Disinhibited Social Engagement Disorder

DisclaimerThis page is not here to be used as a self-diagnosis, self-identification, or promotion - it's simply here to be informational. Whether or not one self-diagnoses, self-identifies, and/or seeks a professional diagnosis is up to them.AbuseThe following page includes discussions of abuse, including verbal, physical, neglect, sexual (**SA also has its own warning**), etc. If you are uncomfortable or get triggered by this topic, it is recommended to not read this page.

**Disinhibited Social Engagement Disorder (DSED)** is an attachment condition characterized by difficulty forming emotional bonds with others and a lack of inhibition around strangers. The condition tends to occur in young children who have experienced neglect, trauma, abandonment or abuse. Instead of forming typically close bonds with parents or caregivers, the child treats strangers with an atypical lack of fear or shyness.

## Signs & Symptoms

DSED symptoms usually begin early in childhood, sometimes in infancy. Common symptoms include:

* Showing little to no fear or inhibition when meeting adult strangers.
* No shyness when meeting new individuals.
* Inappropriate shows of affection to strangers.
* Not needing or seeking permission from caregivers to approach strangers.
* No fear or anxiety when leaving caregivers with strangers.

### Diagnosis

To meet the diagnostic criteria for disinhibited social engagement disorder, a child must exhibit a pattern of behavior that involves approaching and interacting with unfamiliar adults as well as at least two of the following behaviors:

* Overly familiar verbal or physical behavior that is not consistent with culturally sanctioned and appropriate social boundaries.
* Reduced or absent reticence to approach and interact with unfamiliar adults.
* Diminished or absent checking back with an adult caregiver after venturing away, even in unfamiliar settings.
* Willingness to go off with an unfamiliar adult with minimal to no hesitation.

In addition to meeting the diagnostic criteria behaviorally, a child must have a history of neglect as evidence by one of the following:

* Social neglect, including the persistent lack of having basic emotional needs for comfort, stimulation, and affection met by caregiving adults.
* Repeated changes of primary caregivers that limited the child's opportunities to form stable attachments.
* Rearing in unusual settings that limited the child's ability to form selective attachments.

## Causes

DSED can be caused by one or more factors. Cases typically include the absence of a solid, long-term caregiver. A caregiver is someone who:

* Meets the child's needs.
* Spends time teaching the child.
* Feeds, shelters, and provides emotional support for the child.

Some children diagnosed with DSED come from institutionalized settings with a high caregiver-to-child ratio, such as orphanages. Kids in foster care who are shuttled between households repeatedly or who never get adopted may also develop DSED.

Childhood trauma, extreme abuse, or neglect also puts kids at risk if the child doesn't have a caring adult to make the experience less traumatic.

Situations that may increase a child's risk are:

* The death of one or both parents.
* Being raised by an absentee parents or one with a history of substance abuse.
* Early sexual abuse.

## References

https://www.verywellmind.com/what-is-disinhibited-social-engagement-disorder-4138254

https://unitedbrainassociation.org/brain-resources/disinhibited-social-engagement-disorder/

https://www.healthline.com/health/disinhibited-social-engagement-disorder