Adjustment disorder
Meaning of adjustment disorder: For the purposes of this Statement of Principles, adjustment disorder means a disorder of mental health meeting the following diagnostic criteria (derived from DSM-5): (a) The development of emotional or behavioural symptoms in response to an identifiable stressor (s) occurring within three months of the onset of the stressor (s) . (b) These symptoms or behaviours are clinically significant, as evidenced by one or both of the following: (i) Marked distress that is out of proportion to the severity or intensity of the stressor, taking into account the external context and the cultural factors that might influence symptom severity and presentation; or Veterans' Entitlements Act 1986 (ii) Significant impairment in social, occupational, or other important areas of functioning. (c) The stress-related disturbance does not meet the criteria for another mental disorder and is not merely an exacerbation of a preexisting mental disorder. (d) The symptoms do not represent normal bereavement. (e) Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional six months.
Reasonable Hypothesis (RH) — Statement of Principles No. 23 of 2016
At least one of the following factors must as a minimum exist before it can be said that a reasonable hypothesis has been raised connecting adjustment disorder or death from adjustment disorder with the circumstances of a person's relevant service:
- (1)experiencing a category 1A stressor within the three months before the clinical onset of adjustment disorder; Veterans' Entitlements Act 1986;
Note: category 1A stressor is defined in the Schedule 1 - Dictionary.
- (2)experiencing a category 1B stressor within the three months before the clinical onset of adjustment disorder;
Note: category 1 B stressor is defined in the Schedule 1 - Dictionary.
- (3)living or working in a hostile or life-threatening environment for a cumulative period of at least four weeks within the three months before the clinical onset of adjustment disorder;
Note: hostile or life-threatening environment is defined in the Schedule 1 - Dictionary.
- (4)being exposed to repeated or extreme aversive details of severe traumatic events within the three months before the clinical onset of adjustment disorder;
Note: being exposed to repeated or extreme aversive details of severe traumatic events is defined in the Schedule 1 - Dictionary.
- (5)having a significant other who experiences a category 1A stressor within the three months before the clinical onset of adjustment disorder;
Note: category 1A stressor and significant other are defined in the Schedule 1 - Dictionary.
- (6)experiencing a category 2 stressor within the three months before the clinical onset of adjustment disorder;
Note: category 2 stressor is defined in the Schedule 1 - Dictionary.
- (7)experiencing the death of a significant other within the three months before the clinical onset of adjustment disorder;
Note: significant other is defined in the Schedule 1 - Dictionary.
- (8)having, or being diagnosed with, a medical illness or injury which is life-threatening or which results in serious physical or cognitive disability, within the three months before the clinical onset of adjustment disorder;
- (9)having persistent pain of at least three months duration at the time of the clinical onset of adjustment disorder;
Note: persistent pain is defined in the Schedule 1 - Dictionary.
- (10)having a severe, chronic medical condition within the three months before the clinical onset of adjustment disorder;
Note: severe, chronic medical condition is defined in the Schedule 1 - Dictionary.
- (11)having a miscarriage, foetal death in-utero or stillbirth, within the three months before the clinical onset of adjustment disorder;
Note: miscarriage is defined in the Schedule 1 - Dictionary.
- (12)inability to obtain appropriate clinical management for adjustment disorder. Veterans' Entitlements Act 1986;
Aggravation-only factors: the factors in subsection 9(12) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
Balance of Probabilities (BoP) — Statement of Principles No. 24 of 2016
11 factors
At least one of the following factors must exist before it can be said that, on the balance of probabilities, adjustment disorder or death from adjustment disorder is connected with the circumstances of a person's relevant service:
- (1)experiencing a category 1A stressor within the three months before the clinical onset of adjustment disorder; Veterans' Entitlements Act 1986;
Note: category 1A stressor is defined in the Schedule 1 - Dictionary.
- (2)experiencing a category 1B stressor within the three months before the clinical onset of adjustment disorder;
Note: category 1 B stressor is defined in the Schedule 1 - Dictionary.
- (3)being exposed to repeated or extreme aversive details of severe traumatic events within the three months before the clinical onset of adjustment disorder;
Note: being exposed to repeated or extreme aversive details of severe traumatic events is defined in the Schedule 1 - Dictionary.
- (4)having a significant other who experiences a category 1A stressor within the three months before the clinical onset of adjustment disorder;
Note: category 1A stressor and significant other are defined in the Schedule 1 - Dictionary.
- (5)experiencing a category 2 stressor within the three months before the clinical onset of adjustment disorder;
Note: category 2 stressor is defined in the Schedule 1 - Dictionary.
- (6)experiencing the death of a significant other within the three months before the clinical onset of adjustment disorder;
Note: significant other is defined in the Schedule 1 - Dictionary.
- (7)having, or being diagnosed with, a medical illness or injury which is life-threatening or which results in serious physical or cognitive disability, within the three months before the clinical onset of adjustment disorder;
- (8)having persistent pain of at least three months duration at the time of the clinical onset of adjustment disorder;
Note: persistent pain is defined in the Schedule 1 - Dictionary.
- (9)having a severe, chronic medical condition within the three months before the clinical onset of adjustment disorder;
Note: severe, chronic medical condition is defined in the Schedule 1 - Dictionary.
- (10)having a miscarriage, foetal death in-utero or stillbirth, within the three months before the clinical onset of adjustment disorder;
Note: miscarriage is defined in the Schedule 1 - Dictionary.
- (11)inability to obtain appropriate clinical management for adjustment disorder. Veterans' Entitlements Act 1986;
Aggravation-only factors: the factors in subsection 9(11) apply only to material contribution to, or aggravation of, the condition where it was suffered or contracted before or during (but did not arise out of) the person’s relevant service.
