Poster #142 - Exploring Attachment disorders phenotype in school-aged children

• In Event: 1-169 - Poster Session 04
  In Poster Session: PS 04 Section - Parenting & Parent-Child Relationships

Integrative Statement

Introduction: Attachment Disorders (AD), namely Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED), are psychiatric disorders that children may develop as a result of severe early adversity (e.g., maltreatment, institutionalization, repeated change of caregivers). According to DSM-5 criteria, core features of DSED are interactions with unfamiliar adults (criteria A1, A4) and social disinhibition (criteria A2, A3, B); whereas for RAD, core features are lack of selective attachment behavior (A1, A2), social and emotional withdrawal (B1, B2) and emotional dysregulation/unpredictability (B3). Validation data from the recently developed ETRAD-Q (Early TRAuma-related Disorders Questionnaire; Monette, 2016) has shown that this symptoms’ structure is the best fit for samples of typically developing and at-risk (adopted and in out-of-home care) children (Monette et al., submitted). However, it has been suggested that other behaviors may be part of the RAD and DSED phenotypes, specifically callous-unemotional (CU) traits (Mayes et al., 2017) and controlling behaviors (Minnis et al., 2009).

The objective of this study is to examine the factorial structure of RAD and DSED phenotypes using a extended version of the ETRAD-Q, comprising additional scales of CU traits and controlling behaviors.

Method. The sample consists of 834 school-aged children (6-12 years old, M age = 8.23; SD = 2.16), which was divided in four groups: 1. Children from the general population enrolled in regular schools (n = 597); 2. Adopted children (n=101), 3. children in foster care (n=80), and children in residential treatment care (RTC, n=56).

Measures. Primary caregivers completed a Sociodemographic questionnaire; and the ETRAD-Q extended, a 64-item measuring RAD (3 scales: Low selective attachment, Low social and emotional responsiveness, Emotional unpredictability), DSED (2 scales: Interaction with unfamiliar adults, Social disinhibition) and symptoms of CU and controlling behaviors.

Results and conclusion: All items of the ETRAD-Q extended version were subjected to an exploratory factor analysis. Modern extraction techniques (HPA, Velicer MAP test) were used along with scree plot inspection to determine the number of factors to extract. Seven factors were identified: the original five factors and two others (CU traits and controlling behavior). All primary factors were then subjected to a second-order factor analysis, resulting in two factors: RAD and DSED (see table 1). The “Controlling behavior” factor loaded almost equally on RAD and DSED (.47 and .43, respectively). The “CU traits” factor loaded strongly and uniquely (.70) on the RAD factor. These results suggest that controlling behavior is associated with both RAD and DSED, but probably not strongly enough to be considered a core feature. However, CU traits showed a stronger and specific association with RAD core features. More studies are needed to understand this association, but this result suggest that CU traits could be very common in children with RAD. These results also question the very nature of RAD, suggesting that RAD could possibly be understood as a more global form of severe emotional detachment/disconnection, rather than as a specific disorder of the attachment system.

Authors

• Sebastien Monette, UQAM
  Presenting Author

• Chantal Cyr, University of Quebec at Montreal
  Non-Presenting Author

• Maude Archambault, Université du Québec à Montréal
  Non-Presenting Author

• Miguel T. Terradas, Université de Sherbrooke
  Non-Presenting Author

• Sophie Couture, Université de Montréal
  Non-Presenting Author