學前反應性依附障礙症之文獻回顧分析

Literature Review Analysis: Preschool Reactive Attachment Disorder

反應性依附障礙症（Reactive Attachment Disorder，簡稱RAD）為兒童早期極度缺乏照護或因長期社交忽略，甚或剝奪而造成的一種心理疾患，主要特徵為與主要照顧者間缺乏或嚴重未發展的依附關係，並造成其在生活中容易出現表現積極情緒的能力下降，以及無法尋求或接受身體或情感上的親密關係，且縱使在無威脅的狀況下與成人照顧者互動，仍可能出現無法解釋的易怒、悲傷或恐懼，甚至出現暴力行為，以及部分行為模式容易與自閉症等相關障別混淆，RAD與其他障礙類別的區辨重點為幼兒是否有依附關係的缺失、情緒調節能力的受損以及不當的社交互動。透過搜尋「PubMed」、「華藝圖書館」，系統性搜尋了國內外的文獻資料，查詢國外2015年至2023年關鍵字為「Reactive Attachment Disorder」、「反應性依附障礙」之相關研究，整理出與反應性依附障礙症相關之評估工具、介入策略，包含家庭教養策略及學校教育策略，研究發現國內對於RAD的研究仍有相當的空白。本研究特別針對介入策略的研究進一步整理與說明，希冀能提升國內對RAD的理解，並為往後相關研究之參考。

Reactive Attachment Disorder (RAD) is a psychological condition in early childhood caused by extreme lack of care, prolonged social neglect, or deprivation. Its primary characteristic is the absence or severe underdevelopment of attachment relationships with primary caregivers, leading to difficulties in expressing positive emotions and an inability to seek or accept physical or emotional intimacy. Even in nonthreatening situations, children with RAD may exhibit unexplained irritability, sadness, or fear when interacting with adult caregivers, sometimes even displaying violent behavior. Additionally, some behavioral patterns may be easily confused with other disorders, such as autism. The key distinctions between RAD and other disorders are the lack of attachment relationships, impaired emotional regulation, and inappropriate social interactions. Through a systematic review of domestic and international literature using ''PubMed'' and ''Airiti Library,'' this study examined research from 2015 to 2023 with the keywords ''Reactive Attachment Disorder'' and“反應性依附障礙(Reactive Attachment Disorder)'' to identify assessment tools and intervention strategies related to RAD, including family-based and school-based interventions. The findings reveal a significant gap in domestic research on RAD. This study focuses on intervention strategies, aiming to enhance understanding of RAD in Taiwan and serve as a reference for future research.