Signs & Symptoms of Adjustment Disorder

Learn more about adjustment disorder

There are instances in which children and adolescents struggle to appropriately cope with significant life changes or handle major events. For these children and adolescents, such unexpected changes and events can result in severe feelings of distress. If this type of reaction occurs, it is possible that a child or adolescent is suffering from adjustment disorder and may require treatment.

Adjustment disorder is a mental health condition that causes individuals to experience emotional disturbances after going through a change in life, ultimately resulting in the onset of behavioral issues. These emotional and behavioral disturbances typically occur as the result of a child or adolescent’s inability to appropriately cope with new circumstances or situations. There can be any number of circumstances that trigger the onset of symptoms synonymous with adjustment disorder, but some of the most common include experiencing the sudden loss of a loved one, switching schools, moving to a new home, the addition of a new child into one’s family, having one’s parents go through a divorce, or surviving a natural disaster. Symptoms of adjustment disorder can remain for up to six months following the event and can cause children and adolescents to act out at school, at home, or in social settings.

Adjustment disorder statistics

Research has shown that approximately 50% of children and adolescents who receive inpatient treatment for mental health issues meet the diagnostic criteria for adjustment disorder. This mental illness affects boys and girls equally and, when the onset occurs during childhood or adolescents, individuals typically respond by acting out in a negative manner.

Causes and risk factors for adjustment disorder

As is true for other mental health conditions, there does not exist any one identifiable cause that can be attributed to why some children and adolescents develop adjustment disorder while others do not. Rather, it is believed by most professionals in the field that the onset of this condition is a complex combination of genetics, chemical changes in an individual’s brain, life experiences, and a child or adolescent’s individual temperament. Such factors are described in the following:

Genetic: Although there is no indisputable evidence that there exists a specific gene that contributes to the onset of adjustment disorder, it is believed by many researchers that some individuals may possess certain genes that cause them to be susceptible to the development of this condition should an event occur that triggers its onset. While adjustment disorder itself is triggered by an external stressor, the symptoms that arise as a result of the condition are based on a child or adolescent’s interpretation of the stressor. Genetic influences can impact how one perceives, interprets, and responds to the world around him or her. If there is a family history of anxiety disorders, for example, there is an increased likelihood that a child will struggle to cope with significant life changes because anxiety is known to run in families.

Physical: Chemical changes and imbalances in one’s brain are said to play a role in the development of adjustment disorder after a child or adolescent has experienced an event that elicited feelings of extreme distress. Such alterations in a person’s brain chemistry can negatively affect his or her ability to cope with change and stress in a healthy, appropriate manner.

Environmental: Due to the fact that adjustment disorder is triggered by an external stressor, environmental factors are believed to have a significant impact on the development of this condition. When children and adolescents are subjected to environments in which they are confronted with severe and/or frequent stress, they are at an increased risk of experiencing the onset of adjustment disorder due to an inability to appropriately cope with such chronic stress when faced with a major life change.

Risk Factors:

• Family history of anxiety disorders or other mental health conditions
• Preexisting mental illness
• Losing a loved one
• Parental divorce or separation
• Experiencing a traumatic event
• Recent birth or adoption of a child
• Moving to a new place
• Changing schools
• Lacking strong social skills
• Lacking emotional flexibility
• Lacking appropriate coping skills
• Exposure to chronic stress
• Being the victim of abuse and/or neglect

Signs and symptoms of adjustment disorder

Depending on a child’s age, a child’s individual temperament, the circumstances that led to the onset of symptoms, and the level of support that a child has around him or her, the symptoms of adjustment disorder will vary. Examples of various symptoms that may present can include:

Behavioral symptoms:

• No longer participating in activities once enjoyed
• Tearfulness
• School refusal
• Defying / disobeying parents and other authority figures
• Temper tantrums
• Aggressive outbursts
• Vandalism
• Using drugs and/or alcohol
• Engaging in risky or self-destructive behaviors
• Isolating oneself from family and friends
• Engaging in self-harming behaviors

Physical symptoms:

• Sleep disturbances
• Chest pains
• Chronic stomachaches
• Chronic headaches
• Muscle tension
• Trembling / twitching
• Irregular or forceful beating of the heart
• Changes in eating patterns

Cognitive symptoms:

• Memory disturbances
• Concentration difficulties
• Lacking the ability to make plans
• Inability to make good decisions

Psychosocial symptoms:

• Separation anxiety / fearing being apart from certain individuals
• Increased feelings of anxiety
• Excessive feelings of worry / dread / fear
• Depression
• Persistent feelings of nervousness
• Feeling overwhelmed
• Feelings of hopelessness and helplessness
• Feelings of hostility

The effects of adjustment disorder

In most cases, the symptoms of adjustment disorder will dissipate within six months following the event that triggered its onset. However, there are some instances in which children and adolescents continue to experience long-lasting effects, especially when treatment is not sought to alleviate their symptoms. Examples of potential long-term effects that can result from unaddressed adjustment disorder may include:

• Social isolation
• Familial conflict
• Development of symptoms synonymous with other mental illnesses
• Academic struggles / academic failure
• Prolonged, pervasive feelings of depression and anxiety
• Unpredictable mood swings
• Substance abuse and addiction
• Self-harm
• Suicidal thoughts and behaviors

Adjustment disorder and co-occurring disorders

It is not uncommon for children and adolescents who are suffering from adjustment disorder to be struggling with symptoms of another mental illness as well. The following disorders are the most commonly cited as co-occurring with adjustment disorder:

• Attention-deficit/hyperactivity disorder (ADHD)
• Bipolar disorder
• Depressive disorders
• Generalized anxiety disorder
• Obsessive-compulsive disorder (OCD)
• Social anxiety disorder
• Panic disorder
• Specific phobias
• Oppositional defiant disorder (ODD)
• Conduct disorder
• Learning disorders
• Communication disorders
• Eating disorders