Adjustment Disorder in College-Adult
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Adjustment disorder is defined as stress-response syndrome due to a maladaptive reaction
to stressors. This disorder impacts the emotional and behavioral changes in patients, resulting in
hopelessness, anxiety and in most cases, patients become antisocial and introverted. Symptoms
of adjustment disorder often manifest after three to four months of restlessness in the emotions
and behaviors of patients due to stressful events. Diagnosing this disorder is crucial at early
stages since if the condition prolongs, it can significantly impair patients' emotional and
behavioral functioning. Therefore, to discuss the adjustment disorder in a practical context, we
have decided to have a hypothetical patient Lily, an adult female college student who AD has
been diagnosed due to symptoms she displayed. Lily has been contemplating abandoning her
college studies to return home due to the overwhelming stresses of coping with her ever-partying
roommate and emotional dissatisfaction with college life. From this hypothetical case, the
symptoms displayed by Lily and her psychological conditions align with the AD diagnostic
condition.
Epidemiology of AD has been a challenge to its treatment because its often misdiagnosed
as depression, and most patients consider AD as normal life stress issues, thus underreporting to
health institutions for diagnosis. Adjustment disorder is only diagnosed if a person does not meet
the criteria for another disorder (Zelviene & Kazlauskas, 2018). Recent explorations suggested
an increased prevalence rate among teens and youths in their early twenties during life
transitional phases such as when joining universities or colleges or when starting independent
families. However, recent investigations show a higher prevalence among teens and young adults
(early twenties), especially during transitional periods such as starting a family or joining college
or university. This prevalence pattern is due to the broad and challenging nature of the diagnosis
(O'Donnell et al., 2019). In terms of population, studies have shown that approximately 3% of
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the US population suffer from Adjustment Disorder, with ¼ of this population being unemployed
individuals and 1/5 are bereaved people. One longitudinal study showed a continued progression
of the disorder criteria, with 19% of people meeting the criteria three months after injury and
16% still meeting the criteria 12 months after the injury (Zelviene & Kazlauskas, 2018).
Pathogenesis of AD is often associated with the complex interplay of neurological,
environmental, and genetic factors. For example, the variation in neurotransmitters and genetic
predisposition increases an individual's chances of suffering AD, and environmental attributes
like an individual's coping mechanism and life events (surroundings) also can lead to a diagnosis
of adjustment disorder. Another reason for misdiagnosis of AD is because of limited research
studies on the causes, symptoms and diagnosis of AD
Lily's case can be studied to identify some of the clinical features of AD. For example,
the challenges experienced by Lily include lack of sleep (poor sleep), overwhelming stress,
weight loss due to declining appetite, lack of concentration on academic work, low performance,
and social withdrawal. Our patient (Lily) displayed these symptoms are similar to the AD
clinical features outlined in the DSM-5 diagnostic criteria. According to Lily's condition and
history, it's accurate to conclude that the DSM-5RT diagnosis and psychiatric finding on her case
is Adjustment Disorder. Establishing the specific type of AD Lily suffers would require
assessing her stressors' predominant symptoms and nature. For instance, in Lily's case, AD is
attributed to emotional stresses that have influenced her physiological response through complex
interactions between the endocrine, nervous, and brain. Recommended treatment for Lily
includes psychotherapy, stress management sessions, group therapy, and mind-engaging
activities such as yoga or gym sessions. It's also imperative to consider non-pharmaceutical,
social, and cultural interventions while diagnosing AD patients.
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References
Barlow, D. H., Durand, V. M., & Hofmann, S. G. (2022). Psychopathology: An integrative
approach to mental disorders (9th ed.). Cengage Learning.
Carta, M. G., Balestrieri, M., Murru, A., & Hardoy, M. C. (2019). Adjustment Disorder:
epidemiology, diagnosis and treatment. Clinical Practice and Epidemiology in
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Eberle, D. J., & Maercker, A. (2022). Preoccupation as psychopathological process and
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Morgan, M. A., O’Gallagher, K., Kelber, M. S., Garvey Wilson, A. L., Belsher, B. E., &
Evatt, D. P. (2022). Adjustment Disorder in US Service Members: Factors Associated
With Early Separation. Military Medicine, usac008.
O'Donnell, M. L., Agathos, J. A., Metcalf, O., Gibson, K., & Lau, W. (2019). Adjustment
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https://doi.org/10.3390/ijerph16142537
O'Donnell, M.L., Metcalf, O., Watson, L., Phelps, A. and Varker, T. (2018), A Systematic
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in Adults. JOURNAL OF TRAUMATIC STRESS, 31: 321-
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Zelviene, P., & Kazlauskas, E. (2018). Adjustment disorder: current
perspectives. Neuropsychiatric disease and treatment, 14, 375–381.
https://doi.org/10.2147/NDT.S121072
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