before age 5 and occurring in most situations, the
patient?s social relatedness is markedly disturbed and
developmentally inappropriate. This is shown by either
In most social situations, the child doesn?t
interact in a socially appropriate way. This is
shown by responses that are excessively inhibited,
hypervigilant or ambivalent and contradictory. For
example, the child responds to caregivers with
frozen watchfulness or mixed approach-avoidance and
resistance to comforting.
The child?s attachments are diffuse, as shown by
indiscriminate sociability with inability to form
appropriate selective attachments. For example, the
child is overly familiar with strangers or lacks
selectivity in choosing attachment figures.
behavior is not explained solely by a developmental
delay (such as Mental Retardation) and it does not
fulfill criteria for Pervasive Developmental Disorder.
of persistent pathogenic care is shown by one or more
caregiver neglects the child?s basic emotional needs
for affection, comfort and stimulation.
caregiver neglects the child?s basic physical needs.
attachments cannot form because of repeated changes
of caregiver (such as frequent changes of foster
appears that the pathogenic care just described has
caused the disturbed behavior (for example, the
behavior began after the pathogenic behavior).
type, based on predominant clinical presentation:
Type. Failure to interact predominates.
Type. Indiscriminate sociability predominates.
American Psychiatric Association DSM-IV Sourcebook,