The essential characteristic of disinhibited social relationship disorder involves socially inappropriate or inappropriate behavior in which it has often implied more confidence than would be expected by the type of relationship. This overly 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 links according to their development. Thus, uninhibited social relationship disorder is diagnosed when the child is at least 9 months old. The uninhibited 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 negligence, such as malnutrition or poor care. However, signs of this disorder often persist even after other signs of abandonment are no longer exist.
How is disinhibited social relationship disorder diagnosed?
The Diagnostic and Statistical Manual on Mental Disorders, in its fifth edition (DSM-5), cites the criteria for diagnosing this disorder. Let’s see them.
- pattern of behaviour in which a child actively approaches and interacts with foreign adults and presents two or more of the following characteristics:
- Reduction or absence of reluctance to approach and interact with foreign adults.
- Verbal or physical behavior is too familiar. This means that it is inconsistent with culturally accepted and age-appropriate social boundaries.
- Little or no recourse to the adult caregiver after a risky exit, even in strange contexts.
- Willing to go with a strange adult with little or no hesitation.
- The behaviors in criterion A are not limited to impulsivity (as in attention deficit disorder/hyperactivity disorder). However, they include socially disinhibited behavior.
- Child has experienced an extreme pattern of insufficient care. This is evidenced by one or more of the following characteristics:
- Neglect or social deprivation is manifested by the persistent failure to meet basic emotional needs for well-being, encouragement and affection on the part of adult caregivers.
- Repeated changes in primary caregivers that reduce the opportunity to develop stable attachment (e.g., frequent changes in custody).
- Education in unusual contexts which greatly reduces the opportunity to establish selective attachment (e.g., institutions with a high number of children per caregiver).
- It is assumed that the care factor of Criterion C is responsible for altering the behaviour of Criterion A. For example, alterations of Criterion A begin after the pathogenic care of Criterion C).
- 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 neglect of care by an adult.
However, there is no evidence that abandonment after two years is associated with manifestations of the disorder. Studies tell us that if early abandonment occurs and signs of the disorder appear, its clinical characteristics will be moderately stable over time.
Disinhibited social behavior and lack of reserve to approach stranger adults are accompanied by search / demand behaviors in the pre-school stage.
These signs appear to be especially evident when the child interacts with adults. Peer relationships are affected especially in adolescence. It is logical if we think that it is at this stage that disinhibited behaviour and conflict become evident.
As we have seen, disinhibited social relationship disorder occurs exclusively in children. Adult manifestations of the disease are unknown. The consequences of the disorder for the child are often quite negative, since it seriously hinders the ability of these to interact with adults and fellow adventurers.