Editing Reactive attachment disorder (section)

==Causes==
Although increasing numbers of childhood mental health problems are being attributed to [[genetic defect]]s,<ref>Mercer (2006), pp. 104–05.</ref> reactive attachment disorder is by definition based on a problematic history of care and social relationships. Abuse can occur alongside the required factors, but on its own does not explain attachment disorder.<ref>Prior &amp; Glaser (2006), p. 218.</ref> It has been suggested that types of [[temperament]], or constitutional response to the environment, may make some individuals susceptible to the stress of unpredictable or hostile relationships with caregivers in the early years.<ref name="Marshall & Fox (2005)">{{cite journal |year=2005 |title=Relationship between behavioral reactivity at 4 months and attachment classification at 14 months in a selected sample |journal=Infant Behavior and Development |volume=28 |issue=4 |pages=492–502 |doi= 10.1016/j.infbeh.2005.06.002 |vauthors=Marshall PJ, Fox NA }}</ref> In the absence of available and responsive caregivers it appears that most children are particularly vulnerable to developing attachment disorders.<ref name="prior">Prior &amp; Glaser (2006), p. 219.</ref>

While similar abnormal parenting may produce the two distinct forms of the disorder, inhibited and disinhibited, studies show that abuse and neglect were far more prominent and severe in the cases of RAD, disinhibited type. The issue of temperament and its influence on the development of attachment disorders has yet to be resolved. RAD has never been reported in the absence of serious environmental adversity yet outcomes for children raised in the same environment are the same.<ref name="Zeanah &amp; Fox (2004)">{{cite journal |vauthors=Zeanah CH, Fox NA |title=Temperament and attachment disorders |journal=J Clin Child Adolesc Psychol |volume=33 |issue=1 |pages=32–41 |year=2004 |pmid=15028539 |doi=10.1207/S15374424JCCP3301_4 |s2cid=9416146 }}</ref>

In discussing the [[Neurobiology|neurobiological]] basis for attachment and trauma symptoms in a seven-year [[twin study]], it has been suggested that the roots of various forms of [[psychopathology]], including RAD, [[borderline personality disorder]] (BPD), and post-traumatic stress disorder (PTSD), can be found in disturbances in [[Affect (psychology)|affect]] regulation. The subsequent development of higher-order [[Emotional dysregulation|self-regulation]] is jeopardized and the formation of internal models is affected. Consequently, the "templates" in the mind that drive organized behavior in relationships may be impacted. The potential for "re-regulation" (modulation of emotional responses to within the normal range) in the presence of "corrective" experiences (normative caregiving) seems possible.<ref name="Heller et al. (2006)">{{cite journal |vauthors=Heller SS, Boris NW, Fuselier SH, Page T, Koren-Karie N, Miron D |title=Reactive attachment disorder in maltreated twins follow-up: from 18 months to 8 years |journal=Attach Hum Dev |volume=8 |issue=1 |pages=63–86 |year=2006 |pmid=16581624 |doi=10.1080/14616730600585177|s2cid=34947321 }}</ref>