A longitudinal study of adjustment disorder after trauma exposure

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dc.contributor.authorO'Donnell, M.L.
dc.contributor.authorAlkemade, N.
dc.contributor.authorCreamer, M.
dc.contributor.authorMcFarlane, A.C.
dc.contributor.authorSilove, D.
dc.contributor.authorBryant, R.A.
dc.contributor.authorFelmingham, K.
dc.contributor.authorSteel, Z.
dc.contributor.authorForbes, D.
dc.date.issued2016
dc.description.abstractObjective: 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.
dc.description.statementofresponsibilityMeaghan L. O’Donnell, Nathan Alkemade, Mark Creamer, Alexander C. McFarlane, Derrick Silove, Richard A. Bryant, Kim Felmingham, Zachery Steel, David Forbes
dc.identifier.citationAmerican Journal of Psychiatry, 2016; 173(12):1231-1238
dc.identifier.doi10.1176/appi.ajp.2016.16010071
dc.identifier.issn0002-953X
dc.identifier.issn1535-7228
dc.identifier.orcidMcFarlane, A.C. [0000-0002-3829-9509]
dc.identifier.urihttp://hdl.handle.net/2440/105977
dc.language.isoen
dc.publisherAmerican Psychiatric Association
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/1073041
dc.rightsCopyright © American Psychiatric Association. All rights reserved.
dc.source.urihttps://doi.org/10.1176/appi.ajp.2016.16010071
dc.subjectHumans
dc.subjectWounds and Injuries
dc.subjectDisability Evaluation
dc.subjectPrognosis
dc.subjectPrevalence
dc.subjectLongitudinal Studies
dc.subjectAdjustment Disorders
dc.subjectPsychiatric Status Rating Scales
dc.subjectQuality of Life
dc.subjectDiagnostic and Statistical Manual of Mental Disorders
dc.subjectAdult
dc.subjectAustralia
dc.subjectFemale
dc.subjectMale
dc.subjectYoung Adult
dc.titleA longitudinal study of adjustment disorder after trauma exposure
dc.typeJournal article
pubs.publication-statusPublished

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