Post-Traumatic Embitterment Disorder Self-Rating Scale Research Articles

Embitterment in Vietnam War Veterans Predicted by Symptoms of Posttraumatic Stress Disorder.

Research on the association between posttraumatic embitterment disorder (PTED) and other psychopathologies in veterans and adults aged ≥65 years is lacking. This study aimed to assess embitterment among elderly war veterans and its association with major psychopathological factors. Participants included Vietnam War veterans who visited a psychiatric clinic. Based on the Posttraumatic Embitterment Disorder Self-Rating Scale (PTEDS) score, the participants were divided into the embitterment (PTED(+), mean score of PTEDS items [mPTEDS] ≥1.6) and non-embitterment (PTED(-), mPTEDS <1.6) groups. Demographic characteristics, combat exposure severity, depression, anxiety, sleep, and alcohol use disorder symptom scores of the participants were collected and compared between the PTED(+) and PTED(-) groups. A correlation analysis between symptom measure scores and the mPTEDS was conducted. The influence of psychopathology on embitterment was investigated using stepwise multiple linear regression analysis. In total, 60 participants (28 in PTED(+) and 32 in PTED(-)) were included. Among those in PTED(+), 21 (35.0%) showed mild embitterment symptoms (1.6≤ mPTEDS <2.5) and 7 (11.7%) reported moderate or severe embitterment symptoms (mPTEDS ≥2.5). The mean scores of posttraumatic stress disorder (PTSD), depression, and anxiety were significantly higher in the PTED(+) than in the PTED(-) group. The mPTEDS were significantly correlated with PTSD, depression, anxiety, and sleep disorder scores. The PTSD symptoms significantly explained the higher mPTEDS score in a regression model. Embitterment symptoms were associated with PTSD, depression, anxiety, and insomnia symptoms in elderly veterans, similar to the results of prior studies involving only the general population.

Post-traumatic Embitterment Disorder in UK Authorised Firearms Officers Following Post-incident Procedures: A Cross-Sectional Web Survey

AbstractIn the United Kingdom, authorised firearms officers (AFOs) respond to the most serious threats, and in situations where a weapon is discharged may be subject to a post-incident investigation. The investigation may feel unjust and lead to post-traumatic embitterment disorder (PTED), however, there is a lack of research on PTED in this group. The current study estimated the prevalence, predictors, and outcomes of PTED in 40 UK AFOs with experience of a post-incident procedure following a firearms-related incident. An online cross-sectional survey was hosted on Qualtrics, and participants were recruited via a gatekeeper at one UK police force. PTED was assessed using the PTED self-rating scale. Potential predictors and outcomes were measured using surveys of personal and general belief in a just world (BJW), including belief in distributive justice (i.e., fair outcomes) and procedural justice (i.e., fair processes), anger, and social desirability. Participants reported whether they had post-traumatic stress disorder (PTSD) or depression, and whether they experienced the post incident investigation as more problematic than the firearms incident. Results showed 15% of participants displayed clinically relevant levels of PTED. Having a possible post-traumatic stress disorder and/or depression diagnosis, feeling as though the post-incident procedure and subsequent treatment were more problematic than the incident itself, and a lack of belief in personal distributive justice, increased the risk of experiencing PTED and PTED predicted increased feelings of anger. Measures are needed to ensure the post-incident procedure delivers fair outcomes and that AFOs are given the right targeted support throughout the process.

The Relationship Between Posttraumatic Embitterment Disorder and Stress, Depression, Self-Esteem, Impulsiveness, and Suicidal Ideation in Korea Soldiers in the Local Area.

