ABSTRACT
Adjustment disorder (AD) is characterized by disproportionate emotional and behavioural responses to stressors, often leading to significant functional impairment; however, the psychological mechanisms underlying this impairment remain underexplored. This cross-sectional study examined the effects of coping skills and metacognitive beliefs on psychosocial functioning in 83 young male patients (aged 19–30 years) diagnosed with AD according to DSM-5 criteria. Participants completed the Coping Strategies Questionnaire (CSQ), Metacognitions Questionnaire (MCQ-30), Beck Depression Inventory (BDI) and Functioning Assessment Short Test (FAST). Data were analysed using Pearson correlation, multiple linear regression and bootstrap-based mediation analyses. Functional impairment was strongly and positively associated with depression severity (r = 0.459, p < 0.01). Effective coping strategies were negatively associated with functional impairment, whereas biochemical avoidance was positively associated with dysfunction. In multiple regression analyses, depression severity (β = 0.42, p < 0.001) and coping skills (β = −0.28, p = 0.010) emerged as significant predictors of functional impairment, whereas metacognitive beliefs were not independently associated with functioning. Mediation analyses indicated that the effect of depression severity on functioning was largely direct; the indirect effect through coping strategies did not reach statistical significance (95% BCa CI [−0.004, 0.137]). Due to the cross-sectional design, causal inferences cannot be drawn. These findings suggest that functional impairment in AD is primarily associated with depressive symptoms and maladaptive coping styles, highlighting these domains as potential targets for clinical intervention.