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Adjustment Disorders Criteria

Jamie Marich, Ph.D., LPCC-S, LICDC-CS, RMT, edited by C. E. Zupanick, Psy.D.

This section is meant to be an informative guide only. It is not intended for self-diagnosis. These diagnostic summaries are only meant for educational purposes, not diagnostic ones. If you believe that these patterns of symptoms describe you or someone you love, seek out a professional opinion by a treatment provider who understands trauma.

Adjustment Disorders

  • This diagnosis is often given to children and adults who endure an adverse life experience or stressor but may not meet the full criteria for PTSD or an acute stress disorder.
  • The emotional or behavioral symptoms in response to a stressor occur within three months of that stressor's onset. Examples may include persistent negative emotional states (e.g., fear, horror, anger, guilt, sadness, and shame), displays of panic or anxiety, and other impairments in daily functioning.
  • There must be evidence of functional impairment. Some examples include: being unable to work; limited productivity at work; problems in social situations or relationships; problems with health.
  • There must be marked distress that is out of proportion to the intensity of the stressor (taking into account contextual issues like culture and developmental maturity), and no other mental health issue can better explain these problematic symptoms.
  • The symptoms have not persisted for longer than six months after the stressor and its consequences have terminated. If the symptoms last longer, other diagnoses like PTSD, a mood disorder, or an anxiety disorder may need to be considered. With this diagnosis, certain qualifiers are given to describe how the stressor may be most impacting the person:
    • With Depressed Mood
    • With Anxiety
    • With Mixed Anxiety and Depressed Mood
    • With Disturbance of Conduct
    • With Mixed Disturbance of Emotions and Conduct
    • Unspecified
  • Common qualifying stressors in adjustment disorder diagnoses include divorce, conflict in the home, loss of a job, or other major life changes. In the DSM-5 (APA, 2013), bereavement alone cannot qualify a person for an adjustment disorder. However, sometimes the loss of a loved one forces other significant life changes and adjustment. For instance, an elderly widow may no longer be able to live alone. She may need to leave the home she lived in for 30 or more years, and move to an assisted living facility. When bereavement involves other difficult adjustments, then an adjustment disorder diagnosis can be used along with a bereavement V-code. A V-code simply refers to an exacerbating factor that can make a diagnosis more complicated.