A 5-year-old child is accompanied by the foster mother for evaluation of behavioral problems. The foster mother is experienced and has been very successful with children, but this child is very concerning. He has frequent, unexpected episodes of mood and reaction extremes including irritability, sadness, and fearfulness that are disproportionate to the situation. Suspecting reactive attachment disorder, the PMHNP anticipates which of the following to be reported by the foster mother? 

A. Failure to seek or respond to comfort when distressed 

B. Atypical dependency on toys and items that provide comfort 

C. Early toilet training with paradoxical persistent nocturnal enuresis 

D. Tendency toward aggressive behavior and cruelty to animals 

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