Disinhibited attachment disorder, causes and treatment

Disinhibited attachment disorder, causes and treatment

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A good socialization is essential for children from an early age to relate to their environment in an appropriate way. A behavior that is too uninhibited by the child in relation to others could be indicative of an uninhibited social relationship disorder, also known as TRSD.


  • 1 How is this disorder defined?
  • 2 Diagnostic criteria
  • 3 Why does it happen?
  • 4 Is there treatment?

How is this disorder defined?

Until recently, the uninhibited social relationship disorder was included in a broader diagnosis known as Reactive disorder of childhood bonding. The last label was made following the fifth update of the DSM, Behavioral Disorders Reference Manual.

It is a type of psychological disorder exclusive to children and is characterized in that the child does not present any type of fear or repair to initiate contact with unknown adults presenting a completely uninhibited social behavior.

This pattern of behavior It occurs after 9 months and before 5 years and tend to persist over time independently of changes in the child's environment.

The main feature is that it implies a inappropriate social behavior in which there is more implicit trust than would be expected by the type of relationship.

This disorder can be diagnosed after 9 months of age, has not been described in adults and can coexist with delays in cognitive and language development, stereotyping and neglect of attachment behaviors that often persist, although no longer There is abandonment. The consequences for children suffering from the disorder are usually quite negative as it makes it difficult for these children to relate to adults and their peers.

Diagnostic criteria

The main evaluator of this type of disorder is the DSMV. The main symptoms are behavioral in nature and it is specified in the child's way of relating to other people, especially adults. One type of behavior that occurs in these cases is that the child performs attachment seeking behaviors that reveal that the little one can form attachment bonds with anyone, even strangers.

Although the characteristics of this disorder can be confused with more typical ADHD behaviors, the uninhibited attachment disorder has the following diagnostic requirements:

  1. Approach behaviors and active interaction with strange adults with partial or complete lack of distrust to interact with unknown adults and outsiders for the child. Patterns of verbal and / or physical behavior that are too familiar according to social and cultural norms

Lack of the need for caregiver after exposure to unknown situations. Willingness to leave with a strange adult. Sociably uninhibited behaviors may occur.

  1. The child has experienced situations of lack of attachment and care. Negligence situations. Constant changes in custody or primary caregivers. Own institutions with a large number of children per caregiver.
  2. The age of the child varies from 9 months to 5 years.
  3. Behaviors must remain for at least 12 months

After four years, attachment behaviors evolve due to constant demands for attention and disproportionate expressions of affection and affection.

Why happens?

There are some theories that attribute the disorder to a defect of genetic or biological origin such as specific alterations in the amygdala, hippocampus, hypothalamus or prefrontal cortex that can lead to changes in the behavior and inability of the child to understand what happens around it, but although there may be a genetic predisposition, especially, the main causes of the development of the disorder are based on a history of social negligence and lack of care. These children often have social neglect problems in the first months of life. This disorder has been observed in children whose parents show insufficient care, abuse, poor social relations or traumatic events. Very common in children who have spent the first years of life in children's institutions.

These signs seem to be especially evident when the child interacts with adults. And interactions with your peer group are affected in the adolescence, since it is at this stage when uninhibited behaviors and conflicts become apparent.

Is there any treatment?

Among the interventions you can find psychosocial support services for the family, psycho-pedagogical interventions and supervision for social services for the safety of the child within the family environment.

The recommended intervention would be:

Provide an emotionally available attachment figure since it is assumed that children with this disorder have highly distorted internal models of relationship. The treatment would be to create positive interactions with the reference caregiver.

Programs and strategies for problems presented by diagnosed children are based on the so-called attachment theory and concentrate on increasing the degree of reaction and sensitivity of the caregiver. The programs include a detailed assessment of the attachment status or responses of the adult caregiver.

The objective would not only be to modify the behavior of the child but also of the parents, Regarding parents, the safety transmission should be worked on, the permanence of the attachment figure and emotional availability would be the three fundamental pillars

In addition to working with parents, work should also be done with the child so that he can rebuild the sense of security and rebuild a link as healthy and positive as possible.


American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing