Disorganized Attachment and ADHD

How Early Experiences Influence Child Development
The connection between disorganized attachment and Attention Deficit Hyperactivity Disorder (ADHD) has been actively studied over the past decades. Research shows that children with disorganized attachment often display behavioral traits similar to ADHD symptoms, as well as common genetic markers affecting the dopamine system.

What is disorganized attachment?

The term describes a child’s behavior that combines contradictory reactions toward a significant adult: seeking closeness while simultaneously avoiding it (Main & Solomon, 1990). For example, when meeting their mother, a child may initially run toward her, then stop, turn around, and run away, showing hesitation.
Other observed behaviors include:

  • freezing and “pseudo-absence,” resembling a loss of attention;
  • motor restlessness with chaotic shifts in activity direction;
  • emotional outbursts, including collapsing to the floor in a state of affective overload, not related to oppositional behavior (Solomon & George, 1999a).

Why does this happen?

One explanation is a disorganized internal working model of attachment. The mother may be both a source of protection and a source of fear for the child — for example, if in attachment situations she behaves aggressively or, conversely, passively and fearfully (Hesse & Main, 1990).

Connection with ADHD

Children with ADHD are more likely to have a disorganized attachment pattern than their peers without the diagnosis. Moreover, both groups have been found to share similar gene polymorphisms responsible for dopamine receptor function. This may indicate that genetic predisposition can be triggered by traumatic experiences or adverse family interactions (Brisch, 2002b, 2004a).

The role of trauma

Traumatic events (neglect, abuse) are associated with the development of disorganized attachment in 80% of cases (Cicchetti & Barnett, 1991; Lyons-Ruth et al., 1987, 1989).
Even if the mother does not have obvious trauma, her chaotic and inconsistent behavior in interactions with the child can provoke the development of such a pattern (George & Solomon, 1996, 1999a).

Example: Children from Romanian orphanages

Longitudinal studies of children who grew up in deprivation and were adopted into well-functioning families showed that many retained signs of ADHD and attachment disorders even years later (Rutter et al., 1999; O’Connor et al., 2000). The more severe the early experiences, the more pronounced the symptoms (Kreppner et al., 2001).

Why behavioral therapy doesn’t always work

If ADHD in a particular child is rooted in trauma and attachment disruption, behavioral approaches may temporarily reduce symptoms but will not address the underlying cause. In such cases, trauma-focused therapy, including work with parents to stop the intergenerational transmission of trauma, is more effective (Lyons-Ruth et al., 1993).

Conclusion: Disorganized attachment and ADHD may share common roots — a combination of genetic vulnerability and traumatic experiences. Understanding this link helps tailor therapy more precisely, focusing not only on behavior but also on the deeper causes.
References (APA)

  • Ainsworth, M. D. S., & Wittig, B. A. (1969). Attachment and exploratory behavior of one-year-olds in a strange situation. In B. M. Foss (Ed.), Determinants of infant behaviour IV (pp. 113–136). London: Methuen.

  • Brisch, K. H. (2002b). Treating attachment disorders. New York: Guilford Press.

  • Brisch, K. H. (2004a). Attachment disorders in early childhood. In L. Speranza, P. Nicolais, & R. Continisio (Eds.), Attachment and psychoanalysis (pp. 45–60). Milan: Raffaello Cortina.

  • Cicchetti, D., & Barnett, D. (1991). Attachment organization in maltreated preschoolers. Development and Psychopathology, 3(4), 397–411.

  • Cicchetti, D., & Toth, S. L. (1995). A developmental psychopathology perspective on child abuse and neglect. Journal of the American Academy of Child & Adolescent Psychiatry, 34(5), 541–565.

  • George, C., & Solomon, J. (1996). Representational models of relationships: Links between caregiving and attachment. Infant Mental Health Journal, 17(3), 198–216.

  • George, C., & Solomon, J. (1999a). Attachment and caregiving: The caregiving behavioral system. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment: Theory, research, and clinical applications (pp. 649–670). New York: Guilford Press.

  • Hesse, E., & Main, M. (1990). Disorganized infant, child, and adult attachment: Collapse in behavioral and attentional strategies. Journal of the American Psychoanalytic Association, 48(4), 1097–1127.

  • Kreppner, J. M., O’Connor, T. G., Rutter, M., & The English and Romanian Adoptees Study Team. (2001). Can inattention/overactivity be an institutional deprivation syndrome? Journal of Abnormal Child Psychology, 29(6), 513–528.

  • Lyons-Ruth, K., & Jacobvitz, D. (1999). Attachment disorganization: Unresolved loss, relational violence, and lapses in behavioral and attentional strategies. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment (pp. 520–554). New York: Guilford Press.

  • Lyons-Ruth, K. (1996). Attachment relationships among children with aggressive behavior problems: The role of disorganized early attachment patterns. Journal of Consulting and Clinical Psychology, 64(1), 64–73.

  • Main, M., & Solomon, J. (1990). Procedures for identifying infants as disorganized/disoriented during the Ainsworth Strange Situation. In M. T. Greenberg, D. Cicchetti, & E. M. Cummings (Eds.), Attachment in the preschool years: Theory, research, and intervention (pp. 121–160). Chicago: University of Chicago Press.

  • O’Connor, T. G., Rutter, M., & The English and Romanian Adoptees Study Team. (2000). Attachment disorder behavior following early severe deprivation: Extension and longitudinal follow-up. Journal of the American Academy of Child & Adolescent Psychiatry, 39(6), 703–712.

  • Rutter, M., Andersen-Wood, L., Beckett, C., Bredenkamp, D., Castle, J., Groothues, C., ... & The English and Romanian Adoptees Study Team. (1999). Quasi-autistic patterns following severe early global privation. Journal of Child Psychology and Psychiatry, 40(4), 537–549.

  • Solomon, J., & George, C. (1999a). The measurement of attachment security in infancy and childhood. In J. Cassidy & P. R. Shaver (Eds.), Handbook of attachment (pp. 287–316). New York: Guilford Press.
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