. D. Lack of involvement in social activities.

Answer and Explanation

Choice A:

Aggression and violence are not typical psychological signs of reactive attachment disorder (RAD). RAD is characterized by difficulties forming healthy emotional attachments and relationships, rather than overt aggressive behaviors.

Choice B:

Lack of trust and empathy are hallmark psychological signs of RAD. Children with RAD often struggle to establish and maintain trust in caregivers, which can lead to challenges in forming healthy relationships later in life. Additionally, impaired empathy is a common feature, as these children may not fully understand or respond to others' emotions.

Choice C:

Growth retardation and malnutrition are not primarily psychological signs of RAD. While children with RAD may exhibit problems with physical growth and development due to neglect or inconsistent caregiving, these are more related to the physical aspects of care rather than psychological symptoms.

Choice D:

Lack of involvement in social activities is related to RAD. Children with RAD often have difficulty participating in and enjoying social interactions due to their challenges with forming attachments and developing trust. However, this symptom is primarily related to their psychological struggles rather than a lack of interest in social activities.

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Question 2:

(Select all that apply): A nurse is providing nursing interventions for a child with reactive attachment disorder (RAD). Which interventions are appropriate for this child?

A. Educating the child and caregiver about attachment development. B. Protecting the child's rights and ensuring a safe environment. C. Administering psychological tests for personality assessment. D. Providing legal assistance and reporting any suspected abuse.

Answer and Explanation

Choice A:

Educating the child and caregiver about attachment development (Choice A) is an appropriate intervention for a child with reactive attachment disorder (RAD). This disorder is characterized by significant difficulties in forming emotional attachments due to early negative caregiving experiences. Providing education about attachment development can help both the child and caregiver understand the underlying issues and work towards building healthier attachments.

Choice B:

Protecting the child's rights and ensuring a safe environment (Choice B) is crucial for children with RAD. These children often have a history of neglect or abuse, and ensuring their safety and rights is a priority to prevent further harm.

Choice C:

Administering psychological tests for personality assessment (Choice C) is not a primary nursing intervention for RAD. RAD is primarily diagnosed based on clinical observations and history rather than personality assessments.

Choice D:

Providing legal assistance and reporting any suspected abuse (Choice D) is important for ensuring the child's safety, but it is not a direct nursing intervention for RAD. Legal assistance and reporting abuse would be necessary if there are suspicions of maltreatment but are not specific interventions for addressing RAD.

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Question 3:

A client diagnosed with reactive attachment disorder (RAD) states, "I feel so lonely and disconnected from others." Which response by the nurse is appropriate?

A. "It's normal to feel this way sometimes.” B. "You're just imagining these feelings.” C. "I understand. Let's talk about what you're experiencing.” D. "You should focus on making more friends.”

Answer and Explanation

Choice A:

Responding with "It's normal to feel this way sometimes." (Choice A) might minimize the client's emotions and struggles. It's important to validate the client's feelings rather than dismissing them as normal.

Choice B:

Responding with "You're just imagining these feelings." (Choice B) is invalidating and negating the client's emotions. Such a response can damage the therapeutic relationship and discourage the client from opening up further.

Choice C:

Responding with "I understand. Let's talk about what you're experiencing." (Choice C) is appropriate for a client with reactive attachment disorder who expresses feelings of loneliness and disconnection. This response demonstrates empathy, acknowledges the client's emotions, and encourages further discussion to explore their experiences.

Choice D:

Responding with "You should focus on making more friends." (Choice D) overlooks the underlying issues of reactive attachment disorder and oversimplifies the client's feelings. It does not address the core challenges that the client is facing.

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Question 4:

A nurse is assessing a child for reactive attachment disorder (RAD). The child's caregiver reports, "They don't seem to care about anyone or anything." How should the nurse interpret this statement?

A. The child may have difficulty forming attachments. B. The child is likely a social and outgoing individual. C. The child is experiencing normal emotional development. D. The child is showing affection towards others.

Answer and Explanation

Choice A:

Interpreting the caregiver's statement, "They don't seem to care about anyone or anything," as the child may have difficulty forming attachments (Choice A) is accurate. Reactive attachment disorder often leads to difficulties in forming emotional connections and caring for others due to early negative caregiving experiences.

