atypical attachment pattern is considered to be an actual disorder, known as reactive attachment disorder or RAD, which is a recognized psychiatric diagnosis (ICD-10 F94.1/2 and DSM-IV-TR 313.89). Against common misconception, this is not the same as 'disorganized attachment'. The essential feature of reactive attachment disorder is markedly disturbed and developmentally inappropriate social relatedness in most contexts that begins before age five years, associated with gross pathological care. There are two subtypes, one reflecting a disinhibited attachment pattern, the other an inhibited pattern. RAD is not a description of insecure attachment styles, however problematic those styles may be; instead, it denotes a lack of age-appropriate attachment behaviours that may appear to resemble a clinical disorder. Although the term "reactive attachment disorder" is now popularly applied to perceived behavioural difficulties that fall outside the DSM or ICD criteria, particularly on the Web and in connection with the pseudo-scientific attachment therapy, "true" RAD is thought to be rare. "Attachment disorder" is an ambiguous term, which may refer to reactive attachment disorder or to the more problematic insecure attachment styles (although none of these are clinical disorders). It may also be used to refer to proposed new classification systems put forward by theorists in the field, and is used within attachment therapy as a form of unvalidated diagnosis. One of the proposed new classifications, "secure base distortion" has been found to be associated with caregiver traumatization. Clinical practice in adults and families As attachment theory offers a broad, far-reaching view of human functioning, it can enrich a therapist's understanding of patients and the therapeutic relationship rather than dictate a particular form of treatment. Some forms of psychoanalysis-based therapy for adults—within relational psychoanalysis and other approaches—also incorporate attachment theory and patterns. Criticism For attachment theory to be viable, it must be believed that attachment behaviour is strongly affected by one's environment. A 2016 article from the Psychological Bulletin suggests that one's attachment could largely be due to heredity; hence, the authors point to the need to focus research on nonshared environmental effects, requiring "behavioral genetic designs that afford differentiating heritability from shared and nonshared environmental influences". In an interview, Dr. Jerome Kagan also suggests that a child's behaviour is largely due to temperament, as well as social class and culture. He further states, "Attachment is a far less popular explanation in 2019 than it was in the 1960s, and in 10 to 15 years,