Department of Psychology, Psychopathology and Clinical Intervention Unit, University of Zurich, Zurich, Switzerland.
Department of Psychiatry, Groote Schuur Hospital J2, University of Cape Town and MRC Unit on Anxiety & Stress Disorders, Cape Town, South Africa.
Int J Methods Psychiatr Res. 2017 Dec;26(4). doi: 10.1002/mpr.1545. Epub 2016 Nov 9.
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.
适应障碍（AjD）是一种常见但研究不足的诊断，部分原因是缺乏特定的症状标准和足够的测量工具。ICD-11 首次提出了一个阳性症状目录来定义 AjD。本研究验证了适应障碍-新模块（ADNM），这是根据 ICD-11 概念为 AjD 设计的第一个症状严重程度测量工具。在 190 名 DSM-IV 诊断为 AjD 的个体样本中，研究了其有效性和对变化的敏感性。ADNM 量表对焦虑症状（汉密尔顿焦虑量表；精神焦虑 r=0.18-0.31）、功能障碍（Sheehan 残疾量表；r=0.18-0.47）和抑郁（蒙哥马利-阿斯伯格抑郁量表；r=0.13-0.30）具有收敛和区分效度。在基线时，78%的 DSM-IV 诊断为 AjD 的个体也通过 ADNM 进行了分类。重复测量方差分析表明，ADNM 症状在治疗期间显著下降，与汉密尔顿焦虑量表、Sheehan 残疾量表和临床总体印象量表的模式相吻合。本文首次在 AjD 的随机对照干预研究中，将 ADNM 用作 ICD-11 AjD 的测量工具。它为该量表在药物治疗期间的结构有效性和对症状变化的敏感性提供了支持。
