FREE ESSAY ON ADJUSTMENT DISORDER WITH DEPRESSED MOOD

ADJUSTMENT DISORDER WITH DEPRESSED MOOD

Running Head: ADJUSTMENT DISORDER WITH DEPRESSED MOOD CAUSE
Adjustment Disorder
with Depressed Mood, Cause and Affect 
Abstract
Research was conducted to investigate Adjustment Disorder with Depressed Mood, and some
causes, affects, and treatment approaches. Not all individuals manifest or demonstrate
the same depressive symptoms, which can make it difficult for clinicians to diagnose and
treat. The American Psychiatric Association has categorized various depressive disorders
in the Diagnostic and Statistical Manual for Mental Disorders fourth edition (DSM-IV,
1994). Researchers have investigated the validity of the DSM diagnostic criteria over the
years, and have studied various treatment approaches. The treatment approach found to be
most effective and used most often for treating depression is Cognitive and Behavior
therapy.
Adjustment Disorder 
with Depressed Mood, Cause and Affect 
Depression is not unique to our culture it is found throughout the world. Mezzich and
Raab (1980), report that they found comparable depressive severity's in samples from
Austria, Czechoslovakia, England, Germany, Japan, Switzerland and the United States. 
Depression is a term that covers a wide range of emotional states. Klerman (cited in
Marsella, Hirschfeld & Katz, 1987) said that as a normal mood, depression is almost
universal in human experience; for example, not to grieve after the loss of a loved one
is somehow less than human (p.3). Depression can range in severity from normal everyday
moods of sadness, to psychotic episodes with increased risk of suicide (Gotlib & Colby,
1987). 
Depression has been identified as the most common psychiatric symptoms found in hospital
settings (Rodin & Voshart, 1986). It is estimated that depression accounts for 75% of all
hospitalizations, and more than 100 million people in the world develop clinically
recognizable depression (Gotlib & Colby, 1987). The Diagnostic and Statistical Manual of
Mental Disorders (DSM), helps clinicians identify the various depressive disorders
(Snyder, Strain & Wolf, 1990).
The Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM IV),
identifies clinical depressive disorders by diagnostic categories. Adjustment Disorder
with Depressed Mood is the diagnostic term used in the DSM IV, to identify a relatively
mild form of depression (DSM-IV; American Psychiatric Association, 1994).
The focus of this research paper is on Adjustment Disorder with Depressed Mood, and the
treatment approach found to be the most effective. This research will include: (a)
DSM-IV: validity of diagnostic criteria, (b) Adjustment Disorder with Depressed Mood:
cause & affect, and (c) treatment approaches: effective methods.
DSM-IV: validity of diagnostic criteria 
Clinicians need to be able to differentiate between various depressive disorders in order
to properly diagnose and treat them. The information in the DSM-IV allows clinicians to
differentiate between the normal depressive mood state and those abnormal states that
merit clinical intervention (DSM-IV; American Psychiatric Association, 1994). How valid
are the criteria in the DSM-IV? Over the years there have been several studies conducted
that have validated the DSM classification system and the diagnostic criteria for
adjustment disorders, which includes Adjustment Disorder with Depressed Mood (Snyder,
Strain & Wolf, 1990; Andresen & Wasek, 1980; Andresen & Hoenk, 1982). The DSM-IV not only
specifies the criterion that assists clinicians differentiate between various depressive
states, it helps identify some of the cause and affects of the disorders. 
Adjustment Disorder with Depressed Mood: cause & affect
The cause and affects of Adjustment Disorder with Depressed Mood are essentially
described within the diagnostic features. The DSM-IV states that:
The essential feature of an Adjustment Disorder is the development of clinically
significant emotional or behavioral symptoms in response to an identifiable psychological
stressor or stressors . . . The stressor may be a single event (e.g., termination of a
romantic relationship), or there may be multiple stressors (e.g., marked business
difficulties and marital problems). Stressors may be recurrent (e.g., associated with
seasonal business crises) or continuous (e.g., living in a crime-ridden neighborhood).
Stressors may affect a single individual, an entire family, or a larger group or
community (e.g., as in a natural disaster). Some stressors may accompany specific
developmental events (e.g., going to school, leaving the parental home, getting married,
becoming a parent, failing to attain occupational goals, retirement). The symptoms must
develop within 3 months after the onset of the stressors . . . and must resolve within 6
months of the termination of the stressor (p.623).
Research studies support the DSM-IV information on some of the causes of Adjustment
Disorder with Depressed Mood (Snyder, Strain, & Wolf, 1990; Roden & Voshart, 1986). Roden
and Voshart (1986) stated in their study Adjustment Disorders . . . are maladaptive
reactions to an identifiable psychosocial stressor occurring within 3 months after the
onset of the stressor. Physical illness is a common precipitant of an Adjustment Disorder
with Depressed Mood (p.700).
The DSM-IV provides clinicians with a wealth of information on Adjustment Disorder with
Depressed Mood. It describes the causes as psychosocial stressors, and the parameters
they must meet. It also describes the affect as the predominant manifestation of symptoms
such as depressed mood, tearfulness or feelings of hopelessness (p.623). Once clinicians
have decided a client meets the criteria for the diagnosis, they only need to identify
the best treatment approach.
Treatment approaches: effective methods
Aaron T. Beck (cited in Corsini & Wedding, 1989) developed cognitive therapy during his
research of depression. He defined three fundamental concepts in cognitive therapy;
collaborative empiricism, socratic dialogue and guided discovery. These fundamental
concepts have proven to be successful for Beck, in his treatment of depression (p.302).
Since Beck's development of cognitive therapy, hundreds of research studies have been
conducted comparing the various treatment approaches used for treating depression,
including pharmacotherapy. In two studies pharmacotherapy was compared to cognitive
therapy. In one study the results indicated that pharmacotherapy was as effective as
cognitive therapy (Murphy, Simons, Wetzel & Lustman, 1984), while in the other study
results showed that cognitive therapy was more effective (Kovacs, Rush, Beck & Hollon,
1981). 
In conducting their review of various treatment methods, researchers even looked at
gender differences. What they found was more women pursue therapy than men (Frank,
Capenter & Kupfer, 1988). However, both men and women respond similarly to cognitive
behavior therapy (Thase, Reynolds III, Frank, Simons, McGeary, Fasiczka, Garamoni,
Jennings & Kupfer, 1994). 
To date cognitive and behavioral therapies are the methods identified as the most
effective in treating various depressive states including Adjustment Disorder with
Depressed Mood (Gotlib & Colby, 1987; Marsella, Hirschfeld & Katz, 1987; Shaffer,
Shapiro, Sank & Coghlan, 1981; Thase & Wright, 1991; Paykel, 1988; Thase, Reynolds III,
Frank, Simons, McGeary, Fasiczka, Garamoni, Jennings & Kupfer, 1994). 
Conclusion
Research studies have shown that the degree of depression demonstrated by individuals can
vary from normal moods of sadness, To extreme psychotic episodes that involve suicidal
behavior. Adjustment Disorder with Depressed Mood as identified in the DSM-IV, is a mild
depressive reaction to stress (DSM-IV; American Psychiatric Association, 1994). The
DSM-IV not only provides clinicians with the necessary information to identify and
properly diagnose Adjustment Disorder with Depressed Mood, it also provides incite into
the causes and affects of the disorder. Research studies have compared various treatment
methods for treating depression. The results indicate that cognitive behavior therapy is
the most effective in treating depressive disorders including Adjustment disorder with
Depressed Mood.
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