DSM-IV-TR states that the essential feature of adjustment disorder is the development of clinically significant emotional or behavioral symptoms in response to an identifiable psychosocial stressor. The symptoms must develop within 3 months after the onset of the stressor. The clinical significance of the reaction is indicated either by marked distress that is in excess of what would be expected given the nature of the stressor or by significant impairment in social or occupational (academic) functioning. This category should not be used if the emotional and cognitive disturbances meet the criteria for another specific Axis I disorder (e.g., a specific anxiety or mood disorder) or are merely an exacerbation of a pre-existing Axis I or Axis II disorder. Adjustmnet disorder may be diagnosed if other Axis I or II disorders are present, but do not account for the pattern of symptoms that have occurred in response to the stressor. The diagnosis of AD does not apply when the symptoms represent bereavement (criterion D). By definition, AD must resolve within 6 months of termination of the stressor or its consequences. However, the symptoms may persist for a prolonged period (i.e., longer than 6 months) if they occur in response to a chronic stressor (e.g., a chronic, disabling general medical condition) or to a stressor that has enduring consequences (e.g., the financial and emotional difficulties resulting from a divorce).

Each of the diagnostic constructs required for the diagnosis of AD is difficult to assess and measure:(1) the stressor, (2) the maladaptive reaction to the stressor, and (3) the time and relationship between the stressor and the psychological response. None of these three components has been operationalized.