Choice B:

Assuming that the child is likely a social and outgoing individual (Choice B) contradicts the caregiver's report and does not align with the typical characteristics of reactive attachment disorder.

Choice C:

Interpreting the caregiver's statement as the child experiencing normal emotional development (Choice C) is incorrect given the reported lack of caring about others or anything. This statement indicates potential attachment-related issues.

Choice D:

Interpreting the caregiver's statement as the child showing affection towards others (Choice D) contradicts the reported observation of the child's lack of caring. Reactive attachment disorder is characterized by challenges in forming emotional bonds.

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Question 5:

A client diagnosed with reactive attachment disorder (RAD) has poor hygiene, growth retardation, and malnutrition. What could be the underlying reason for these physical signs?

A. Indiscriminate social behavior. B. Lack of involvement in social activities. C. Inhibited emotional withdrawal. D. Exposure to neglect or abuse.

Answer and Explanation

Choice A:

Indiscriminate social behavior is not likely the underlying reason for poor hygiene, growth retardation, and malnutrition in a child with reactive attachment disorder (RAD). Indiscriminate social behavior refers to a lack of preference for familiar caregivers over unfamiliar individuals, which might result in approaching strangers, but it doesn't directly explain the physical signs mentioned in the question.

Choice B:

Lack of involvement in social activities is also unlikely to be the main reason for the physical signs. While this might contribute to a child's overall well-being, RAD typically stems from early disruptions in attachment due to neglect or abuse, leading to physical and emotional consequences.

Choice C:

Inhibited emotional withdrawal is a hallmark of RAD, characterized by a child's reluctance to seek or respond to comfort from caregivers. However, this choice doesn't directly explain the physical signs mentioned.

Choice D:

Exposure to neglect or abuse is the most likely reason for the physical signs described. Children with RAD often experience early, severe disruptions in their attachment relationships due to neglect, maltreatment, or inconsistent care, leading to difficulties in forming healthy relationships and developmental delays including poor hygiene, growth retardation, and malnutrition.

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Question 6:

A nurse is assessing a child with reactive attachment disorder (RAD). Which of the following is a common clinical manifestation of RAD?

A. Frequent mood swings and emotional instability. B. Excessive fear of strangers and new situations. C. Rapid speech and impulsivity. D. Heightened sense of empathy and trust.

Answer and Explanation

Choice A:

Frequent mood swings and emotional instability are not typical clinical manifestations of reactive attachment disorder (RAD). RAD is characterized by difficulties forming emotional bonds, not necessarily by mood swings.

Choice B:

Excessive fear of strangers and new situations is a common clinical manifestation of RAD. Children with RAD often have trouble trusting and forming attachments, leading to heightened anxiety and fear in unfamiliar settings or with unfamiliar people.

Choice C:

Rapid speech and impulsivity are not typically associated with RAD. These traits might be seen in other behavioral disorders but are not primary characteristics of RAD.

Choice D:

Heightened sense of empathy and trust is unlikely in children with RAD. They tend to have difficulties with empathy and trust due to their attachment challenges.

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Question 7:

(Select all that apply). A nurse is providing education to parents about preventing reactive attachment disorder (RAD) in their child. What primary prevention strategies should the nurse include? Select all that apply.

A. Teaching the child about attachment and its types. B. Providing therapy to the child after signs of RAD are observed. C. Offering support groups to children who have been exposed to abuse. D. Educating caregivers about the importance of consistent bonding. E. Administering psychological tests to children to identify RAD.

Answer and Explanation

Choice A:

Teaching the child about attachment and its types is a primary prevention strategy that can help children understand healthy relationships and possibly prevent attachment disorders like RAD. Educating children about attachment can promote awareness and facilitate the development of secure bonds.

Choice B:

Providing therapy to the child after signs of RAD are observed is not a primary prevention strategy but rather a secondary intervention. Primary prevention aims to prevent the development of the disorder before it occurs.

