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The Best Therapy for Adults with Disinhibited Social Engagement Disorder (DSED)

January 4, 2022

5 min read

Author : United We Care
The Best Therapy for Adults with Disinhibited Social Engagement Disorder (DSED)

Disinhibited social engagement disorder (DSED) is a condition in which children or adults find it extremely difficult to emotionally bond with others. It is a form of attachment disorder [1]. There are two types of attachment disorders – disinhibited reactive attachment disorder (RAD) and disinhibited social engagement disorder. People with RAD have a hard time forming emotional bonds with family members or others, whereas those with DSED appear to be friendly and sociable, but they are unable to form stable bonds.

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How Do You Define DSPD – Disinhibited Social Engagement Disorder?

Disinhibited social engagement disorder is common in children with a history of neglect or trauma. In this condition, children find it challenging to form meaningful bonds with parents, guardians, or other people. Although DSED is more common in children, attachment disorder might also develop in adults. DSED generally occurs in children between two years and adolescence, and if neglected in the early years, it will persist until early adulthood.
Adults suffering from disinhibited social engagement disorder have difficulty trusting others and are afraid of forming deep and stable relationships. They might have the habit of asking intrusive questions to people they meet and becoming overly chatty or friendly, demonstrating a lack of inhibition. 

Most Common Signs and Symptoms of Disinhibited Social Engagement Disorder

Disinhibited social engagement disorder generally begins in childhood, as early as nine months of age. However, it can continue into adulthood if not treated or checked in time. Even if a child or an adult exhibits any two symptoms of DSED, they may be suffering from the disorder [2].

  1. People suffering from disinhibited social engagement disorder are not shy or afraid to meet new people. They feel excited to meet strangers.
  1. People with DSED appear to be very friendly, overly chatty, and physically close with new people.
  2. They do not hesitate to walk away with a stranger.
  3. People with disinhibited social engagement disorder are impulsive to the point of being socially disinhibited.
  4. Most adults suffering from DSED have a history of neglect, abuse, or trauma which prevents them from forming deep relationships.

Is Disinhibited Social Engagement Disorder Similar to Reactive Attachment Disorder?

Both disinhibited social engagement disorder and reactive attachment disorder are attachment disorders. However, they are different. People with reactive attachment disorder do not want to be attached to anyone. In the case of children, they do not want the care of parents or caregivers when sad or hurt and become irritated when comforted by caregivers. They want to be left alone. Adults with reactive attachment disorder have a hard time interacting with others and even expressing their feelings.
Although people with disinhibited social engagement disorder are comfortable interacting with strangers, they struggle to form deep relationships. They are friendly and outgoing but impulsive enough to go out with strangers. People with DSED require proper treatment since childhood. Otherwise, the condition can persist into adulthood.

Treatment of DSED (Especially for Adults)

As mentioned before, disinhibited social engagement disorder is an attachment disorder that is mostly seen in children and teenagers, but it can also affect adults. Therefore, it must get proper treatment in childhood so that symptoms do not persist into adulthood. Most people with DSED in adulthood had a history of childhood trauma or neglect. The treatment of disinhibited social engagement disorder comprises a combination of therapy and medication [3].

  1. Play Therapy – Children suffering from disinhibited social engagement disorder are treated with play therapy. Play is crucial for the healthy development of a child. The therapist will try to solve the child’s problems through play. The child is allowed to play different games so that he feels safe in his surroundings. The adults also get to understand the child’s likes and dislikes.
  2. Art Therapy – An art therapy is also used to treat patients with DSED. An art therapist will use different creative tools to improve a patient’s mental disorder. 
  3. Behavioral Management – Behavioural management is very effective for DSED in adulthood. Adult patients suffering from insecurity can seek couple’s therapy, in which a therapist will assist both partners in becoming more secure in their relationship.
  4. Medications – Although there are no direct medicines for patients with DSED, doctors can prescribe medications as a treatment of DSED if the patient has anxiety, mood disorder, or hyperactivity disorder.

Assessment and Treatment for DSED

The Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has certain criteria for DSED, including specific behavioral patterns while interacting with strangers or with a parent. DSED is often diagnosed in children who have faced social deprivation, abusive childhood, been in institutions like orphanages where their emotional attachment was low, or had frequent changes of caregivers.
Disinhibited social engagement disorder was found in 22% of children who had been maltreated in their childhood, and 20% of children who had been in some institution like an orphanage. The disorder has been common in children who were deprived at their school-going age. A huge percentage of children, around 49% who were adopted between the age of six and 11, have been diagnosed with disinhibited social engagement disorder.
Therapy is crucial in the treatment of DSED or any other attachment disorder. People with DSED can benefit from therapies like play therapy, art therapy, and couple’s therapy to cope with anxiety and hyperactivity. You can book an appointment for the best therapists at unitedwecare.com.

[1]C. H. Zeanah et al., “Practice parameter for the assessment and treatment of children and adolescents with reactive attachment disorder and disinhibited social engagement disorder,” J. Am. Acad. Child Adolesc. Psychiatry, vol. 55, no. 11, pp. 990–1003, 2016.
[2]“What Is Disinhibited Social Engagement Disorder?,” WebMD. [Online]. Available: https://www.webmd.com/children/what-is-disinhibited-social-engagement-disorder. [Accessed: 03-Aug-2022].
[3]“Disinhibited Social Engagement Disorder Treatment,” The Recovery Village Drug and Alcohol Rehab, 02-Nov-2020. [Online]. Available: https://www.therecoveryvillage.com/mental-health/disinhibited-social-engagement-disorder/treatment/. [Accessed: 03-Aug-2022].


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Author : United We Care

Founded in 2020, United We Care (UWC) is providing mental health and wellness services at a global level, UWC utilizes its team of dedicated and focused professionals with expertise in mental healthcare, to solve 2 essential missing components in the market, sustained user engagement and program efficacy/outcomes.

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