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Skipper L Harvey, PsyD
December 14, 2013

What Is Adjustment Disorder?

Adjustment Disorder is an abnormal and extreme reaction to a life stressor that can significantly impact a child’s social, emotional, behavioral, and academic functioning. Stressful events may include moving to a new home, attending a new school, divorce, or a death in the family. Because of the difficulty of coping with strong emotions, a child with Adjustment Disorder may develop symptoms of depression, anxiety, aggression, isolation, school avoidance, or sleep difficulties. Their academic performance may decline and personal relationships may be negatively affected. Keep in mind that sometimes children may not have developed the ability to manage uncontrollable change when it occurs; therefore, what may not seem like a difficult event to an adult may be the cause of extreme stress for a child as they have a different perspective and response.

What Is The Diagnostic Criteria For Adjustment Disorder According To The DSM-5?

A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).By banging or punching objects to the point that there is bruising or bleeding. An individual may also bang or punch their own body to the point of self-harm.

B. These symptoms or behaviors are clinically significant, as evidenced by one or both of the following:

1. Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation.
2. Significant impairment in social, occupational, or other important areas of functioning.

C. The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder.

D. The symptoms do not represent normal bereavement.

E. Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.

Types Of Adjustment Disorders

Adjustment Disorder With Depressed Mood. Low mood, tearfulness, or feelings of hopelessness are predominant.

Adjustment Disorder With Anxiety. Nervousness, worry, jitteriness, or separation anxiety is predominant. Children may have a strong fear response to being separated from their parents and loved ones.

Adjustment Disorder With Mixed Anxiety and Depressed Mood. A combination of depression and anxiety is predominant.

Adjustment Disorder With Disturbance of Conduct. Symptoms mostly involve behavioral difficulties like fighting, skipping school, or vandalizing property.

Adjustment Disorder With Mixed Disturbance of Emotions and Conduct. Both emotional symptoms (e.g., depression, anxiety) and a disturbance of conduct are predominant.

Adjustment Disorder Unspecified. For maladaptive reactions that are not classifiable as one of the specific subtypes of adjustment disorder.

How Is Adjustment Disorder Treated?

While medication may be provided to lessen behavior problems and symptoms of depression and anxiety, Adjustment Disorder is primarily treated with psychotherapy. Psychotherapy gives a child/teen the opportunity to express their emotions in a supportive environment and develop healthy coping skills to deal with life stressors. Family therapy may be recommended as well since adjustment difficulties can impact the entire family. Group therapy with peers may also be suggested with a focus on social and interpersonal skills. Most importantly, early detection and intervention can reduce the severity of symptoms and improve a child or adolescent’s quality of life.

Websites for Additional Information,P01573/


About Dr. Skipper
Dr. Skipper is a Florida Licensed Clinical Psychologist who works extensively with children, adolescents, and families to provide therapy and psychoeducational assessment services.

She received her doctorate degree from the Florida School of Professional Psychology.  Dr. Skipper has worked with children, adolescents, and families in a variety of settings which include mental health clinics, residential settings, drug treatment facilities, and schools.

Through the integration of a variety of empirically-based treatment approaches, Dr. Skipper assists her clients by providing new skills and empowering strategies to build distress tolerance, enhance awareness and communication, facilitate insight, and challenge maladaptive relationship and thinking patterns. She employs an active therapeutic stance to facilitate long-lasting, positive change. 

Dr. Skipper’s background also includes a B.A. in Elementary Education with 11 years of experience in primary education. 

Disclaimer: The above information is not intended to provide professional advice or diagnostic service. If you have any concerns about Adjustment Disorder or other health issues, please consult a qualified health care professional in your community.