As presented in the case study, Jonathan often engages in disruptive behavior in the classroom, including interrupting the teacher, walking around the room, and throwing objects. These symptoms are signs that he has a disruptive behavior disorder (DBD). This disorder includes manifestations of destructive, aggressive, oppositional, and antisocial behavior. DBD is associated in the long term with impaired communication with peers, as well as poor academic performance (Bizzi et al., 2017). Most importantly, Jonathan is potentially at increased risk for depression, legal trouble, or substance abuse in the future (Bizzi et al., 2017). Thus, for an adequate and effective therapy of psychopathology, it is necessary to consider the causes of the development of the disorder, which may be hidden in insecure attachment between child and caregiver.
Attachment patterns that characterize the relationship between a child and a parent in the early stages of development play a key role in shaping the psychological and relational characteristics of the individual. Bizzi et al. (2017) underline that “insecure attachment and mentalization difficulties have received increasing attention as general risk factors for the development of the child and adolescent psychopathology” (p. 1). According to Bowlby’s theory of attachment, the formation of a secure attachment in the first months of an infant’s life ensures the integration of affective, cognitive, and behavioral skills (Capaldo & Perrella, 2018). In turn, the basis for the formation of healthy attachment patterns is the ability for emotional regulation and a sense of self (Bizzi & Pace, 2020). In the situation of failure in the formation of a secure attachment, the child has the risk of not developing the skills of emotional regulation and adequate self-image, which are formed within the relationships.
In Jonathan’s case, the disruption of attachment patterns may be the primary reason for the development of DBD. Bizzi and Pace (2020) note that children diagnosed with this disorder in middle childhood and early adolescence show patterns of avoidance of negative emotions. In particular, they distance themselves from “the dependency to attachment relationships, deactivating attachment-based feelings, experiences and needs respect” (Bizzi & Pace, 2020, p. 9). Thus, disruptive behavior is a form of protection for them from an unwanted negative reaction to the subject of interaction. Children with early disrupted attachment patterns may later use aggression and opposition as methods of distancing.
With regard to the attachment theory, these factors suggest that in the future, children with DBD will use negative relationship patterns with their caregivers. Jonathan, in this case, may use disruptive behavior as a way to protect himself from potentially hurtful feelings and emotions. This factor is explained by the fact that in the early stages of development, he did not receive an adequate emotional response to his needs, which formed an insecure attachment. At a later age, this violation resulted in Jonathan’s inability to adequately regulate his emotions, as well as acquire the necessary relational skills. In this case, the child cannot assess the impact of his actions on other people’s feelings since he did not have an image in the form of a caregiver. Additionally, insecure attachment prevented him from developing an appropriate self-image and assessing his feelings in the context of the situation. Combined, these factors led to the development of disruptive behavior as the main form of avoiding negative feelings and receiving an emotional response that the caregiver did not give.
Bizzi, F., Ensink, K., Borelli, J. L., Mora, S. C., & Cavanna, D. (2018). Attachment and reflective functioning in children with somatic symptom disorders and disruptive behavior disorders. European Child & Adolescent Psychiatry, 28, 1-13. Web.
Bizzi, F., & Pace, C. S. (2020). Attachment representations in children with disruptive behavior disorders: A special focus on insecurity in middle childhood. Clinical Child Psychology and Psychiatry, 25(4), 1-14. Web.
Capaldo, M., & Perrella, R. (2018). Child maltreatment: An attachment theory perspective. Mediterranean Journal of Clinical Psychology, 6(1), 1-20. Web.