Adjustment disorders as a stress-related disorder: a longitudinal study of the associations among stress, resources, and mental health
Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients...
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| description | Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design.
The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients' presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time.
Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p |
| doi_str_mv | 10.1371/journal.pone.0097303 |
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The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients' presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time.
Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β= -0.23, R2corr=0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df=15.26; RMSEA=0.21).
Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0097303</identifier><identifier>PMID: 24825165</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Adjustment ; Adjustment Disorders - etiology ; Adjustment Disorders - physiopathology ; Affective Symptoms - physiopathology ; Analysis of Variance ; Anxiety ; Biology and Life Sciences ; Correlation analysis ; Disorders ; Emotions ; Gender differences ; Germany ; Humans ; Linear Models ; Longitudinal Studies ; Mathematical models ; Medicine ; Medicine and Health Sciences ; Mental disorders ; Mental health ; Mental Health - statistics & numerical data ; Nuclear factor I ; Occupational stress ; Patients ; Perception ; Perceptions ; Primary care ; Psychosomatic medicine ; Quality of life ; Regression analysis ; Research and Analysis Methods ; Social Sciences ; Stress ; Stress response ; Stress, Psychological - physiopathology ; Stresses ; Surveys and Questionnaires ; Time Factors ; Variance analysis</subject><ispartof>PloS one, 2014-05, Vol.9 (5), p.e97303</ispartof><rights>2014 Kocalevent et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2014 Kocalevent et al 2014 Kocalevent et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c526t-2fa3200a114883e866a86ed777fdbab84aa8e33b775a65db5f94ec3f803348c03</citedby><cites>FETCH-LOGICAL-c526t-2fa3200a114883e866a86ed777fdbab84aa8e33b775a65db5f94ec3f803348c03</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019534/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC4019534/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,860,881,2096,2915,23845,27901,27902,53766,53768,79343,79344</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/24825165$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Dichter, Gabriel S.</contributor><creatorcontrib>Kocalevent, Rüya-Daniela</creatorcontrib><creatorcontrib>Mierke, Annett</creatorcontrib><creatorcontrib>Danzer, Gerhard</creatorcontrib><creatorcontrib>Klapp, Burghard F</creatorcontrib><title>Adjustment disorders as a stress-related disorder: a longitudinal study of the associations among stress, resources, and mental health</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design.
The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients' presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time.
Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β= -0.23, R2corr=0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df=15.26; RMSEA=0.21).
Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress.</description><subject>Adjustment</subject><subject>Adjustment Disorders - etiology</subject><subject>Adjustment Disorders - physiopathology</subject><subject>Affective Symptoms - physiopathology</subject><subject>Analysis of Variance</subject><subject>Anxiety</subject><subject>Biology and Life Sciences</subject><subject>Correlation analysis</subject><subject>Disorders</subject><subject>Emotions</subject><subject>Gender differences</subject><subject>Germany</subject><subject>Humans</subject><subject>Linear Models</subject><subject>Longitudinal Studies</subject><subject>Mathematical models</subject><subject>Medicine</subject><subject>Medicine and Health Sciences</subject><subject>Mental disorders</subject><subject>Mental health</subject><subject>Mental Health - statistics & numerical data</subject><subject>Nuclear factor I</subject><subject>Occupational stress</subject><subject>Patients</subject><subject>Perception</subject><subject>Perceptions</subject><subject>Primary care</subject><subject>Psychosomatic medicine</subject><subject>Quality of life</subject><subject>Regression analysis</subject><subject>Research and Analysis Methods</subject><subject>Social Sciences</subject><subject>Stress</subject><subject>Stress response</subject><subject>Stress, Psychological - 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Academic</collection><collection>PubMed Central (Full Participant titles)</collection><collection>DOAJ Directory of Open Access Journals</collection><jtitle>PloS one</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Kocalevent, Rüya-Daniela</au><au>Mierke, Annett</au><au>Danzer, Gerhard</au><au>Klapp, Burghard F</au><au>Dichter, Gabriel S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Adjustment disorders as a stress-related disorder: a longitudinal study of the associations among stress, resources, and mental health</atitle><jtitle>PloS one</jtitle><addtitle>PLoS One</addtitle><date>2014-05-13</date><risdate>2014</risdate><volume>9</volume><issue>5</issue><spage>e97303</spage><pages>e97303-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>Adjustment disorders are re-conceptualized in the DSM-5 as a stress-related disorder; however, besides the impact of an identifiable stressor, the specification of a stress concept, remains unclear. This study is the first to examine an existing stress-model from the general population, in patients diagnosed with adjustment disorders, using a longitudinal design.
The study sample consisted of 108 patients consecutively admitted for adjustment disorders. Associations of stress perception, emotional distress, resources, and mental health were measured at three time points: the outpatients' presentation, admission for inpatient treatment, and discharge from the hospital. To evaluate a longitudinal stress model of ADs, we examined whether stress at admission predicted mental health at each of the three time points using multiple linear regressions and structural equation modeling. A series of repeated-measures one-way analyses of variance (rANOVAs) was performed to assess change over time.
Significant within-participant changes from baseline were observed between hospital admission and discharge with regard to mental health, stress perception, and emotional distress (p<0.001). Stress perception explained nearly half of the total variance (44%) of mental health at baseline; the adjusted R2 increased (0.48), taking emotional distress (i.e., depressive symptoms) into account. The best predictor of mental health at discharge was the level of emotional distress (i.e., anxiety level) at baseline (β= -0.23, R2corr=0.56, p<0.001). With a CFI of 0.86 and an NFI of 0.86, the fit indices did not allow for acceptance of the stress-model (Cmin/df=15.26; RMSEA=0.21).
Stress perception is an important predictor in adjustment disorders, and mental health-related treatment goals are dependent on and significantly impacted by stress perception and emotional distress.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>24825165</pmid><doi>10.1371/journal.pone.0097303</doi><oa>free_for_read</oa></addata></record> |
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| subjects | Adjustment Adjustment Disorders - etiology Adjustment Disorders - physiopathology Affective Symptoms - physiopathology Analysis of Variance Anxiety Biology and Life Sciences Correlation analysis Disorders Emotions Gender differences Germany Humans Linear Models Longitudinal Studies Mathematical models Medicine Medicine and Health Sciences Mental disorders Mental health Mental Health - statistics & numerical data Nuclear factor I Occupational stress Patients Perception Perceptions Primary care Psychosomatic medicine Quality of life Regression analysis Research and Analysis Methods Social Sciences Stress Stress response Stress, Psychological - physiopathology Stresses Surveys and Questionnaires Time Factors Variance analysis |
| title | Adjustment disorders as a stress-related disorder: a longitudinal study of the associations among stress, resources, and mental health |
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