Adjustment Disorder

An adjustment disorder occurs when an individual is unable to adjust to or cope with a particular stressor, like a major life event. Since people with this disorder normally have symptoms that depressed people do, such as general loss of interest, feelings of hopelessness and crying, this disorder is also sometimes known as situational depression. Unlike major depression however, the disorder is caused by an outside stressor and generally resolves once the individual is able to adapt to the situation. The condition is different from anxiety disorder, which lacks the presence of a stressor, or post-traumatic stress disorder and acute stress disorder, which usually are associated with a more intense stressor.

Its common characteristics include mild depressive symptoms, anxiety symptoms, and traumatic stress symptoms or a combination of the three.

There are nine different types of adjustment disorders listed in the DSM-III-R. In DSM-IV, adjustment disorder was reduced to six types, classified by their clinical features, which characterize the predominant symptoms.

Adjustment disorder may also be acute or chronic, depending on whether it lasts more or less than six months. According to the DSM-IV-TR, if the adjustment disorder lasts less than 6 months, then it may be considered acute. If it lasts more than 6 months, it may be considered chronic.

However, the symptoms cannot last longer than six months after the stressor(s), or its consequences, have terminated.\

 Diagnosis of adjustment disorder is quite common; there is an estimated incidence of 5–21% among psychiatric consultation services for adults.

Adult women are diagnosed twice as often as are adult men, but among children and adolescents, girls and boys are equally likely to receive this diagnosis.

Adjustment disorder was introduced into the psychiatric classification systems almost 30 years ago, but the concept was recognized for many years before that. When considering biopsychosocial disorders, an athlete’s overtrained state can be due to an adjustment disorder.

Explanation of Stages of Erik Erkson

It is human to have a long childhood; it is civilized to have an even longer childhood. Long childhood makes
a technical and mental virtuoso out of man, but it also leaves a life-long residue of emotional immaturity in him.

— Erik Homburger Erikson (1902-1994)

Our personality traits come in opposites. We think of ourselves as optimistic or pessimistic, independent or dependent, emotional or unemotional, adventurous or cautious, leader or follower, aggressive or passive. Many of these are inborn temperament traits, but other characteristics, such as feeling either competent or inferior, appear to be learned, based on the challenges and support we receive in growing up.

As you read through the following eight stages of Erik Erikson's categories with their sets of opposites, notice which strengths you identify with most and those you need to work on some more.

Infancy: Birth to 18 Months

Ego Development Outcome: Trust vs. Mistrust
Basic strength: Drive and Hope

Erikson also referred to infancy as the Oral Sensory Stage (as anyone might who watches a baby put everything in her mouth) where the major emphasis is on the mother's positive and loving care for the child, with a big emphasis on visual contact and touch. If we pass successfully through this period of life, we will learn to trust that life is basically okay and have basic confidence in the future. If we fail to experience trust and are constantly frustrated because our needs are not met, we may end up with a deep-seated feeling of worthlessness and a mistrust of the world in general.

Incidentally, many studies of suicides and suicide attempts point to the importance of the early years in developing the basic belief that the world is trustworthy and that every individual has a right to be here.

Not surprisingly, the most significant relationship is with the maternal parent, or whoever is our most significant and constant caregiver.

2. Early Childhood: 18 Months to 3 Years

Ego Development Outcome: Autonomy vs. Shame
Basic Strengths: Self-control, Courage, and Will

During this stage we learn to master skills for ourselves. Not only do we learn to walk, talk and feed ourselves, we are learning finer motor development as well as the much appreciated toilet training. Here we have the opportunity to build self-esteem and autonomy as we gain more control over our bodies and acquire new skills, learning right from wrong. And one of our skills during the "Terrible Two's" is our ability to use the powerful word "NO!" It may be pain for parents, but it develops important skills of the will.

It is also during this stage, however, that we can be very vulnerable. If we're shamed in the process of toilet training or in learning other important skills, we may feel great shame and doubt of our capabilities and suffer low self-esteem as a result.

The most significant relationships are with parents.

3. Play Age: 3 to 5 Years

Ego Development Outcome: Initiative vs. Guilt
Basic Strength: Purpose

During this period we experience a desire to copy the adults around us and take initiative in creating play situations. We make up stories with Barbie's and Ken's, toy phones and miniature cars, playing out roles in a trial universe, experimenting with the blueprint for what we believe it means to be an adult. We also begin to use that wonderful word for exploring the world — "WHY?"

While Erikson was influenced by Freud, he downplays biological sexuality in favor of the psychosocial features of conflict between child and parents. Nevertheless, he said that at this stage we usually become involved in the classic "Oedipal struggle" and resolve this struggle through "social role identification." If we're frustrated over natural desires and goals, we may easily experience guilt.

