Adjustment Disorder - Risk Factors

Risk Factors

Various factors have been found to be more associated with a diagnosis of AD than other Axis I disorders, including:

• younger age
• more identified psychosocial and environmental problems
• increased suicidal behaviour, more likely to be rated as improved by the time of discharge from mental healthcare
• less frequent previous psychiatric history
• shorter length of treatment

Those exposed to repeated trauma are at greater risk, even if that trauma is in the distant past. Age can be a factor due to young children having fewer coping resources; however, children are also less likely to assess the consequences of a potential stressor.

A stressor is generally an event of a serious, unusual nature that an individual or group of individuals experience. The stressors that cause adjustment disorders may be grossly traumatic or relatively minor, like loss of a girlfriend/boyfriend, a poor report card, or moving to a new neighborhood. It is thought that the more chronic or recurrent the stressor, the more likely it is to produce a disorder. The objective nature of the stressor, however, is of secondary importance. Stressors' most crucial link to their pathogenic potential is their perception by the patient as stressful. The presence of a causal stressor is essential before a diagnosis of adjustment disorder can be made p. 279.

There are certain stressors that are more common in different age groups:

Adulthood:

• Marital conflict
• Financial conflict

Adolescence and childhood:

• Family conflict/parental separation
• School problems/changing schools
• sexuality issues
• death/illness in the family

In a study conducted from 1990 till 1994 on 89 psychiatric outpatient adolescent, 25% had attempted suicide in which 37.5% had misused alcohol, 87.5% displayed aggressive behaviour, 12.5% had learning difficulties, and 87.5% had anxiety symptoms.