Social relationship syndromes

ICD-10 provides a category for disorders of social functioning with onsets specific to childhood and adolescence. These are a somewhat heterogeneous group of disorders that have, in common, abnormalities of social functioning beginning during the developmental period. But (unlike pervasive developmental disorders) they are not primarily characterized by a constitutional social incapacity or deficit that pervades all areas of functioning. In many instances, serious environmental distortions or privations probably play a social role in aetiology. ICD-10 treats these phenomena as disorders, and includes elective mutism, reactive and disinhibited attachment disorders of childhood. In contrast, DSM-IV has no such category of disorders, although it refers to 'relational problems' under 'other conditions'. Interestingly, DSM-IV does not appear to consider relational problems as diagnoses but as abnormal patterns of interactions that are frequently the focus of clinical attention. They are viewed more as correlates of mental disorder and, unlike ICD-10, DSM-IV makes no comment on the aetiological role of the relationship difficulty in the onset of the emotional (or behavioural) symptoms in the child.

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