The most significant relationship is with the basic family.

4. School Age: 6 to 12 Years

Ego Development Outcome: Industry vs. Inferiority
Basic Strengths: Method and Competence

During this stage, often called the Latency, we are capable of learning, creating and accomplishing numerous new skills and knowledge, thus developing a sense of industry. This is also a very social stage of development and if we experience unresolved feelings of inadequacy and inferiority among our peers, we can have serious problems in terms of competence and self-esteem.

As the world expands a bit, our most significant relationship is with the school and neighborhood. Parents are no longer the complete authorities they once were, although they are still important.

5. Adolescence: 12 to 18 Years

Ego Development Outcome: Identity vs. Role Confusion
Basic Strengths: Devotion and Fidelity

Up to this stage, according to Erikson, development mostly depends upon what is done to us. From here on out, development depends primarily upon what we do. And while adolescence is a stage at which we are neither a child nor an adult, life is definitely getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.

Our task is to discover who we are as individuals separate from our family of origin and as members of a wider society. Unfortunately for those around us, in this process many of us go into a period of withdrawing from responsibilities, which Erikson called a "moratorium." And if we are unsuccessful in navigating this stage, we will experience role confusion and upheaval.

A significant task for us is to establish a philosophy of life and in this process we tend to think in terms of ideals, which are conflict free, rather than reality, which is not. The problem is that we don't have much experience and find it easy to substitute ideals for experience. However, we can also develop strong devotion to friends and causes.

It is no surprise that our most significant relationships are with peer groups.

6. Young Adulthood: 18 to 35

Ego Development Outcome: Intimacy and Solidarity vs. Isolation
Basic Strengths: Affiliation and Love

In the initial stage of being an adult we seek one or more companions and love. As we try to find mutually satisfying relationships, primarily through marriage and friends, we generally also begin to start a family, though this age has been pushed back for many couples who today don't start their families until their late thirties. If negotiating this stage is successful, we can experience intimacy on a deep level.

If we're not successful, isolation and distance from others may occur. And when we don't find it easy to create satisfying relationships, our world can begin to shrink as, in defense, we can feel superior to others.

Our significant relationships are with marital partners and friends.

7. Middle Adulthood: 35 to 55 or 65

Ego Development Outcome: Generativity vs. Self absorption or Stagnation
Basic Strengths: Production and Care

Now work is most crucial. Erikson observed that middle-age is when we tend to be occupied with creative and meaningful work and with issues surrounding our family. Also, middle adulthood is when we can expect to "be in charge," the role we've longer envied.

The significant task is to perpetuate culture and transmit values of the culture through the family (taming the kids) and working to establish a stable environment. Strength comes through care of others and production of something that contributes to the betterment of society, which Erikson calls generativity, so when we're in this stage we often fear inactivity and meaninglessness.

As our children leave home, or our relationships or goals change, we may be faced with major life changes — the mid-life crisis — and struggle with finding new meanings and purposes. If we don't get through this stage successfully, we can become self-absorbed and stagnate.

Significant relationships are within the workplace, the community and the family.

8. Late Adulthood: 55 or 65 to Death

Ego Development Outcome: Integrity vs. Despair
Basic Strengths: Wisdom

Erikson felt that much of life is preparing for the middle adulthood stage and the last stage is recovering from it. Perhaps that is because as older adults we can often look back on our lives with happiness and are content, feeling fulfilled with a deep sense that life has meaning and we've made a contribution to life, a feeling Erikson calls integrity. Our strength comes from a wisdom that the world is very large and we now have a detached concern for the whole of life, accepting death as the completion of life.

On the other hand, some adults may reach this stage and despair at their experiences and perceived failures. They may fear death as they struggle to find a purpose to their lives, wondering "Was the trip worth it?" Alternatively, they may feel they have all the answers (not unlike going back to adolescence) and end with a strong dogmatism that only their view has been correct.

Explanation of Stages of Erik Erkson

It is human to have a long childhood; it is civilized to have an even longer childhood. Long childhood makes
a technical and mental virtuoso out of man, but it also leaves a life-long residue of emotional immaturity in him.

— Erik Homburger Erikson (1902-1994)

Our personality traits come in opposites. We think of ourselves as optimistic or pessimistic, independent or dependent, emotional or unemotional, adventurous or cautious, leader or follower, aggressive or passive. Many of these are inborn temperament traits, but other characteristics, such as feeling either competent or inferior, appear to be learned, based on the challenges and support we receive in growing up.

