Meta-Analyses of the Associations Between Disinhibited Social Engagement Behaviors and Child Attachment Insecurity or Disorganization.

Children with disinhibited social engagement disorder show reduced reticence with strangers, do not check back with their caregiver after venturing away, and may willingly leave with an unfamiliar adult. The recent DSM-5 has moved away from an attachment framework to understand disinhibited social engagement behavior (DSEB) due to studies indicating its presence in previously institutionalized children even after these children are adopted and show a selective, more secure attachment with their substitute caregiver (e.g. Chisholm et al., 1998). This meta-analysis aims to clarify the size of the associations between DSEB and attachment insecurity or disorganization. It also examines whether studies effect sizes differ according to various moderators (e.g., child age, type of attachment and DSEB measures). The results (k = 24) showed that the associations between DSEB and attachment insecurity (d = 0.48) or attachment disorganization (d = 0.47) were of small magnitude. There were no publication biases. As for moderator analyses on both attachment insecurity and disorganization, the effect sizes in studies using DSEB observational measures (respectively d = 0.63 and 0.57) were of moderate magnitude and stronger than those in studies not using an observational component (respectively d = 0.28 and 0.32). Given these small-to-moderate associations, attachment can be considered a relationship process associated with DSEB, and attachment-informed interventions could be potential tools to reduce DSEB in children. Nevertheless, given the sizable unshared portion of variance between DSEB and child attachment, future studies should examine other variables related to caregiving and noncaregiving contexts to further understand DSEB.

Disinhibited social engagement behaviors in young maltreated children: Dysfunctional behavior of biological parents and child attachment.

BACKGROUND: Studies on children with disinhibited social engagement behavior (DSEB) and their caregivers have primarily been limited to institution-reared children. OBJECTIVE: Using a sample of intact parent-child dyads, the current study examined the distinct contributions of dysfunctional (disconnected/extremely insensitive) parental behaviors and type of maltreatment on maltreated children's levels of DSEB. Child time in foster care and quality of attachment to caregiver were taken in account. PARTICIPANTS: The sample comprised 67 children (1-5 years old) and their biological parent with substantiated maltreatment and recruited through child protective services between the years of 2008 and 2012. METHODS: Observations of parent-child interactions were collected and child CPS files were consulted. RESULTS: Results indicate that very few children (4%), in this predominantly neglected sample (79 %), showed high levels of DSEB. Levels of socioeconomic risks, child age, child sex, time in placement, or attachment to caregiver were not significantly related to DSEB. The vast majority of the children developed an insecure attachment to their parent (76 %), especially of the disorganized type (51 %). Finally, beyond neglect, which was no longer associated with DSEB in the final model, we found that the more the parent showed disconnected and extremely insensitive behavior (R2 = .10), in particular withdrawn behavior, the more the children exhibited DSEB. CONCLUSION: Albeit of a small magnitude, we suggest that the quality of parental behavior could play a role in children's development and recovery of DSEB.