What Is Disinhibited Social Engagement Disorder in Children?

Disinhibited social engagement disorder (DSED) is characterized by an exaggerated trust in strangers. This can lead to dangerous situations, especially when it comes to children. Discover the most frequent symptoms, causes, and treatments.
What Is Disinhibited Social Engagement Disorder in Children?

Last update: 27 May, 2022

Have you ever heard of disinhibited social engagement disorder (DSED) in children? This disorder refers to a behavioral pattern in children who actively approach and interact with strangers without any sense of caution or fear. In some cases, this disorder is related to attention deficit hyperactivity disorder (ADHD).

In the following article, we’ll talk about the symptoms and causes of this disorder. What’s more, we’ll also share talk about some treatment options for this disorder that exclusively affects children.

Disinhibited social engagement disorder in children

How to recognize this disorder

First of all, these are some of the frequent signs that may help detect and diagnose this disorder in children:

  • The child shows no fear or shyness when meeting someone new.
  • He or she displays an active attitude in regard to strangers as if he or she were interacting with a trusted friend. The child will hug strangers willingly.
  • Children with this disorder have no problem going off with someone they don’t know. What’s more, they’ll do so without asking for permission from parents or caretakers.

As you can imagine, children that suffer from this disorder are at great risk on a daily basis given their willingness to go off with strangers. What’s more, they may have a hard time connecting on an emotional level with their peers and family members.

Read also: Teach a Child What to Do if They Get Lost

When should you talk to your doctor?

A girl walking with a woman.
When a child displays excessive interest and trust in strangers, then we can suspect the presence of this disorder.

In order to determine if you should see a doctor, ask yourself the following questions:

  • Instead of turning to parents, relatives, and teachers, does your child seek the support, comfort, and company of strangers?
  • Does he or she have an overly sociable and affectionate attitude toward strangers?
  • Does your child move away from parents and caretakers upon arriving at a new place?
  • Is your child prone to asking strangers very personal questions?

What does DSED have to do with ADHD?

Disinhibited social engagement disorder in children can have factors in common with attention deficit hyperactivity disorder, according to some psychiatric specialists. However, it’s important to know the difference between the two.

The common ground between these two disorders is an excessive and inappropriate friendliness toward strangers. At the same time, both disorders involve difficulty establishing limits in social relations. However, ADHD is not associated with a lack of attachment in the early stages of life.

What’s the cause of disinhibited social engagement disorder?

A victim of child abuse.

In some cases, experts point to a lack of attention toward the child during the early stages of life, including infancy. This lack of attachment can later lead to disinhibited social engagement disorder in children. But other factors can also lead to this disorder, including living in orphanages or shelters from a young age.

However, while a lack of attention in early childhood increases a child’s chances of developing DSED, not all children who develop the disorder experienced neglect. In fact, the disorder is also associated with unstable or inconsistent family environments as well as with traumatic events. 

Is disinhibited social engagement disorder treatable?

Disinhibited social engagement disorder is treatable on a psychological level once a specialist evaluates both the child and his or her family. Then, the specialist can establish an individualized treatment.

The treatment will always aim to make the child feel comfortable in his or her daily environment. And it may involve activities like playing and drawing. The objective will be to support the family, facilitate understanding of the disorder, and strengthen the parent-child bond.

When will the child begin to show signs of improvement?

However, it’s impossible to say how soon children will manage to achieve a healthy and positive development on a social and emotional level, and begin to feel cared for and protected in their immediate surroundings. Therefore, the duration of treatment will vary according to each child, as well as to his or her age.

All cited sources were thoroughly reviewed by our team to ensure their quality, reliability, currency, and validity. The bibliography of this article was considered reliable and of academic or scientific accuracy.

  • Zeanah, C. H., & Gleason, M. M. (2015). Annual research review: Attachment disorders in early childhood – Clinical presentation, causes, correlates, and treatment. Journal of Child Psychology and Psychiatry and Allied Disciplines. https://doi.org/10.1111/jcpp.12347
  • Humphreys, K. L., Nelson, C. A., Fox, N. A., & Zeanah, C. H. (2017). Signs of reactive attachment disorder and disinhibited social engagement disorder at age 12 years: Effects of institutional care history and high-quality foster care. Development and Psychopathology. https://doi.org/10.1017/s0954579417000256
  • Zeanah, C. H., Chesher, T., Boris, N. W., Walter, H. J., Bukstein, O. G., Bellonci, C., … Stock, S. (2016). Practice Parameter for the Assessment and Treatment of Children and Adolescents With Reactive Attachment Disorder and Disinhibited Social Engagement Disorder. Journal of the American Academy of Child and Adolescent Psychiatry. https://doi.org/10.1016/j.jaac.2016.08.004
  • Rubio Morell, Belen & Gastaminza, Xavier & Práxedes, MD. (2016). TRASTORNO DE RELACION SOCIAL DESINHIBIDA (TRSD) y TDAH.
  • CEBC » Search › Topic Areasdsm5 › Dsm 5 Criteria For Disinhibited Social Engagement Disorder. Retrieved from https://www.cebc4cw.org/search/topic-areasDSM5/dsm-5-criteria-for-disinhibited-social-engagement-disorder/

This text is provided for informational purposes only and does not replace consultation with a professional. If in doubt, consult your specialist.