Adjustment disorder diagnosis: Improving clinical utility
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OBJECTIVES: Adjustment disorder (AD) is a frequent diagnosis in clinical practice worldwide. After long neglect in mental health research, the new DSM definition and in particular the ICD-11 model of AD is about to create a fresh impulse for research on AD and for refined clinical use of the diagnosis. METHODS: This paper outlines the clinical features of AD according to the ICD-10, ICD-11 and DSM-5 definitions, and provides case vignettes of patients with AD with clinical presentations of dominating anxiety, depressed mood or mixed symptom presentations. The available clinical assessments and diagnostic tools are described in detail, together with findings on their psychometric properties. RESULTS: The current AD definitions are consistent with a new nosological grouping of AD with posttraumatic stress disorder in the chapter on trauma- and stressor-related disorders, or stress response syndromes. CONCLUSIONS: This nosological specification opens new avenues for neurobiological and psychological research on AD and for developing novel therapies.
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Conceptualizing infidelity as its own unique traumatic experience within the lens of AD may help to accurately capture the impact of these situations while shedding light on the potential overdiagnosis and reliance of the PTSD label.
“Therefore, conceptualizing infidelity as its own unique traumatic experience within the lens of AD may help to accurately capture the impact of these situations while shedding light on the potential overdiagnosis and reliance of the PTSD label [49,58,59].”
From Love and Infidelity: Causes and Consequences (2023) · cites this paper as [49]
The similarities of PTSD and adjustment disorder can be traced back to cognitive distortions surrounding safety and trust which are developed from the maladaptive memories of a traumatic event.
“According to Maercker and Lorenz, the similarities of both conditions can be traced back to cognitive distortions surrounding safety and trust which are developed from the maladaptive memories of a traumatic event [49].”
From Love and Infidelity: Causes and Consequences (2023) · cites this paper as [49]
In response, ICD-11 has added a requirement not included in DSM-5 that specific symptoms be present indicating maladaptive reaction to stressor: 'preoccupation with the stressor or its consequences, including excessive worry, recurrent and distressing thoughts about the stressor, or constant rumination about its implications'.
“In response, the ICD-11 has added a requirement - not included in the DSM-5 - that specific symptoms be present indicating a maladaptive reaction to the stressor: 'preoccupation with the stressor or its consequences, including excessive worry, recurrent and distressing thoughts about the stressor, or constant rumination about its implications' 64,65 .”
From An organization‐ and category‐level comparison of diagnostic requirements for mental disorders in <scp>ICD</scp> ‐11 and <scp>DSM</scp> ‐5 (2021) · cites this paper as [65]
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Harris, B. E., Murray, C., Rice, K., & Thorsteinsson, E. (2025) · European Journal of Oncology Nursing · doi:10.1016/j.ejon.2025.102979
Validation of the International Adjustment Disorder Questionnaire and Adjustment Disorder in Türkiye
Alpay, E. H., & Özçürümez, G. (2026) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2026.2718742
- Authors
- Maercker, A., & Lorenz, L.
- Affiliations
- Department of Psychology, University of Zurich
- University of Zurich (CH)
- Venue
- The World Journal of Biological Psychiatry
- Publisher
- Informa UK Limited
- Published
- 2018-06-22
- Volume
- 19
- Issue
- sup1
- Pages
- S3-S13
- ISSN
- 1562-2975 (ISSN-L)
- 1814-1412
- OpenAlex
- W2891613329
- Cited by
- 47
- References
- 51
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 7 · 2023: 5 · 2022: 5 · 2021: 9 · 2020: 5 · 2019: 5 · 2018: 1
- FWCI
- 5.88
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- The World Journal of Biological Psychiatry (publishedVersion)
- PubMed (publishedVersion)
- Zurich Open Repository and Archive (University of Zurich) (acceptedVersion, cc-by-nc-nd)
- Zurich Open Repository and Archive (University of Zurich) (submittedVersion, cc-by-nc-nd)
- Zurich Open Repository and Archive (University of Zurich)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Personality Disorders and Psychopathology
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- adjustment disorder, ICD-11, DSM-5, ICD-10, disease classification, diagnostic criteria, clinical assessment tools, psychometric properties, stress response syndromes, trauma- and stressor-related disorders, anxiety, depressive mood, case vignettes
- MeSH terms
- Adjustment Disorders, Adult, Female, Humans, Male, Middle Aged, International Classification of Diseases, Diagnostic and Statistical Manual of Mental Disorders
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