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Chapter 18. Adjustment Disorders

James J. Strain, M.D.; Kimberly G. Klipstein, M.D.; Jeffrey H. Newcorn, M.D.
DOI: 10.1176/appi.books.9781585623402.305784

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Excerpt

In the gray area of diagnosis that lies between normal behavior, problem-level issues, and major disorders reside the subthreshold disorders, which are often poorly defined, overlap with other diagnostic groupings, have indefinite symptomatology, and consequently present confounds for reliability and validity. DSM-IV-TR (American Psychiatric Association 2000, pp. xxx–xxi) describes these boundary categories within another conceptual framework:

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TABLE 18–1. DSM-IV-TR diagnostic criteria for adjustment disorders
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TABLE 18–2. Diagnostic categories of adjustment disorder
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TABLE 18–3. Symptom comparisons among subtypes of adjustment disorder (AD) in 2,224 adult (ages 19–64 years) psychiatric patients
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TABLE 18–4. Types of DSM-IV-TR adjustment disorder
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Adjustment disorders are of two forms: acute (6 months or less) and chronic (greater than 6 months).

In children, adjustment disorders are predictive of more serious mental illnesses for late adolescence and adulthood.

An adjustment disorder diagnosis can be used concurrently with another Axis I diagnosis.

The adjustment disorders have a clear threshold for when they are supplanted by another Axis I diagnosis, because the other diagnoses have established thresholds and symptom guidelines. The point at which the patient crosses the threshold between normal behavior and an adjustment disorder is less clear, however, because the symptom guidelines for entry are less specific.

It has been suggested that adjustment disorders could be placed with other diagnoses identified by the mood and behavior; for example, adjustment disorder with depressed mood could be positioned as an affective disorder.

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The adjustment disorder diagnosis in DSM-IV-TR (American Psychiatric Association 2000) has been found to have certain advantages and disadvantages for patients and clinicians. Which of the following is the major disadvantage of using the diagnosis?
2.
Which of the following statements concerning the diagnosis of adjustment disorder is true?
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Despland et al. (1995) demonstrated identical profiles for the DSM-IV-TR subtypes of adjustment disorder with depressed mood and. . .
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