Conditions & Treatments

Adjustment Disorders

An adjustment disorder is defined as an emotional or behavioral reaction to an identifiable stressful event or change in a person's life that is considered maladaptive or somehow not an expected, healthy response to the event or change.

Adjustment Disorders

What is an adjustment disorder?

An adjustment disorder is defined as an emotional or behavioral reaction to an identifiable stressful event or change in a person's life that is considered maladaptive or somehow not an expected healthy response to the event or change. The reaction must occur within three months of the identified stressful event or change happening. The identifiable stressful event or change in the life of a child or adolescent may be a maladaptive response to a family move, a parental divorce or separation, the loss of a pet, or the birth of a brother or sister. A sudden illness, or restriction to a child's life because of chronic illness may also provoke an adjustment response. 

What causes adjustment disorders?

Adjustment disorders are a reaction to stress. There is not a single direct cause between the stressful event and the reaction. Children and adolescents vary in their temperament, past experiences, vulnerability, and coping skills. Their developmental stage and the capacity of their support system to meet their specific needs related to the stress are factors that may contribute to their reaction to a particular stress. Stressors also vary in duration, intensity, and effect. No evidence is available to suggest a specific biological factor that causes adjustment disorders.

Who is affected by adjustment disorders?

Adjustment disorders are quite common in children and adolescents. They occur equally in males and females. While adjustment disorders occur in all cultures, the stressors and the signs may vary based on cultural influences. Adjustment disorders occur at all ages. However, it is believed that characteristics of the disorder are different in children and adolescents than they are in adults. Differences are noted in the symptoms experienced, in the severity and duration of symptoms, and in the outcome. Adolescent symptoms of adjustment disorders are more behavioral, such as acting out, while adults experience more depressive symptoms.

What are the symptoms of an adjustment disorder?

In all adjustment disorders, the reaction to the stressor seems to be in excess of a normal reaction, or the reaction significantly interferes with social, occupational, or educational functioning. There are six subtypes of adjustment disorder that are based on the type of the major symptoms experienced. The following are the most common symptoms of each of the subtypes of adjustment disorder. However, each adolescent may experience symptoms differently:

  • Adjustment disorder with depressed mood. Symptoms may include:

    • Depressed mood

    • Tearfulness

    • Feelings of hopelessness

  • Adjustment disorder with anxiety. Symptoms may include:

    • Nervousness

    • Worry

    • Jitteriness

    • Fear of separation from major attachment figures

  • Adjustment disorder with anxiety and depressed mood. A combination of symptoms from both of the above subtypes (depressed mood and anxiety) is present.

  • Adjustment disorder with disturbance of conduct. Symptoms may include:

    • Violation of the rights of others

    • Violation of societal norms and rules (truancy, destruction of property, reckless driving, or fighting)

  • Adjustment disorder with mixed disturbance of emotions and conduct. A combination of symptoms from all of the above subtypes are present (depressed mood, anxiety, and conduct).

  • Adjustment disorder unspecified. Reactions to stressful events that do not fit in one of the above subtypes are present. Reactions may include behaviors such as social withdrawal or inhibitions to normally expected activities (for example, school or work).

The symptoms of adjustment disorders may resemble other medical problems or psychiatric conditions. Always consult your adolescent's health care provider for a diagnosis.

How are adjustment disorders diagnosed?

A child and adolescent psychiatrist or a qualified mental health professional usually makes the diagnosis of an adjustment disorder in children and adolescents following a comprehensive psychiatric evaluation and interview with the child or adolescent and the parents. A detailed personal history of development, life events, emotions, behaviors, and the identified stressful event is obtained during the interview.

Treatment for adjustment disorders

Specific treatment for adjustment disorders will be determined by your adolescent's health care provider based on:

  • Your adolescent's age, overall health, and medical history

  • Extent of your adolescent's symptoms

  • Subtype of the adjustment disorder

  • Your adolescent's tolerance for specific medications or therapies

  • Expectations for the course of the stressful event

  • Your opinion or preference

Treatment may include:

  • Individual psychotherapy using cognitive-behavioral approaches. Cognitive-behavioral approaches are used to improve age-appropriate problem solving skills, communication skills, impulse control, anger management skills, and stress management skills.

  • Family therapy. Family therapy is often focused on making needed changes within the family system, such as improving communication skills and family interactions, as well as increasing family support among family members.

  • Peer group therapy. Peer group therapy is often focused on developing and using social skills and interpersonal skills.

  • Medication. While medications have very limited value in the treatment of adjustment disorders, medication may be considered on a short-term basis if a specific symptom is severe and known to be responsive to medication.

Prevention of adjustment disorders

Preventive measures to reduce the incidence of adjustment disorders in adolescents are not known at this time. However, early detection and intervention can reduce the severity of symptoms, enhance the adolescent's normal growth and development, and improve the quality of life experienced by children or adolescents with adjustment disorders.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



MassGeneral Hospital for Children

  • Psychology Assessment Center
    The pediatric neuropsychology specialists at Massachusetts General Hospital’s Psychology Assessment Center provide neuropsychological assessments to aid in the diagnosis and treatment of neurological, medical, genetic and developmental disorders.
  • Pediatric Psychiatry
    The Division of Child and Adolescent Psychiatry at MassGeneral Hospital for Children provides comprehensive evaluation and treatment of children and adolescents with the full spectrum of psychiatric conditions and behavioral or emotional difficulties in both inpatient and outpatient settings.
  • Division of Adolescent and Young Adult Medicine
    The Division of Adolescent and Young Adult Medicine at MassGeneral Hospital for Children provides outstanding primary care and consultative care to adolescents and young adults.
Department of Neurology

  • Cognitive Behavioral Neurology Unit
    The Cognitive Behavioral Neurology Unit offers diagnosis and treatment to patients with disorders and diseases of the brain affecting language, memory, problem solving, emotional function and behavior.
Obstetrics and Gynecology

  • Midlife Women's Health Center
    The Massachusetts General Hospital Midlife Women’s Health Center brings together experts from more than 15 specialties to improve, promote and advance health care for women at menopause and beyond through research, collaboration and education.

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Departments and Centers at Mass General have a reputation for excellence in patient care. View a list of all departments.