Adjustment Disorder

A diagnosis of adjustment disorder is appropriate to consider when symptoms cause significant impairment, appear to be a psychological response to an identifiable stressor within 3 months of the onset of the stressor, and do not meet the criteria for another specific DSM-IV-TR Axis I disorder. The "with anxiety" specifier is appropriate for an individual with a clinically significant level of symptoms, such as nervousness, worry, jitteriness, or separation fears, whereas the "with mixed anxiety and depressed mood" specifier is more appropriate for an individual with a combination of depression and anxiety symptoms.

Table 7-3. DSM-IV-TR diagnostic criteria for posttraumatic stress disorder

A. The person has been exposed to a traumatic event in which both of the following were present:

(1) the person experienced, witnessed, or was confronted with an event or events that involved actual or threatened death or serious injury, or a threat to the physical integrity of self or others

(2) the person's response involved intense fear, helplessness, or horror. Note: In children, this may be expressed instead by disorganized or agitated behavior.

B. The traumatic event is persistently reexperienced in one (or more) of the following ways:

(1) recurrent and intrusive distressing recollections of the event, including images, thoughts, or perceptions. Note: In young children, repetitive play may occur in which themes or aspects of the trauma are expressed.

(2) recurrent distressing dreams of the event. Note: In children, there may be frightening dreams without recognizable content.

(3) acting or feeling as if the traumatic event were recurring (includes a sense of reliving the experience, illusions, hallucinations, and dissociative flashback episodes, including those that occur on awakening or when intoxicated). Note: In young children, trauma-specific reenactment may occur.

(4) intense psychological distress at exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

(5) physiological reactivity on exposure to internal or external cues that symbolize or resemble an aspect of the traumatic event

C. Persistent avoidance of stimuli associated with the trauma and numbing of general responsiveness (not present before the trauma), as indicated by three (or more) of the following:

(1) efforts to avoid thoughts, feelings, or conversations associated with the trauma

(2) efforts to avoid activities, places, or people that arouse recollections of the trauma

(3) inability to recall an important aspect of the trauma

(4) markedly diminished interest or participation in significant activities

(5) feeling of detachment or estrangement from others

(6) restricted range of affect (e.g., unable to have loving feelings)

(7) sense of a foreshortened future (e.g., does not expect to have a career, marriage, children, or a normal life span)

D. Persistent symptoms of increased arousal (not present before the trauma), as indicated by two (or more) of the following:

(1) difficulty falling or staying asleep

(2) irritability or outbursts of anger

(3) difficulty concentrating

(4) hypervigilance

(5) exaggerated startle response

E. Duration of the disturbance (symptoms in Criteria B, C, and D) is more than 1 month.

F. The disturbance causes clinically significant distress or impairment in social, occupational, or other important areas of functioning.

Specify if:

Acute: if duration of symptoms is less than 3 months Chronic: if duration of symptoms is 3 months or more Specify if:

With Delayed Onset: if onset of symptoms is at least 6 months after the stressor

The Insomnia Battle

The Insomnia Battle

Who Else Wants To Sleep From Lights Out 'Til Sunrise Without Staring At The Ceiling For Hours Leaving You Feeling Fresh And Ready To Face A New Day You know you should be asleep. You've dedicated the last three hours in the dark to trying to get some sleep. But you're wide awake.

Get My Free Ebook


Post a comment