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Adjustment disorder is an excessive or abnormal behavioral or emotional reaction to a stressor or a series of stressors. The reaction is often more severe than what is typically expected for a stressor. Stressors can affect an individual person like a loss of a job or an entire family or large group such as a natural disaster. Examples of stressors most commonly seen are moving, marriage, crime, illness, divorce, and losing a job.
Adjustment disorders are common and it has been estimated that 32% of adolescents have had an adjustment disorder. There is no difference in the rate between males and females.
Symptoms of adjustment disorder vary widely and fall into three broad categories: depression, anxiety, and conduct. Specific symptoms may include tearfulness, feeling hopeless, nervous, and jittery, truancy from school, fighting, and aggressive behaviors. Children and adolescents tend to have more behavioral symptoms compared to adults who are more likely to have depressive symptoms. An individual can have depression symptoms, anxiety, or conduct symptoms or any combination of the three areas.
Why is an adjustment disorder a concern?
Adjustment disorders are associated with an increased risk of suicide attempts and completed suicides. Adolescents with Adjustment Disorder are more likely to engage in self-harming behavior or substance abuse.
Adjustment disorder is diagnosed by a mental health professional after meeting with the child, family, and in some cases, school staff. Obtaining a family history, and identifying a specific stressor or series of stressors is important in the evaluation. The mental health professional explores how the individual coped with stressors prior to the one that caused the behavioral and emotional concerns.
Medication is rarely used for adjustment disorders alone. Psychotherapy has been shown to be the most effective form of treatment. Psychotherapy may include individual and family sessions to help develop age appropriate coping skills.
Psychotherapy may be helpful when your child or adolescent experiences a stressor and they cope with it in a manner that is not typical for them and the reaction is more severe than what is expected. The sooner treatment is started the better symptoms may be reduced.
The long term outlook for adjustment disorder is promising as long as the correct treatment is received soon after experiencing the stressor(s). Adjustment Disorder typically does not last more than 6 months.
Living with an adjustment disorder
Preventive measures to reduce the risk of getting an adjustment disorder are not known; however, teaching your child healthy coping skills, building a strong network of supports, and seeking professional help may reduce the severity of stressors when they occur.