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Disinhibited Social Engagement Disorder

What is Disinhibited Social Engagement Disorder (DSED)?

DSED is believed to be one of the two attachment disorders that tend to develop in childhood when an individual lacks appropriate nurturing and affection from their parent or primary caregiver (the individual is typically diagnosed before age 18). As a result of the lack of attention and affection to the child from the parent, the child is not only not closely bonded to their parents, but the child also feels as comfortable with strangers as they do with their parent and/or primary caregiver.

IMPORTANT NOTE: A caregiver is the individual who meets the child’s needs, spends time teaching and/or educating, and feeds, shelters, and provides the child with emotional support to say the least.

What are the symptoms of DSED?

Signs and symptoms begin to appear after the age of 9 months.

According to the DSM-V, in order for a child to be diagnosed with such disorder they must show at least 2 of the following symptoms:

  • A child is not shy nor afraid of meeting new people for the first time
  • The child shows familiar verbal and physical interaction that is outside the expected norms
  • The child does not look back for support nor do they ensure that an adult is with them when embarking in a new activity and/or journey
  • The child is willing to leave an adults sight without hesitation
  • The child shows no fear for adult strangers

What causes DSED?

Experts believe that an individuals caregiving environment plays a strong role in the development of such disorder. For instance, babies between 6 months and 2 years of age who are left in an orphanage, those who are going from one family to the next with no consistency, or those who have suffered some sever trauma (i.e. death of a parent or abuse) or social neglect, are at a higher risk of developing DSED. It is important to note however, that just because an individual has experienced a neglectful or inconsistent caregiver does it mean that they will develop the disorder. In fact, some individuals will not, but such characteristics in a caregiver do increase the chances of an individual developing DSED. In addition, it is believed that genetics also play a role.

How is DSED treated?

  • Play Therapy
    • Provides children with a way to express emotions and their experiences in a constructive way
    • Children decide the outcome in therapy, which gives them a sense of power that can then aid in self-healing
    • Can help a therapist and/or psychologist diagnose a child through observation
  • Expressive Therapy

The goal of the therapies mentioned above is to foster the formations of attachments.

How can I help someone who has DSED?

  • Educate yourself on the subject
  • Be patient
  • Listen to the child’s needs
  • Ensure that the child is receiving the appropriate treatment and/or therapy
  • Set some time aside for the individual (stay consistent)