The narrative measures used were considered helpful in tracking how early attachment disruption is associated with later expectations about relationships.One paper using questionnaires found that children aged three to six, diagnosed with RAD, scored lower on empathy but higher on self-monitoring (regulating your behavior to "look good"). These differences were especially pronounced based on ratings by parents, and suggested that children with RAD may systematically report their personality traits in overly positive ways. Their scores also indicated considerably more behavioral problems than scores of the control children. Epidemiology
Epidemiological data are limited, but reactive attachment disorder appears to be very uncommon. The prevalence of RAD is unclear but it is probably quite rare, other than in populations of children being reared in the most extreme, deprived settings such as some orphanages. There is little systematically gathered epidemiologic information on RAD. A cohort study of 211 Copenhagen children to the age of 18 months found a prevalence of 0.9%.Attachment disorders tend to occur in a definable set of contexts such as within some types of institutions, in the presence of repeated changes of primary caregiver or of extremely neglectful identifiable primary caregivers who show persistent disregard for the childs basic attachment needs, but not all children raised in these conditions develop an attachment disorder. Studies undertaken on children from Eastern European orphanages from the mid-1990s showed significantly higher levels of both forms of RAD and of insecure patterns of attachment in the institutionalized children, regardless of how long they had been there.
Segmental arterial mediolysis (SAM) is a rare disorder of the arteries characterized by the development of aneurysms, blood clots, narrowing of the arteries (stenoses), and blood collections (hematomas) in the affected distribution.SAM most commonly affects the arteries supplying the intestines and abdominal organs. Signs and Symptoms
Varies depending on the location of the affected blood vessels. Gastrointestinal System:
Acute abdominal pain (most common)
Flank pain
Nausea
Vomiting
Diarrhea
Bloody stools
Back painNervous System
Headache
StrokeThe most severe signs occur if an aneurysm ruptures potentially resulting in:
Shock
Loss of consciousness
Bleeding into the abdominal cavity
Bleeding into the brain

Mechanism
The middle layer of an artery, called the media, made of smooth muscle is damaged. Mediolysis occurs when the smooth muscle cells in the area of damage are destroyed. Small gaps are formed in the wall of the artery which then fill with blood. Gaps create weakness in the wall of the artery, allowing increasing pressure from blood to expand the gaps resulting in an aneurysm. Aneurysms have potential for rupture. Diagnosis
Often Segmental Arterial Mediolysis is diagnosed after clinical presentation with symptoms as above followed by CT angiogram or MRI demonstrating aneurysm(s). The gold standard method for confirming the diagnosis is surgical resection of the affected area of blood vessel followed by histologic investigation under a microscope. Segmental Arterial Mediolysis must be differentiated from fibromuscular dysplasia, atherosclerosis, and other systemic vasculidites including polyarteritis nodosa, Takayasus arteritis, Behcets disease, cystic medial necrosis, and cystic adventitial artery disease. Treatment
Patients presenting with bleeding into the abdominal cavity require possible blood transfusions and emergent intervention with coil embolization via catheter angiography.