The purpose of this study was to identify the prevalence of posttraumatic embitterment disorder (PTED) among soldiers, and examine its relation to stress, depression, self-esteem, impulsiveness, and suicidal ideation. The subjects of this study were 200 soldiers and 197 control subjects, a total of 397 persons. Measurement tools used included the PTED self-rating scale, Stress Response Inventory, Beck Depression Inventory, Rosenberg Self-Esteem Inventory, Barratt Impulsiveness Scale, and Beck Scale of Suicide Ideation. The major findings of the analysis are as follows: first, 11.5% of the soldiers were in the risk group for PTED, and 4% of them had PTED. Second, PTED in the soldiers was significantly associated with a number of variables such as their educational background, stress, depression, self-esteem, impulsiveness, and suicidal ideation, while it was not significantly associated with age. Third, through the hierarchical multiple regression analysis, it was found that academic background, stress, and depression had a statistically significant positive effect on the incidence of PTED in the soldiers. In order to prevent and effectively intervene in PTED in soldiers, there is a need for interventional efforts focused on depression and stress related to negative life events.

Morally injurious events and post-traumatic embitterment disorder in UK health and social care professionals during COVID-19: a cross-sectional web survey

ObjectiveTo estimate the prevalence and predictors of morally injurious events (MIEs) and post-traumatic embitterment disorder (PTED) in UK health and social care professionals during the COVID-19 pandemic.DesignCross-sectional study.SettingSeptember–October 2020 in...

[Embitterment and Aggression in Psychotherapy Patients].

Embitterment is an emotion which is known to everybody. Embitterment results in suffering for the afflicted person and the environment, including dysfunctional behavior and aggressive phantasies. This should be recognized in psychotherapy. There is a lack of respective data. The present study examines the rate and correlation of embitterment and aggression in psychotherapy patients. The study was done in an outpatient behavior therapy clinic. Patients filled in the PTED scale (Post-Traumatic Embitterment Disorder self-rating scale), the K-FAF (brief questionnaire to assess aggression factors), and the SCL-90-S (Symptom Checklist-90-Standard). Sociodemographic data were taken from the routine database of the clinic. A total of 118 patients, with a mean age of 38 years (SD=13.3 years, R=18-76 years), agreed to participate in the study. The mean score of the PTED scale was M=1.8 (SD=0.81; R=0-3.38). A cut-off-value of M≥2.5, which indicates clinically relevant embitterment was found in 22% of patients. The mean sum score of the aggressiveness scale (total) was 30.25 (SD=17.94). There were 23.7% of patients with a cut-off≥18.37 in reactive aggression and 54.2% with a cut-off≥14.8 in explosive aggression. Significant correlations were found between the PTED scale and the aggression scale (total) (r=0.422, p<0.001), as well as the subcategories "explosive" (r=0.355, p<0.001) and "reactive" aggression (r=0.425, p<0.001). A comparison of patients with increased embitterment, with increased aggression, with increased combined embitterment/aggression, and with inconspicuous patients showed a significant increase in regard to general mental distress as measured with the SCL-90 (GSI of the SCL-90-S: f(3,71)=4.00, p=0.011) and the rate of unemployment (Fisher-Test p=0.008) in the combined as compared to the inconspicuous group (GSI of the SCL-90-S: f(3,71)=4.00, p=0.011). There were no further significant differences in regard to other sociodemographic variables (age, gender, family status and education). The data show that embitterment and aggression are seen in relevant frequency in psychotherapy patients. They are significantly correlated, as suggested by theory. Therapists should be aware of this problem and intervene adequately.

Reliability and validity of the Chinese version of the post-traumatic embitterment disorder self-rating scale (PTED-21) among inpatients in general hospital.

Embitterment and in some cases also post-traumatic embitterment disorder (PTED) are relevant problem in the general population and even more so in psychiatric patients. PTED screening should be an essential component of routine mental health management, which can be done by the 21-item Post-traumatic Embitterment Disorder Self-Rating Scale (C-PTED-21), which measures the intensity of reactive stimulus bound embitterment. The PTED-21 German version was translated into Chinese, and 200 nonpsychiatric inpatients, reporting major negative life events, were recruited through convenience sampling to evaluate test performance. Ninety patients were selected for retest 2weeks later to examine scale reliability. Factor analysis was used to assess construct validity and receiving operating characteristic curve analysis based on the "PTED standardized diagnostic interview" to assess diagnostic utility. Correlations with depression, somatic symptom, and anxiety scales were examined to assess aggregate validity. The C-PTED-21 demonstrated high internal consistency (Cronbach's α=0.944) and good test-retest reliability (total score r=0.783, individual item r value range, 0.635-0.889). Factor analysis revealed three common factors consistent with PTED core features. Total C-PTED-21 score was strongly correlated with the score on the nine-item Patient Health Questionnaire depression scale (PHQ-9, r=0.735). Mean PTED-21 score ≥1.6 points distinguished clinical PTED as defined by diagnostic interview with 97.6% sensitivity and 90.5% specificity (AUC=0.988, 95%CI: 0.976-0.999). The results show that the C-PTED-21 can assess the severity of PTED with good reliability and validity.

