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Related Experiment Videos

Is adjustment disorder unidimensional or multidimensional? Implications for ICD-11.

Louisa Lorenz1, Philip Hyland2, Axel Perkonigg1

  • 1Department of Psychology, University of Zurich, Zurich, Switzerland.

International Journal of Methods in Psychiatric Research
|October 10, 2017
PubMed
Summary

This study explored the structure of adjustment disorder (AjD) symptoms, finding evidence for a single underlying AjD factor. Results suggest AjD can be understood as a unidimensional construct, informing future diagnostic criteria.

Keywords:
ICD-11adjustment disorderbifactor modelconfirmatory factor analysis (CFA)

Related Experiment Videos

Area of Science:

  • Psychiatry
  • Psychological Assessment
  • Mental Health Diagnostics

Background:

  • The diagnostic criteria for adjustment disorder (AjD) have been revised for ICD-11, but its underlying structure remains unclear.
  • Debate exists on whether AjD is best conceptualized as a unidimensional or multidimensional disorder.

Purpose of the Study:

  • To comprehensively assess the latent structure of AjD symptomatology.
  • To evaluate the concurrent and discriminant validity of AjD constructs.

Main Methods:

  • Confirmatory factor analysis was used to test seven alternative models of AjD structure.
  • A sample of 333 individuals experiencing involuntary job loss completed a self-report measure of AjD symptoms.
  • Construct validity was assessed using measures of general psychological distress, social functioning, occupational self-efficacy, and sense of coherence.

Main Results:

  • A bifactor model with one dominant general AjD factor and five correlated group factors (preoccupation, failure-to-adapt, avoidance, affective reaction, impulsivity) demonstrated optimal fit.
  • The general AjD factor showed significant positive correlations with psychological distress and social impairment.
  • The AjD factor exhibited moderate negative correlations with occupational self-efficacy and sense of coherence.

Conclusions:

  • Current findings support the plausibility of a unidimensional conceptualization of adjustment disorder symptoms.
  • Future research should aim to refine essential characteristics and reduce symptom overlap in the AjD definition.
  • These results contribute to the ongoing refinement of diagnostic criteria for adjustment disorder in preparation for ICD-11.