Mental Health A to Z

DSM-IV-TR

Diagnostic criteria for 309.4 Adjustment Disorder with Mixed
Disturbance of Emotions and Conduct

1. The development of emotional or behavioral symptoms in response to an identifiable stressor(s) occurs within 3 months of the onset of the stressor(s).
2. These symptoms or behaviors are clinically significant, as evidenced by either of the following:
   - Marked distress in excess of what is expected from exposure to the stressor
   - Significant impairment in social or occupational (academic) functioning
3. The stress-related disturbance does not meet criteria for another specific axis I disorder and is not merely an exacerbation of a preexisting axis I or axis II disorder.
4. The symptoms do not represent bereavement.
5. Once the stressor (or its consequences) has terminated, the symptoms do not persist for more than an additional 6 months.

• Adjustment Disorders with Mixed Disturbance of Emotions and Conduct subtype is selected when the predominant manifestations are both emotional symptoms (e.g. depression, anxiety) and a disturbance of conduct (e.g. truancy, vandalism, reckless driving, fighting, defaulting on legal responsibilities).

Reference:

Diagnostic and Statistical Manual of Mental Disorders, 4th ed Text Revision (DSM-IV-TR). Washington DC: American Psychiatric Association. 2000.