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Type: Journal article
Title: A longitudinal study of adjustment disorder after trauma exposure
Author: O'Donnell, M.L.
Alkemade, N.
Creamer, M.
McFarlane, A.C.
Silove, D.
Bryant, R.A.
Felmingham, K.
Steel, Z.
Forbes, D.
Citation: American Journal of Psychiatry, 2016; 173(12):1231-1238
Publisher: American Psychiatric Association
Issue Date: 2016
ISSN: 0002-953X
Statement of
Meaghan L. O’Donnell, Nathan Alkemade, Mark Creamer, Alexander C. McFarlane, Derrick Silove, Richard A. Bryant, Kim Felmingham, Zachery Steel, David Forbes
Abstract: Objective: Adjustment disorder has been recategorized as a trauma- and stressor-related disorder in DSM-5. The aim of this study was to determine the prevalence of adjustment disorder in the first 12 months after severe injury; to determine whether adjustment disorder was a less severe disorder compared with other disorders in terms of disability and quality of life; to investigate the trajectory of adjustment disorder; and to examine whether the subtypes described in DSM-5 are distinguishable. Method: In a multisite, cohort study, injury patients were assessed during hospitalization and at 3 and 12 months postinjury (N=826). Structured clinical interviews were used to assess affective, anxiety, and substance use disorders, and self-report measures of disability, anxiety, depression, and quality of life were administered. Results: The prevalence of adjustment disorder was 19% at 3 months and 16% at 12 months. Participants with adjustment disorder reported worse outcomes relative to those with no psychiatric diagnosis but better outcomes compared with those diagnosed with other psychiatric disorders. Participants with adjustment disorder at 3 months postinjury were significantly more likely to meet criteria for a psychiatric disorder at 12 months (odds ratio=2.67, 95% CI=1.59−4.49). Latent-profile analysis identified a three-class model that was based on symptom severity, not the subtypes identified by DSM-5. Conclusions: Recategorization of adjustment disorder into the trauma- and stressor-related disorders is supported by this study. However, further description of the phenomenology of the disorder is required.
Keywords: Humans
Wounds and Injuries
Disability Evaluation
Longitudinal Studies
Adjustment Disorders
Psychiatric Status Rating Scales
Quality of Life
Diagnostic and Statistical Manual of Mental Disorders
Young Adult
Rights: Copyright © American Psychiatric Association. All rights reserved.
DOI: 10.1176/appi.ajp.2016.16010071
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