Disinhibited Social Engagement Disorder in Children

September 7, 2020
On occasion, there are children that display uninhibited social conducts toward strangers. Today, we'll talk about disinhibited social engagement disorder in children.

Parents want their children to have good social skills and be able to relate to others in a proper way. However, on occasion, uninhibited behaviors can indicate that a child is suffering from disinhibited social engagement disorder.

This disorder typically appears between 9 months and 5 years of age, during the infant stage. However, it can persist over time. The main characteristic is that children have no fears or qualms about initiating interaction with strangersRather, they’re completely uninhibited. Do you want to know more about disinhibited social engagement disorder? Keep reading.

Characteristics of disinhibited social engagement disorder

  • Children with this disorder have disinhibited social conduct. In other words, they don’t feel at all uncomfortable regarding the presence of strangers and immediately interact with them as if they knew them.
  • These behaviors make their relationships with other children and adults complicated.
  • This disorder appears during early childhood, between 9 months and 5 years of age. However, it can continue to persist in subsequent stages.
  • Children with this disorder initiate contact with any stranger. Since they’re unaware of the risks that talking to strangers or going away with them involves, this conduct can put their lives and wellbeing at risk.
  • These children seek connection, even if it’s with strangers.
Disinhibited Social Engagement Disorder in Children

Diagnostic criteria

This is the diagnostic criteria for disinhibited social engagement disorder according to the DSM-V:

  1. Behavior that involves approaching strangers without distrust or hesitation.
  2. The child has gone through situations involving a lack of care or attachment regarding their main caregiver.
  3. The disorder appears between 9 months and 5 years of age.
  4. These behaviors must persist for at least 12 months. After the age of 4, the symptoms will involve constant attention-seeking and disproportionate expressions of affection.

Symptoms associated with disinhibited social engagement disorder

Most symptoms have to do directly with the child’s behavior regarding how they relate to others. Mainly, it has to do with how they relate to adults.

  • A lack of feelings of fear when it comes to strangers.
  • Children interact without inhibition with adults who aren’t their family members and who they don’t even know.
  • These children don’t often look for or need their parents or caregivers when in an unfamiliar environment.
  • A tendency to go off with strangers.
  • Verbally and physically affectionate behavior that exceeds their age and social norms.

Causes of disinhibited social engagement disorder

  1. The cause may be an attachment disorder during infancy where a child didn’t receive proper care and affection as a baby.
  2. Some theories also indicate there may be certain biological circumstances at play. These are associated with the child’s temperament and their regulation of affection. According to these theories, certain alterations in certain areas of the brain (hippocampus, amygdala, prefrontal cortex) may be responsible for these behavior problems. However, there’s still no confirmation that these theories are true.
  3. However, experts have observed various key causes of this disorder. For example, neglect and family violence. Living in an orphanage where there’s a lack of affection and frequent changes in main caregivers is also a major factor. In all of these cases, children are unable to establish healthy bonds with anyone. And, as a result, they may develop this disorder.

Treatment

In these cases, it’s best to offer children a stable bond. Little ones with this disorder have a completely distorted model when it comes to relationships. So, therapists must work with parents as well as children in order to establish positive interaction between both parties.

In this case, the objective is to change the behavior of parents toward the child.

  • With parents, a professional will help them offer security, be available emotionally, and be stable attachment figures.
  • With the child, the professional will work on the reconstruction of their feelings of safety in order to reconstruct attachment in a healthy and positive way.

Help for children with disinhibited social engagement disorder

If you suspect that your child has this disorder, or you simply have concerns, it’s important to consult a professional. A trained psychologist will be able to make a more exhaustive evaluation and recommend proper treatment as soon as possible.

 

  • American Psychiatric Association (APA).(2013).Diagnostic and stadistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric PUblishing.
  • Fernández Rivas, Aránzazu; Ortiz Villalobos, Aránzazu; Rodríguez Ramos, Prudencio. (2010). “8. Trastorno reactivo del vínculo, TEPT y abuso crónico”. César Soutullo Esperón y María Jesús Mardomingo Sanz, ed. Manual de Psiquiatría del Niño y del Adolescente. Madrid: Editorial Médica Panamericana. p. 131