Adjustment disorders Flashcards
What might be some common precipitants for adjustment disorders?
Bereavement
Changing schools or jobs
Moving house
Adjustment disorders can occur after traumatic events but in this case it is important to distinguish them from PTSD
How long does a normal grief reaction last?
Normal grief reaction is up to 6 months
How do we distinguish adjustment disorder from PTSD?
PTSD has an acute and severe panic element to it as well as the hyper-arousal and vigilance and flashbacks.
What are some more common symptoms of adjustment disorder?
- Depressive symptoms (but not enough to be called depression)
- Anxiety symptoms (but not enough to be called anxiety)
- Feeling of inability to cope
What might development in more severe cases of adjustment disorder?
CONDUCT DISORDER
e.g. Reckless driving, truancy and aggressive behaviour
What sort of things might be risk factors for adjustment disorder?
Personality type
Resilience to stress
How is a diagnosis of adjustment disorder made?
The symptoms should have come on WITHIN 1 MONTH of the event occurring and LAST LESS THAN 6 MONTHS
IT IS A DIAGNOSIS OF EXCLUSION - consider PTSD, depression and anxiety all first
What is the main treatment for adjustment disorder?
CBT
What is a stressor?
Something that places a strain on the person’s ability to cope - this is relative to the patient
What do we mean when we say traumatic stress?
This is something that would cause a stress reaction in nearly anyone
Pathological reactions to stress can lead to psychiatric conditions. What are some examples of these?
Adjustment disorder
Traumatic stress disorder or PTSD
Dissociative disorder
Other major psychiatric illness such as depression or anxiety
What is dissociative disorder?
- Disorder in consciousness, memory, cognition, perception, identity and movement
- The awareness and control of movement becomes separate from someone’s personality
What are some types of dissociation?
Depersonalisation (feeling like your body is in some way strange or unreal)
Derealisation (External reality feels strange or unreal)
What are the 7 stages of grief?
Shock Denial Anger Bargaining Depression Testing Acceptance
What characteristics of a bereavement reaction might make you consider it to be abnormal?
- Lasting longer than 6 months
- Guilt about things OTHER than actions taken/not taken around time of loved ones death
- Thoughts of death BEYOND thinking they should be dead instead of loved one
- Morbid preoccupation with worthlessness
- Marked psychomotor retardation
- Prolonged or marked functional impairment
- Extensive hallucinatory experiences that extend beyond occasionally seeing or hearing loved one
whats the difference between normal and abnormal grief?
ABNORMAL GRIEF
1) Delayed onset
2) Greater intensity of symptoms
3) Prolonged reaction
What are risk factors for atypical grief reaction? (3)
- Relationship with diseased was problematic (over or under involved)
- The death was sudden
- Normal grief was impended by social constrains (brave face for the kids)
Treatment for abnormal grief?
ventilation of emotions
CBT
Should not be diagnosed if a depressive order is present
What is an acute stress reaction
-The SYMPTOMS OCCUR IMMEDIATELT AFTER OR WITHIN A FEW MINUTES OF STRESSOR:
○ Combat fatigue
○ Psychic shock
○ Dazed
○ Narrowing of attention
○ Inability to process external stimuli and disorientation
○ Amnesia for the episode
***these symptoms usually resolve within a few hours. In the scenario where the trauma is prolonged it might take a few days
What is an ICD-10 requirement of dissociative disorder?
There has to be a stressor causing the dissociative disorder
Diagnosis CANNOT be made if there is evidence of any psychiatric disorder that might be able to explain the symptoms