Exposure to Negative Life Events and Post-Traumatic Embitterment Symptoms in Young Adults in Korea: Cumulative and Differential Effects

Background: Post-traumatic embitterment disorder (PTED) has recently been introduced as a subgroup of adjustment disorders related to stressful life events. Embitterment is defined as persistent feelings of inadequacy or hoping for revenge after being insulted but feeling helpless after experiencing a life stressor. This study aims to investigate the cumulative and differential effects of negative life events on the risk of developing embitterment among young adults in South Korea. Methods: Data for the present study were collected from a web-based survey of 1,000 young adults aged 18–35 years. All participants completed a list of negative life events, the PTED Self-Rating Scale. Logistic regression analysis was conducted to evaluate the relationships between the number of negative life events and reactive embitterment. Analyses of the relationships between each negative life event and reactive embitterment were performed using covariates, including childhood trauma, depression, and anxiety symptoms. Results: The total number of participants with reactive embitterment (cut-off scores > 2.5) was 452 (45.2%). Greater exposure to negative life events increased the risk of reactive embitterment compared to no negative events. Negative life events, including financial problems, family problems, and being excluded by friends, had significant associations with the risk of reactive embitterment. Conclusions: The present study revealed a substantial number of young adults with a high level of embitterment. Furthermore, cumulative and differential effects of negative events increased the risk for reactive embitterment. Our findings underlined the crucial role of adverse life events in the development of reactive embitterment.

Social support moderates association between posttraumatic growth and trauma-related psychopathologies among victims of the Sewol Ferry Disaster

Disasters have numerous harmful effects on the mental health status of trauma-exposed people. We investigated the differences in the association between trauma-related psychopathologies and posttraumatic growth according to the perceived social support level among victims of the Sewol Ferry disaster on April 16, 2014, in South Korea. Data from 241 bereaved family members, survivors, and family members of survivors were used. The Duke-UNC Functional Social Support Questionnaire, Posttraumatic Growth Inventory, PTSD Checklist-5, Posttraumatic Embitterment Disorder Self-Rating Scale, Patient Health Questionnaire-9, and Generalized Anxiety Disorder-7 were used to evaluate perceived social support, posttraumatic growth, and trauma-related psychopathologies. We found that the severity of depression and anxiety showed inverse correlations with posttraumatic growth only in the low-social support group, while they did not demonstrate significant correlations in the high-social support group. The social support level had correlations with posttraumatic growth and the severity of posttraumatic stress disorder and posttraumatic embitterment disorder only in female respondents. Furthermore, there was a mediation pathway from social support level to posttraumatic growth through depressive symptoms. This study explored the complex relationship between social support, posttraumatic growth, trauma-related psychopathologies, and gender among trauma-exposed individuals in the aftermath of the Sewol Ferry disaster.