As you read through the following eight stages of Erik Erikson's categories with their sets of opposites, notice which strengths you identify with most and those you need to work on some more.

Infancy: Birth to 18 Months

Ego Development Outcome: Trust vs. Mistrust
Basic strength: Drive and Hope

Erikson also referred to infancy as the Oral Sensory Stage (as anyone might who watches a baby put everything in her mouth) where the major emphasis is on the mother's positive and loving care for the child, with a big emphasis on visual contact and touch. If we pass successfully through this period of life, we will learn to trust that life is basically okay and have basic confidence in the future. If we fail to experience trust and are constantly frustrated because our needs are not met, we may end up with a deep-seated feeling of worthlessness and a mistrust of the world in general.

Incidentally, many studies of suicides and suicide attempts point to the importance of the early years in developing the basic belief that the world is trustworthy and that every individual has a right to be here.

Not surprisingly, the most significant relationship is with the maternal parent, or whoever is our most significant and constant caregiver.

2. Early Childhood: 18 Months to 3 Years

Ego Development Outcome: Autonomy vs. Shame
Basic Strengths: Self-control, Courage, and Will

During this stage we learn to master skills for ourselves. Not only do we learn to walk, talk and feed ourselves, we are learning finer motor development as well as the much appreciated toilet training. Here we have the opportunity to build self-esteem and autonomy as we gain more control over our bodies and acquire new skills, learning right from wrong. And one of our skills during the "Terrible Two's" is our ability to use the powerful word "NO!" It may be pain for parents, but it develops important skills of the will.

It is also during this stage, however, that we can be very vulnerable. If we're shamed in the process of toilet training or in learning other important skills, we may feel great shame and doubt of our capabilities and suffer low self-esteem as a result.

The most significant relationships are with parents.

3. Play Age: 3 to 5 Years

Ego Development Outcome: Initiative vs. Guilt
Basic Strength: Purpose

During this period we experience a desire to copy the adults around us and take initiative in creating play situations. We make up stories with Barbie's and Ken's, toy phones and miniature cars, playing out roles in a trial universe, experimenting with the blueprint for what we believe it means to be an adult. We also begin to use that wonderful word for exploring the world — "WHY?"

While Erikson was influenced by Freud, he downplays biological sexuality in favor of the psychosocial features of conflict between child and parents. Nevertheless, he said that at this stage we usually become involved in the classic "Oedipal struggle" and resolve this struggle through "social role identification." If we're frustrated over natural desires and goals, we may easily experience guilt.

The most significant relationship is with the basic family.

4. School Age: 6 to 12 Years

Ego Development Outcome: Industry vs. Inferiority
Basic Strengths: Method and Competence

During this stage, often called the Latency, we are capable of learning, creating and accomplishing numerous new skills and knowledge, thus developing a sense of industry. This is also a very social stage of development and if we experience unresolved feelings of inadequacy and inferiority among our peers, we can have serious problems in terms of competence and self-esteem.

As the world expands a bit, our most significant relationship is with the school and neighborhood. Parents are no longer the complete authorities they once were, although they are still important.

5. Adolescence: 12 to 18 Years

Ego Development Outcome: Identity vs. Role Confusion
Basic Strengths: Devotion and Fidelity

Up to this stage, according to Erikson, development mostly depends upon what is done to us. From here on out, development depends primarily upon what we do. And while adolescence is a stage at which we are neither a child nor an adult, life is definitely getting more complex as we attempt to find our own identity, struggle with social interactions, and grapple with moral issues.

Our task is to discover who we are as individuals separate from our family of origin and as members of a wider society. Unfortunately for those around us, in this process many of us go into a period of withdrawing from responsibilities, which Erikson called a "moratorium." And if we are unsuccessful in navigating this stage, we will experience role confusion and upheaval.

A significant task for us is to establish a philosophy of life and in this process we tend to think in terms of ideals, which are conflict free, rather than reality, which is not. The problem is that we don't have much experience and find it easy to substitute ideals for experience. However, we can also develop strong devotion to friends and causes.

It is no surprise that our most significant relationships are with peer groups.

6. Young Adulthood: 18 to 35

Ego Development Outcome: Intimacy and Solidarity vs. Isolation
Basic Strengths: Affiliation and Love

In the initial stage of being an adult we seek one or more companions and love. As we try to find mutually satisfying relationships, primarily through marriage and friends, we generally also begin to start a family, though this age has been pushed back for many couples who today don't start their families until their late thirties. If negotiating this stage is successful, we can experience intimacy on a deep level.

If we're not successful, isolation and distance from others may occur. And when we don't find it easy to create satisfying relationships, our world can begin to shrink as, in defense, we can feel superior to others.

