May 26th, 2009
Reactive Attachment Disorder: Etiology, Symptoms, Affected Brain Areas and Treatment
Reactive Attachment Disorder (RAD) is characterized by considerably disturbed and inappropriate social interaction, across situations, that is manifested before the age of five (DSM-IV-R). Evidence for the disorder is usually seen in continuous failure to respond appropriately in social situations (being hypervigilant, inhibited, or ambivalent) and/or inability to develop and exhibit selective attachment to primary caregiver(s) (DSM-IV-R). The causes for the disturbed behavior in Reactive Attachment are associated with the developmental stages of Infancy and Early childhood, when pathogenic care can have profound and lasting effects. DSM-IV outlines three aspects of pathogenic care that explain the disturbance in normal development and behavior: persistent disregard for the child’s physical and emotional needs, as well as repeated changes of primary caregiver and/or surroundings. The connection between pathogenic care and disrupted behavior is compelling and reminds of the critical importance of nurture and effective parenting. Many psychologists have studied in depth child development during the first years of life and reveal that this is an extremely sensitive period for both physical and emotional development and maturation. It is a critical time for cultivating attachment, social skills, developing empathy and understanding basic values.
Prozak (fluoxetine) is among the Selective serotonin reuptake inhibitors (SSRIs), aka. second-generation antidepressants. As all SSRIs, Prozak blocks the reuptake transporter for serotonin, preventing it from being taken back to the axon terminal. Since this transporter is blocked, serotonin remains in the synaptic cleft for long periods, continuing to have its effect on the postsynaptic neuron. Although this effect takes place very quickly, depression symptoms take long periods to be alleviated. This phenomenon is not fully understood, but it’s interesting to note that Prozak increases the production of new neurons in the hippocampus - a limbic structure that is very vulnerable to stress-induced damage. Therefore, it is suspected that this renewal in the hippocampus is exactly the reason behind this antidepressant’s effect.
receptors are very common in the nervous system and their function is to inhibit other neurons. One such receptor that is affected by GABA is the GABAa receptor that contains chloride channels. When the receptor is excited, an influx of Cl ions takes place, increasing the negative charge on the inside – hyperpolarization – making initiation, or propagation of an action potential much more difficult. However, this GABAa receptor has not only a binding site for GABA, but two other binding sites as well. One is the sedative-hypnotic site, the other is the anxiety site.
Until recently, the study of deafness has been viewed within a deficit model, with focus on the “almost invariably negative effects of a sensory impairment or deficit” (Gregory, Hartley, Constructing Deafness). In my opinion, this has been a largely distorted view of professionals who have had no experience within the deaf community and have only viewed deaf people as a group who is deviating from the norm. In a primarily male-dominated society, many events and medical conditions have not been properly studied and documented, simply because they have concerned and affected only women. Similar is the ignorance, misunderstanding and disregard for issues concerning deaf individuals in a primarily hearing world. In fact, the first attempts, at least in the field of Cognitive Psychology, to study deaf people have been done in effort to understand the functioning of the hearing. Throughout human history, there is a myriad of examples when minorities, or underprivileged people have been labeled as ‘different‘ and, therefore, not worth too much effort to be understood, or helped. Sadly, this appears to be a challenge even for scientists and researchers who, above all, should be dispassionate and objective observers and analyzers of phenomena and human behavior. Following the evolutionary perspective in Psychology, we can allude there is an inborn instinct in species to avoid something that is new, foreign and unfamiliar, as it might hurt us. Even if this is the case, humanity has walked a long way in this process of evolution and if we are to take pride in being highly civilized and humane, we are to try to understand the unfamiliar better before putting any sort of label. The population of the United States includes more than 1 million deaf people, most of whom chose to identify themselves as part of the Deaf culture. People within this culture really do share unique values and norms, and use American Sign Language as a primary way of communication (Stebnicki, Coeling, 1999). These are not people who want to be victimized, ignored or viewed as impaired and in many situation the only difference between a hearing and a deaf individual can be the different treatment that we have.
The eighteenth century, following the age of Reason, gave birth to a new philosophical, intellectual and cultural movement that transformed the mentality of people not only in the Old Continent, but in the New World alike. This era, known as the Age of Enlightenment, promoted human intellect, reasoning, liberty and virtue. The symbolism behind Enlightenment is found in the elaborate metaphor of light being cast upon the world to reveal the truth in science, social and political order, education and all other human affairs. Probably the best way to describe the spirit of this historically significant period is to view it from the eyes of its most pronounced thinkers. In his work, Immanuel Kant explains: “Enlightenment is man’s emergence from his self-imposed nonage. Nonage is the inability to use one’s own understanding without another’s guidance. This nonage is self-imposed if its cause lies not in lack of understanding but in indecision and lack of courage to use one’s own mind without another’s guidance. Dare to know! (Sapere aude) ‘Have the courage to use your own understanding’ is therefore the motto of the Enlightenment.”
The Achievement Motivation Inventory AMI (Schuler, Thornton, Frintrup & Mueller Hanson, 2004) is based on a new trait-oriented concept of Achievement Motivation that assumes it is build up of multiple interrelated components. Specifically, the Inventory employs 17 scales of measurement, 170 items total (each scale has ten items). The inventory is intended for use in work and employment context.
The Five Factor Theory was first introduced by McCrae and Costa (1984) and is based on the assumption that personality is relatively stable in adulthood. Generally, the traits that we show at the age of 30 would remain essentially unchanged into old age. (McCrae & Costa, Personality in Adulthood) Therefore, assessing personality based on the core traits what will not change through adult life seemed like a reliable method. There have been a lot of multi-cultural, cross-sectional and longitudinal studies throughout the past two decades. All of this research has confirmed the reliability and validity in the NEO Personality Inventory, or NEO-PI (Costa & McCrae, 1985, 1989a) and has postulated there are indeed universal personality traits that characterize people all over the world.
Axis II in DSM-IV versus the Five Factor Model