Embitterment in war veterans with posttraumatic stress disorder (PTSD)

The aim of this study was to analyse frequency of embitterment in war veterans with Posttraumatic stress disorder (PTSD) as well as the potential impact of embitterment on the development of chronic PTSD.Patients and methodsIt was analyzed 174 subjects (from Health Center Zivinice/mental health center) through a survey conducted in the period from March 2015 to June 2016, of which 87 war veterans with PTSD and control subjects 87 war veterans without PTSD. The primary outcome measure was the post-traumatic embitterment disorder self-rating scale (PTED Scale) who contains 19 items designed to assess features of embitterment reactions to negative life events. Secondary efficacy measures included the clinician-administered PTSD scale–V (CAPS), the PTSD checklist (PCL), the combat exposure scale (CES), the Hamilton depression rating scale (HAM-D), the Hamilton anxiety rating scale (HAM-A) and the World health organization quality of life scale (WHOQOL-Bref). All subjects were male. The average age of patients in the group war veterans with PTSD was 52.78 ± 5.99. In the control group, average age was 51.42 ± 5.98. Statistical data were analyzed in SPSS statistical program.ResultsComparing the results, t-tests revealed significant difference between group veterans with PTSD and control group (t = −21,21, P &lt; 0.0001). War veterans group with PTSD (X = 51.41, SD = 8,91), control group (X = 14.39, SD = 13.61).ConclusionEmbitterment is frequent in war veterans with PTSD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Standardization of the Korean Version of the Posttraumatic Embitterment Disorder Self-Rating Scale

ObjectiveEmbitterment is a persistent feeling of being let down or insulted, feeling like a "loser", or feeling revengeful but helpless. In South Korea, social injustice experienced during rapid industrial development and protracted unemployment during the Asian economic crisis may lead to strong feelings of embitterment. North Korean defectors and victims of industrial disasters may also experience humiliation and feelings of injustice. Posttraumatic Embitterment Disorder (PTED) is a recent conceptualization of a new psychiatric disorder. This study tested the reliability and validation of the Korean version of the PTED Scale.MethodsSubjects aged 18 years or older were recruited from a psychiatric outpatient clinic. All subjects were diagnosed with a depressive disorder. Subjects completed the Korean version of the PTED Scale, the Patient Health Questionnaire (PHQ-9) and the Patient Health Questionnaire (PHQ-15) at baseline and two weeks later.ResultsApproximately 15.4% of subjects could be categorized as having PTED. The test-retest reliability of the PTED Scale was good (r=0.76) and the internal consistency was very high (Cronbach's alpha=0.962). Positive correlations were found between the PTED Scale, the PHQ-9 and the PHQ-15, indicating substantial convergent validity of the PTED Scale.ConclusionThe Korean version of the PTED Scale is a reliable and valid measurement of embitterment in Korean adults as an emotional reaction to a negative life event.

Different typologies of workplace conflict and their connections with post traumatic embitterment disorder (PTED)

Reported is an empirical study which shows that Post-Traumatic Embitterment Disorder (PTED) is the most appropriate psychological diagnosis for victims of workplace conflicts, particularly bullying. A group of 118 people all reporting conflict at work were evaluated with the LIPT questionnaire, the PTED self-rating scale and a guided psychological interview. 91.5% proved to be affected by a PTED, the slight majority males, aged between 31 and 40 years and subjected to bullying. The evidence suggests that some workplace conflict victims who are presently diagnosed and treated as depression or phobia can be in fact cases of PTED. The treatment may be adjusted and the PTED scale may be used as a screening in-strument similar to scales for anxiety and depressive disorders.

The post‐traumatic embitterment disorder Self‐Rating Scale (PTED Scale)

The present study introduces the Post-Traumatic Embitterment Disorder Self-Rating Scale (PTED Scale), which asks for prolonged and disabling embitterment reactions in the aftermath of negative life events. The PTED Scale was administered to four independent samples of patients and normals. Internal consistency and test-retest reliability were high. Factor analysis indicated a two-factor solution, accounting for 55.25% of the total variance. The PTED Scale discriminated significantly between patients who had been classified according to clinical judgement as suffering from pathological embitterment. Correlations with related instruments demonstrated good convergent validity. Data obtained from a non-clinical sample indicated a prevalence of clinically relevant embitterment in the general population of about 2.5%. The PTED Scale is a reliable and valid measure for embitterment as an emotional reaction to a negative life event. Furthermore, results demonstrate that reactive embitterment in connection to a negative life event is a prevalent phenomenon among clinical and non-clinical populations.