Adjustment disorders

Question 1

What might be some common precipitants for adjustment disorders?

Answer 1

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

Question 2

How long does a normal grief reaction last?

Answer 2

Normal grief reaction is up to 6 months

Question 3

How do we distinguish adjustment disorder from PTSD?

Answer 3

PTSD has an acute and severe panic element to it as well as the hyper-arousal and vigilance and flashbacks.

Question 4

What are some more common symptoms of adjustment disorder?

Answer 4

• Depressive symptoms (but not enough to be called depression)
• Anxiety symptoms (but not enough to be called anxiety)
• Feeling of inability to cope

Question 5

What might development in more severe cases of adjustment disorder?

Answer 5

CONDUCT DISORDER

e.g. Reckless driving, truancy and aggressive behaviour

Question 6

What sort of things might be risk factors for adjustment disorder?

Answer 6

Personality type

Resilience to stress

Question 7

How is a diagnosis of adjustment disorder made?

Answer 7

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

Question 8

What is the main treatment for adjustment disorder?

Answer 8

CBT

Question 9

What is a stressor?

Answer 9

Something that places a strain on the person’s ability to cope - this is relative to the patient

Question 10

What do we mean when we say traumatic stress?

Answer 10

This is something that would cause a stress reaction in nearly anyone

Question 11

Pathological reactions to stress can lead to psychiatric conditions. What are some examples of these?

Answer 11

Adjustment disorder
Traumatic stress disorder or PTSD
Dissociative disorder
Other major psychiatric illness such as depression or anxiety

Question 12

What is dissociative disorder?

Answer 12

• Disorder in consciousness, memory, cognition, perception, identity and movement
• The awareness and control of movement becomes separate from someone’s personality

Question 13

What are some types of dissociation?

Answer 13

Depersonalisation (feeling like your body is in some way strange or unreal)
Derealisation (External reality feels strange or unreal)

Question 14

What are the 7 stages of grief?

Answer 14

Shock
Denial 
Anger 
Bargaining 
Depression
Testing 
Acceptance

Question 15

What characteristics of a bereavement reaction might make you consider it to be abnormal?

Answer 15

• 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

Question 16

whats the difference between normal and abnormal grief?

Answer 16

ABNORMAL GRIEF

1) Delayed onset
2) Greater intensity of symptoms
3) Prolonged reaction

Question 17

What are risk factors for atypical grief reaction? (3)

Answer 17

1. Relationship with diseased was problematic (over or under involved)
2. The death was sudden
3. Normal grief was impended by social constrains (brave face for the kids)

Question 18

Treatment for abnormal grief?

Answer 18

ventilation of emotions
CBT
Should not be diagnosed if a depressive order is present

Question 19

What is an acute stress reaction

Answer 19

-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

Question 20

What is an ICD-10 requirement of dissociative disorder?

Answer 20

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