What distinguishes Reactive Attachment Disorder from Disinhibited Social Engagement Disorder?

The distinguishing factor between Reactive Attachment Disorder (RAD) and Disinhibited Social Engagement Disorder (DSED) lies in the pattern of attachment behaviors exhibited by individuals with these disorders.

In Reactive Attachment Disorder, children typically show a lack of attachment to their primary caregivers. They may exhibit withdrawn behavior, avoiding comfort and affection, and generally do not seek out or respond to social interactions in the same way that a securely attached child would. This pattern indicates a failure to form the expected healthy emotional and social connections, often due to neglect or inconsistent caregiving in early childhood.

On the other hand, children with Disinhibited Social Engagement Disorder display an unusual level of openness and indiscriminate sociability toward unfamiliar adults. They may approach strangers, exhibit a lack of hesitation in seeking attention, and have difficulty maintaining boundaries. This behavior stems from a lack of consistent caregiving and attachment, resulting in a social engagement pattern that is overly familiar and risky.

Understanding these distinct patterns of attachment behavior is crucial as it informs treatment approaches and interventions, guiding therapists to tailor their strategies to the specific needs and symptoms of each disorder.