Exploring Characteristics of Preoccupation and Failure to Adapt Among Patients Suffering From Adjustment Disorder: A Qualitative Study

Authors

  • Alexis Vancappel Orcid
    CHRU de Tours, Pôle de Psychiatrie-Addictologie, Centre Régional de Psychotraumatologie CVL, Tours, France; Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique,Université de Tours, Tours, France
  • Rania Chkili
    Département de Psychologie, QualiPsy, Qualité de Vie et santé Psychologique,Université de Tours, Tours, France
  • David J. Eberle Orcid
    Department of Psychology, Universität Zürich, Zurich, Switzerland
  • Andreas Maercker Orcid
    Department of Psychology, Universität Zürich, Zurich, Switzerland
  • Wissam El-Hage Orcid
    CHRU de Tours, Pôle de Psychiatrie-Addictologie, Centre Régional de Psychotraumatologie CVL, Tours, France; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France
  • Rahel Bachem Orcid
    Department of Psychology, Universität Zürich, Zurich, Switzerland

Abstract

Background: Adjustment Disorder (AjD) is a frequent diagnosis in psychological and psychiatric consultations. Recently, the ICD-11 has introduced preoccupation and failure to adapt as core symptoms of AjD. However, empirical research that explores the various possible manifestations of preoccupation and failure to adapt in AjD patients is sparse. Therefore, the study aimed to explore patients’ experiences of the core symptoms of AjD in a qualitative study. Method: We recruited 16 patients suffering from ICD-11 AjD who filled in self-report questionnaires to assess sociodemographic information, adjustment disorder symptoms, anxiety and depression. Then, they participated in a semi-structured interview with a trained psychologist to explore the determinants and characteristics of their preoccupation and failure to adapt symptoms. Thematic analysis was applied to analyze the responses. Results: Six themes were identified in our analysis 1) Preoccupation triggers, 2) Preoccupations and negative emotions, 3) Strategies to stop preoccupation, 4) Consequences of preoccupation, 5) Manifestation of difficulties/failure to adapt and 6) Strategies to address difficulties/failure to adapt. Conclusion: We found partial congruence between our data and previous conceptualizations of AjD. Preoccupations seem to be time-consuming, center around stressors and their consequences, and be associated with negative emotions. Some preoccupations reported by the patients could also be labeled as ruminations or worries. The failure to adapt symptoms seemed to be broader than the exemplary symptoms highlighted in current measures of AjD.