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Adjustment Disorder
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Andreas Maercker – One of the best experts on this subject based on the ideXlab platform.
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the 12 month course of icd 11 Adjustment Disorder in the context of involuntary job loss
Clinical Psychology in Europe, 2020Co-Authors: Louisa Lorenz, Andreas Maercker, Rahel BachemAbstract:Background: After its redefinition in ICD-11, Adjustment Disorder (AjD) comprises two core symptom clusters of preoccupations and failure to adapt to the stressor. Only a few studies investigate the course of AjD over time and the definition of six months until the remission of the Disorder is based on little to no empirical evidence. The aim of the present study was to investigate the course of AjD symptoms and symptom clusters over time and to longitudinally evaluate predictors of AjD symptom severity.
Method: A selective sample of the Zurich Adjustment Disorder Study, N = 105 individuals who experienced involuntary job loss and reported either high or low symptom severity at first assessment (t1), were assessed M = 3.4 (SD = 2.1) months after the last day at work, and followed up six (t2) and twelve months (t3) later. They completed a fully structured diagnostic interview for AjD and self-report questionnaires.
Results: The prevalence of AjD was 21.9% at t1, 6.7% at t2, and dropped to 2.9% at t3. All individual symptoms and symptom clusters showed declines in prevalence rates across the three assessments. A hierarchical regression analysis of symptoms at t3 revealed that more symptoms at the first assessment (β = 0.32, p = .002) and the number of new life events between the first assessment and t3 (β = 0.29, p = .004) significantly predicted the number of AjD symptoms at t3.
Conclusion: Although prevalence rates of AjD declined over time, a significant proportion of individuals still experienced AjD symptoms after six months. Future research should focus on the specific mechanisms underlying the course of AjD. -
translation and psychometric evaluation of the chinese Adjustment Disorder new module 20
International Journal of Mental Health, 2020Co-Authors: Louisa Lorenz, Andreas Maercker, Athena C. Y. Chan, Daniel Bressington, Wai Tong Chien, Mark Shevlin, Philip Hyland, Thanos KaratziasAbstract:The Adjustment Disorder – New Module 20 (ADNM-20) was developed for the assessment of Adjustment Disorder symptoms. The aim of the present study was to translate and conduct psychometric testing of…
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Risk factors of ICD-11 Adjustment Disorder in the Lithuanian general population exposed to life stressors
European journal of psychotraumatology, 2020Co-Authors: Paulina Zelviene, Evaldas Kazlauskas, Andreas MaerckerAbstract:Background: A new definition of Adjustment Disorder symptoms has been included in the 11th edition of the International Classification of Diseases (ICD-11). However, little is known about risk factors of ICD-11 Adjustment Disorder. Objective: The study aimed to analyse risk factors of Adjustment Disorder in a sample of the Lithuanian general population exposed to life-stressors. Method: In total, the study included 649 adult participants from the general population with various recent significant life-stressor experiences. ICD-11 Adjustment Disorder symptoms were measured using the Adjustment Disorder New Module-8 (ADNM-8) scale. Results: The prevalence of the ICD-11 Adjustment Disorder diagnosis in the sample was 16.5%. Job-related stressors and health-related stressors were significantly associated with Adjustment Disorder. Other risk factors for Adjustment Disorder in this study were female gender, greater age, and university education. Conclusions: We conclude that stressor type and demographic characteristics are associated with the risk of developing an Adjustment Disorder.
Patricia Casey – One of the best experts on this subject based on the ideXlab platform.
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Sleep Disturbance in Adjustment Disorder and Depressive Episode
International Journal of Environmental Research and Public Health, 2019Co-Authors: Anne M. Doherty, Louisa Lorenz, Faraz Jabbar, Eamonn O'leary, Patricia CaseyAbstract:Background: In this paper, we aimed to examine the patterns of sleep disturbance in Adjustment Disorder (AD) and depressive episode (DE), to examine the variables associated with sleep disturbance in AD and DE and associated impairment in functioning. Methods: This is a multi-centre case-control study of 370 patients: 185 patients with AD and 185 patients with a diagnosis of DE, recruited from the liaison psychiatry services of three Dublin hospitals. We examined the participants’ sleep pathology using the sleep disturbance items on the Schedule for Clinical Assessment in Neuropsychiatry, and the Inventory of Depressive Symptoms—Clinician-rated-30. Results: Patients with a diagnosis of AD were less likely to report disturbed sleep than those with a diagnosis of DE (p = 0.002). On multivariate analysis, sleep disturbance was significantly associated with greater severity of certain depressive symptoms: decreased appetite (p < 0.001) and psychomotor agitation (p = 0.009). Decreased appetite, younger age and single marital status were significantly associated with sleep disturbance in male patients, and decreased appetite and psychomotor agitation were significantly associated with sleep disturbance in female participants. Conclusions: This is the largest study to date which has examined sleep disturbance in Adjustment Disorder. Disturbance of sleep is a significant symptom in AD and may represent a potential target for treatment. With further research, patterns of sleep disturbance may be useful in differentiating AD from DE.
