Adjustment Disorder

Every so often, we may misjudge our own ability to face up to or manage stressful situations or issues. Many of us may view the same stressor differently due to the ways we have been brought up or taught. We also find ourselves reacting to stress in a very different manner in the physical, psychological and behavioural domains. Some physical symptoms may include headache, muscle tension, chest discomfort, stomach upset or tiredness. Mental phenomena may include feeling anxious, feeling overwhelmed, having a sense of irritability, anger or even sadness. Some of us may even resort to excessive eating or usage of drugs to cope, and sometimes we withdraw from our family and friends. If not attended to or ignored, maladjustment or stress can lead to other more serious mental health conditions.

Adjustment Disorder therefore refers to a set of maladaptive emotional and/or behavioural responses to an identifiable psychosocial stressor. These responses are experienced at a disproportionate level compared to the severity of the stressor. This is not the same as Post-Traumatic Stress Disorder (PTSD) or acute stress disorder though the nature of a stressor event may include traumatic (e.g. threatened death), and/or non-traumatic ones (e.g. unemployment, illness, financial difficulty, death of a loved one, interpersonal conflict).

The Diagnostic and Statistical Manual of Mental Disorders describe it as the development of emotional or behavioural symptoms in response to an identifiable stressor(s) occurring within three months from the onset of the stressors(s). The distress can be disproportionate to the severity or intensity of the stressor after taking into account contextual and cultural factors. There may be significant impairment in social and occupational domains of functioning. Symptoms do not last for more than six months after the stressor has been resolved.

Evidence has shown that resolution of the stressor itself can lead to symptom improvement. Although this is the case, it is important that psychological interventions be provided to reduce the psychological burden and improve wellness. Some of these interventions may include brief cognitive behaviour therapy, self-help bibliotherapy, and solution-focused therapy.