Adjustment disorder with disturbance of emotions and conduct

Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

Adjustment disorder with mixed disturbance of emotions and conduct is characterized by excessive reaction to a stressful life event which causes negative behavioral changes and impacts emotional stability. Most often, children under the age of 18 are more susceptible to symptoms of this diagnosis, but it can affect adults as well. Anytime a stressful life event occurs, it can cause anxiety, sadness or disruption of normal routine. When a person has trouble overcoming these symptoms and begins to act out or feel emotions which interfere with school, work, home or family life, adjustment disorder with mixed disturbance of emotions and conduct may be the cause.

Symptoms of Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

Adjustment disorder with mixed disturbance of emotions and conduct may result from any stressful change that impacts family life. Often, death of a loved one, divorce, loss of a home, move to another state or any significant change can result in mood swings or feelings of sadness. Some children and adults can overcome symptoms in a reasonable amount of time, while others find that their lives and feelings are impacted in a significantly negative way. Following is a brief list of symptoms that may be apparent when someone is experiencing adjustment disorder with mixed disturbance of emotions and conduct:

• Distress caused by an stressful and life-changing event
• Behavioral patterns are impacted in a substantially negative way
• Enjoyable, healthy and fun activities no longer attract interest
• Sadness, helplessness, hopelessness or symptoms of clinical depression
• Anxiety, panic attacks, nervousness or problems with sleeping
• Behavioral issues, such as acting out in a negative way at home, at school at work or in public
• Potential arrest or school suspension for behavioral problems

Causes of Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

The exact cause of adjustment disorder with mixed disturbance of emotions and conduct is not known. The apparent trigger is the stressful event that leads to symptoms, but the differences between people who are more emotionally resilient and those who are deeply affected by the reaction to the event remains a mystery. Research provides suggestions that biological, environmental and genetic factors may all play a role in the manifestation of symptoms. Susceptibility to mental illness can be passed down the family tree either through heredity or through behavioral reactions that may be learned as a child. Additionally, a chemical imbalance in the brain can cause a person to lose the ability to process emotions and feelings in a healthy way.

Diagnosis of Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

A medical doctor should first perform a physical examination to rule out any ailments that may be contributing to symptoms of adjustment disorder with mixed disturbance of emotions and conduct. Depending upon the results, a psychologist or psychiatrist may be recommended. A psychoanalysis should reveal signs of this disorder by focus on behavioral responses, answers to specific questions and analysis of family medical history. In order for this particular diagnosis to be made, no other signs of mental illness can be present and the condition must not have lasted longer than 6 months.

Treatment Options for Adjustment Disorder with Mixed Disturbance of Emotions and Conduct

Because adjustment disorder with mixed disturbance of emotions and conduct is temporary in nature, therapy options are recommended over treatment with prescription drugs. When children are involved, family therapy can benefit a great deal by involving parents and offering advice and exercises on how to reward positive behavior and discourage acting out. One-on-one psychotherapy is also recommended to provide a confidential option for patients to express feelings, and to give the therapist the opportunity to evaluate progress of the disorder.

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. 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 their 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 their 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. They talk with you, your partner, and your child. They will ask for a full history of your child’s development, life events, emotions, behaviors, school performance, and the stressful event.

How is an adjustment disorder treated in a child?

Treatment will depend on your child’s symptoms, age, and health. It will also depend on how severe the disorder is.

Treatment may include:

• Psychotherapy using cognitive behavioral methods. A child learns how to better solve problems, communicate, and handle stress. They will also learn how to control impulses and anger.

• Family therapy. This therapy is often focused on making needed changes in the family. It may include improving communication skills and family interactions. It may also boost support among family members.

• Peer group therapy. This therapy develops social and interpersonal skills.

• Medicines. These are not often used. But a child may need them for a short time if a certain symptom is severe.

What can I do to prevent an adjustment disorder in my child?

It’s not known how to prevent an adjustment disorder in a child. But spotting it early and getting expert help for your child can ease severe symptoms. Taking these steps can enhance a child’s normal growth and development. It can improve your child’s quality of life.

How can I help my child live with an adjustment disorder?

You can do these things to help your child:

• Keep all appointments with your child’s healthcare provider.

• Talk with your child’s healthcare provider about other providers who will be included in your child’s care. Your child may get care from a team that may include counselors, therapists, social workers, psychologists, and psychiatrists. Your child’s care team will depend on your child’s needs and how serious the adjustment disorder is.

• Work closely with school staff. Your child's adjustment disorder may significantly interfere with his or her ability to learn. If this is the case, the Americans with Disabilities Act (ADA) or Section 504 of the Civil Rights Act may allow the school to offer reasonable accommodations in the school setting.

• Tell others about your child’s adjustment disorder. Work with your child’s healthcare provider and school to create a treatment plan.

• Reach out for support from local community services. Being in touch with other parents who have a child with an adjustment disorder may be helpful.

When should I call my child’s healthcare provider?

Call your child’s healthcare provider if your child has:

• Symptoms that don’t get better, or get worse

• New symptoms

Key points about an adjustment disorder in children

• An adjustment disorder is an unhealthy emotional or behavioral reaction to a stressful event or change in a child’s life.

• Adjustment disorders happen equally in boys and girls and in all cultures. But the stressors and signs of the disorder may vary based on cultural influences.

• Symptoms happen within 3 months of the stressful event.

• There are 6 subtypes. They are based on the major symptoms a child may feel, such as depression or anxiety.

• psychiatric evaluation can help diagnose it.

• Personal, family, and group therapy can help.

Next steps

Tips to help you get the most from a visit to your child’s healthcare provider:

• Know the reason for the visit and what you want to happen.

• Before your visit, write down questions you want answered.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you for your child.

• Know why a new medicine or treatment is prescribed and how it will help your child. Also know what the side effects are.

• Ask if your child’s condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if your child does not take the medicine or have the test or procedure.

• If your child has a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your child’s provider after office hours. This is important if your child becomes ill and you have questions or need advice.

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