Adjustment Disorder

Question 1

Supportive psychotherapy

Answer 1

Type of therapy that integrates various types of therapeutic techniques to relieve/reduce the intensity of symptoms, distress, and disability by providing therapeutic support

Question 2

Timecourse of adjustment disorder

Answer 2

Usually begins within 3 months of the stressful event and improves when the stressor resolves or the patient has adapted to changes.

Symptoms do not persist for more than 6 months after the stressor or its consequences are over.

The stressor may be acute (< 6 months in duration) or chronic (> 6 months).

Question 3

Diagnostic criteria for Adjustment Disorder

Answer 3

Development of an emotional response to a stressor within 3 months of the onset of that stressor

Clinically significant symptoms developed as a response to the stressor

Symptoms do not persist longer than 6 months after the stressor is resolved

Six different subtypes are recognized: With anxiety, with depressed mood, with disturbance of conduct, with mixed anxiety and depressed mood, with mixed distubrance of emotions and conduct, Unspecified

Question 4

If __ symptoms are involved, it is not adjustment disorder

Answer 4

If psychotic symptoms are involved, it is not adjustment disorder

Question 5

In grief, __ is usually preserved, whereas it is lost in depressive disorders

Answer 5

In grief, self esteem is usually preserved, whereas it is lost in depressive disorders

Question 6

Pseudo-passive SI in grief

Answer 6

Thoughts of “one day joining” a dead loved one

This is very different from even typical passive SI in depression, which focuses on feelings of worthlessness, feeling undeserving of life, or unable to cope with the pain of depression

Question 7

Treatment of adjustment disorder

Answer 7

Adjustment disorder is the perfect disorder to treat with psychotherapy alone

In a minority of cases, medications may be used to facilitate sleep, but otherwise medication is not indicated.

Question 8

Treatment of bereavement

Answer 8

Supportive psychotherapy is the best modality to help patients without underlying mood disorder or psychosis deal with response to loss

Question 9

Children often experience __ rather than depressed mood

Answer 9

Children often experience anger, frustration, or irritability rather than depressed mood

Question 10

MDD and adjustment disorder may both. . .

Answer 10

. . . occur in response to a stress

As may acute stress disorder. So watch out.

Question 11

Relationship between adjusment disorder and PTSD

Answer 11

Adjustment-disordered patients react to a stressor that does not meet PTSD criteria OR have symptoms that do not meet all the PTSD criteria in response to a stressor that does