How to write an adjustment disorder treatment plan

Diagnosing adjustment disorder requires certain criteria, which are outlined in the DSM-5. The following criteria apply to people of all ages:

Criterion A

The development of emotional or behavioral symptoms in response to identifiable stressors, all occurring within a span of three months from the onset of these stressor(s).

Criterion B

These symptoms or behaviors exhibit clinical significance, as demonstrated by one or both of the following criteria:

• Marked distress that is in excess of what would be expected given the nature or intensity of the stressor(s)
• Significant impairment in one's social, professional, or other essential areas of life functioning.

Criterion C

The stress-related disturbance does not meet the diagnostic criteria for any other mental disorder and is not merely an exacerbation of a pre-existing mental disorder.

Criterion D

The symptoms do not reflect normal bereavement.

Criterion E

Once the stressor(s) or its consequences have terminated, the symptoms do not persist for more than an additional 6 months.

Adjustment disorder specifiers

• With depressed mood: Predominant symptoms include persistently low mood, tearfulness, or feelings of hopelessness.
• With anxiety: Predominant symptoms involve nervousness, excessive worry, jitteriness, or separation anxiety.
• With mixed anxiety and depressed mood: A combination of depression and anxiety predominates.
• With disturbance of conduct: Predominant symptoms are characterized by a disturbance of conduct.
• With mixed disturbance of emotions and conduct: Both emotional symptoms(e.g., depression, anxiety) and disturbance of conduct are predominant.
• Unspecified: If the predominant symptoms are not sufficiently severe for any of the above categories, or are of another type.

Adjustment disorder differential diagnosis

Keep in mind that onset and duration are important aspects of an adjustment disorder diagnosis. To qualify for adjustment disorder, symptoms must begin within three months of an identifiable stressor. These symptoms must resolve within six months after the stressor or its consequences are no longer present. 

Generally, adjustment disorder is not a long-term, indefinite diagnosis. If symptoms persist beyond that timeframe, a different diagnosis—such as major depressive disorder or generalized anxiety disorder—should be considered. Further, adjustment disorder is not the right diagnosis if a client’s symptoms meet criteria for another disorder, like MDD, GAD, or post-traumatic stress disorder.