ADJUSTMENT DISORDERS

Adjustment Disorders appear following one or more stressful events, which influence both the psychological and social spheres of an affected individual. These disturbances are usually transitory. The traumatic event or events must be clearly identifiable however. At times it occurs that situations that are objectively traumatic do not produce any signs of sufferance in individuals, while other apparently harmless situations do so. The quality and intensity of an ‘interaction’ occurring between a subject and a particular event is entirely subjective. The intense sufferance caused by the disorder results in an impairment of functioning at the relational, occupational and social levels. The disorder must present within three months following the traumatic event and should last no longer than six months.

Many life events are potentially capable of inducing stress, and these are often cases of separation and divorce (particularly in Western countries), the death of a loved one, occupational problems and illnesses. When a problem arises following a disease or injury or even its related treatment (which might be long and stressful and even eventually have an outcome whereby the individual is left with a permanent impairment), people may begin to show signs of a lack of adjustment with respect to their state of illness or invalidity, and their psycho-physical functioning may be altered. If the symptoms last longer than six months, it is possible to speak in terms of a Chronic Adjustment Disorder. The disorder is sub-typed into various groups, depending on which symptoms are predominant.

Adjustment Disorder with Depressed Mood occurs in cases where patients present a state of depression, become tearful and often cry and feel that all hope is lost. An Adjustment Disorder with Anxiety is characterised by irritability, worry, restlessness and, in children, the fear of being separated from figures they are attached to (see Separation Anxiety). However, it is possible to identify concomitant symptoms of both depression and anxiety. In this case the diagnosis would be Adjustment Disorder with Mixed Anxiety and Depressed Mood. An Adjustment Disorder may also be accompanied by a Disturbance of Conduct (see Conduct Disorder), and in such cases a person will violate the rights of others and the norms and laws of society and may also commit misdemeanours such as dangerous driving, vandalism and neglect his/her responsibilities.

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