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Adjustment Disorder: A diagnosis whose time has come
Journal of affective disorders, 2017Co-Authors: Rahel Bachem, Patricia CaseyAbstract:Abstract Background Adjustment Disorder is among the most frequently diagnosed mental Disorders in clinical practice although it has received little academic attention and been the subject of substantial criticism over the past decades. While those suffering with Adjustment Disorders are often treated by mental health professionals, research interest in the origin of the Disorder or the effectiveness of psychotherapeutic and medical interventions has only recently begun to emerge. This article summarizes the empirical literature published on Adjustment Disorder and points out current diagnostic developments in DSM-5 and ICD-11. Methods Literature for this review was identified through established online search tools, including publications in English, German, and Spanish. Results This paper reviews literature on the evolution of Adjustment Disorder, and highlights the current state of research with regard to genesis and treatment. Importantly, for the first time ICD-11 intends to define Adjustment Disorder by explicit symptom groups, unlike DSM-5. Limitations Publications without an English abstract were not included. Conclusions Key directions for future research include investigating the concordance of the ICD-11 and DSM-5 concepts and the effect that the diverging conceptualizations may have. Risk and protective factors specific to AD should be identified and the biological underpinnings of the Disorder should be explored. Finally, given the high prevalence of AD in certain clinical settings effective Disorder-specific interventions should be developed and evaluated.
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suicidal behaviours in Adjustment Disorder and depressive episode
Journal of Affective Disorders, 2015Co-Authors: Patricia Casey, Faraz Jabbar, Eamonn Oleary, Anne M. DohertyAbstract:BACKGROUND: Little is known about suicidal ideation and behaviours in Adjustment Disorder (AD). In this paper we sought to examine the variables independently associated with suicidal ideation and behaviour in patients diagnosed with AD or depressive (DE) episode among psychiatric outpatients and in liaison psychiatry. METHODS: 370 patients who were referred to the liaison psychiatry services (including those seen in the Emergency Department) at 3 Dublin hospitals, and were clinically diagnosed with either DE or AD, based on the ICD 10 diagnostic criteria, were recruited to the study. We examined their demographic and clinical characteristics, and the associations between these and suicidal ideation and behaviour on multivariate analysis. RESULTS: Younger age, single marital status, and greater severity of depressive symptoms were significantly associated with suicidality across both diagnoses. On multivariate analysis, greater severity of depressive symptoms was associated with suicidality in those with AD (p=0.012) and DE (p=0.009). Those with AD exhibited suicidality at lower symptom scores than did those with DE but in both groups it still occurred at the highest level of severity. There were differences in the objective circumstances measure of suicide intent. LIMITATIONS: We used clinical diagnosis rather as the main diagnostic classification. The generalisability of this paper may be limited to consultation-liaison psychiatry settings, where suicidal ideation and behaviours are common. CONCLUSIONS: Suicidality in AD and DE has broadly similar risk factors but differ in aspects of suicide intent. Different mechanisms may underpin suicidality in those with AD compared to DE. Language: en
Yves De Roten – One of the best experts on this subject based on the ideXlab platform.
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one minute of grief emotional processing in short term dynamic psychotherapy for Adjustment Disorder
Journal of Consulting and Clinical Psychology, 2015Co-Authors: Ueli Kramer, Jeannicolas Despland, Antonio Pascualleone, Yves De RotenAbstract:Objective: Depth of emotional processing has shown to be related to outcome across approaches to psychotherapy. Moreover, a specific emotional sequence has been postulated and tested in several studies on experiential psychotherapy (Pascual-Leone & Greenberg, 2007). This process-outcome study aims at reproducing the sequential model of emotional processing in psychodynamic psychotherapy for Adjustment Disorder and linking these variables with ultimate therapeutic outcome. Method: In this study, 32 patients underwent short-term dynamic psychotherapy. On the basis of reliable clinical change statistics, a subgroup (n 16) presented with good outcome and another subgroup (n 16) had a poor outcome in the end of treatment. The strongest alliance session of each case was rated using the observer-rated system Classification of Affective Meaning States. Reliability coefficients for the measure were excellent ( .82). Results: Using 1 min as the fine-grained unit of analysis, results showed that the experience of fundamentally adaptive grief was more common in the in-session process of patients with good outcome, compared with those with poor outcomes ( 2 6.56, p .01, d 1.23). This variable alone predicted 19% of the change in depressive symptoms as measured by the Beck Depression Inventory at the end of treatment. Moreover, sequences of the original model were supported and related to outcome. Conclusions: These results are discussed within the framework of the sequential model of emotional processing and its possible relevance for psychodynamic psychotherapy. What is the public health significance of this article? This study found that the experience of adaptive grief by adults during short-term psychodynamic psychotherapy was related to better outcome. A short moment of such productive grief at the right moment of psychotherapy may be enough for symptom change. Patients who benefit from symptom relief present a typical sequence of emotional processes in a good therapy session, which is less the case in patients with less optimal results.
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change in defense mechanisms and coping over the course of short term dynamic psychotherapy for Adjustment Disorder
Journal of Clinical Psychology, 2010Co-Authors: Ueli Kramer, Jeannicolas Despland, Luc Michel, Martin Drapeau, Yves De RotenAbstract:Short-term dynamic psychotherapy (STDP) has rarely been investigated with regard to its underlying mechanisms of change, even if psychoanalytic theory informs us about several potential putative mechanisms of change in patients. Change in overall defensive functioning is one. In this study, we explored the role of overall defensive functioning, by comparing it on the process level with the neighbouring concept of overall coping functioning. A total of N=32 patients, mainly presenting Adjustment Disorder, were included in the study. The patients underwent STDP up to 40 sessions; three sessions per psychotherapy were transcribed and analyzed by using two observer-rating scales: Defense Mechanism Rating Scales (Perry, 1990) and Coping Action Patterns (Perry, Drapeau, Dunkley, & Blake, 2005). Hierarchical linear modeling was applied to model the change over the course of therapy and relate it to outcome. Results suggest that STDP has an effect on the target variable of overall defensive functioning, which was absent for overall coping functioning. Links with outcome confirm the importance of the effect. These results are discussed from methodological and clinical viewpoints.