jake is a 4-year-old adopted boy who at the age of two years and four months was brought by his adoptive mother to a child psychiatrist with symptoms of irritability, fearfulness, emotional dysregulation, and attachment issues. the child would rarely or minimally seek comfort when distressed, nor did he respond to comfort from the adoptive mother when distressed. little is known about jake's early history. there is suspicion that his mother was neglectful with feeding and frequently left him crying, unattended, or with strangers. he was taken away from his mother's care at seven months due to neglect and placed with his aunt, who after two months decided she was unable to take care of him. given the abuse pattern of neglect and repeated changes of primary caregivers in jake's early years, the psychiatrist diagnosed him with