understanding abnormal behavior


Sue, D., Sue, D. W., Sue, D., & Sue, S. (2014). Essentials of understanding abnormal behavior (2nd ed.). Belmont, CA: Wadsworth Cengage Learning.



Chapter 5

5-1aAdjustment Disorders

An  adjustment disorder  (AD) occurs when someone has difficulty coping with or adjusting to a specific life stressor—the reactions to the stressor are disproportionate to the severity or intensity of the event or situation. Common stressors such as interpersonal or family problems, divorce, academic failure, harassment or bullying, loss of a job, or financial problems may lead to an AD. When do these common stressors cause diagnosable AD? According to DSM-5, the following is necessary for a diagnosis of AD (APA, 2013):

1. Exposure to an identifiable stressor that results in the onset of significant emotional or behavioral symptoms that occur within 3 months of the event.

2. Emotional distress and behavioral symptoms that are out of proportion to the severity of the stressor and result in significant impairment in social, academic, or work-related functioning, or other life activities.

3. These symptoms last no longer than 6 months after the stressor or consequences of the stressor have ended.

Adjustment disorders often involve mood or behavioral changes, including symptoms of anxiety or depression. It is not always easy to distinguish between normal adaptive stress, adjustment disorders, and depressive and anxiety disorders. The main differentiating factor is that a specific stressor precedes the symptoms seen in AD and that the person experiences an unusually intense reaction to the stressor. To increase diagnostic accuracy and to rule our preexisting mental health conditions, clinicians also consider a person’s emotional functioning prior to encountering the stressor (Kangas, 2013).

We have limited data on the prevalence of AD in the general population. However, it is a common diagnosis among people seeking help from medical or mental health professionals. The prevalence in that population ranges from 7 to 28 percent (P. Casey, 2009; Mitchell et al., 2011; Pelkonen, Marttunen, Henriksson, & Lönnqvist, 2007). AD is particularly common among those who have received a worrisome medical diagnosis; for example, up to one third of those diagnosed with cancer meet the criteria for an AD diagnosis.

As you will see in the next section, in contrast to an AD diagnosis that involves exposure to stressors that range in their level of severity, other trauma-related disorders (acute and post-traumatic stress disorders) require the presence of certain traumatic stressors