University Of Tasmania

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A longitudinal study of adjustment disorder after trauma exposure

journal contribution
posted on 2023-05-19, 05:19 authored by O'Donnell, ML, Alkemade, N, Creamer, M, McFarlane, AC, Silove, D, Bryant, RA, Kim FelminghamKim Felmingham, Steel, Z, Forbes, D
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 morelikely to meet criteria for a psychiatric disorder at 12 months (odds ratio=2.67, 95% CI=1.5924.49). Latentprofile 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.


Publication title

American Journal of Psychiatry










School of Psychological Sciences


American Psychiatric Publishing, Inc.

Place of publication

United States

Rights statement

Copyright 2016 American Psychiatric Publishing, Inc.

Repository Status

  • Restricted

Socio-economic Objectives

Mental health

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