Transcript DSM-IV

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