Adjustment disorder is a condition arising from abnormal and severe reaction to identifiable life stressors. On the other hand, anxiety disorders are a group of mental disorders that cause distress interrupting an individual from leading a normal life. They include panic disorder, specific phobias, social anxiety disorder, generalized anxiety disorder (GAD), post-traumatic stress disorder (PSTD), panic disorder, health anxiety, and obsessive-compulsive disorder (OCD) among others. The paper describes the differences between anxiety disorders and adjustment disorders and provides the diagnostic criteria for phobias anxiety disorder. Furthermore, the article discusses the evidence-based psychotherapy and psychopharmacological treatment for phobias anxiety disorder.
Adjustment disorder arises from an unusual and extreme reaction to an identifiable life stressor. The reaction is often more severe and can lead to significant impairment in social, academic, and occupational functioning. On the other hand, anxiety disorders are a collection of mental conditions that cause distress interrupting an individual from leading a healthy lifestyle. The most significant difference between the two is that anxiety disorders do not arise from life stressor, or acute stress disorder and post-traumatic stress disorder that is typically linked to a more intense stressor. Furthermore, individuals with anxiety disorders such as GAD often portray a long and consistent history of experiencing worry and anxiety relating to a variety of events. However, adjustment disorder victims only present their symptoms during the period of stress or change ("Is It GAD or Adjustment Disorder?” 2018). Another difference lies in the fact that anxiety disorders like GAD worsen and become severe due to change in the process of adjusting to new routines meaning that anxiety is continual for these type of patients. In contrast, adjustment disorder patients often record a significant decrease in anxiety levels during the times they are adapting to life changes ("Is It GAD or Adjustment Disorder?" 2018).
Diagnostic Criteria for Phobias Anxiety Disorder
Mental health specialists are required to use proper clinical skills and judgment when diagnosing phobias, and these should go hand-in-hand with the diagnostic criteria documented in the DSM-V (Diagnostic and Statistical Manual, 5th Ed., 2013). Social phobia, specific phobia, and agoraphobia are the three common types of phobia. Every kind of phobia exhibits a unique type of diagnostic criteria. However, the available evidence points out some overlaps. Diagnostic criteria that show some similarity among the three types of phobia include:
Ø Life-Limiting: Unless a phobia exerts some significant impacts on the life of the patient, then it cannot be diagnosed.
Ø Avoidance: some individuals with clinically diagnosable phobias are healthy enough to tolerate the feared condition. However, the physicians should be keen to note the attempts in avoiding the feared situation since they present an essential criterion for phobia diagnosis.
Ø Anticipatory Anxiety: there is a tendency to dwell on upcoming events noticeable among the people with phobias featuring the feared condition or object.
The physician must be able to identify one or more situations or objects as the cause of fear as this significantly assists in the diagnosis of specific phobia. However, people who have specific phobia portray the symptoms of other anxiety disorders complicating the diagnostic criteria (Diagnostic and Statistical Manual, 5th Ed., 2013). Social phobia mostly concerns the phobia of interacting with strange people especially in social situations. This type of phobia may be attributed to one type of situation, or it may even be generalized to include all or most social settings. Severe social phobia often displays similar signs and symptoms to those of agoraphobia. However, the difference comes in the exact cause of the fear (Diagnostic and Statistical Manual, 5th Ed., 2013).
Evidence-Based Psychotherapy and Psychopharmacological Treatment for Phobias Anxiety Disorder
There are numerous psychological treatments for patients with anxiety disorders. Techniques such as exposure therapy, cognitive behavioral therapy (CBT), and cognitive therapy have proved effective in treating anxiety disorders (Bandelow et al., 2015). A study conducted to examine the efficacy of counseling for patients experiencing emotional challenges found that the short-term effectiveness of counseling for the PHC (primary health care) patients was higher than that of standard general practitioner care, with or without antidepressant treatment (Baldwin et al., 2014). There is limited research on some psychological interventions like psychotherapy. However, the available evidence indicates that the method produces superior relaxation effects among the patients with panic disorder but is less beneficial in the treatment of GAD when compared to CBT (Baldwin et al., 2014). The pharmacological treatments involve the use of medications such as SSRIs and SNRIs which have proved useful in combating OCD and anxiety disorders. Paroxetine and Fluoxetine inhibit some cytochrome P450 enzyme and hence has a capability of interacting with other psychotropic drugs aiding in the treatment of other physical illnesses (Baldwin & Brandish, 2014). Psychopharmacological treatment involves a combination of the psychological treatment techniques such as CBT with pharmacological interventions, and this is used as first-line management of social anxiety disorder (Nathan & Gorman, 2015).
In contrast to adjustment disorders, anxiety disorders do not arise from life stressor, or acute stress disorder and post-traumatic stress disorder usually associated with a more intense stressor. The diagnostic criteria for social phobia, specific phobia, and agoraphobia unveils some similarity in the life-limiting, avoidance, and anticipatory anxiety perspective. Psychopharmacological treatment techniques such as the use of CBT coupled with pharmacological intervention has established itself as a first-line treatment for social anxiety disorder.
1. American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
2. Baldwin, D. S., and Brandish, E. K. (2014). Pharmacological treatment of anxiety disorders. The wiley handbook of anxiety disorders, 865-882.
3. Baldwin, D. S., Anderson, I. M., Nutt, D. J., Allgulander, C., Bandelow, B., den Boer, J. A., ... and Malizia, A. (2014). Evidence-based pharmacological treatment of anxiety disorders, post-traumatic stress disorder and obsessive-compulsive disorder: a revision of the 2005 guidelines from the British Association for Psychopharmacology. Journal of Psychopharmacology, 28(5), 403-439.
4. Bandelow, B., Reitt, M., Röver, C., Michaelis, S., Görlich, Y., and Wedekind, D. (2015). Efficacy of treatments for anxiety disorders: a meta-analysis. International Clinical Psychopharmacology, 30(4), 183-192.
5. Is It GAD or Adjustment Disorder? (2018). Retrieved from https://www.verywellmind.com/gad-and-adjustment-disorder-1393126
6. Nathan, P. E., and Gorman, J. M. (Eds.). (2015). A guide to treatments that work. Oxford University Press.