Reactive Attachment Disorder is characterized by markedly disturbed and developmentally inappropriate social relatedness in most contexts, beginning before age 5 as evidenced by either:

• Persistent failure to initiate or respond in a developmentally appropriate fashion to most social interactions, as manifest by excessively inhibited, hyper vigilant, or highly ambivalent and contradictory responses (e.g. the child may respond to caregivers with a mixture of approach, avoidance, and resistance to comfort, or may exhibit frozen watchfulness)
• Diffuse attachments as manifest by indiscriminate sociability with marked inability to exhibit appropriate selective attachment (e.g. excessive familiarity with relative strangers or lack of selectivity in choice of attachment figures)