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Psychiatry Disorders » Adjustment DisorderAdjustment Disorder

  • Overview

    Last updated February 27th, 2010, 4:27 PM

    Adjustment disorder is an abnormal and excessive psychological response to an identifiable life stressor.

  • Signs and symptoms

    Last updated February 27th, 2010, 4:30 PM

    Possible symptoms include:

    • Depressed mood, tearfulness, or feelings of hopelessness
    • Nervousness, worry, or jitteriness, or, in children, fears of separation from major attachment figures
    • Disturbance of conduct (e.g., truancy. vandalism, reckless driving, fighting, defaulting on legal responsibilities).
    • Agitation
    • Palpitations
    • Physical complaints
    • Trembling or twitching

  • Diagnosis

    Last updated February 27th, 2010, 5:53 PM

    To diagnose adjustment disorder, a specific stressor must be identified, and development of emotional or behavioral symptoms must occur within 3 months of its onset. The symptoms must cause either marked distress that is in excess of what would be expected from exposure to the stressor or significant impairment in social or occupational (academic) functioning. Once the stressor (or its consequences) has gone away, the symptoms cannot persist for more than an six months.

    The diagnostic criteria in the DSM-IV are

    1. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within three months of the onset of the stressor(s).

    2. These symptoms or behaviors are clinically significant as evidenced by either of the following:

      1. marked distress that is in excess of what would be expected from exposure to the stressor

      2. significant impairment in social or occupational (academic) functioning

    3. The stress-related disturbance does not meet the criteria for another specific Axis I disorder and is not merely an exacerbation of a preexisting Axis I or Axis II disorder.

    4. The symptoms do not represent bereavement.

    5. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional six months.

  • Etiology

    Last updated February 27th, 2010, 4:45 PM

    Many possible stressors can cause adjustment disorder. In adults, the stressor are usually either financial or marital in nature. In adolescents, the stressors commonly include academic, family, or sexualiy problems. However, any stressor may potentially  cause adjustment disorder including natural disasters, death of a loved one, life-style changes (e.g. starting college, moving to a new location, etc.).

  • Treatment

    Last updated February 27th, 2010, 4:54 PM

    Depending on the severity of the illness, the treatment may vary. The usual primary treatments for adjustment disorder are psychotherapy, crisis intervention, family therapy, and group therapy. All of these modalities encourage verbalization of fears, anxiety, rage, helplessness, and hopelessness. Frequently, just by talking about the stressor helps to reduce pressure and to enhance coping. However, when the reaction to the stressor is severe, psychoactive medications such benzodiazepines, buspirone, or antidepressants may be used.

  • Prognosis

    Last updated February 27th, 2010, 5:02 PM

    Adjustment disorders usually get better within six months (or possibly much quicker) without any remaining symptoms.

  • Risk factors

    Last updated February 27th, 2010, 5:01 PM

    Although predicting who will develop adjustment disorder to a given stressor is not currently possible, the risk factors may include poor coping strategies and genetic susceptibility.

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