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DSM-IV: Adjustment Disorder


Significant life events, whether positive or negative, can stress us emotionally and psychologically. The resulting presence of symptoms and impaired functioning can result in a diagnosis of one of the mental disorders we call an adjustment disorder.

These can be further classifed as adjustment disorder with ______ (Depressed Mood, Anxiety, Disturbance of Conduct, Mixed Anxiety and Depressed Mood, Mixed Disturbance of Emotions and Conduct)

Diagnostic criteria for Adjustment Disorders 
(cautionary statement)
 

A. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s). 

B. These symptoms or behaviors are clinically significant as evidenced by either of the following: 

(1) marked distress that is in excess of what would be expected from exposure to the stressor 
(2) significant impairment in social or occupational (academic) functioning 

C. The stress-related disturbance does not meet the criteria for another specific Axis I disorder and is not merely an exacerbation of a preexisting Axis I or Axis II disorder. 

D. The symptoms do not represent Bereavement

E. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months. 

Specify if: 

Acute: if the disturbance lasts less than 6 months 
Chronic: if the disturbance lasts for 6 months or longer Adjustment Disorders are coded based on the subtype, which is selected according to the predominant symptoms. 

The specific stressor(s) can be specified on Axis IV. 

309.0 With Depressed Mood 
309.24 With Anxiety 
309.28 With Mixed Anxiety and Depressed Mood 
309.3 With Disturbance of Conduct 
309.4 With Mixed Disturbance of Emotions and Conduct 
309.9 Unspecified

Reprinted with permission from the Diagnostic and Statistical Manual of Mental Disorders, fourth Edition. Copyright 1994 American Psychiatric Association

Also: adjustment reaction, transient situational disorder

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