Adjustment Disorder

Nature

Adjustment Disorder is characterized by emotional and behavioral changes that occur following an identifiable stressor.

A stressor can be a single event or multiple events that are continuous. The stressor does not necessarily have to be something experienced by the individual. It can also be one experienced by a close group such as the family or community.

Potential Stressors include:

  • Entering a new school or leaving a school
  • Family disruption due to divorce
  • Illnesses of self or loved-one
  • Death of a loved one
  • Natural disasters
  • Termination of a relationship
  • Marital problems
  • Work difficulties
  • Getting married
  • Becoming a parent
  • Residing in a high crime neighborhood
  • Retirement

Experience

Individuals with an Adjustment Disorder may experience a sense of hopelessness, frustration, sadness, irritability, and many other emotional and behavioral responses.

Due to the various events that may contribute to an Adjustment Disorder, the subjective distress can impair the individual’s performance in school, work, social, and other areas of their life. For Individuals with a general medical condition, an Adjustment Disorder may complicate the condition due to the individual’s decline in performance.

Impact

Adjustment Disorders consist of emotional and behavioral symptoms resultant from identified stressors.

Individuals that meet criteria for an Adjustment Disorder often experience a level of distress, impairing their performance in a social, occupational, and academic realm. Sufferers experience feelings of hopelessness, low mood, withdrawal, agitation, fear, worry, and changes in conduct.

Typically, symptoms will reduce or eliminate following the termination of the identified stressor. If symptoms do not reduce or eliminate within a specified duration of time, a different diagnosis will be assessed.

Prevalence of Adjustment Disorder

The prevalence of Adjustment Disorder is estimated to be between 2% and 8% in children in adolescents. While more common in disadvantaged circumstances, Adjustment Disorders affect men and women equally.

Treatment

Adjustment Disorders may present differently for each individual, so it is important to tailor treatment appropriately.

Adjustment Disorders typically do not last longer than 6 months, and therefore, realistic treatment goals should be targeted accordingly.

Solution Focused Therapy (SFT) is a common approach used to help clients create strategies to effectively navigate specific life problems. SFT is a goal-directed and collaborative model focusing on the solution as opposed to the stressor. The clinician works closely with the client and family members to develop effective coping strategies for problem solving.

Cognitive Behavioral Therapy (CBT) can also be helpful when addressing the anxiety response that may occur with an identifiable stressor. Through CBT, individuals identify, and challenge irrational thoughts associated with their challenging life events. Exposure Response and Prevention (ERP) is also utilized to gradually expose and habituate the individual to situations they perceive to be challenging or dangerous. The assigned exposures aid in helping the individual learn new ways of coping with their anxiety. The idea is to modify the learned response (hence the name “response prevention”) so more healthy behaviors and thoughts take their place. ERP takes intensive practice through repeated exposures over many months. For many, ERP in combination with medications provide much-needed relief for people suffering from Adjustment Disorder.

Resources

Adjustment Disorder in Children: Symptoms, Effects, Treatment
HealthyPlace
Read Article

Adjustment disorder in teens: causes, therapy
AdjustmentDisorders.org
Read Article

Diagnostic and Statistical Manual of Mental Disorders (5th ed.)
American Psychiatric Association. (2013).
Find it on Amazon

Encyclopedia of Children’s Health;
http://www.healthofchildren.com/A/Adjustment-Disorders.html

National Youth Network;
http://www.nationalyouth.com/adjustmentdisorder.html

Science Direct;
https://www.sciencedirect.com/topics/neuroscience/adjustment-disorder