Adjustment Disorder DSM-5 Criteria

When someone has difficulty coping with a stressor and meets criteria outlined in The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), he/she can be diagnosed with adjustment disorder. Adjustment disorder is often difficult to diagnose because it shares symptoms with other mental health disorders; thus, professionals turn to the DSM-5, for adjustment disorder criteria. Developed and published by the American Psychiatric Association (2013), the DSM-5 is the widely accepted authority on mental illness.

DSM-5 Criteria for Adjustment Disorder

The DSM-5 defines adjustment disorder as “the presence of emotional or behavioral symptoms in response to an identifiable stressor(s) occurring within 3 months of the onset of the stressor(s)” (American Psychiatric Association, 2013).

In addition to exposure to one or more stressors, other DSM-5 criteria for adjustment disorder must be present. One or both of these criteria exist:

• Distress that is out of proportion with expected reactions to the stressor
• Symptoms must be clinically significant—they cause marked distress and impairment in functioning

Further, these criteria must be present:

• Distress and impairment are related to the stressor and are not an escalation of existing mental health disorders
• The reaction isn’t part of normal bereavement
• Once the stressor is removed or the person has begun to adjust and cope, the symptoms must subside within six months.

Types of Adjustment Disorder in the DSM-5

There are six subtypes of adjustment disorder delineated in the DSM-5. All share the above criteria; specifically, they are precipitated by an obvious stressor, cause distressful symptoms, and are time-limited.

The DSM-5 criteria for each type of adjustment disorder relate to its specific symptoms. The manual specifies adjustment disorder with

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• Adjustment disorder with depressed mood
• Adjustment disorder with Anxiety
• Adjustment disorder with mixed depressed mood and anxiety
• Adjustment disorder with disturbance of conduct
• Unspecified (symptoms don’t quite meet the criteria for any of the defined categories)

When diagnosing an adjustment disorder, clinicians examine the specific DSM-5 criteria for adjustment disorder and match the person’s symptoms to the subtypes. Specifying the type of adjustment disorder someone is experiencing helps the person receive the correct treatment.

Anxiety and fear are common human responses to stressors. Sometimes people experience anhedonia; they lose their sense of pleasure and enjoyment. Low mood is another response to a stressor. Sometimes, people exhibit irritability, anger, or aggression. These all are normal human reactions to stressors; however, when they meet the DSM criteria for adjustment disorder, a diagnosis is made and a proper treatment plan can begin.

DSM-5 Adjustment Disorder Criteria and Differential Diagnosis

A large part of helping someone receive the correct treatment is knowing exactly what is going on. Adjustment disorder can mimic other disorders, such as depression, anxiety disorders, substance abuse, personality disorders, and more. When professionals use the adjustment disorder criteria in the DSM-5, they can make a differential diagnosis; that is, they can distinguish adjustment disorders from other disorders with similar symptoms.

One of the main DSM criteria for adjustment disorder is that its symptoms must occur in response to a stressor and must happen first, before a diagnosis of anxiety disorder, depression, or other mental health disorder.

The adjustment disorder criteria in the DSM-5 also help differentiate adjustment disorder from other trauma- and stressor-related disorders. Adjustment disorder can result from stressors of any severity, even ones that might seem relatively mild. Also, the symptoms of adjustment disorder don’t quite reach the level of those that occur with posttraumatic stress disorder (PTSD) or acute stress disorder (ASD).

The DSM-5 criteria for adjustment disorders help shed light on this stressor-induced disorder so people can understand and overcome it.

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