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Adjustment Disorders

emotional development adolescence suicide suicidal behavior adolescents stress psychological stressful

The development of significant emotional or behavioral symptoms in response to an identifiable event that precipitated significant psychological or social stress.

Adjustment disorders are maladpative, or unhealthy, responses to stressful or psychologically distressing life events, such as the end of a romantic relationship or being terminated from a job.

The American Psychiatric Association has identified and categorized several varieties of adjustment disorders, depending on accompanying symptoms and their duration. These subtypes include adjustment disorder with depressed mood, with anxiety, with anxiety and depressed mood, and with disturbances of conduct. The disorders can additionally be classified as acute or chronic. It is thought that adjustment disorders are fairly common; recent figures estimate that 5 to 20 percent of persons seeking outpatient psychological treatment suffer from one of these disorders. Psychiatrists rigidly define the time frames in which these disorders can occur to differentiate them from other types of responses to stressful events, such as post-traumatic stress disorder and acute stress disorder. Adjustment disorders must occur within three months of the stressful event and can, by definition, last no longer than six months.

Symptoms of these various adjustment disorders include a decrease in performance at work or school, and withdrawal from social relationships. These disorders can lead to suicide or suicidal thinking and can 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. Other adolescents with adjustment disorders may, alternately, become passive and withdrawn, and older teens often experience intense anxiety or depression. They may experience what psychologists call "depersonalization," a state in which a person feels he or she can observe their 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 sort of 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.

Further Reading

Diagnostic and Statistical Manual of Mental Disorders. 4th ed. Washington, D.C.: American Psychiatric Association, 1994.

Nicholi, Armand, ed. The New Harvard Guide to Psychiatry. Cambridge, MA: Harvard University Press, 1988.

"The Not-So Maddening Crowd: Crowding Stress Leads to Coping Behavior in Primates." Discover (February 1994): 14.

Shanok, Rebecca. "Coping with Crisis." Parents Magazine (October 1991): 169.

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