Reactive Attachment Disorder of Infancy or Early Childhood 嬰兒或兒童

Reactive Attachment Disorder of Infancy or Early Childhood 嬰兒或兒童的反應性依附障礙

A. Markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 years, as evidenced by either (1) or (2):
很多場合下的依附關係需要出現顯著的障礙並與發育年紀不符,發生在五歲以前,表現有以下的一種
(1) persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hyper vigilant, or highly ambivalent and contradictory responses (e.g., the child may respond to caregivers with a mixture of approach, avoidance, and resistance to comforting, or may exhibit frozen watchfulness)
反複無法在相應發育年齡段合適地在一些人際互動場合作出或啟動正確的反應,表現為過於抑製,過於警覺,對相應的人過於表現出矛盾的反應(比如,孩子對撫養自己的人既想接近,又想回避,不接受對方給予的安撫,或表現為僵化警覺)
(2) diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachments (e.g., excessive  with relative strangers or lack of selectivity in choice of attachment figures)
散漫的依附表現為不加選擇人際交往,沒有能力選擇正確的依附對象(比如,與相對不熟悉的過於親熱,選擇依附對象時缺乏選擇性)
B. The disturbance in Criterion A is not accounted for solely by developmental delay (as in Mental Retardation) and does not meet criteria for a Pervasive Developmental Disorder.
診斷標準A的障礙不能完全由發育遲緩解釋(比如精神發育遲緩)也不符合全身性發育障礙的診斷.
C. Pathogenic care as evidenced by at least one of the following:
撫養過程中有嚴重的問題,至少有以下一項
(1) persistent disregard of the child’s basic emotional needs for comfort, stimulation, and affection
持久地忽略孩子們基本的情感上對安撫,激發,和慈愛的需求
(2) persistent disregard of the child’s basic physical needs
持久地忽略孩子基本的生理需求
(3) repeated changes of primary caregiver that prevent formation of stable attachments (e.g., frequent changes in foster care)
反複地更換孩子的主要撫養人以至於孩子無法與撫養人形成穩定地依附關係(比如,撫養院裏的經常變動工)
D. There is a presumption that the care in Criterion C is responsible for the disturbed behavior in Criterion A (e.g., the disturbances in Criterion A began following the pathogenic care in Criterion C)
標準C裏的撫養缺陷有可能造成了標準A裏的病理行為(比如,病理行為出現在撫養有問題後)