Our significant relationships are with marital partners and friends.

7. Middle Adulthood: 35 to 55 or 65

Ego Development Outcome: Generativity vs. Self absorption or Stagnation
Basic Strengths: Production and Care

Now work is most crucial. Erikson observed that middle-age is when we tend to be occupied with creative and meaningful work and with issues surrounding our family. Also, middle adulthood is when we can expect to "be in charge," the role we've longer envied.

The significant task is to perpetuate culture and transmit values of the culture through the family (taming the kids) and working to establish a stable environment. Strength comes through care of others and production of something that contributes to the betterment of society, which Erikson calls generativity, so when we're in this stage we often fear inactivity and meaninglessness.

As our children leave home, or our relationships or goals change, we may be faced with major life changes — the mid-life crisis — and struggle with finding new meanings and purposes. If we don't get through this stage successfully, we can become self-absorbed and stagnate.

Significant relationships are within the workplace, the community and the family.

8. Late Adulthood: 55 or 65 to Death

Ego Development Outcome: Integrity vs. Despair
Basic Strengths: Wisdom

Erikson felt that much of life is preparing for the middle adulthood stage and the last stage is recovering from it. Perhaps that is because as older adults we can often look back on our lives with happiness and are content, feeling fulfilled with a deep sense that life has meaning and we've made a contribution to life, a feeling Erikson calls integrity. Our strength comes from a wisdom that the world is very large and we now have a detached concern for the whole of life, accepting death as the completion of life.

On the other hand, some adults may reach this stage and despair at their experiences and perceived failures. They may fear death as they struggle to find a purpose to their lives, wondering "Was the trip worth it?" Alternatively, they may feel they have all the answers (not unlike going back to adolescence) and end with a strong dogmatism that only their view has been correct.

Psychology

Psychology is an academic and applied discipline that involves the scientific study of mental functions and behaviors. Psychology has the immediate goal of understanding individuals and groups by both establishing general principles and researching specific cases, and by many accounts it ultimately aims to benefit society. In this field, a professional practitioner  or researcher is called a psychologist, and can be classified as a social, behavioral, or cognitive scientist. Psychologists attempt to understand the role of mental functions in individual and social behavior, while also exploring the physiological and neurobiological processes that underlie certain cognitive functions and behaviors.

Psychologists explore concepts such as perception, cognition, attention, emotion, phenomenology, motivation, brain functioning , personality, behavior, and interpersonal relationships. Psychologists of diverse stripes also consider the unconscious mind. Psychologists employ empirical methods to infer causal and co relational relationships between psychosocial variables. In addition, or in opposition, to employing empirical and deductive methods, some—especially clinical and counseling psychologists—at times rely upon symbolic interpretation  and other inductive techniques. Psychology has been described as a "hub science", with psychological findings linking to research and perspectives from the social sciences, natural sciences, medicine, and the humanities, such as philosophy.

Developmental stages by Erikson

Erikson's stages of psychosocial development as articulated by Erik Erikson explain eight stages through which a healthily developing human should pass from infancy to lateadulthood. In each stage the person confronts, and hopefully masters, new challenges.

Each stage builds on the successful completion of earlier stages. The challenges of stages not successfully completed may be expected to reappear as problems in the future.

However, mastery of a stage is not required to advance to the next stage. Erikson's stage theory characterizes an individual advancing through the eight life stages as a function of negotiating his or her biological forces and sociocultural forces. Each stage is characterized by a psycho social crisis of these two conflicting forces .If an individual does indeed successfully reconcile these forces ,he or she emerges from the stage with the corresponding virtue. For example, if an infant enters into the toddler stage (autonomy vs. shame & doubt) with more trust than mistrust, he or she carries the virtue of hope into the remaining life stages.

The Stages

1.      Hopes: Trust vs. Mistrust (Oral-sensory, Birth-2 years)

2.      Will: Autonomy vs. Shame & Doubt (Muscular-Anal, 2-4 years)

3.      Purpose: Initiative vs. Guilt (Locomotor-Genital, Preschool, 4-5 years)

4.      Competence: Industry vs. Inferiority (Latency, 5-12 years)

5.      Fidelity: Identity vs. Role Confusion (Adolescence, 13-19 years)

6.      Love: Intimacy vs. Isolation (Young adulthood, 20-24, or 20-40 years)

7.      Care: Generativity vs. Stagnation (Middle adulthood, 25-64, or 40-64 years)

8.      Wisdom: Ego Integrity vs. Despair (Late adulthood, 65-death)

Explanation of Psychosexual Stages

Each psychosexual stage has three main parts:

1. A physical focus: where the child’s energy is concentrated and their gratification obtained.
2. A psychological theme: this is related to both the physical focus and the demands being made on the child by the outside world as he/she develops.  For each stage, there can be two extremes in psychological reaction - either doing too much or not enough of what is ideal.
3. An adult character type: in the first three stages this adult character type is one that is related to being fixated or stuck at that stage. If a person doesn’t resolve the psychological issues that arise at that stage they will always have problems relating to those issues.

