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ADJUSTMENT DISORDERS - ADJUSTMENT DISORDERS DSM-IV...

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ADJUSTMENT DISORDERS DSM-IV ADJUSTMENT DISORDERS (SPECIFY IF ACUTE/CHRONIC) 309.24 With anxiety 309.0 With depressed mood 309.3 With disturbance of conduct 309.4 With mixed disturbance of emotions and conduct 309.28 With mixed anxiety and depressed mood The essential feature of adjustment disorders is a maladaptive reaction to an identifiable psychosocial  stressor that occurs within 3 months of the onset of the stressor. (The reaction to the death of a loved one is  not included here, as it is generally diagnosed as bereavement.) The stressor also does not meet the criteria  for any specific Axis I disorder or represent an exacerbation of a preexisting Axis I or Axis II disorder. The response is considered maladaptive because social or occupational functioning is impaired or  because the behaviors are exaggerated beyond the usual expected response to such a stressor. Duration of  the symptoms for more than 6 months indicates a chronic state. By definition, an adjustment disorder must  resolve within 6 months of the termination of the stressor or its consequences. If the stressor / consequences  persist (e.g., a chronic disabling medical condition, emotional difficulties following a divorce, financial  reversals resulting from termination of employment, or a developmental event such as leaving one’s  parental home, retirement), the adjustment disorder may also persist. ETIOLOGICAL THEORIES Psychodynamics Factors implicated in the predisposition to this disorder include unmet dependency needs, fixation in  an earlier level of development, and underdeveloped ego. The client with predisposition to adjustment disorder is seen as having an inability to complete the  grieving process in response to a painful life change. The presumed cause of this inability to adapt is  believed to be psychic overload—a level of intrapsychic strain exceeding the individual’s ability to cope.  Normal functioning is disrupted, and psychological or somatic symptoms occur. Biological The presence of chronic disorders is thought to limit an individual’s general adaptive capacity. The  normal process of adaptation to stressful life experiences is impaired, causing increased vulnerability to  adjustment disorders. A high family incidence suggests a possible hereditary influence. The autonomic nervous system discharge that occurs in response to a frightening impulse and / or  emotion is mediated by the limbic system, resulting in the peripheral effects of the autonomic nervous  system seen in the presence of anxiety.
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