Adjustment disorder has been a category of its own in DSM-IV. IN DSM-V, the workgroup is proposing that it be included in a category of trauma and stressor-related disorders. I agree to this, as there is a lot of resemblance with other trauma and stressor disorders. Further, the criteria are almost the same as those in DSM-IV. However, a few new subtypes are considered:
- With PTSD/ASD-like symptoms: if the person experiences symptoms similar to PTSD or acute stress disorder, but the full critieria for trauma or for the symptoms of PTSD/ASD are not met.
- Related to bereavement: when the stress reaction is related to the death of a close relative or friend, and the person experiences intense longing for the deceased that is in excess to what is normal.
The workgroup also proposes a new disorder for research purposes only: bereavement related disorder. In this condition, after the death of a close relative or friend, the person not only experiences intense longing for the deceased, but also a number of specific symptoms, including social or identity disturbances and reactive distress symptoms. This condition is very controversail, as it is generally believed that grief and distress are normal responses to death, and that even complicated greif is not a psychiatric disorder. I agree to this and feel that bereavement related disorder should not be included in DSM-V.
The disturbance in adjustment disorder must last for no longer than six months after the stressor or its consequences have stopped. An exception is made for the bereavement-related type, where the adjustment problems must last for at least twelve months. I consider that a reasonable timeframe, if bereavement is going to be seen as a disorder at all, but I do not agree to the six months cut-off for the other types, that is also present in DSM-IV. After all, an adjustment problem can last for more than six months, and it is strange that a person must then be diagnosed with another mental illness which they may not have. In my own case, I was diagnosed with impulse control disorder NOS after my six months with adjustment disorder, and this diagnosis was not only incorrect, but failed to reflect the fact that my behavior was in large part a reaction to an unstable situation.