Adjustment Disorders in Children

What is an adjustment disorder in children?

An adjustment disorder is an
unhealthy emotional or behavioral reaction to a stressful event or change in a person’s
life. The response happens within 3 months of the stressful event. Some events that may
lead to this problem in a child or teen are:

  • A family move
  • Death of a parent, sibling, grandparent, or other significant
    person
  • Parents’ divorce or separation
  • Death of a pet
  • A new brother or sister
  • A sudden sickness in the child or a
    family member
  • A long-lasting (chronic) illness in
    the child or a family member

What causes an adjustment disorder in a child?

Adjustment disorders are a reaction to stress. There is not one direct cause. Children and teens differ in their personalities, past experiences, vulnerability, and coping skills. Where they are in their development and ability to deal with a stressor may also play a part in how they react. Stressors also vary in how long they last, how strong they are, and what effect they have.

Which children are at risk for an adjustment disorder?

Adjustment disorders happen at all ages and are quite common in children and teens. They happen equally in boys and girls. They happen in all cultures. But the stressors and signs may vary based on cultural influences.

What are the symptoms of an adjustment disorder in a child?

Children and teens have different
symptoms of an adjustment disorder than adults do. Children tend to have more behavioral
symptoms, such as acting out. Adults have more depressive symptoms. Age differences also
affect how long symptoms last, how strong they are, and what effect they have.

In all adjustment disorders, the reaction to the stressor seems to be more than what is thought to be normal. Or the reaction greatly interferes with how the child functions day to day.

There are 6 subtypes of adjustment disorder. They are based on the type of major symptoms a child may feel. Each child’s symptoms may vary. These are the most common symptoms of each subtype:

  • Adjustment disorder with depressed mood. A child may feel depressed, tearful, and hopeless.
  • Adjustment disorder with anxiety. Symptoms may include nervousness, worry, and jitteriness. A child may also fear losing important people in his or her life.
  • Adjustment disorder with anxiety and depressed mood. A child has a mix of symptoms from both of the above subtypes (depressed mood and anxiety).
  • Adjustment disorder with disturbance of conduct. A child may violate other people’s rights or violate social norms and rules. Examples include not going to school, destroying property, driving recklessly, or fighting.
  • Adjustment disorder with mixed disturbance of emotions and conduct. A child has a mix of symptoms from all of the above subtypes.
  • Adjustment disorder unspecified. A child has reactions to stressful events that don’t fit in one of the above subtypes. These may include behaviors such as withdrawing from friends and school.

Symptoms of an adjustment disorder
can look like other health problems or mental illnesses. Have your child see his or her
healthcare provider for a diagnosis.

How is an adjustment disorder diagnosed in a child?

A mental health expert such as a
psychiatrist often makes the diagnosis after an evaluation. He or she talks with you,
your partner, and your child. He or she will ask for a full history of your child’s
development, life events, emotions, behaviors, school performance, and the stressful
event.