Adjustment Disorders
Category of mental disorder featuring significant emotional or behavioral symptoms in response to an identifiable event that precipitated significant psychological or social stress.
Adjustment disorders are maladpative responses to stressful or psychologically distressing life events, such as being placed in day care for the first time, being injured in an accident, or experiencing a natural disaster. The diagnosis of an adjustment disorder requires that the inappropriate emotional or behavioral symptoms develop within three months of the stressful event or occurrence.
The American Psychological Association (APA) has identified and catagorized several varieties of adjustment disorders, depending on accompanying symptoms and their duration. These subtypes and their related symptoms are as follows:
1.) adjustment disorder with depressed mood, marked by tearfulness and feelings of intense discouragement;
2.) adjustment disorder with anxiety, where the individual appears extremely nervous or jittery, or the child displays an unusual or intense fear of being separated from parents, caregivers, or other significant adults;
3.) adjustment disorder with disturbance of conduct, where the major symptom is the breaking of societal norms or rules through vandalism, truancy, physical aggression, or other inappropriate behavior.
Two other subtypes, with mixed anxiety and depressed mood and with mixed disturbance of emotions and conduct, allow for the diagnosis of an individual displaying more than one category of symptoms.
In addition, adjustment disorders can be classified as acute (lasting less than six months) or chronic (lasting more than six months). Adjustment disorders are fairly common; in the mid-1990s, it was estimated that 5-20% of persons seeking outpatient psychological treatment suffered from an adjustment disorder. However, adjustment disorders can occur at any age, and appear to affect males and females equally.
Symptoms of these various adjustment disorders include a decrease in performance at school and withdrawal from social relationships. Adjustment disorders can lead to suicidal thinking or complicate the course of other diseases when, for instance, a sufferer loses interest in taking medication as prescribed or adhering to difficult diets or exercise regimens.
Adjustment disorders can occur at any stage of life. In early adolescence, individuals with adjustment disorders tend to be angry, aggressive, and defiant. Temper tantrums are common and are usually well out of balance with the event that caused them. Alternatively, adolescents with adjustment disorders may become passive and withdrawn. Older teenagers often experience intense anxiety and depression, or what psychologists call "depersonalization," a state in which a person feels he can observe his body interacting with others, but feels nothing.
Many psychological theorists and researchers consider adjustment disorders in adolescents as a stage in establishing an identity. Adolescents may develop adjustment disorders as part of a defense mechanism meant to break their feelings of dependence on their parents. This psychological maneuver may precipitate problems in families as adolescents begin seeking individuals outside the family as replacements for their parents. This can be particularly destructive when these feelings of dependence are transferred to involvement with gangs or cults.
For Further Study
Books
Doft, Norma. When Your Child Needs Help. 1st ed. New York: Harmony Books, 1992.
Varma, Ved P. The Management of Children With Emotional and Behavioural Difficulties. New York: Routledge, 1990.
Periodicals
Shanok, Rebecca. "Coping with Crisis." Parents Magazine, October 1991, p. 169.
Organizations
American Academy of Child and Adolescent Psychiatry
Address: 3615 Wisconsin Avenue, NW
Washington, DC 20016-3007
Telephone: (202) 966-7300
website: http://www.aacap.org
(Profesional organization that provides education about psychiatric disorders affecting children and adolescents.)
The Federation of Families for Children's Mental HealthAddress: 1021 Prince Street
Alexandria, VA 22314-2971
Telephone: (703)684-7710
(A national parent-run organization focused on the needs of children and youth with emotional, behavioral, or mental disorders and their families.)
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