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#disinhibited social engagement disorder – @scriptshrink on Tumblr

Script Shrink

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Anonymous asked:

Do you think you could tell me if someone who was isolated for a long time and became used to being alone becomes clingy when someone finally pays attention to them? Will they avoid the person paying attention because it feels strange after years of being ignored, or take what they can get and be happy to finally have someone to bond with?

While Reactive Attachment Disorder and Disinhibited Social Engagement Disorder are both diagnoses meant for children, I think they’re somewhat comparable to the situation you’re describing. (See here!) 

It would really depend on the character which way they would go. Your character could also start out initially reserved and withdrawn, and over time become re-acclimated to social interaction.

#social relationships#Anonymous#asks#reactive attachment disorder#disinhibited social engagement disorder#characterization#character critique#this is not psychological or medical advice#this is writing advice#isolation#solitary confinement
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Reactive Attachment Disorder & Disinhibited Social Engagement Disorder - Demystifying the DSM-V

Okay, just as a heads up, I haven’t covered these two in class yet.  I don’t know these as well, so please take them with a grain of salt.

These two disorders are weirdly kind of similar.

BOTH of these require social neglect – meaning that their caregivers have neglected them at some point when the character was a child.

They just have different reactions to that neglect; Reactive attachment disorder is when all the bad shit experienced is internalized, leading the character to be depressed and withdrawn from others.

Disinhibited social engagement disorder, on the other hand, is when the character externalizes their feelings, and becomes excessively and unhealthily social.

Reactive attachment disorder

First, your child character needs to show a consistent pattern of being withdrawn and reserved behavior towards their caregivers.  This is seen through BOTH:

  • The child character doesn’t, or very rarely, wants to be comforted when they’re upset
  • The child character doesn’t, or minimally, feel comforted when others attempt to do so.

There also needs to be problems in their social interactions and emotions, seen with two or more:

  • Very little social or emotional response to others
  • Doesn’t show very many positive emotions
  • Unexplained anger, sadness, or fear appears when interacting with caregivers (even if the caregiver is not threatening in any way).

The child character also needs to have experienced abuse, in one or more of the following forms:

  • The character was socially neglected or deprived, because caregivers didn’t provide comfort, affection, or even interaction.
  • The child character had frequent changes in who was caring for them as they were growing up, which prevented them from forming stable relationships
  • Being raised in a place or situation that makes it difficult to form individual bonds with caregivers (for example, an orphanage with lots of kids and only a few caregivers)

The neglect seen above needs to appear to be responsible for the child character’s problems.

The character can’t have autism.

The character needs to have begun showing symptoms before they’re 5 years old.  The character needs to be older than 9 months.

Specifiers:

If the character has had these problems for more than 12 months, you add the specifier “Persistent”.

If the character has ALL the symptoms listed above, and at a high level, add the specifier “Severe”.

In short, the child character has been failed by their caregivers.  So they won’t let anyone else close so they can be hurt again; or even have never learned how to develop those attachments in the first place.

Disinhibited Social Engagement Disorder

The child character has to have a pattern of approaching and interacting with strangers, and has two or more of the following:

  • No or very little reluctance approaching and talking to strange adults
  • The character is overly familiar either verbally or in physical behavior.  This is inconsistent with the child’s age.
  • The child character doesn’t really ever check back with their caregiver after going off on their own, even when in unfamiliar situations
  • The child character is willing to leave with strange adults with almost no, or no, hesitation.

The child character also needs to have experienced abuse, in one or more of the following forms:

  • The character was socially neglected or deprived, because caregivers didn’t provide comfort, affection, or even interaction.
  • The child character had frequent changes in who was caring for them as they were growing up, which prevented them from forming stable relationships
  • Being raised in a place or situation that makes it difficult to form individual bonds with caregivers (for example, an orphanage with lots of kids and only a few caregivers)

These symptoms must be distinguished from the impulsive symptoms seen in an ADHD diagnosis.  

The neglect seen above needs to appear to be responsible for the child character’s problems.

The character needs to be older than 9 months.

Specifiers:

If the character has had these problems for more than 12 months, you add the specifier “Persistent”.

If the character has ALL the symptoms listed above, and at a high level, add the specifier “Severe”.

Disclaimer

#reactive attachment disorder#rad#disinhibited social engagement disorder#demystifying the dsm 5#children#neglect#child abuse#criteria#this is not psychological or medical advice#this is writing advice#demystifying#demystifying the DSM 5
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