Аdjustment disorders in students who have suffered psychoemotional stress: systematic review of diagnostics, treatment and preventive care

Currently, the mental health problem of students, which often leads to the creation of unfavorable foundations for the development of non-psychotic mental disorders, is particularly relevant and socially significant. The purpose of this article was to conduct a systematic literature review of the current state of the problems of students` adjustment disorders, taking into account interventions aimed at preventing and correcting them, and analyzing the results. We searched the electronic databases Oxford, Google Scholar, PubMed, Medline and Web of Science, ScienceDirect, Scopus, Cyberleninka, PsycInfo on prevalence, adverse effects, and interventions in students with adjustment disorders. Of the 25 studies published over the period from 2004 to 2020, 10 (40%) data on treatment and preventive measures are reported. The search revealed that interventions aimed at correcting and preventing adjustment disorders in students may improve various aspects of well-being, including psychological, pedagogical and medical ones. However, the evidence is limited by the relative inadequacy of long-term and reliable experimental studies. In view of this, it is advisable to further implement larger projects and conduct broader and longer-term research, which will contribute to a more reliable and in-depth study of the impact and effectiveness of such interventions. Based on a scientific search, the theoretical and methodological foundations of psychocorrection of students with adjustment disorders are substantiated, taking into account the specifics of the mental functioning of this category. While there are few works devoted to the study of developmental issues, clinical and psychopathological features, dynamics of non-psychotic mental disorders, taking into account gender and organizational factors in university students in the context of higher education reform, such issues require further study applying systemic approach in order to develop and implement in practice the early diagnosis as well as corrective and preventive measures.

Social frustratedness as a psychogenesis factor of adjustment disorders

Summary. The current biopsychosocial paradigm in medicine and medical psychology ensures the development of the theory and methodology of medical psychodiagnostics as a comprehensive study of psychological and psychosocial factors underlying mental adaptation. The diagnostic of prenosological and initial manifestations of borderline spectrum disorders designated as adjustment disorders in ICD-10 (F43.2), requires the criteria qualification of real or potential stressogenic social functioning conditions, thus, an arsenal of adequate methods of clinical and medical-psychosocial psychodiagnostics is required. The questionnaire «Social Frustration Level» represents one of such methods. The study of social frustration phenomenon as a predictor of emotional tension and stress resistance allows to characterize personality traits in relation to environmental influence and assess the specificity and pathogenic significance of socially frustrating factors. The article substantiates theoretical and methodological foundations of the questionnaire, its attributive characteristics — the phenomena of external and internal social frustration identified in medical psychodiagnostics for the first time. Socio-diagnostic criteria are illustrated by examples of the practical use in medical psychodiagnostics of social frustration in teachers of mass schools, the military and in patients with focal epilepsy. The specified research contingent is united by the problem of stress resistance in crisis situations (including a disease situation and the attitude to the disease). The questionnaire «Social Frustration Level» can be considered as a necessary form of psychosocial diagnostics of stress genesis, a source of information in screening psychoprophylactic studies, as well as in the forming of indications for psycho- and sociotherapy.

Mental health

Suicide and deliberate self-harm?, Acute behavioural disturbance?, Common mental disorders?, Severe mental disorders psychoses?, Disorders due to substance abuse?, Withdrawal states?, Adjustment disorders and bereavement?, Post-traumatic stress disorder?, Intellectual learning disability?, Disorders in children and adolescents?

Art Therapy for Adjustment Disorders in Adolescent with Systemic Lupus Erythematosus (SLE) and Pulmonary Tuberculosis (TB)

This study presents an experimental Single Case-Single Subject ABA design of a 17-year-old female patient suffering from Systemic Lupus Erythematosus (SLE) and Pulmonary Tuberculosis (TB) who experience adjustment disorders. The purpose of this study is to reduce adjustment disorders in the patient with SLE and pulmonary TB by using art therapy. The assessment methods are observation, interviews, and psychological testing tools. Data analysis was carried out using the qualitatively and quantitatively. Quantitative analysis is performed using visual inspection by looking at the comparison of Depression Anxiety Stress Scale (DASS) scores. Initial measurements using DASS showed a level of depression with a score of 26 (severe), anxiety score at 23 (very severe), and stress score at 19 (moderate). Art therapy is given as a therapeutic intervention for the patient. After the therapy was given, there was a decrease in the DASS score with a depression score to 20 (moderate), anxiety score at 19 (severe), and stress score at 17 (mild). The patient also felt moreable to express and control emotions more precisely. These results indicate that art therapy is one of the interventions that can overcome psychological problems in the patient with adjustment disorders.

