Adjustment disorder is one of the most widespread mental disorders worldwide. In ICD-11, adjustment disorder is characterised by two main symptom clusters: preoccupation with the stressor and failure to adapt. A network analytic approach has been applied to most ICD-11 stress-related disorders. However, no study to date has explored the relationship between symptoms of adjustment disorder using network analysis.

We aimed to explore the network structure of adjustment disorder symptoms and whether its structure replicates across questionnaire versions and samples.

A network analysis was conducted on adjustment disorder symptoms as assessed by the Adjustment Disorder–New Module (ADNM-8) and an ultra-brief version (ADNM-4) using data from 2524 participants in Nigeria (n = 1006), Kenya (n = 1018) and Ghana (n = 500).

There were extensive connections between items across all samples in both ADNM versions. Results highlight that preoccupation symptoms seem to be more prominent in terms of edges strengths (i.e. connections) and had the highest centrality in all networks across samples and ADNM versions. Comparisons of network structure invariance revealed one difference between Nigeria and Ghana in both ADNM versions. Importantly, the ADNM-8 global strength was similar in all networks whereas in the ADNM-4 Kenya had a higher global strength score compared with Nigeria

Results provide evidence of the coherence of adjustment disorder in ICD-11 as assessed by the ADNM questionnaire. The prominence of preoccupation symptoms in adjustment disorder highlights a possible therapeutic target to alleviate distress. There is a need to further replicate the network structure of adjustment disorder in non-African samples.

适应障碍是世界范围内最普遍的精神障碍之一。在 ICD-11 中，适应障碍的特点是两个主要症状群：专注于压力源和无法适应。网络分析方法已应用于大多数 ICD-11 压力相关疾病。然而，迄今为止，还没有研究使用网络分析探索适应障碍症状之间的关系。

我们旨在探索适应障碍症状的网络结构，以及其结构是否在问卷版本和样本中重复。

使用来自尼日利亚（n = 1006）、肯尼亚（n = 1018) 和加纳 ( n = 500)。

在两个 ADNM 版本中，所有样本的项目之间都有广泛的联系。结果强调，在边缘强度（即连接）方面，全神贯注的症状似乎更为突出，并且在跨样本和 ADNM 版本的所有网络中具有最高的中心性。网络结构不变性的比较揭示了尼日利亚和加纳在两个 ADNM 版本中的一个差异。重要的是，ADNM-8 的全球实力在所有网络中都相似，而在 ADNM-4 中，肯尼亚的全球实力得分高于尼日利亚

结果为 ADNM 问卷评估的 ICD-11 中适应障碍的一致性提供了证据。适应障碍中注意力集中症状的突出突出了减轻痛苦的可能治疗目标。需要在非非洲样本中进一步复制调整障碍的网络结构。