Choice C:

Offering support groups to children who have been exposed to abuse is a primary prevention strategy. These support groups can provide a safe space for children to share their experiences, learn healthy coping strategies, and potentially prevent the development of RAD.

Choice D:

Educating caregivers about the importance of consistent bonding is a crucial primary prevention strategy. Healthy attachment bonds formed through consistent care can prevent the onset of RAD.

Choice E:

Administering psychological tests to children to identify RAD is not a primary prevention strategy. Psychological tests are typically used for assessment and diagnosis, rather than prevention.

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Question 8:

A nurse is conducting a nursing assessment of a child with suspected reactive attachment disorder (RAD). The child's caregiver says, "The child never seeks comfort when upset and avoids interactions." What statement from the nurse is appropriate?

A. "It sounds like the child has a healthy attachment with you.” B. "Your child's behavior is likely a temporary phase.” C. "It's common for children to show such behaviors during development.” D. "Your description matches the characteristic of inhibited type RAD.”

Answer and Explanation

Choice A:

This choice is incorrect because a child with reactive attachment disorder (RAD) is not likely to have a healthy attachment with their caregiver. RAD is characterized by difficulties in forming healthy attachments due to early neglect or inconsistent care.

Choice B:

This choice is incorrect because describing the child's behavior as a "temporary phase" overlooks the severity and persistent nature of RAD symptoms. RAD is a complex and chronic condition that requires appropriate assessment and intervention.

Choice C:

This choice is incorrect because while some challenging behaviors are common during child development, RAD goes beyond normal behaviors. RAD is rooted in disrupted early attachments and leads to profound difficulties in forming emotional bonds.

Choice D:

This choice is correct. The nurse's response acknowledges the caregiver's concerns and accurately relates the child's behavior to the characteristics of inhibited type RAD. This response opens the door for further discussion, assessment, and potential intervention.

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Question 9:

A nurse is assessing a child with reactive attachment disorder (RAD). The child expresses feelings of sadness, guilt, and low self-esteem. Which statement is an appropriate therapeutic response from the nurse?

A. "Don't worry, these feelings will go away soon.” B. "You need to focus on positive thoughts to overcome these feelings.” C. "It's important to acknowledge your feelings and talk about them.” D. "Everyone feels this way at times, so you're not alone.”

Answer and Explanation

Choice A:

This choice is incorrect because dismissing the child's feelings as temporary might invalidate their emotions and hinder therapeutic rapport. RAD-related emotions often require more comprehensive interventions.

Choice B:

This choice is incorrect because telling the child to focus solely on positive thoughts oversimplifies their emotional struggles. RAD-related feelings typically require a more nuanced approach.

Choice C:

This choice is correct. The nurse's response validates the child's feelings and encourages open discussion about them. This therapeutic response fosters trust, allows emotional expression, and supports the child's emotional well-being.

Choice D:

This choice is incorrect because stating that everyone feels this way at times minimizes the unique challenges faced by children with RAD. Such a response might not address the underlying causes of the child's emotions.

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Question 10:

A nurse is providing education to a group of caregivers about nursing interventions for children with reactive attachment disorder (RAD). What should the nurse include as part of nursing interventions?

A. Administering medication to alleviate emotional symptoms. B. Avoiding involvement of the family in care planning. C. Reporting suspected neglect or abuse to authorities. D. Encouraging children to isolate themselves to prevent triggers.

Answer and Explanation

Choice A:

This choice is incorrect because administering medication to alleviate emotional symptoms does not directly address the underlying attachment and emotional issues that children with RAD face. Medication might play a role in some cases, but it is not a core nursing intervention.

Choice B:

This choice is incorrect because involving the family in care planning is essential for children with RAD. Family support and involvement are crucial components of treatment and interventions for improving attachment and relationships.

Choice C:

This choice is correct. Reporting suspected neglect or abuse is an important nursing intervention for children with RAD. Early identification of potential maltreatment can lead to protective measures and appropriate interventions.

Choice D:

This choice is incorrect because encouraging children to isolate themselves contradicts therapeutic goals for children with RAD. Encouraging social interaction and healthy relationships is a key aspect of treatment for this disorder. .

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Reactive Attachment Disorder (RAD)

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