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Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder (DSED) defines a pattern of behavior characterized by the absence of developmentally expected reticence in young children about engaging and interacting socially with unfamiliar adults. This entry reviews several aspects of DSED, including clinical presentation, etiology, impairments and developmental challenges, intervention, and prognosis.

Clinical Presentation

In the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), DSED and reactive attachment disorder (RAD) are classified under trauma and stressor-related disorders. RAD includes only a description of the “inhibited” attachment presentation, and the DSED has replaced RAD “disinhibited” type. The rationale for the changes was that other than arising in similar conditions of social neglect, the two disorders differ in most other important ways, including phenotypic characteristics, correlates, course, and response to caregiving or ...

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