The network structure of ICD-11 adjustment disorder: A comparison of clinical and nonclinical samples

Abstract

Background International Classification of Diseases, 11th revision (ICD-11) adjustment disorder (AjD) is characterized by two main symptom clusters: preoccupation with the stressor and failure to adapt to the stressor. The network analytic approach provides important information on the structural validity of a disorder and reveals which symptoms are most prominent. To date, no study compared the network structure of AjD symptoms in clinical and nonclinical samples, which could potentially inform our understanding of psychopathological mechanisms that underlie AjD and identify core targets for therapy. Methods A network analysis was conducted on AjD symptoms as assessed by the Adjustment Disorder—New Module (ADNM-8) using data from 330 clinical participants from the UK and a nonclinical sample of 699 participants from Switzerland. Results Comparisons of network structure invariance revealed differences between the network structure of the clinical and the nonclinical samples. Results highlight that in terms of both edges strength and centrality, failure to adapt symptoms was more prominent in the clinical sample, while the preoccupation symptoms were more prominent in the nonclinical sample. Importantly, global strength was similar across networks. Conclusions Results provide evidence of the coherence of AjD in the ICD-11 as assessed by the ADNM questionnaire. They tentatively suggest that subclinical AjD may be characterized by emerging preoccupation symptoms that may result in failure to adapt and functional impairment in clinical manifestation of AjD. However, there is a need for replication and longitudinal research to further validate this hypothesis.

Relationship between adjustment disorder symptoms and probable diagnosis before and after second lockdown in Israel: longitudinal symptom network analysis

“…Strong associations were observed between individual preoccupation symptoms and between failure-to-adapt symptoms, but weaker associations between these core symptom clusters. This confirms our hypothesis and replicates earlier network studies in non-clinical 12 and clinical samples 29 and confirms the structure of adjustment disorder suggested in ICD-11. We report the first study to show that overall connectivity of adjustment disorder symptoms remained equally strong over 3 months, further confirming the validity of the adjustment disorder symptoms in ICD-11.…”

“…Strong associations were observed between individual preoccupation symptoms and between failureto-adapt symptoms, but weaker associations between these core symptom clusters. This confirms our hypothesis and replicates Adjustment disorder symptoms and probable diagnosis earlier network studies in non-clinical 12 and clinical samples 29 and confirms the structure of adjustment disorder suggested in ICD-11.…”

“…This confirms our hypothesis that the most central symptom would predict the diagnosis and our expectation that preoccupation symptoms provide the grounds for the development of adjustment disorder in non-clinical samples, whereas failure-to-adapt symptoms have a greater significance in the clinical context. 29 However, longitudinal research with clinical samples is needed to clarify the mechanisms underlying the development of the disorder.…”

A cross-sectional study on the Arabic Version of the Adjustment Disorder–New Module20 for Cancer Patients: Tool Validation, Prevalence, and Risk Factors

“…Furthermore, the meta-analysis conducted by Mitchell et al also found a signi cant association between AjD and female sex (7). This association has also been found in clinical samples of patients from the UK and nonclinical participants from Switzerland (32). Similarly, a study conducted by Abumadini on Saudi patients visiting psychiatric outpatient clinics found that 69.6 percent of participants who had a diagnosis of AjD were women (33).…”

The role of daily adjustment disorder, depression and anxiety symptoms for the physical activity of cardiac patients

“…Chronic diseases can represent such a stressor (De Ridder et al, 2008 ). ICD-11 adjustment disorder has two core symptoms: preoccupations and failure to adapt (Levin et al, 2022 ; Maercker & Lorenz, 2018 ). In the case of cardiac disease, preoccupations can comprise repeated, afflicting, and involuntary thoughts about the disease or its consequences (e.g.…”