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Adjustment Disorder In Children: Types, Symptoms, Causes And Prevention

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When a child exhibits an unhealthy behavioral or emotional reaction to a sudden change in life or distressing event, it is called an adjustment disorder. Adjustment disorders in children can last for long periods and cause fairly noticeable changes in the child’s demeanor.

Every child is different, and so are the symptoms they display when facing adjustment issues. Yet, an unhealthy change in behavior is most often a reliable indicator. Most children show signs of adjustment issues within three months of the stressful event/change (1) (2).

Keep reading to know about the types, risks, causes, symptoms, treatment, and effective prevention of adjustment disorders in children.

Symptoms Of Adjustment Disorder

Some common signs and symptoms of adjustment disorder in children are (1):

  • Trouble sleeping
  • Depression
  • Anxiety
  • Avoiding school, family, and friends
  • Crying more than usual
  • Fighting with peers and family members
  • Irritability

These symptoms interfere with the child’s daily life and routine.

Types Of Adjustment Disorder

There are six subtypes of adjustment disorder classified based on the symptoms a child experiences (3).

Adjustment disorder with depressed mood

  • Depression
  • Tearful
  • Feeling hopeless

Adjustment disorder with anxiety

  • Worry
  • Nervousness
  • Feeling jittery

Adjustment disorder with anxiety and depressed mood

Show symptoms of both anxiety and depression

Adjustment disorder with disturbance of conduct

  • Encroachment of others’ rights
  • Violating the rules and norms of society, such as destructing property, fighting, reckless behaviour, vandalism, and stealing

Adjustment disorder with mixed disturbance of emotions and conduct

Shows a combination of symptoms from all the above subtypes

Adjustment disorder unspecified

The symptoms do not fit into any subtypes mentioned above. However, the reactions to identifiable triggering events may include and inhibitions to the usual activities.

The above symptoms may also be experienced in some other medical conditions. Your child’s healthcare provider will help you arrive at the correct diagnosis.

Causes Of Adjustment Disorder In Children

Adjustment disorders are a reaction to some outside triggers or stressors. The reaction may differ based on how long the stressors last, how strong they are, and their effect on the child (3). Also, each child may have varying susceptibility, state of mind, and coping skills. Therefore, it is impossible to pinpoint the cause of adjustment disorder (2).

Some examples of stressors for adjustment disorders in children are:

  • Parental separation
  • Frequent relocating
  • Diagnosis of a serious disease in parents or siblings
  • Death or loss of a pet
  • Problems at school
  • Conflicts in the family
  • Sexuality issues
  • Experiencing, witnessing, or being involved in violence

Incidence and prevalence of adjustment disorders in children (3).

  • Happen equally in males and females.
  • Might happen in all cultures, but the triggers and signs may differ due to cultural influences.
  • Occur in all age groups, but the characteristics vary from children to adolescents.

Diagnosis Of Adjustment Disorder In Children

A qualified mental health professional will do a detailed psychiatric analysis and talk to the child and parents. The doctor will also ask for a detailed history of how and when the negative emotions began to develop and identify the root cause.

Treatment For Adjustment Disorder In Children

The treatment depends on the child’s age, general health, medical history, the severity of the symptoms, subtype, expectations from the treatment, and tolerance towards treatments.

The treatment options for adjustment disorders may include (3) (4).

  • Individual psychotherapy using cognitive-behavioural approaches

Cognitive behavior therapy helps in improving age-appropriate skills on problem-solving, communication, impulse control, anger control, and stress management.

  • Family therapy

It focuses on improving interaction and communication skills within the family. The therapy also helps in strengthening the mutual support amongst the family members.

  • Group therapy

It focuses on developing social and interpersonal skills.

  • Medications

Medicines have a limited role to play in the treatment of adjustment disorders. However, the doctor may prescribe a particular medicine based on how a particular symptom responds to the medicine.

Prevention Of Adjustment Disorder In Children

Prevention is not possible as the exact cause is unknown. However, early diagnosis and intervention can help in reducing the severity of symptoms. It also helps in normal growth and development and improves the child’s quality of life (3).

Older kids with untreated adjustment disorders are at a higher risk of developing depression, chronic anxiety, substance abuse, etc. (5). If you suspect your child with an adjustment disorder, discuss their behaviour with other caregivers such as coaches, teachers, or daycare providers. An accidental event or stressful episode at the child’s school might trigger, and you may be unaware of it.

References:

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Dr. Ritika Shah

Dr. Ritika Shah is a dental surgeon with more than seven years of clinical experience across various cities in India. During her clinical practice, pediatric dentistry was her particular area of interest, and she constantly thrived to inculcate the latest advancements in the field of dentistry into her practice. Dr. Shah's deep interest in the well-being of babies and children... more