Disinhibited social engagement behaviour (DSEB) is defined in the DSM-5 as a pattern of behaviour with at least two of the following: reduced reticence in interacting with unfamiliar adults, overly familiar verbal or physical behaviour, a failure to maintain proximity to the primary caregiver in unfamiliar settings and willingness to go off with strangers1. Importantly, the DSM-5 states that to qualify for a clinical diagnosis, children must be raised in an environment with extreme, inadequate caregiving and neglect. Indeed, most studies on DSEB have involved children raised in foster care or institutions2. Whether DSEB also affects children raised at home with biological parents, however, is unclear.
Researchers in the Netherlands have now addressed this question in a longitudinal study of 124 children (mean age 4 years) living at home with their biological parents, who were referred for treatment for emotional and behavioural problems. Scheper et al. assessed neglect, emotional maltreatment, emotional control and DSEB at referral and again 4 years later. They found that parent-reported DSEB persisted in 57% of the children with DSEB at baseline. Interestingly, the course of DSEB was not associated with neglect, emotional maltreatment or effortful control but there was evidence for a significant association with attention deficit/hyperactivity disorder and oppositional defiant disorder. These findings suggest that DSEB should be considered in the assessment and treatment process in referred young children and that DSEB should not necessarily be used as an indicator for maltreatment.
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Scheper, F.Y., Groot, C.R.M., de Vries, A.L.C., Doreleikers, T.A.H., Jansen, L.M.C. & Schuengel, C. (2019), Course of disinhibited social engagement behavior in clinically referred home-reared preschool children. J. Child Psychol. Psychiatr. 60: 555-565. doi: 10.111/jcpp.12994.
Effortful control: Defined by Rothbart, M.K. et al. in 1994 as the ability of a child to use attentional resources and to inhibit or activate behavioural responses to regulate emotions and related behaviours. Effortful control allows for control over actions and adjustment to different situations in a flexible and conscious manner.
1American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders- fifth edition (DSM-5). Washington DC.
2Zeanah,C.H. et al. (2015), Annual Research Review: Attachment disorders in early childhood – clinical presentation, causes, correlates, and treatment. J. Child Psychol. Psychiatr. 56: 207–222. doi: 10.1111/jcpp.12347.