What is Attachment Disorder in Adults? What you Need to Know.

Attachment Disorder in Adults

Part 1: Demystifying Diagnoses: Beyond The Definition of Attachment Disorder

What is Attachment Disorder in adults and how does it affect their daily lives? How is attachment disorder diagnosed? What's the difference between an attachment disorder and an attachment style? What kinds of treatments are available for attachment disorder? These are just three of the questions this article tackles in the first of our new series, Demystifying Diagnoses & the DSM-5: Beyond The Definition. 

While Attachment disorders and attachment styles are not a new concept, the general public's interest has grown in understanding not only the answer to What is Attachment Disorder in Adults? but What Is My Attachment Style? Read more to learn about the difference between attachment disorders and attachment styles, and how a deeper understanding of both can help everyone.

What Is Attachment Disorder in Adults? What is Attachment Theory?

Infants look to their caregivers for safety and nurturing. At this vulnerable time, infants are utterly dependent on the care and concern demonstrated by their primary guardians and parents. Attachment theory theorizes that children naturally signal their familiar caregiver when they become alarmed, sick, or experience distress. How their caregiver responds to this "signal" will ultimately determine the child's attachment style as they grow and mature into children and eventually into adults.

Reactive attachment disorder (RAD)

Defined broadly, infants and young children with Reactive attachment disorder (RAD) typically withdraw emotionally from primary caregivers and parental figures. They have trouble connecting with other people in meaningful ways, which leads to difficult behavioral patterns like:

  • The inability to manage their emotions 
  • A sense of discomfort or fear around their caregivers, despite obvious shows of comfort and concern by these same caregivers
  • Irritability and sadness 

Disinhibited social engagement disorder (DSED)

On the surface, behavior typical to DSED may look like the opposite of RAD, but it is far more complex. Where children with RAD are disconnected emotionally from caregivers, children with DSED are connected emotionally to strangers. These children may approach strangers without reservation and show affection with unknown adults without hesitation. DSED leads to complicated behavioral patterns like:

  • meets or engaged strangers or new adults without inhibition and with extreme excitement 
  • interacts with strangers in an overly comfortable, chatty, or in another way that may not be socially acceptable 
  • displays ability to follow a stranger or leave their safe location to go with unfamiliar adults 
  • demonstrates inability or disinterest in reporting to an adult before leaving, even if the intended location is unfamiliar or possibly dangerous
  • interacts with strangers in an overly comfortable, chatty, or in another way that may not be socially acceptable 

If you asked a member of the general public to define What is Attachment Disorder in Adults? they'd have a much harder time answering the clinical question than they could answer the following: 

Have they known someone who seems never to feel secure in their relationships, no matter how hard they try (or the other person in the relationship tries)?

Have they known someone who frequently fluctuates between an intense need for closeness and an equally intense need to pull away from others?

Have they known someone who inherently feels uncomfortable with close relationships, often choosing independence above intimacy?

Depending on where they are in their lives, it's common for healthy people in healthy relationships to experience fluctuations in their need for closeness to, or independence from, other people in their lives. However for those with attachment disorders or with insecure attachment styles, relating to others in a deep and meaningful way presents its own set of unique challenges.

What is My Attachment Style?

Attachment Styles vs. Attachment Disorder in Adults

“Attachment styles” in adults refers to a set of patterns with relation to attachment and relationships, and how bonds are formed at an early age. Attachment and related disorders are more complex than can be summarized in just one article, but the four types of attachment listed below offer a shorthand for these concepts. Do you recognize any of these attachment styles in adults in yourself in someone else you know?

Secure Attachment:
  • Demonstrates empathetic qualities
  • Responds to the needs of others and themselves
  • Reacts with appropriate emotions to situations
  • Maintains comfortable levels of intimate relationships 
  • Demonstrates thoughts, feelings, and actions that serve others and themselves
Avoidant Attachment:
  • Dismisses others' thoughts and actions
  • Struggles to recognize the needs of others 
  • Vacillates between running "hot and cold" emotionally
  • Creates distance from others to mitigate discomfort
  • Avoid closeness and emotional, mental, or physical intimacy
  • Gravitates to those who are emotionally unavailable
Anxious Attachment:
  • Preoccupied with others' thoughts, feelings, and actions while possibly ignoring their own 
  • Struggles to recognize the needs of others 
  • Needs closeness and intimacy to feel comfortable
  • Withholds contact or is aggressive when stressed
Disorganized Attachment:
  • Alternates between coldness and clinginess
  • Unable to self-regulate emotional responses
  • Behaves in both avoidant and anxious attachment styles
  • Want close relationships but are also fearful of them
  • Exhibits behavior that is both anxious and hypervigilant 

Note: The four categories listed above are attachment styles, not official diagnoses of attachment disorder in adults.

Attachment disorder in adults poses serious and complex consequences and may necessitate the help of a mental health professional. However just because someone shows similar characteristics of any or all of the attachment styles above does not mean they have an attachment disorder. While there is no official diagnosis of attachment disorder in adults, seek medical advice from a trained mental health professional if you or someone else you know is struggling.

For information regarding Attachment Disorder in children, visit the AACAP website.