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DSM diagnoses related to a lack of engagement are Reactive Attachment Disorder (RAD), which involves a consistent pattern of withdrawn and inhibited behavior toward caregivers, and Disinhibited Social Engagement Disorder (DSED), which involves overly familiar and indiscriminate engagement with unfamiliar adults. Both are types of attachment disorders rooted in a history of social neglect or insufficient care during early childhood. Another potential diagnosis to consider is Avoidant Personality Disorder, which involves a pattern of social inhibition and feelings of inadequacy in adults. 

Reactive Attachment Disorder (RAD): Characterized by a lack of emotionally withdrawn behavior, such as rarely seeking or responding to comfort from caregivers. This is a more inwardly-focused disorder where the person shows a persistent failure to initiate or respond to social interactions in a developmentally appropriate way.

Disinhibited Social Engagement Disorder (DSED): Characterized by a lack of inhibition in social situations. This manifests as approaching and interacting with unfamiliar adults in overly familiar ways, and may include a lack of checking in with a caregiver in unfamiliar settings. This is an outwardly-focused and often indiscriminate form of social engagement. 

Avoidant Personality Disorder: This adult personality disorder involves a pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation. Individuals with this disorder may avoid social contact due to fears of criticism, disapproval, or rejection, and are unwilling to get involved with people unless they are certain of being liked.

Oppositional Defiant Disorder (ODD): While not directly related to a lack of engagement, some symptoms of ODD can be a response to the environment or relationships, such as deliberately annoying people or often arguing with adults. 

Developmental disabilities: Children with developmental disabilities may show behaviors that look like DSED, such as a lack of inhibition with strangers, because of their age and developmental level rather than a disorder. It is crucial to distinguish if the lack of inhibition is due to a developmental disability or DSED.

Differential diagnosis: A thorough evaluation is necessary to rule out other possibilities and to determine the correct diagnosis. A mental health professional will consider all of the patient's symptoms, history, and developmental stage before making a formal diagnosis.