Editing Reactive attachment disorder (section)

===Alternative diagnosis===
In the absence of a standardized diagnosis system, many popular, informal classification systems or checklists, outside the [[Diagnostic and Statistical Manual of Mental Disorders|DSM]] and [[ICD]], were created out of clinical and parental experience within the field known as [[attachment therapy]]. These lists are unvalidated and critics state they are inaccurate, too broadly defined or applied by unqualified persons. Many are found on the websites of attachment therapists. Common elements of these lists such as lying, lack of remorse or conscience and cruelty do not form part of the diagnostic criteria under either DSM-IV-TR or ICD-10.<ref>Chaffin et al. (2006), pp. 82–83. The APSAC Taskforce Report</ref> Many children are being diagnosed with RAD because of behavioral problems that are outside the criteria.<ref name="Hanson&Spratt2000"/> There is an emphasis within attachment therapy on aggressive behavior as a symptom of what they describe as attachment disorder whereas mainstream theorists view these behaviors as comorbid, [[Externalization (psychology)|externalizing]] behaviors requiring appropriate assessment and treatment rather than attachment disorders. However, knowledge of attachment relationships can contribute to the cause, maintenance and treatment of externalizing disorders.<ref name="Gutman-Steinmetz &amp; Crowell (2006)">{{cite journal |vauthors=Guttmann-Steinmetz S, Crowell JA |title=Attachment and externalizing disorders: a developmental psychopathology perspective |journal=J Am Acad Child Adolesc Psychiatry |volume=45 |issue=4 |pages=440–51 |year=2006 |pmid=16601649 |doi=10.1097/01.chi.0000196422.42599.63 }}</ref>

The Randolph Attachment Disorder Questionnaire or RADQ is one of the better known of these checklists and is used by attachment therapists and others.<ref name="Randolph 1996">Randolph, Elizabeth Marie. (1996). ''Randolph Attachment Disorder Questionnaire''. Institute for Attachment, Evergreen CO.</ref> The checklist includes 93 discrete behaviours, many of which either overlap with other disorders, like conduct disorder and oppositional defiant disorder, or are not related to attachment difficulties. Critics assert that it is unvalidated<ref name="Mercer J.">{{cite journal |author=Mercer J |title=Coercive restraint therapies: a dangerous alternative mental health intervention |journal=MedGenMed |volume=7 |issue=3 |pages=6 |year=2005 |pmid=16369232 |url=http://www.medscape.com/viewarticle/508956 |pmc=1681667 }}</ref> and lacks [[Specificity (tests)|specificity]].<ref name="Cappelletty et al. (2005)">{{cite journal |title= Correlates of the Randolph Attachment Disorder Questionnaire (RADQ) in a Sample of Children in Foster Placement |year=2005 |journal=Child and Adolescent Social Work Journal |volume=22 |issue=1 |pages=71–84 |doi=10.1007/s10560-005-2556-2 |quote=The findings showed that children in foster care have reported symptoms within the range typical of children not involved in foster care. The conclusion is that the RADQ has limited usefulness due to its lack of specificity with implications for treatment of children in foster care |vauthors=Cappelletty G, Brown M, Shumate S |s2cid=143743052 }}</ref>