Overview
Adjustment disorder with anxious mood is characterized by emotional or behavioral symptoms in response to an identifiable stressor, occurring within three months of its onset. These symptoms cause significant distress or impairment in social, occupational, or other important areas of functioning.
Diagnosis
Symptoms include prominent anxiety, worry, nervousness, or jitteriness, along with other adjustment disorder features 13.
Symptoms do not meet criteria for another mental disorder and are not merely an exacerbation of a pre-existing disorder.
The symptoms represent a significant emotional or behavioral disturbance that is clinically significant due to marked distress or significant impairment in functioning.
Once the stressor or its consequences have terminated, the symptoms do not persist for more than an additional six months.Management
Intolerance of uncertainty is a transdiagnostic factor associated with emotional disorders and may be a target for intervention 24.
Therapeutic interventions targeting intolerance of uncertainty have shown a large effect on reducing it, which corresponds with improved anxiety symptom severity 4.
Cognitive avoidance is a maladaptive emotion regulation strategy strongly associated with intolerance of uncertainty 2.
Mindfulness is an adaptive emotion regulation strategy strongly associated with intolerance of uncertainty 2.Special Populations
Perfectionism is associated with anxiety symptoms in young people aged 6-24 years 3.
Perfectionism is associated with general anxiety, social anxiety, and task anxiety in adults 1.Key Recommendations
Consider interventions targeting intolerance of uncertainty, as these have demonstrated significant efficacy in reducing this factor and improving anxiety symptom severity 4. (Evidence: Strong)
Emotion regulation strategies, particularly maladaptive ones like cognitive avoidance, are associated with intolerance of uncertainty and may be a target for therapeutic change 2. (Evidence: Strong)
Perfectionism is a transdiagnostic process associated with anxiety symptoms in both adults and young people 13. (Evidence: Strong)References
1 Callaghan T, Greene D, Shafran R, Lunn J, Egan SJ. The relationships between perfectionism and symptoms of depression, anxiety and obsessive-compulsive disorder in adults: a systematic review and meta-analysis. Cognitive behaviour therapy 2024. link
2 Sahib A, Chen J, Cárdenas D, Calear AL. Intolerance of uncertainty and emotion regulation: A meta-analytic and systematic review. Clinical psychology review 2023. link
3 Lunn J, Greene D, Callaghan T, Egan SJ. Associations between perfectionism and symptoms of anxiety, obsessive-compulsive disorder and depression in young people: a meta-analysis. Cognitive behaviour therapy 2023. link
4 Miller ML, McGuire JF. Targeting intolerance of uncertainty in treatment: A meta-analysis of therapeutic effects, treatment moderators, and underlying mechanisms. Journal of affective disorders 2023. link
5 Hohls JK, König HH, Quirke E, Hajek A. Anxiety, Depression and Quality of Life-A Systematic Review of Evidence from Longitudinal Observational Studies. International journal of environmental research and public health 2021. link