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Revision as of 19:26, 25 December 2005

do we need all of those footnots? -- from cleanup

my persional oppinion is yes, yes, YES. infact i would go as far to sa that this is what most wikipedia articals lack tooto 22:20, 23 Aug 2004 (UTC)

I agree. Footnotes add veracity to the material and allows readers to delve more deeply into the subject AWeidman 25 Dec 2005

Introduction

The first paragraph of this article is overly complex and does not give a clear description of this disorder that would be accessible to many people who do not have a background in the subject.

Reactive Attachment Disorder (sometimes called "RAD")(DSM-IV 313.89, ICD-10 F94.1/2) is a psychophysiologic condition secondary to pathogenic behaviour from a caregiver during the first three years of life which would, in the absence of such pathogenic behaviour, normally meet well-timed milestones, so that the developmental trajectory is qualitatively different from the superficially similar failures or deviances in Mental retardation and Pervasive developmental disorders). This pathogenic caregiving behaviour constitutes any form of neglect, abuse, mistreatment and abandonment.

The DSM-IV intro is much clearer.

The essential feature of Reactive Attachment Disorder is markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before age 5 years and is associated with grossy pathological care.

May I suggest this replacement:

Reactive Attachment Disorder (sometimes called "RAD")(DSM-IV 313.89, ICD-10 F94.1/2) is a psychophysiologic condition with markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before age five years and is associated with grossly pathological care. This pathological caregiving behaviour may consist of any form of neglect, abuse, mistreatment and abandonment.

In Mental retardation attachments to caregivers are consistent with the level of development. In Pervasive developmental disorders attachments to caregivers either fail to develop or are highly deviant, but this usually occurs in a context of reasonably supportive care.

--CloudSurfer 22:19, 7 Oct 2004 (UTC)

Thank you, CloudSurfer.

Imagine that, to have written a first paragraph to an article in an online encyclopedia that is much less clear than the DSM-IV. And that book is not a piece of obscurantist dogma, or it shouldn't be.

Still, four big words in the middle clause (the one that begins with 'so that'...)- I am not doing that again in a big hurry! The four were 'developmental' 'trajectory' (might have just said 'path', but that might have connoted spirituality), 'qualitiatively' and 'superficial'.

The lack of clarity was in part due to political correctness: or, more simply, not wanting to offend anybody in the three diagnostic categories mentioned. As you might see, 'markedly disturbed' and 'developmentally inappropriate' are very loaded words (though usually not meant so in the medical context), as when discussing Pervasive Developmental Disorders as being 'highly deviant' in this area. This is well-balanced by the 'reasonably supportive care'.

Apart from these points, I do agree with the replacement and the editing of the first paragraph. I suppose 'pathogenic' would be a loaded word too (as psychogenic had been), as compared to pathological, in terms of how things are caused.

As to the background thing would this 'markedly disturbed' and 'developmentally appropriate' be obvious to doctors, to parents, and/or to you and me?

Your edits make much better that point that Reactive Attachment Disorder is different, especially to the ordinary reader.

Just a little point: it is five years, not three, according to the DSM-IV?

EuropracBHIT

Thanks for that, so it seems you are happy with the suggestions so I have put it in, with 5 not 3 years. I just wanted to check that I wansn't missing anything crucial. --CloudSurfer 05:11, 9 Oct 2004 (UTC)

Hi, I don't know what 'grossly pathological care'/pathogenic caregiving means... would it be useful to have a link to a definition, or include the definition here? Nao* 14:50, 7 September 2005 (UTC)

Hi, I noted the thing about Randalph Questionnaire. But I saw a site that mentioned that this Questionnaire is ONLY used for attachment disorder. Reactive attachment disorder and ODD/CD togheter in one person are not common. However, the real Questionnaire can only be used for Attachment disorder (AD) and not RAD...

Actually, most children with a clinical diagnosis of Reactive Attachment Disorder would also meet the DSM IV criteria for ODD and/or CD. That is because DSM IV diagnoses are usually made solely based on the presence of absence of certain behaviors. RAD is one of the few diagnoses in the DSM that relies on cause or etiology. AWeidman 25 Dec 2005