Reactive Attachment Disorder and Disinhibited Social Engagement Disorder

Aberrant social behaviors in young children who experience serious neglect have been described for more than half a century and have been used as the basis for defining disorders of attachment. A broad consensus notes two phenotypes in early childhood—one characterized by socially withdrawn behavior and restricted positive affect and the other by disinhibited social behavior and repeated violations of conventional interpersonal boundaries. Reactive attachment disorder seems to be quite responsive to enhanced caregiving environments, although the indiscriminate behavior of disinhibited social engagement disorder persists in some cases even after affected children receive enhanced caregiving. Keywords: psychopathology; attachment; disinhibited social engagement disorder; indiscriminate behavior; parenting; reactive attachment disorder