Harald Baumeister1, Katharina Kufner. 1. Department of Rehabilitation Psychology and Psychotherapy, Institute of Psychology, University of Freiburg, Freiburg, Germany. baumeister@psychologie.uni-freiburg.de
Abstract
PURPOSE OF REVIEW: A recent review highlighted the existing lack of evidence concerning adjustment disorders. It concluded that we should wait to adjust adjustment disorders until evidence is available. This is circular reasoning, fixing the poor definition of adjustment disorders. The present article outlines why we should amend adjustment disorders and which major obstacles need to be removed when revising this category. RECENT FINDINGS: Adjustment disorder is a frequent disorder at least in medical settings. Many of these patients do not fulfill the criteria of a more specific diagnosis, but are still regarded as 'in need of treatment'. Clinicians appreciate the possibility of assigning adjustment disorders as 'wild card' diagnoses. The drawback of this clinical utility consists in the lack of operational diagnostic specificity. This leads to the resistance of adjustment disorders being researched properly, resulting in a substantial proportion of patients receiving treatments that are not evidence based. Thus, there is a need for revision of adjustment disorders. Thereby, the border disputes of what differentiates adjustment disorders from normal human adaptation processes and from other (more specific) disorders need to be solved. SUMMARY: Given the high prevalence rates of adjustment disorders and their scientific neglect, it is time to revise adjustment disorders.
PURPOSE OF REVIEW: A recent review highlighted the existing lack of evidence concerning adjustment disorders. It concluded that we should wait to adjust adjustment disorders until evidence is available. This is circular reasoning, fixing the poor definition of adjustment disorders. The present article outlines why we should amend adjustment disorders and which major obstacles need to be removed when revising this category. RECENT FINDINGS: Adjustment disorder is a frequent disorder at least in medical settings. Many of these patients do not fulfill the criteria of a more specific diagnosis, but are still regarded as 'in need of treatment'. Clinicians appreciate the possibility of assigning adjustment disorders as 'wild card' diagnoses. The drawback of this clinical utility consists in the lack of operational diagnostic specificity. This leads to the resistance of adjustment disorders being researched properly, resulting in a substantial proportion of patients receiving treatments that are not evidence based. Thus, there is a need for revision of adjustment disorders. Thereby, the border disputes of what differentiates adjustment disorders from normal human adaptation processes and from other (more specific) disorders need to be solved. SUMMARY: Given the high prevalence rates of adjustment disorders and their scientific neglect, it is time to revise adjustment disorders.
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