Abstract

Background: HIV/AIDS orphans and vulnerable children (OVC) frequently face placement/residential changes, inconsistent caregivers, abuse, neglect, disruptions in their lives, and mental health issues. This can result in reactive attachment disorder (RAD), a disorder of emotional functioning in which the child is wary, watchful, and emotionally withdrawn. Despite its clinical significance, little is known about RAD in OVC. The following questions were addressed in this study: (1) whether RAD symptoms can occur in children with HIV/AIDS; (2) the relationship between RAD and other psychiatric symptoms; (3) possible contextual factors for high RAD symptoms; and (4) any interactive, cumulative effects between the contextual factors (both risks and protective) for higher RAD symptoms.

Method: In a cross-sectional survey, 191 OVC and 100 non-OVC caregivers completed questionnaires on mental health problems, including RAD and contextual variables.

Results: The findings showed that RAD is present in OVC and that RAD symptoms may be caused by both environmental and genetic factors. The study also discovered a high level of comorbidity between RAD and other disorders such as depression, conduct problems, and hyperactivity. Finally, OVC who experienced more neglect and psychological abuse were five times more likely to develop RAD symptoms.

Conclusion: The paper discusses the clinical implications of these findings for community service development for this vulnerable group, concluding that RAD was not uncommon among HIV/AIDS-affected children