A socio-interpersonal approach to adjustment disorder: the example of involuntary job loss

Abstract

Background: Adjustment disorder (AjD) was redefined for ICD-11 with core symptoms of preoccupation with a stressor and failure to adapt. The socio-interpersonal framework model for stress-response syndromes suggests that interpersonal factors, besides intrapersonal processes, substantially contribute to the development of AjD. Objective: The current study aimed to identify predictive factors in the development of AjD symptoms by the application of a framework model for stress-response syndromes. Method: N = 321 recently laid-off participants (47.7% female) were assessed with a newly developed standardized clinical diagnostic interview section on ICD-11 AjD. Self-report questionnaires measured AjD symptom severity, and interpersonal and intrapersonal predictors. Path analysis was used to model the associations between AjD symptom severity and the predictor variables. We conducted logistic regression to identify associated characteristics of diagnostic status. Results: AjD symptoms were highly prevalent and 25.6% of participants met the diagnostic criteria. Higher loneliness, higher dysfunctional disclosure, and lower self-efficacy were associated with both higher symptom severity and higher likelihood of meeting the diagnostic criteria for AjD. Higher perceived social support was associated with higher likelihood for AjD diagnosis. Conclusions: Research on risk factors for AjD is still sparse. This study provided empirical evidence on the role of interpersonal factors supporting the socio-interpersonal model for stress-response syndromes.

Risk factors of ICD-11 adjustment disorder in the Lithuanian general population exposed to life stressors

“…Knowledge about the predictors or risk factors of ICD-11 adjustment disorder is lacking. Previous studies found that adjustment disorder may be associated with various life-stressors (Lorenz et al, 2018a;Zelviene et al, 2017), exposure to trauma (O'Donnell et al, 2016;Ring et al, 2018), demographic characteristics and sociointerpersonal factors (Horn & Maercker, 2016;Lorenz et al, 2018aLorenz et al, , 2018b. In a community sample of survivors from terror attack in Israel it was found that previous traumatic experiences, stressful events and younger age were significant predictors associated with ICD-11 adjustment disorder symptoms, whereas physical proximity to the site of the terror attack and gender were not (Mahat-Shamir et al, 2017).…”

“…In the context of involuntary job loss, ICD-11 adjustment disorder was associated with greater age, lower financial household budget, and exposure to multiple stressors and workrelated factors (Perkonigg et al, 2018). Interpersonal factors, such as higher loneliness, higher dysfunctional disclosure, and lower self-efficacy were associated with higher adjustment disorder symptom severity and a higher likelihood of meeting the diagnostic criteria for ICD-11 adjustment disorder (Lorenz et al, 2018a).…”

“…The most recent studies on ICD-11 adjustment disorder are generally focused on the validation of the symptom structure (Glaesmer, Romppel, Brahler, Hinz, & Maercker, 2015;Kazlauskas, Gegieckaite, Eimontas, Zelviene, & Maercker, 2018;Lorenz, Hyland, Perkonigg, & Maercker, 2017;Lorenz, Perkonigg, & Maercker, 2018a;Zelviene, Kazlauskas, Eimontas, & Maercker, 2017), development of assessment instruments (Bachem, Perkonigg, Stein, & Maercker, 2016;Ben-Ezra, Mahat-Shamir, Lorenz, Lavenda, & Maercker, 2018), development of interventions Eimontas, Rimsaite, Gegieckaite, Zelviene, & Kazlauskas, 2018;Maercker, Bachem, Lorenz, Moser, & Berger, 2015;Moser, Bachem, Berger, & Maercker, 2019;Rachyla et al, 2018), exploring the symptom change (Lorenz, Perkonigg, & Maercker, 2018b;O'Donnell et al, 2016), and possible predictors of ICD-11 adjustment disorder (Lorenz et al, 2018b;Mahat-Shamir et al, 2017;Ring et al, 2018).…”

“…Research on ICD-11 adjustment disorder primarily focuses on target populations exposed to specific stressor, such as people who have recently lost their job (Lorenz et al, 2018a), burglary victims , survivors of traumatic events, or terror attacks (Mahat-Shamir et al, 2017;Ring et al, 2018). However, several studies also explored ICD-11 adjustment disorder symptoms in the general population, such as Lithuania (Zelviene et al, 2017) or Germany (Glaesmer et al, 2015;Maercker et al, 2012).…”

Childhood traumatic experiences, alexithymia, and resilience in patients with adjustment disorder

“…control group, they have fewer individual characteristics like self-acceptance, self-confidence, goal setting, empathy, helpfulness, hopefulness about the future, and social interaction, so that they are not very capable of coping with stressful situations. Lorenz et al(32) ve Oh et al(33) similarly reported that patients with adjustment disorder were not very successful at coping with stress.…”