title: Measuring the ICD-11 adjustment disorder concept: Validity and sensitivity to change of the Adjustment Disorder - New Module questionnaire in a clinical intervention study.
abstract: Adjustment disorder (AjD) is a frequent but under-researched diagnosis due in part to a lack of specific symptom criteria and adequate tools of measurement. The ICD-11 for the first time proposes a positive symptom catalogue to define AjD. This study presents a validation of the Adjustment Disorder - New Module (ADNM), the first symptom severity measure for AjD according to the ICD-11 concept. Validity and sensitivity to change were investigated in a sample of 190 individuals with a DSM-IV diagnosis of AjD. The ADNM scales demonstrated convergent and discriminant validity for anxiety symptoms (Hamilton Anxiety Scale; psychic anxiety r = 0.18-0.31), functional impairment (Sheehan Disability Scale; r = 0.18-0.47), and depression (Montgomery-Asberg Depression Scale; r = 0.13-0.30). At baseline 78% of the individuals with a DSM-IV diagnosis of AjD were also classified so by the ADNM. Repeated-measures ANOVA indicated significant ADNM-symptom decrease during treatment, replicating the patterns of the Hamilton Anxiety Scale, Sheehan Disability Scale, and Clinical Global Impression Scale. This article presents the first use of the ADNM as a measure for ICD-11 AjD in a randomized-controlled intervention study of AjD. It provides support for the construct validity and sensitivity to symptom change of this scale during pharmacological treatment.
authors.affiliation: Department of Psychology, Psychopathology and Clinical Intervention Unit, University of Zurich, Zurich, Switzerland.
authors.forename: Rahel
authors.initials: R
authors.lastname: Bachem
authors.affiliation: Department of Psychology, Psychopathology and Clinical Intervention Unit, University of Zurich, Zurich, Switzerland.
authors.forename: Axel
authors.initials: A
authors.lastname: Perkonigg
authors.affiliation: Department of Psychiatry, Groote Schuur Hospital J2, University of Cape Town and MRC Unit on Anxiety & Stress Disorders, Cape Town, South Africa.
authors.forename: Dan J
authors.initials: DJ
authors.lastname: Stein
authors.affiliation: Department of Psychology, Psychopathology and Clinical Intervention Unit, University of Zurich, Zurich, Switzerland.
authors.forename: Andreas
authors.initials: A
authors.lastname: Maercker
mesh_terms: D000275:Adjustment Disorders / Q000145:classification / Q000175:diagnosis*; D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D038801:International Classification of Diseases / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales / Q000592:standards*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D055815:Young Adult
keywords: methodology; randomized controlled trial; self-report measure; stress response disorders