This diagnosis, featured in the Diagnostic Classification of Mental Health and Developmental Disorders of Infancy and Early Childhood, Revised Edition (DC 0-3R; Zero to Three, 2005), is very similar to Reactive Attachment Disorder, but more encompassing in its scope. Although the diagnostic criteria is broader and less strict, it applies only to young children 3 years old or younger.
Definition & diagnosis of Deprivation/Maltreatment Disorder of Infancy
The DC 0-3R defines children with this disorder as having “markedly disturbed and developmentally inappropriate attachment behaviors in which (the) child rarely or minimally turns preferentially to a discriminated attachment figure for comfort, support, protection, and nurturance.” (ibid, p. 18) Just as with reactive attachment disorder, other types of developmental disorders that might explain the behavior must first be ruled out.
Signs, symptoms & types of Deprivation/Maltreatment Disorder
The DC 0-3R describes the symptoms of this disorder according to three patterns of behavior:
Emotionally withdrawn or inhibited pattern
For a diagnosis a child must exhibit 3 of the following 4 symptoms: “A) rarely or minimally seeking comfort in distress, B) responding minimally to comfort offered to alleviate distress, C) limited positive affect and excessive levels of irritability, sadness or fear, and D) reduced or absent social and emotional reciprocity (e.g., reduced affect sharing, social referencing, turn-taking, and eye contact).”
Indiscriminate or disinhibited pattern
Children with this subset may be capable of normal attachment behaviors, but they do so indiscriminately, not directing them at a preferred caregiver. Children with this pattern must exhibit at least two of the following: “A) Overly familiar behavior and reduced or absent reticence around unfamiliar adults, B) failure, even in unfamiliar settings, to check back with adult caregivers after venturing away, and C) willingness to go off with an unfamiliar adult with minimal or no hesitation.”
The final subtype is a mix of the first two patterns, with a child showing at least 2 symptoms from each of the first 2 patterns in order to be diagnosed.