Overview
Disinhibited attachment disorder is a condition characterized by a pattern of behavior in children where they exhibit overly familiar and indiscriminate social interactions with unfamiliar adults. This disorder is often associated with early experiences of neglect or trauma.Diagnosis
Management
Trauma-informed care (TIC) interventions show promise for improving the well-being of children involved with the child welfare system 3.
Motivational interviewing (MI) training for pediatricians is associated with higher caregiver uptake of health behavior and lifestyle treatment 1.
Video Intervention Therapy (VIT) may enhance parental reflective functioning in caregivers of children with severe psychopathology in a hospitalized context 2.
The Attachment & Child Health (ATTACH) intervention, focusing on improving parental reflective function, has shown moderate effect sizes in at-risk mothers and young children 4.Special Populations
Children aged 3-8 years with a BMI ≥85th percentile for age and sex are eligible for health behavior and lifestyle treatment referrals when pediatricians are trained in motivational interviewing 1.
Caregivers of children admitted to child psychiatry units, often from multi-problem families, may benefit from Video Intervention Therapy to enhance parental reflective functioning 2.
Children involved with the child welfare system may benefit from trauma-informed care interventions 3.
Mothers and children under 36 months of age affected by toxic stress may benefit from interventions focused on improving parental reflective function and attachment security 4.Key Recommendations
Trauma-informed care interventions are promising for children involved with the child welfare system, with moderate effects on child well-being indicators such as PTSD symptom reduction and behavioral problem reduction 3. (Evidence: Moderate)
Motivational interviewing training for pediatricians is associated with significantly higher caregiver uptake of health behavior and lifestyle coaching compared to untrained pediatricians 1. (Evidence: Moderate)
Video Intervention Therapy, which includes video-recorded play sessions and group sessions, is being explored to enhance parental reflective functioning in caregivers of hospitalized children with severe psychopathology 2. (Evidence: Weak)
Interventions aimed at improving parental reflective function, such as the ATTACH program, may buffer the negative effects of toxic stress on attachment in young children 4. (Evidence: Moderate)References
1 Moore E, Vallejo J, Sidell MA, Li X, Delacroix E, Young DR et al.. Training in motivational interviewing for pediatricians was associated with a higher uptake of health behavior and lifestyle treatment: Results from the KP Wellness Coaching for Families and Kids (WC4K) Program. Patient education and counseling 2025. link
2 Leyton F, Olhaberry M, Morán J, De la Cerda C, León MJ, Sieverson C et al.. Video Intervention Therapy for primary caregivers in a child psychiatry unit: a randomized feasibility trial. Trials 2021. link
3 Zhang S, Conner A, Lim Y, Lefmann T. Trauma-informed care for children involved with the child welfare system: A meta-analysis. Child abuse & neglect 2021. link
4 Letourneau N, Anis L, Ntanda H, Novick J, Steele M, Steele H et al.. Attachment & Child Health (ATTACH) pilot trials: Effect of parental reflective function intervention for families affected by toxic stress. Infant mental health journal 2020. link