The course of early disinhibited social engagement among post-institutionalized adopted children

Jamie M. Lawler, Kalsea J. Koss, Colleen M. Doyle, Megan R. Gunnar

Research output: Contribution to journalArticlepeer-review

18 Scopus citations


Background: Approximately 20% of post-institutionalized (PI) children exhibit disinhibited social engagement (DSE) or the propensity to approach and engage strangers. There is little longitudinal research examining changes in DSE after adoption, or methods of identifying children with persistent behaviors. Methods: DSE was assessed observationally four times during the first 2 years postadoption in PI children 16–36 months at adoption (n = 68) relative to same-age nonadopted children (n = 52). At age 5, a validated interview determined which PI children met criteria for Disinhibited Social Engagement Disorder (DSED). Results: DSE trajectories initially increased and then stabilized. PIs had higher DSE levels initially and a steeper increase rate than NAs. When separated into physical and nonphysical DSE components, group differences arose in initial physical DSE and the rate of change of nonphysical DSE. DSE rate of increase predicted DSED diagnosis, as did longer institutional duration and poorer institutional care. Conclusions: The rate of increase in DSE postadoption, rather than the level observed at adoption, is predictive of disordered social engagement by age 5 years.

Original languageEnglish (US)
Pages (from-to)1126-1134
Number of pages9
JournalJournal of Child Psychology and Psychiatry and Allied Disciplines
Issue number10
StatePublished - Oct 1 2016

Bibliographical note

Funding Information:
The authors thank the families for their participation and the International Adoption Project. Grant support was provided by R01 MH080905 and P50 MH078105 (to M.R.G.), by the Center for Neurobehavioral Development (University of Minnesota), and by NIMH training grant T32 MH018921 (to K.J.K.). The content is solely the responsibility of the authors and does not represent the views of the National Institutes of Health. The authors have declared that they have no competing or potential conflicts of interest in relation to this article.


  • Adoption
  • attachment disorders
  • deprivation
  • developmental psychopathology
  • social behavior


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