Signs, Symptoms, & Causes of Adjustment Disorder

Learn about adjustment disorder

Adjustment disorder is a form of mental illness that results from an unhealthy, or maladaptive, response to a psychologically distressing life event. When people are unable to successfully adjust to presenting situations, they may begin to develop negative emotional and/or behavioral symptoms. Adjustment disorder has the potential of being acute or chronic, depending on how long the symptoms last. Most symptoms will dissipate within six months following the stressful event that triggered the onset of the illness.

When struggling with adjustment disorder, children often feel fearful and hopeless. They may also begin to lose interest in things like school, sports, or friends. However, adjustment disorder is triggered by an external stimuli, so once the child or adolescent has processed through and adapted to the new situation or circumstance, the symptoms will remit.

Things that may trigger the onset of adjustment disorder will vary from person to person, but the most common examples of things that cause it to develop in children and adolescents can include:

• Addition of another child into the family
• Parents getting divorced
• Moving to a different state
• Switching schools
• Doing poorly in school (when feeling pressured to meet high expectations)
• Losing a close friend
• Surviving a natural disaster

Adjustment disorder statistics

According to the American Psychiatric Association, the prevalence of receiving a diagnosis of adjustment disorder in an outpatient clinical setting can be anywhere between 5-20% and, in psychiatric hospital settings, it is said to be the most common mental health diagnosis given, with statistics reaching as high as 50%. Both boys and girls are known to suffer from adjustment disorder equally and, while adults with adjustment disorder tend to experience more emotional turmoil, children and adolescents typically respond by acting out in a negative manner.

Causes and risk factors for adjustment disorder in children and teens

As is true for other mental health disorders, there is no one identifiable cause attributed to why some people develop adjustment disorder while others do not. Instead, it is believed by most professionals in the field to be a complex combination of genetics, life experiences, chemical changes in the brain, and a person’s individual temperament. The following include factors that have been linked to the development of adjustment disorder:

Genetic: While there is no indisputable evidence of any specific gene playing a role in the development of adjustment disorder, it is believed by many that some individuals may possess certain genes that lead them to be susceptible to developing adjustment disorder, should an event occur that provokes its onset. Even though adjustment disorder is triggered by an external stressor, the symptoms that result are produced based on the person’s interpretation of the stressor. Genetics can influence how people perceive the world, therefore aiding in how a person interprets the things that happen to him or her. Those perceptions and interpretations can then play a role in whether or not adjustment disorder will come as a consequence to the significant life stressor that a person experiences.

Physical: Certain chemical changes in one’s brain are believed to play a role in whether or not a child or adolescent will develop adjustment disorder after experiencing an event that causes him or her great distress.

Environmental: When children and adolescents are surrounded by an environment in which they are faced with severe and frequent stress, they are more likely to develop adjustment disorder as they process through any changes that occur in the world around them.

Risk Factors:

• Having someone close to the child die
• Major life changes, including moving and changing schools
• Parents separating or getting divorced
• Being in the foster care system and having to move amongst different foster care homes
• Adoption
• Experiencing a traumatic event
• Having other mental illnesses
• Being diagnosed with a serious medical illness
• Being assaulted, abused, and/or neglected
• Lack of emotional flexibility
• Lack of social and coping skills

Signs and symptoms of adjustment disorder in children and teens

The signs and symptoms of adjustment disorder will vary from one child to the next depending on the situation or circumstances that led to the onset of the disorder, the individual child’s temperament, and the support system that the child has around him or her. Regardless of the type of symptoms that are experienced, however, in all cases the symptoms must develop within three months of the event’s occurrence. Some examples of signs and symptoms that may indicate that a child or adolescent is suffering from adjustment disorder can include:

Behavioral symptoms:

• Tearfulness
• No longer participating in activities that he or she once enjoyed
• Spending increasing amounts of time alone
• Refusing to go to school
• Using drugs or alcohol
• Actively defying or disobeying parents and other authority figures
• Engaging in risky or self-destructive behaviors
• Participating in self-harm
• Vandalism
• Fighting
• Jitteriness

Physical symptoms:

• Having difficulty sleeping
• Irregular or forceful beating of the heart
• Chronic headaches
• Chronic stomachaches
• Chest pain
• Increased muscle tension
• Trembling or twitching

Cognitive symptoms:

• Having difficulty concentrating
• Having difficulty making plans
• Experiencing memory problems

Psychosocial symptoms:

• Depression
• Anxiety
• Hopelessness
• Chronic nervousness
• Excessive worry
• Feelings of hostility
• Fearing separation from certain individuals
• Inability to enjoy things
• Feeling desperate
• Feeling overwhelmed

Effects of adjustment disorder in children and teens

While the symptoms of adjustment disorder typically dissipate within six months following the event that caused its onset, there is a possibility that some children and adolescents may experience long-lasting effects based on how they respond to stressor and whether or not they received treatment to meet any disabling symptoms. Examples of long-term effects that may result from untreated or unaddressed adjustment disorder can possibly include:

• Social isolation
• Familial conflict
• Marriage conflicts once the child or adolescent reaches adulthood
• Decreased ability to successfully perform academic or occupational tasks
• Alcohol and drug use
• Significant, lasting negative behavioral changes
• Prolonged feelings of depression and anxiety
• Self-harm
• Mood swings
• Suicidal thoughts and behaviors

Adjustment disorder and co-occurring disorders

Adjustment disorder can easily, and commonly does, co-exist alongside many other mental or medical disorders. Some examples of these co-occurring disorders can include:

• Generalized anxiety disorder
• Obsessive-compulsive disorder
• Panic disorder
• Specific phobias
• Social anxiety disorder
• Selective mutism
• Attention-deficit hyperactivity disorder
• Bipolar disorder
• Conduct disorder
• Depressive disorders
• Oppositional defiant disorder
• Learning disorders
• Eating disorders