A Korean Syndrome of Attachment Disturbance Mimicking Symptoms of Pervasive Developmental Disorder

Abstract

The variations of disturbances in attachment have received little attention in a cultural context. This report describes a clinical syndrome of 25 Korean children (2 to 4 years of age) who presented with serious disturbances of attachment relationships with caregivers and with problems in social and language development, in some ways mimicking symptoms of pervasive developmental disorder (PDD). The children did not have a history of severe abuse or chaotic family environments. Many of the children were referred to Yonsei University Hospital outpatient clinic in Seoul, Korea, with a preliminary diagnosis of autism. Extensive medical and psychological assessments were carried out and results were striking. Changes in child symptoms began to take place during evaluations and difficulties in caregiving relationships became apparent. A subgroup of 10 children received treatment for a year or more with varying degrees of improvement. The clinical features are discussed in terms of some particular Korean cultural and contextual factors.