Adjustment Disorders Maladaptive reactions to psychosocial stressors occurring within the past 3 months Not do to another mental disorder Described as relatively benign, transient, but maladaptive situational reactions

Adjustment Disorders-DSM Development of emotional or behavioral symptoms in response to identifiable stressor within 3 months of stressor Clinically significant symptoms Marked distress Significant role impairment Symptoms do not represent Bereavement Symptoms do not persist for > 6 months*

AD Presentations Generalized-disruption of mood or conduct Specific Depression (with SI) Anxiety Mixed Be careful NOT to neglect a MDD diagnosis if these symptoms are present

AD Clinical Course 59-71% of adults make strong recovery Only 44% of adolescents recover to the same level (less resources-vocational & $). Other predictors of poor outcome were chronicity, frequency of misconduct symptoms and number of stressors Depressive symptoms did not predict Dx. in 5% of inpatients and 20% of outpatients; Dx 3 times more in adolescents

AD Treatment To treat or not to treat? NOT to treat Waste time, $, and effort for remitting prob. Foster therapy dependency Worsen problem Why TO treat (following crisis intervention) Stabilize, minimize adversity, hasten recovery Capitalize on turmoil to change long-standing maladaptive patterns to more satisfying ones