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This disorder is unusual because it is diagnosed only if a child has received very bad care from parents or alternative caretakers. The child's emotional or physical needs must have been neglected, or there must have been frequent turnover of caretakers. In addition, this poor care must be presumed to have resulted in the child's failure to respond appropriately in social interactions, for example by being unresponsive or excessively anxious. Such
anxious or withdrawn children are often found in orphanages,
particularly in impoverished countries. The disorder must not be
better accounted for by conditions like Pervasive
Developmental Disorder or Mental
Retardation. If the child does not enter a consistently
supportive environment after diagnosis, the disorder may be
permanent. Treatment is difficult and time-consuming, but usually
successful.
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