The Course of Adjustment Disorder Following Involuntary Job Loss and Its Predictors of Latent Change

Abstract

Adjustment disorders (AjDs) usually resolve after the precipitating life event and its consequences are terminated. However, they bear the risk for the development of severe mental illness. The present study investigates the natural course of AjD as defined for International Classification of Diseases, 11th version (ICD-11). A total of 303 individuals who involuntarily lost their jobs were assessed initially after the job loss and 6 months later. Latent class latent change analysis and multinomial logistic regression were performed. Two groups showed low (n = 149, 49.2%) and medium (n = 108, 35.6%) symptom severity at initial assessment that declined over time. The third group (n = 46, 15.2%) showed a high initial response and a small effect of worsening of symptoms. Female gender, higher age, first dismissal, impaired social functioning, dysfunctional disclosure, less social support, and less social acknowledgment were associated with belonging to the latter group. It might be beneficial to target individuals at high risk with interventions that aim at the improvement of skills relevant for stress management. AbstractAdjustment disorders (AjD) usually resolve after the precipitating life event and its consequences are terminated. However, they bear the risk for the development of severe mental illness. The present study investigates the natural course of AjD as defined for ICD-11. N=303 individuals who involuntarily lost their jobs were assessed initially after the job loss and 6 months later. Latent class latent change analysis and multinomial logistic regression were performed. Two groups showed low (n=149, 49.2%) and medium (n=108, 35.6%) symptom severity at initial assessment that declined over time. The third group (n=46, 15.2%) showed a high initial response and a small of worsening of symptoms. Gender, age, first dismissal, impaired social functioning, dysfunctional disclosure, social support, and social acknowledgement were associated with belonging to the latter group. It might be beneficial to target individuals at high risk with interventions that aim at the improvement of skills relevant for stress management.

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

“…Adjustment disorder was also associated with exposure to stressors, particularly those related to employment and health. Our findings are largely in line with other studies that found female gender and elderly age were associated with higher rates of adjustment disorder symptoms (Ayuso-Mateos et al, 2001;Lorenz et al, 2018b). Surprisingly, university education was also found to be a risk factor for adjustment disorder, even though higher education is often considered to be a protective factor for mental disorders.…”

“…Our study is in line with other studies that found that job-related stressors, such as higher responsibilities or occupational demanding work positions were associated with ICD-11 adjustment disorder symptoms (Perkonigg et al, 2018). Unemployment in our study was not associated with adjustment disorder in contrast to previous studies that identified high adjustment disorder prevalence associated with job loss (Lorenz et al, 2018b). Exposure to life-stressors, job-or health-related stressors, was significantly associated with ICD-11 adjustment disorder.…”

“…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).…”

“…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).…”

Mental, behavioral and neurodevelopmental disorders in the ICD-11: an international perspective on key changes and controversies

“…It can be assigned some days after the stressor has impacted on the person, and it is typically expected to resolve within 6 months unless the stressor persists for a longer duration. Adjustment disorder is not a trivial conditionif it goes undetected and untreated it may lead to more severe mental disorders or an elevated risk of suicide [67,68]. The four diagnoses presented here are intended to fulfill the aim of the ICD-11 to provide clear, simple diagnoses that meet the needs of clinicians worldwide.…”