Association of adjustment disorder with childhood trauma and symptom patterns

Objective: Adjustment disorder is described in “trauma and stressor associated disorders” in DSM-V. DSM-V includes no clear-cut definition for adjustment disorder and it is ambiguously defined as a manifest trouble disproportionate to the intensity of the stressor with resultant significant impairment in functionality.

Methods: Preliminary results of an ongoing large-scale study in our clinic including patients with adjustment disorder are partly presented. We compared the SCL-90 symptom evaluation list data between the patient group (n=113) and the control group (n=63). The patient group was divided into 2 groups regarding the childhood traumas and compared with each other using SCL-90 subscale scores.

Results: Compared to the control group, patients with adjustment disorder had significantly higher anxiety symptom scores (p=0.048, t=1.994) and phobic anxiety symptoms (p=0.001, t=3.417). 33% of the patients with adjustment disorder had childhood trauma. Except for the somatization and paranoid signs, all SCL-90 subscale scores were significantly higher in patients with adjustment disorder and childhood traumas compared to those without childhood traumas at subgroup analysis (p<0.05).

Conclusion: Significantly higher anxiety symptom scores in the adjustment disorder patients compared to the control group may suggest the presence of a patient subgroup having adjustment disorder concurrent with anxiety symptoms. Nevertheless, the DSM definition “a manifest trouble disproportionate to the intensity of the stressor” may be insufficient to define the symptoms of patients with adjustment disorder. Childhood traumas have been associated with various psychopathologies, and this study revealed that patients with childhood traumas more intensely experienced the symptoms of adjustment disorder.