Adjustment disorder: A new way of conceptualizing the overtraining syndrome

It is proposed that an athlete's overtrained state is more perceptible in its etiology, diagnosis, treatment and prevention if considered from the context of a biopsychosocial disorder of adjustment. By shifting focus from a limited notion of excessive training loads and inadequate recovery schedules onto a comprehensive model of maladjustment, the full scope of the phenomenon becomes clearer. Specifically, the overtrained state is reconceptualized as an Adjustment Disorder and thus should be treated from the perspective of this diagnosis. Adjustment Disorder is viewed as a response to an identifiable stressor or stressors that results in clinically significant symptoms, and 'can be triggered by a stressor of any severity and may involve a wide range of possible symptoms' (DSM-IV-TR, 2000, p. 682). A rationale for the adoption of this definition is proposed. Included in this rationale is a comprehensive model of maladjustment with an overview of relevant subtypes to clarify the complex interaction of variables involved in the etiology, diagnosis, treatment, and prevention of the athlete's maladjusted state.