Oral stage: Birth - 18 months (approx.)

Physical focus: mouth, lips tongue (sucking). Sucking is the primary source of pleasure for a newborn. Everything goes in the mouth. Sucking  = food.

Psychological theme: dependency. A baby is very dependent and can do little for itself. If babies needs properly fulfilled can move onto the next stage. But if not fulfilled baby will be mistrustful or over-fulfilled baby will find it hard to cope with a world that doesn’t meet all of his/her demands.

Adult character: highly dependent/highly independent. If baby becomes fixated at this stage Freud felt that he or she would grow to be an oral character. Mostly these people are extremely dependent and passive people who want everything done for them. However Freud also suggests that another type of oral character is the person who is highly independent and that when under stress the orally fixated person may flip from one type to the other. This exemplifies Freud’s doctrine of opposites.

Anal Stage: 18 months - 3.5 years (approx.)

Physical focus: anus (elimination). Until now the baby has had it pretty easy. Now baby is supposed to control bowels. Freud believed baby’s sexual pleasure centered around the anus at this time.

Psychological theme: self-control/obedience. These things are not just related to toilet training but also the baby must learn to control urges and behaviours (terrible twos). What goes wrong here is either parents being too controlling or not controlling enough (Freud was a great believer in moderation).

Adult character: anally retentive (rigid, overly organised, subservient to authority) vs. anally expulsive (little self-control, disorganised, defiant, hostile).

Phallic Stage: 3.5 - 6 years (approx.)

Physical focus: penis. Freud believed that boys and girls both focussed on the penis. Boys: why hasn’t she got one? Girls: why haven’t I got one? Children become particularly interested in playing with their genitals at this stage.

Psychological theme: morality and sexuality identification and figuring out what it means to be a girl/boy. Children, according to Freud have sexual feelings for the opposite sexed parent at this stage (and deal with Oedipus / Electra complexes - basically erotic attachment to parent of opposite sex, but since these feelings are not socially acceptable, it may become hostility) and feel some hostility to same-sex parent.  Boys experience castration anxiety and girls suffer penis envy.  During this time emotional conflicts are resolved by eventually identifying with the same sex parent

Adult character: promiscuous and amoral/ asexual and puritanical (Doctrine of opposites again)

Latency Stage: 6 years to puberty --> (approx.)

The latency stage is the period of relative calm. The sexual and aggressive drives are less active and there is little in the way of psychosexual conflict.

Genital stage: post puberty

Physical focus: genitals

Psychological theme: maturity and creation and enhancement of life.  So this is not just about creating new life (reproduction) but also about intellectual and artistic creativity. The task is to learn how to add something constructive to life and society.

Adult character: The genital character is not fixed at an earlier stage. This is the person who has worked it all out. This person is psychologically well-adjusted and balanced. According to Freud to achieve this state you need to have a balance of both love and work.

If you have had problems during any of the psychosexual stages which are not effectively resolved,  then you will become fixated at one of the earlier stages and when under stress will regress more and more to characteristics of that stage.

Psychosexual Stages by Freud

According to Sigmund Freud, personality is mostly established by the age of five. Early experiences play a large role in personality development and continue to influence behavior later in life.

Freud's theory of psychosexual development is one of the best known, but also one of the most controversial. Freud believed that personality develops through a series of childhood stages during which the pleasure-seeking energies of the id become focused on certain erogenous areas. This psychosexual energy, or libido, was described as the driving force behind behavior.

If these psychosexual stages are completed successfully, the result is a healthy personality. If certain issues are not resolved at the appropriate stage, fixation can occur. A fixation is a persistent focus on an earlier psychosexual stage. Until this conflict is resolved, the individual will remain "stuck" in this stage.

 For example, a person who is fixated at the oral stage may be over-dependent on others and may seek oral stimulation through smoking, drinking, or eating.

STAGES:

 1: The Oral Stage
Age Range: Birth to 1 Year

2: The Anal Stage
Age Range: 1 to 3 years

3: The Phallic Stage
Age Range: 3 to 6 Years

4: The Latent Period
Age Range: 6 to Puberty

5: The Genital Stage:
Age Range: Puberty to Death