Adjustment Disorder and its effect on new soldiers to S. Korea

by Capt. Tinika Nixon, Brian Allgood Army Community Hospital/121st CSH
U.S. Army

What is an Adjustment Disorder and how does it affect a vast majority of Initial Entry Soldiers? According to the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), an Adjustment Disorder occurs when someone develops emotional and/or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s).

These symptoms or behaviors are clinically significant, as evidenced by one or both of the following: marked distress that is out of proportion to the severity or intensity to the stressor; significant impairment in social, occupational and/or other important areas of functioning.

Once the stressor or consequences have terminated the symptoms do no persist for more than an additional 6 months (DSM-V).  Emotional symptoms of an adjustment disorder are sadness, hopelessness, lack of enjoyment, crying spells, nervousness, anxiety, worry, desperation, trouble sleeping, feeling overwhelmed, and thoughts of suicide. Behavioral symptoms of an adjustment disorder are aggressiveness, avoiding friends and family, poor performance, absenteeism, and suicidal behaviors.

Initial Entry Soldiers between the ages of 18-20 make up approximately 50% of Inpatient Psychiatric Unit admissions in South Korea with a diagnosis of Adjustment Disorder. The vast majority of these soldiers experience a cultural shock because of living in a foreign country and being away from home for the first time. This cultural shock can be extremely overwhelming without the proper support.

Although identifying a Soldier experiencing an Adjustment Disorder may be difficult, it is everyone’s responsibility to assist a Soldier when identified. Once a new Soldier arrives to your location it is exceedingly important to identify emotional symptoms and behaviors associated with an Adjustment Disorder. If an Adjustment Disorder is suspected, a leader can recommend that the Soldier becomes familiar with the Surgeon’s General Performance Triad.

The Performance Triad is a comprehensive plan to improve readiness and increase resilience through public health initiatives and leadership engagement. The focus of the Performance Triad is on Sleep, Activity, and Nutrition and this being an advantageous place to start in an attempt to treating an Adjustment Disorder.

Treatment includes exercising regularly; physical activity can boost moods and clear the mind. Eating healthy meals to help the body and mind and trying to get a good night’s sleep; getting quality sleep can aid in feeling better. In addition to becoming familiar with the Surgeon’s General Performance Triad leaders can encourage Soldiers to participate in various activities: hobbies or other activities they enjoy, unit morale groups, United Service Organization (USO) volunteer, Better Opportunity for Single Soldiers (BOSS) and mentoring groups.

Soldiers respond differently to various programs; therefore, if the attempts fail, a referral to Behavioral Health may be beneficial. Behavioral Health Services are required when there is a safety concern.

Finally, although an Adjustment Disorder may not be preventable it is treatable with the proper compassion, support, and care from members of the organizations. Unit Chaplin’s are available through the Soldier’s unit and Military Family Life Counselors are available through Army Community Services (ACS) 0503-338-7505, DSN 738-7505. The information is confidential without record or documentation. However, Behavioral Health Services are always available for Soldiers that require additional assistance dealing with Adjustment Disorders.

Additional information on Adjustment Disorders may be obtained from

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