Disinhibited Social Engagement Disorder

DSED or Disinhibited Social Engagement Disorder is another type of attachment disorder seen in children. It can be described by inappropriate and overfamiliar social interactions with other adults despite the presence of their family/parents. They show decreased or absolutely no fear of new and unfamiliar situations and people, hold hands, hug or sit on the laps of a new person without any hesitation. They can be willing to go to unknown places with an unfamiliar person. 

As with RAD, DSED is associated with neglect, maltreatment, and abuse during infancy and early childhood. This can include emotionally nonresponsive immediate caregivers within the family subsystem. This severe neglect during the child’s developmental period leads to a delay or even abruption of the formation of a secure attachment bond. There are developmental delays in physical, social, and emotional areas. 

RAD and DSED can be both diagnosed in early childhood, usually before five years of age. Their inability to form secure and healthy attachment bonds and develop meaningful interactions directly results from the relational trauma they go through in their early childhood. 

Even though we have well-established ‘diagnoses’ in the psychiatric community, it is essential to understand that trauma does and can exist outside the boundaries of these diagnoses. It can affect how one views self, others, and the world. Even without the frames of trauma-specific or any other mental health condition, trauma can affect the individual’s whole being. Thus, it becomes imperative to acknowledge the subjective effects of any situation the individual has gone through to develop what was lost to them in the first place – trust, trust in themselves, others, and the world.