Disinhibited Social Engagement Disorder

Abstract

This chapter provides an overview of a disorder newly defined in Diagnostic and Statistical Manual (DSM)-5 (American Psychiatric Association [APA], 2013), disinhibited social engagement disorder (DSED). This disorder has been recognized and described by various names since at least the mid-twentieth century and defines a pattern of behavior characterized by the absence of developmentally expected reticence in young children about engaging and interacting socially with unfamiliar adults. These defining behaviors have been identified most readily in young children raised in institutions or in those who have been neglected and placed in foster care. The chapter begins by providing a brief history of the development of this diagnosis in the DSM. Reviews have documented a large number of studies that form an empirical justification for the diagnosis of DSED. The chapter updates and expands on these reviews, and considers the symptom presentation, etiology of the disorder, associated impairments and comorbidities, course and developmental challenges, intervention, and what the data suggests regarding prognosis and outcome. In addition, it considers whether it is appropriate to consider DSED as an attachment disorder. The chapter concludes with recommendations for further study. (PsycInfo Database Record (c) 2021 APA, all rights reserved)