Richters M M, Volkmar F R
Yale Child Study Center, Yale University, New Haven CT.
J Am Acad Child Adolesc Psychiatry. 1994 Mar-Apr;33(3):328-32. doi: 10.1097/00004583-199403000-00005.
Since its introduction into DSM-III, reactive attachment disorder has stood curiously apart from other diagnoses for two reasons; it remains the only diagnosis designed for infants, and it requires the presence of a specific etiology. This paper describes the pattern of disturbances demonstrated by some children who meet DSM-III-R criteria for reactive attachment disorder. Three suggestions are made: (1) the sensitivity and specificity of the diagnostic concept may be enhanced by including criteria detailing the developmental problems exhibited by these children; (2) the etiological requirement should be discarded given the difficulties inherent in obtaining complete histories for these children, as well as its inconsistency with ICD-10; and (3) the diagnosis arguably is not a disorder of attachment but rather a syndrome of atypical development.
自反应性依恋障碍被纳入《精神疾病诊断与统计手册》第三版（DSM-III）以来，它因两个原因而奇怪地与其他诊断区分开来：它仍然是唯一针对婴儿的诊断，并且它需要存在特定的病因。本文描述了一些符合DSM-III-R反应性依恋障碍标准的儿童所表现出的紊乱模式。提出了三点建议：（1）通过纳入详细说明这些儿童所表现出的发育问题的标准，可能会提高诊断概念的敏感性和特异性；（2）鉴于获取这些儿童完整病史存在固有困难，以及该病因要求与《国际疾病分类》第十版（ICD-10）不一致，应摒弃病因要求；（3）可以说该诊断不是一种依恋障碍，而是一种非典型发育综合征。
