Disinhibited social engagement behaviour is not unique to children exposed to inadequate caregiving

Last updated 5 January 2024

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.

A pdf version of this article is available to download.

Referring to:

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.

Tagged with:
Dr Jessica Edwards
Jessica received her MA in Biological Sciences and her DPhil in Neurobehavioural Genetics from the University of Oxford (Magdalen College). After completing her post-doctoral research, she moved into scientific editing and publishing, first working for Spandidos Publications (London, UK) and then moving to Nature Publishing Group. Jessica is now a freelance editor and science writer, and started writing for “The Bridge” in December 2017.

Add a comment

Your email address will not be published. Required fields are marked *