Assessing stressor exposure, chemsex use, and adjustment disorder in a sample of men who have sex with men

Background: Evidence suggests that men who have sex with men (MSM) experience heightened risk for stressor-related mental health issues. This may be exacerbated among those who engage in chemsex; recreational substance use during sex. Valid assessment of adjustment difficulties, and risk factors associated with these, is needed to better understand these wellbeing risks. The present study aimed to validate a novel screening tool for Adjustment Disorder (AjD) in this population. Method: A sample of MSM (N = 503) completed an online survey of stressful life experiences. Among those who reported exposure to a stressor (n = 376), the factorial structure of the International Adjustment Disorder Questionnaire (IADQ) was assessed using Confirmatory Factor Analysis. Probable diagnostic status was assessed using established criteria. Associations with stressor exposure and chemsex participation were examined using between-group comparisons. Results: A unidimensional model representing a single latent AjD factor best fit these data. AjD symptomatology was commonly reported, with screening results indicating that 36.44% of participants met criteria for a probable AjD diagnosis. Small effect sizes were found for associations between positive AjD screening status, chemsex participation, and a range of stressors including problems related to health, relationships, finances, work, and housing. A medium effect size was found for the association between multiple stressor exposure and probable AjD diagnosis. Conclusions: Findings support the use of the IADQ as a brief and valid measure of AjD among men who have sex with men. Various stressful life experiences and chemsex participation may constitute risk factors for AjD, with exposure to multiple stressor types representing a particularly salient risk factor. Screening for stressful life experiences, chemsex practice, and AjD may identify those at risk for adverse health and wellbeing outcomes in this population.