Dopamine D4 receptor (DRD4) gene polymorphism is associated with attachment disorganization in infants.

About 15% of one-year-old infants in non-clinical, low-risk and up to 80% in high-risk (eg maltreated) populations show extensive disorganized attachment behavior(1,2) in the Strange Situation Test.(3) It has also been reported that disorganization of early attachment is a major risk factor for the development of childhood behavior problems.(4) The collapse of organized attachment strategy has been explained primarily by inappropriate caregiving, but recently, the contribution of child factors such as neurological impairments and neonatal behavioral organization(6) has also been suggested. Here we report an association between the DRD4 III exon 48-bp repeat polymorphism and attachment disorganization. Attachment behavior of 90 infants was tested in the Strange Situation and they were independently genotyped for the number of the 48-bp repeats by polymerase chain reaction (PCR). The 7-repeat allele was represented with a significantly higher frequency in infants classified as disorganized compared to non-disorganized infants: 12 of 17 (71%) vs 21 of 73 (29%) had at least one 7-repeat allele (chi2 = 8.66, df = 1, P < 0.005). The estimated relative risk for disorganized attachment among children carrying the 7-repeat allele was 4.15. We suggest that, in non-clinical, low-social-risk populations, having a 7-repeat allele predisposes infants to attachment disorganization.