Blended Families: Navigating through adjustment disorders

Blended Families: Navigating through adjustment disorders

Sept. 16, 2015 marked National Step Family Day, a celebration of the unique challenges and triumphs of blended families.

Divorce is difficult. Entering a new family as a step-parent is difficult. Children and adolescents can have an especially hard time adjusting to the presence of a new family member — or the absence of an old family member — and may be at risk for an adjustment disorder.

What is an adjustment disorder?

An adjustment disorder is defined as an emotional or behavioral reaction to a stressful event or change in a person’s life. This stressor can be a positive event (e.g., a wedding) or a negative event (e.g., the loss of a job). Common stressors associated with adjustment disorders in children are a family move, a divorce or separation, the loss of a pet or the birth of a sibling. No specific stressor is guaranteed to result in an adjustment disorder.

Adjustment disorders happen equally in males and females of all ages. Adults with an adjustment disorder tend to experience depressive symptoms, whereas adolescents and children are more likely to act out.

Adjustment disorder subtypes

There are six subtypes of adjustment disorders.

  1. Adjustment disorder with depressed mood is characterized by symptoms that include tearfulness, feelings of hopelessness and low motivation.
  2. Adjustment disorder with anxiety includes symptoms such as nervousness, worry, jitteriness or unfounded fears.
  3. Adjustment disorder with anxiety and depressed mood is characterized by a combination of depressive and anxious symptoms.
  4. Adjustment disorder with disturbance of conduct includes symptoms such as violation of the rights of others and violation of society’s norms and rules including truancy, reckless driving or fighting.
  5. Adjustment disorder with mixed disturbance of emotions and conduct includes symptoms from all of the above subtypes.
  6. Adjustment disorder unspecified includes symptoms that do not fit in any of the above categories including social isolation or inhibitions to normally expected activities such as school or work.

The symptoms associated with the disorder must 1) be more severe than a normal reaction toward a stressor or 2) significantly interfere with social, occupational or education functioning. In addition, symptoms should not meet the criteria for another mental health disorder or persist for more than an additional six months. If symptoms do persist for more than six months, they likely indicate a more severe mental health disorder.


There are numerous treatment options for adjustment disorders including individual psychotherapy, cognitive behavioral therapy, family therapy and peer group therapy. If the symptoms associated with the adjustment disorder are particularly severe, then medication may be necessary.

A trained clinician will be able to evaluate the symptoms and determine the best course of treatment.

Watch out for the signs

Currently, there are no known ways to prevent the development of an adjustment disorder. Sometimes, however, it is possible to predict the disorder’s onset by asking: Is there a major event on the horizon? Has the child been acting out more than usual, perhaps due to a divorce or remarriage?

The earlier an adjustment disorder is treated, the better. The best thing parents can do is keep an eye out for the symptoms.

To learn more about the dynamics of blended families, look for more blogs in this series. If you or someone you know is struggling with a mental illness or a behavioral issue, contact the Florida Mental Health Helpline at any time at 866-846-5588 to speak with someone who would be happy to help you today.