From Tucson Parent Magazine 11/15/2000
WHAT PARENTS SHOULD KNOW ABOUT “ADJUSTMENT DISORDER”
-By David Bynes LCSW
Children who have gone through significant life changes such as a divorce, a death, a change in the family structure, a change of schools, moving, changing teachers, or experiencing an illness, can develop Adjustment Disorder. If your child goes through a significant life event and her performance or behavior in school or at home is significantly impaired, then she has met the criteria for Adjustment Disorder and needs to be seen by a mental health professional.
Assessment and diagnosis of Adjustment Disorder needs to be done by a qualified mental health professional. However, it simply isn’t feasible (or advisable) for most parents to take their child for a mental health evaluation after every significant event in their child’s life. Therefore, parents need to be able to gauge whether or not their child’s reactions are a normal adjustment reaction or represent Adjustment Disorder. As mentioned above, any significant change in academic performance is a red flag for Adjustment Disorder. Similarly, significant changes in your child’s behavior at home should be cause for concern during the weeks and months following a significant stressful event.
Adjustment Disorder can include some very serious symptoms such as depression, anxiety, disturbance of conduct, and disturbance of emotion. These symptoms can be serious enough to include suicidal behavior, truancy, fighting, reckless driving, excessive worry, and fear of separation from parents. If your child shows any of these symptoms it is important to take your child to a mental health professional for evaluation and treatment. Some other symptoms to watch for include: changes in eating and/or sleeping patterns, deterioration of personal hygiene (hair combing, dressing, makeup, etc.), self-mutilation (cutting on self, self-inflicted wounds or scratches, or burns). Parents should be aware of increased preoccupation with death, suicidal statements (either direct or metaphorical) and seek help immediately if these symptoms are present. Similarly, parents should be concerned if their child displays a new interest in morbidity through movies, poetry, literature, music or video games. Please keep in mind, that in screening for Adjustment Disorder you should look for changes in these areas. Thus, if your child has been interested in the band “Mega Death” for three months and then experiences a death in the family, her interest in “Mega Death” is not a symptom of possible Adjustment Disorder. But, if your child has recently changed schools and then becomes interested in poetry about death, you need to take her to a mental health professional.
Adjustment Disorder is quite common for children in general, and very prevalent in children who have been through a stressful event, such as a divorce or death in the family. In my practice, I have found Adjustment Disorder to be the single most prevalent disorder for children, but I find that most parents are largely unaware of this disorder. This is alarming due to the seriousness of the disorder and also the high number of incident s where Adjustment Disorder leads to major depression or anxiety disorders.
Other disorders such as Post Traumatic Stress Disorder and Acute Stress Disorder can develop from stressful events, but they are not nearly as common as Adjustment Disorder.
Adjustment Disorder is more serious than the label implies and should almost always warrant treatment. Symptoms of Adjustment Disorder are more intense and lasting than the usual period of mourning, bereavement or adjustment for a particular event. How long it takes a child to overcome specific stressors varies greatly depending on what type of situation the child is facing, as well as the norms of the child’s culture. Support groups for parents and families who have survived a death in the family or divorce are an excellent way to gauge how effectively your child is dealing with a certain event and whether her reactions are within normal limits of behavior. Consulting parenting literature or a professional’s advice, when you child faces a major life change, is another way to take precautions against Adjustment Disorder.
-David Bynes is owner of “Academic and Behavioral Center” 323-9835
www.abctucson.com, a private mental health service specializing in helping children and families with educational issues. He holds a Master’s Degree in Clinical Social Work from Arizona State University, and is a state certified teacher.