Adjustment Disorder Flashcards
Adjustment disorder: diagnostic criteria
- Identifiable stressor→Emotional or behavioral sx
- Within 3 months after onset of stressor
- Clinically significant:
- Distress in excess of what would be expected
- Significant impairment (social or work)
Adjustment disorders do not meet the criteria for other psychiatric disorders or bereavement. Once the stressor or its consequences has terminated the symptoms do not persist more than ______.
6 months
(adjustment disorder sx appear within 3 months of stressor)
Adjustment disorder course of illness
- Days to weeks
- No longer than 6 months after stressor is gone
(stressor could be chronic (married to an alcoholic spouse), but to be adjustment disorder sx will stop 6 months after stressor is gone)
Adolescents with adjustment disorder are more likely to be suicidal. _____% Of outpatient mental health patients have this diagnosis. _____ of ER patients w/self-harm
- 35%
- 1/3
(most adolescents w/adjustment disorder → psychiatric condition dx later in life)
Adjustment disorder is most common in patietns w/ ______.
- maladaptive styles, such as those with personality disorders (borderline)
(Threshold of stress required to cause psychiatric symptoms varies by individual)
Event if a patient has a stressor that may cause adjustment disorder, if the symptoms meet criteria for another major psychiatric disorder, which would be diagnosed?
psychiatric disorder
(suicide is a high risk in adjustment disorder)
Adjustment disorder prognosis
Most recover within 3 months and learn from the experience
Adjustment disorder treatment involves (4)
- Symptomatic treatment of anxiety and insomnia
- Search for the meaning of the stressor to the patient
- Coping strengths
- Community resources
Define bereavement
“To be robbed by Death”
Define grief
- Grief: the physical and emotional pain precipitated by a significant loss
(Can be due to the loss of a person, place, pet, job, object, health, independence, amputation)
Define mourning:
Behaviors, rituals and observances reflecting a culture’s/religion’s views about the meaning of death and the role of the survivor
List the different types of grief (4)
- Anticipatory
- Acute
- Delayed
- Complicated
Define anticipatory grief
anticipating impending loss
Define acute grief
1st stage of the bereavement process
Define Delayed grief
Absence of expression of grief at the time of the loss
Define Unresolved grief
Extreme grief symptoms
(more intense & last longer than expected)
Define Complicated grief
unresolved grief + physical sx
(interferes w/function)
What symptoms are typically seen in patients in the mourning stage of bereavement (5).
- Decreased appetite
- Decreased concentration
- Hallucinations of the deceased
- Self-reproach
- Sleep disturbances
Stages of normal bereavement (3)
- Shock and denial
- Mourning: physical, emotional sx & social isolation
- Reorganization of life that acknowledges the loss
Difference between mourning & MDD
Symptoms of mourning only last a few days
Examples of reorganization of life that is experienced in normal bereavement
- different relationships
- new identity (widow, orphan, only child)
Biggest differentiating factors between MDD & complex bereavement
MDD has neurovegitative sx (not eating, drinking, unable to care for themselves)
Duration of normal bereavement
Indeterminate: typically do not diagnose MDD immediately following a death
Factors for poor bereavement outcome (4)
- Type of death: sudden or suicide (stigma)
- Who: child, relationship of dependency or ambivalence w/decedent
- Current psychological state: social support, concurrent crisis, low socioeconomic status
- Current health: age or health