This article will provide a comprehensive understanding of Disinhibited Social Engagement Disorder (DSED), outlining its symptoms, causes, and treatments.
What is Disinhibited Social Engagement Disorder (DSED)?
Disinhibited social engagement disorder (DSED) is an attachment disorder that tends to occur in young children who have experienced abuse, abandonment, or neglect. Under normal conditions, children are cautious with people they don’t know, but that fear does not exist in individuals with DSED disorder. This is a particularly dangerous condition that presents serious safety problems for children if left untreated.
Symptoms and Diagnosis of DSED
Common symptoms of disinhibited social engagement disorder can include:
- Being excessively familiar both verbally and physically toward people they don’t really know, especially adults
- Not checking in with caregivers or parents
- Having no social boundaries
- Having minimal inhibition with strangers and a willingness to go off with strangers with no hesitation
These symptoms can cause a lot of complications.
Under normal circumstances, if a child falls on the playground and injures themselves, they’ll look for the caregiver or parent they came with. By comparison, someone with DSED disorder will reach out to any stranger for emotional support. They might sit on someone’s lap on a park bench or tell a stranger that they got hurt.
Tangentially, most young children lack the ability to identify predatory facial expressions, but they remain cautious about strangers based on their facial expressions. By comparison, children with DSED are more willing to engage with complete strangers because they actually have challenges with facial recognition. Brain imaging research has found that children with disinhibited social engagement disorder are unable to discriminate between an adult who looks untrustworthy and mean compared to an adult who looks safe and kind.
Finally, under normal circumstances, children get kindness from their safe person, their parents or caregiver. But children with DSED don’t have a safe person, so they show affection toward anyone who provides any level of attention. They might talk to unfamiliar adults, sit down with other families at a picnic, or hug strangers at the park. They often indiscriminately seek physical affection and kindness.
Causes and Risk Factors
Disinhibited social engagement disorder is often caused by neglect, particularly during infancy. Infancy is when children bond and form attachments with trusting caregivers or parents. Children who are neglected don’t have the opportunity to form these bonds.
This type of disorder happens when a child is neglected during the first few months of life because they are living in institutions or foster homes where a single, trusted caregiver is not available. Symptoms often manifest by the age of two. DSED is more common in children who grew up in orphanages, were raised in several institutions, or have been placed in multiple foster care homes.
DSED in Different Environments
Research indicates that disinhibited social engagement disorder looks slightly different in a variety of environments. The behaviors can evolve as a child ages.
Toddlers start by showing fear whenever they are presented with adults they don’t know. Even something as simple as holding hands with a stranger will manifest in a lot of fear.
Once children reach preschool, they start displaying the attention-seeking behaviors of DSED disorder, doing things to get adults to look at them, like making loud noises.
As children enter school, the behavioral signs of disinhibited social engagement disorder will look like overfamiliarity. For example, a child might meet a new person in school and immediately tell them, “I want to go to your house after school to hang out.”
At this age, it’s also common for individuals with DSED to have inauthentic emotional expressions. Somewhere around the age of 10 or 11, they might laugh when they see other people laughing or try to manipulate social situations by seeming sad even if they aren’t.
During adolescence, the behavioral symptoms of DSED start to affect other people, including teachers, parents, and peers. At this level, teenagers will have superficial relationships, but they won’t be able to develop meaningful attachments; they will usually struggle with a lot of conflict and maintain their distrust of adults.
Without treatment, as individuals progress into adulthood, they can experience emotional issues and cognitive impairment that mirror some of the same social bonding and relationship issues experienced during adolescence.
The Role of Caregivers and Professionals
Children who are struggling with attachment disorders need to receive consistent care. If a child continues to live in an orphanage or moves from one foster home to the next, their condition is unlikely to improve.
As such, once a child is able to receive consistent care from their parents or caregivers, then professional treatment can be considered as a way to help improve that bond. Research indicates that attachment disorders do not improve naturally, so professional treatment involving therapy for children and their caregivers or parents can provide the best approach to meeting and addressing symptoms.
How to treat DSED Disorder
As a parent or caregiver, there are things you can do to help children with DSED better manage their behavior and form social bonds with others.
-Establishing a Safe and Predictable Environment
If you have a child diagnosed with DSED, the most important thing you can do is to provide them with stability. They need to have consistent care that doesn’t fluctuate or change.
They also need to know, as part of that stability, what is expected from them in terms of behavior and what the subsequent consequences are if they don’t meet those expectations. This means you have to not only set clear expectations but also clear rules explaining the consequences if a child crosses any established boundary.
-Developing Secure Attachments
Developing a routine goes a long way toward aiding with consistent and stable care. Having household routines that are done the same way every day can help children know what is expected of them, and they can learn that they can trust their caregivers when they stick with this routine.
What you do in the household may be insufficient, however, and could be better aided by therapeutic interventions. There are certain symptoms that are more appropriately addressed with professional therapy.
Play therapy can be a viable therapeutic intervention that allows children the opportunity to better express issues, concerns, and attachment through play.
-Social Skills Training
Social skills training can be an effective way to help children learn to develop and maintain social relationships.
If you have a child presenting with DSED, don’t hesitate to contact specialists. Professional treatment may be necessary to address behavior problems and attachment issues that are currently interfering with relationship formation.
With disinhibited social engagement disorder, there are several things you can do as a caregiver or parent to ensure that a child is receiving consistent care, but long-term success in managing symptoms is best aided by professional consultations.