The essential characteristic of Disinhibited Social Relationship Disorder involves socially inappropriate or inappropriate behavior in which there is usually more confidence implicit than would be expected from the type of relationship. This all-too-familiar behavior goes beyond the social limits of culture.
At the time of diagnosis, it is not done before children are able to create selective bonds according to their development. Thus, Disinhibited Social Relationship Disorder is diagnosed when the child has at least a developmental age of 9 months. Disinhibited social relationship disorder has not been described in adults.
This disorder can coexist with developmental delays, especially cognitive and language delays, stereotypes, and other signs of gross neglect, such as malnutrition or poor care. However, the signs of this disorder often persist even after other signs of neglect no longer exist.
How is Disinhibited Social Relationship Disorder diagnosed?
The Diagnostic and Statistical Manual of Mental Disorders, in its fifth edition ( DSM-5 ), cites the criteria for diagnosing this disorder. Let’s see them.
A. Behavioral pattern in which a child actively approaches and interacts with strange adults and exhibits two or more of the following characteristics:
- Reduced or absent reluctance to approach and interact with strange adults.
- Overly familiar verbal or physical behavior. This means that it is not consistent with culturally accepted and age-appropriate social limits.
- Little or no recourse to the adult caregiver after a risky outing, even in strange settings
- Willingness to go off with a strange adult with little or no hesitation.
B. Criterion A behaviors are not limited to impulsivity (as in attention deficit / hyperactivity disorder). However, they include socially uninhibited behavior.
C. The child has experienced an extreme pattern of insufficient care. This is evidenced by one or more of the following characteristics:
- Neglect or social deprivation that is manifested by the persistent lack of having the basic emotional needs covered in order to have well-being, encouragement and affection from adult caregivers.
- Repeated changes in primary caregivers that reduce the opportunity to develop a stable attachment (eg, frequent changes in custody).
- Education in unusual settings that greatly reduces the opportunity for selective attachment (eg, institutions with a high number of children per caregiver).
D. It is assumed that care factor criterion C is responsible for altering behavior criterion A. For example, alterations of criterion A begin after pathogenic care of criterion C).
E. The child has a developmental age of at least 9 months.
How does Disinhibited Social Relationship Disorder develop?
Children diagnosed with Disinhibited Social Relationship Disorder often have problems of social neglect in the first few months of life, even before the disorder is diagnosed. Social neglect is a form of child abuse that includes intentional omissions of care by an adult.
However, there is no evidence that dropping out after two years is associated with manifestations of the disorder. Studies tell us that if early dropout occurs and signs of the disorder appear, its clinical characteristics will be moderately stable over time.
Disinhibited social behavior and a lack of reserve to approach strange adults are accompanied by attention seeking / demanding behaviors in the preschool stage. When the disorder persists in middle childhood, the symptoms manifest as excessive verbal and physical familiarity and an inauthentic expression of emotions.
These signs seem to be especially evident when the child interacts with adults. Peer relationships are especially affected in adolescence. It is logical if we think that it is at this stage that uninhibited behavior and conflicts become evident.
As we have seen, uninhibited social relationship disorder occurs exclusively in children. The adult manifestations of the disease are unknown. The consequences of the disorder for the child are usually quite negative, since it seriously hampers their ability to interact with adults and adventure companions.