Effectiveness of mindfulness-based stress reduction and attachment-based compassion therapy for the treatment of depressive, anxious and adjustment disorders in mental health settings: A randomized controlled trial

Objectives: To study the effectiveness of Attachment-Based Compassion Therapy (ABCT) for reducing affective distress in a sample of outpatients with depressive, anxiety or adjustment disorders, and to explore its action mechanisms.Methods: This randomised controlled trial involved assessment time points of pre-treatment, post-treatment, and 6-months follow-up. A total of 90 patients from three mental health units in Castellón (Spain) were recruited and randomly assigned to ‘ABCT + treatment as usual (TAU)’, ‘Mindfulness-based stress reduction (MBSR) + TAU’, or ‘TAU’ alone. Affective distress, as measured by the ‘Depression, Anxiety and Stress Scales’ (DASS-21) was the main outcome; self-compassion and mindfulness were also assessed. Multilevel mixed-effects models were performed to estimate the efficacy of the programme, and path analysis were conducted to study the potential mechanistic role of mindfulness and self-compassion.Results: ABCT was not superior to MBSR in any outcome or assessment point. ABCT was superior to TAU both post-treatment (B=-13.20; 95% CI: -19.57, -6.84) and at 12-month follow-up (B=-7.20; 95% CI: -13.63, -0.76) for reducing DASS-21, and MBSR was superior to TAU both post-treatment (B=-11.51; 95% CI: -17.97, -5.05) and at 12-month follow-up (B=-8.59; 95% CI -15.09, -2.10), with large effects (d≥0.90). Changes produced in DASS-21 by ABCT were mediated by self-compassion, while changes produced by MBSR were mediated by both mindfulness and self-compassion.Conclusion: ABCT is efficacious for reducing affective distress in patients with anxiety, depressive or adjustment disorders, although its effect is not superior to MBSR’s. Self-compassion seems to be a significant mediator of the effects of ABCT.

Preditores de risco psicológico em Psicologia da Saúde: uma revisão da literatura

O ajuste psicológico é um fenômeno dinâmico e multidimensional, e não pode ser reduzido simplesmente a uma ausência de distúrbio psicológico. O sucesso dos cuidados psicológicos junto a enfermos crônicos inicia-se com a identificação das condições de risco e seus preditores. A compreensão do conhecimento acumulado e das evidências mais atuais sobre o tema favorece a elaboração do diagnóstico e no planejamento de ações.Objetivo:Realizar uma revisão integrativa dos fatores que influenciam o processo de adaptação psicológica e fatores de risco para morbidade psicológica e/ou psiquiátrica no adoecimento.Metodologia:Foi realizada uma busca da literatura especializada por meio de artigos científicos nas bases de dados: Portal de Periódicos Capes/MEC, BVS e PubMed utilizando os seguintes descritores: emotional adaptation and adjustment disorders and hospitalization and psychosocial impact.Resultados:A busca pelos descritores nas bases de dados selecionadas resultou em 1.368 artigos, que após a seleção por meio da aplicação dos critérios de inclusão e exclusão e triagem dos títulos, resumos e leitura completa, foram reduzidos a 54 artigos incluídos na análise. Os dados retirados dos artigos foram tabulados e analisados conforme a freqüência. Os principais resultados encontrados nos artigos foram analisados conforme método de análise de conteúdo proposto por Bardin. Conclusão: A Revisão da literatura possibilitou identificar os principais Preditores de Risco Psicológico em Saúde: sofrimento emocional, história prévia, percepção do diagnóstico/prognóstico, suporte social, fatores sociodemográficos e a forma com que a pessoa lida com o processo.

Psychometric study of civilians that exposed to psychosocial stress in conditions of military conflict

The aim of the work was to conduct a psychometric study of civilians that experienced psychosocial stress in a military conflict to assess the patterns of clinical and psychopathological signs of adjustment disorders. 109 persons with diagnosed mental disorders of cluster F43.2 — adjustment disorders have been examined the participants have been divided into three groups: widows of military personnel (6 persons), relatives of combatants who returned to peaceful life (71 persons), and internally displaced persons (IDP) — 32 persons. To assess the severity of psychopathological symptoms, the Symptom Check List-90‑Revised L. R. Derogatis (SCL‑90-R), adapted by N. Tarabrina and the Hamilton Depression Rating Scale (HRSD) were used. The study has revealed a low level of symptomatic disorders in all participants, but with higher indicators on the scales of somatization, obsessive- compulsive disorder, anxiety and phobic anxiety in the IDP group, on the scale of depression — in the group of relatives of combatants who returned to a peaceful life. Hamilton Rating Scale for Depression has revealed mild depression in widows of military personnel and IDP; in relatives of combatants who returned to a peaceful life, the quantitative value of the indicator has corresponded to the absence of depression signs. Discrepancy at the objective and subjective assessment of the level of depression in the participants has been established. The identified patterns of clinical and psychopathological characteristics of adjustment disorders should be taken into account while developing therapeutic, rehabilitation and preventive measures for civilians that exposed to psychosocial stress in a military conflict.