Signs of Adjustment Disorder in Children

An adjustment disorder refers to a mental health condition that may require professional attention if a child experiences changes in mood or behavior after a stressful event. These disorders typically respond well to treatment.

Causes

Adjustment disorders are triggered by a maladaptive response to stress, often stemming from various life changes, such as:

• Divorce leading to changes in living arrangements and parental absence.
• Moving to a new neighborhood or city, affecting friendships and routines.
• Changing schools, impacting peer groups and daily schedules.
• Changes in health, whether affecting the child or a family member.

Stressful situations can be one-time events like pet death or ongoing issues like repeated bullying.

Subtypes

There are several subtypes of adjustment disorders, diagnosed based on a child's emotional symptoms and behavior:

1. Adjustment Disorder with Depressed Mood:

   • Crying spells, loss of interest in activities, feelings of hopelessness, and increased sadness.

2. Adjustment Disorder with Anxiety:

   • Increased anxiety and worry, potentially leading to separation anxiety.

3. Adjustment Disorder with Mixed Anxiety and Depressed Mood:

   • Experiencing both depressed mood and anxiety.

4. Adjustment Disorder with Disturbance of Conduct:

   • Changes in behavior without significant mood changes, such as increased defiance, stealing, or aggression.

5. Mixed Disturbance of Emotions and Conduct:

   • A combination of disturbance in mood or anxiety and changes in behavior.

6. Adjustment Disorder Unspecified:

   • Difficulty coping with a stressful event without meeting specific criteria for other subtypes.

Symptoms

For an adjustment disorder diagnosis, impairment must go beyond what's considered normal for the circumstances, affecting a child's social or academic functioning. Symptoms include:

• Decline in grades
• Difficulty maintaining friendships
• Unwillingness to attend school
• Anti-social behavior (for adolescents)
• Physical symptoms like stomachaches and headaches
• Sleep problems and fatigue

Symptoms must appear within three months of a stressful event and should not last longer than six months. Otherwise, a different disorder might be diagnosed.

Risk for Suicide

Adolescents with high distress levels are at increased risk for suicide. Approximately 25% of teens with adjustment disorders experience suicidal thoughts or attempts, with girls showing higher tendencies than boys.

Diagnosis

A healthcare professional or mental health expert conducts a comprehensive assessment, including interviews with the child and parents. Other relevant individuals, like teachers or caregivers, may also provide information.

Treatment

Customized treatment plans are created based on the child's age, symptoms, and the stressful event. Common treatments include:

1. Individual Therapy: Teaches problem-solving, impulse control, anger management, stress management, and communication skills.

2. Family Therapy: Addresses changes in family dynamics and improves communication.

3. Parent Training: Equips parents with skills to manage behavior problems and set effective limits.

4. Medication: Rarely used but may be prescribed for specific symptoms if they are severe.

5. Group Therapy: Helps improve social and communication skills, offering peer support.

Early Intervention

Early intervention can be instrumental in treating adjustment disorders and preventing more serious conditions.

Recognizing Adjustment Disorder in Your Child

Symptoms may start slowly, and changes in mood or behavior should not be ignored. If they persist for more than two weeks, schedule an appointment with your child's pediatrician to discuss your concerns.

Even if a stressful event cannot be identified, the changes could indicate an adjustment disorder or another condition. A physician will rule out physical health issues and refer the child to a mental health professional if necessary.