Adjustment Disorder

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When people experience life changes such as moving, changing jobs, a child leaving home, or a breakup of a relationship, they have to adjust themselves to cope with stress caused by these events.

While people are generally capable of adjusting to such changes in a relatively short period of time, a diagnosis of adjustment disorder may be indicated if the individual shows excessive distress in reaction to such a stressful event or if the symptoms she experiences cause significant impairment in functioning in social or occupational contexts.

The symptoms of adjustment disorder include feelings of anxiety, depressed mood, and “disturbance of conduct,” which includes antisocial behaviors that disregard other people’s rights or social norm violations, for instance, fighting, vandalism, reckless driving, and failure to meet financial obligations.

In some cases adjustment disorder is accompanied by several physical symptoms including generalized pains, headache, and heart palpitations. Thoughts of suicideOpens in new window may be present, sometimes involving suicide attempts. Drug or alcohol abuse may occur.

To be diagnosed with adjustment disorder, the symptoms must not more accurately reflect another disorder, such as acute stress disorderOpens in new window or posttraumatic disorderOpens in new window, both of which occur in the aftermath of more objectively serious stressors. Also, for diagnosis, the emotional reaction must occur in response to a specific life stressor or stressors within three months of the occurrence of the stressor(s), and the symptoms may last up to six months after the end of the stressor but not longer.

Both adults and children can be diagnosed with adjustment disorder. For adults, marital issues, finances, and work problems are common triggers. Adolescents, on the other hand, are more likely to develop adjustment disorder related to school problems, perceived rejection by parents, parents’ marital problems, and alcohol or drug problems (Andreasen & Wasek, 1980).

The most common treatments for adjustment disorder are psychotherapy, which may be in individual, group, or family forms, and antidepressant or antianxiety medications (Mayo Clinic, 2009). Some, such as Casey (2001), argue that adjustment disorder often resolves on its own and thus treatment is generally not indicated except in special circumstances such as when risk of suicide is present.

Adjustment disorder is controversial as a diagnostic category, with some arguing that the condition is overdiagnosed largely because it is less stigmatizing than other disorders.

As many as 30 percent of people in outpatient therapy are diagnosed with this disorder (American Psychiatric Association, 2000). However, in a review of the information available on adjustment disorder, Patricia Casey (2001) argues that evidence supports the validity and usefulness of this diagnostic category.

See also:
  1. American Psychiatric Association (2000). Diagnostic and statistical manual of mental disorders (4th ed., text rev.). Washington, DC: Author.
  2. Andreasen, N.C., & Wasek, P. (1980). Adjustment disorders in adolescent and adults. Archives of General Psychiatry, 37, 1166 – 1170.
  3. Casey, P. (2001). Adult adjustment disorder: A review of its current diagnostic status. Journal of Psychiatric Practice, 7(1), 32 – 40.