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Original Paper

Adjustment Disorders as Stress Response Syndromes: A New Diagnostic Concept and Its Exploration in a Medical Sample

Maercker A.a · Einsle F.b · Köllner V.c, d

Author affiliations

aDepartment of Psychopathology, University of Zurich, Zurich, Switzerland; bClinic for Psychosomatics and Psychotherapy, University Hospital Carl Gustav Carus Dresden, Dresden, cClinic for Psychosomatic Medicine, Bliestal Hospital, and dInstitute of Psychoanalysis, Psychotherapy and Psychosomatic Medicine, University Hospital of the Saarland, Homburg/Saar, Germany

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Psychopathology 2007;40:135–146

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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 02, 2006
Published online: February 05, 2007
Issue release date: March 2007

Number of Print Pages: 12
Number of Figures: 0
Number of Tables: 5

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP

Abstract

Objective: Adjustment disorders (AD) are an ill-defined category in the present diagnostic nomenclature. We propose a new diagnostic model that describes AD as particular forms of stress response syndrome, in which intrusions, avoidance of reminders and failure to adapt are the central processes and symptoms. In line with the existing classification, the description of AD subtypes is included. Backgrounds on existing psychopathological models of stress response disorders are outlined. Methods: Data from a clinical sample of patients with an automatic implantable cardioverter defibrillator (n = 160, mean age 63 years, 90% males) are investigated. Results: The items tapping the individual symptoms meet psychometric requirements for diagnostic applications. The diagnostic algorithm chosen indicates a 17% prevalence of AD in the sample. The subtype most commonly diagnosed is AD with mixed emotional features (41%). In a subsample, diagnostic sensitivity was 0.58 and specificity 0.81 in relation to traditional AD cases diagnosed by the Structured Clinical Interview for DSM-IV. By applying the most strongly conservative exclusion rule analogous to the Structured Clinical Interview for DSM-IV, the AD prevalence was reduced to 9%. Conclusion: The new AD concept is theory driven and shows methodological soundness. Its application to further samples is recommended.

© 2007 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Original Paper

Received: February 02, 2006
Published online: February 05, 2007
Issue release date: March 2007

Number of Print Pages: 12
Number of Figures: 0
Number of Tables: 5

ISSN: 0254-4962 (Print)
eISSN: 1423-033X (Online)

For additional information: https://www.karger.com/PSP


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