Jeannie Koch has been known to child protective services since she was 2 years old. Her mother, Carmen, never married. Jeannie's father lost touch with the family after his last incarceration for selling drugs. The case notes describe Jeannie's mother as struggling with depression indicating that she was often "unavailable" due to recurring bouts of depression. During episodes of feeling "down," Carmen would leave Jeannie in the care of various sitters or relatives. While there was no history of serious abuse or neglect, Jeannie's mother was often not able to attend to her daughter's needs. Carmen has just been hospitalized for a major depressive episode and this time around the caseworker was unable to locate relatives who could take care of Jeannie - now 4 years of age - for an extended period of time and so the youngster was placed in temporary foster care. Soon after placement, the foster mother reports, "She keeps to herself and hardly talks to any of us. I can hear that child sobbing when she is alone in her room. And when I ask Jeannie if she's worried about her mother, she insists that her mom is on vacation and will be back soon." Further, Jeannie seems unresponsive to any efforts to comfort her. What do you think is the appropriate diagnosis for Jeannie Koch?

Question

Quizplus · Accepted Answer

Jeannie's behavior is consistent with the diagnosis of reactive attachment disorder, which is characterized by emotional withdrawal and a lack of responsiveness to social stimuli due to a failure to form normal attachments to caregivers during infancy or early childhood. Her history of being left in the care of various sitters or relatives during her mother's episodes of depression may have contributed to her inability to form these attachments. Additionally, her belief that her mother is simply on vacation and will return soon suggests a lack of understanding about the permanence of separation, which can also be a symptom of reactive attachment disorder.

Jeannie Koch Has Been Known to Child Protective Services Since