Social neglect tends to precede those who end up with the diagnosis. Among institutionalized, neglected children, the disorder symptomology tends to be stable. In institutions in the United Kingdom and the United States, social intrusion, and attention-seeking behavior is a key feature. In institutions in other countries, physical contact with strangers is common. In middle childhood, verbal and physical overfamiliarity continues, sometimes with insincere displays of emotion. In adolescence, this behavior may extend to peers and they may have more shallow relationships and increased conflicts with them. Adults with this diagnosis tend to disclose excessively to and have less awareness with strangers.