Embitterment pp 255-273 | Cite as

Posttraumatic embitterment disorder, PTED

  • Michael Linden


It is generally accepted in clinical medicine that stressful life events can impair psychological and somatic functioning. It was shown that life events tend to occur to an extent greater than chance expectation before a variety of psychiatric disorders, including depression, schizophrenia, and anxiety disorders. The effect is moderate in magnitude but varies with the type of illness. In most of these cases life events are not a sufficient explanation for the development of the mental disorders but part in a complex multifactorial causative chain including genetics, other biological factors, personality, coping style, social experience, or environmental factors (Paykel 1974; Finlay-Jones and Brown 1981; Van der Kolk et al. 1994, 1996; Paykel 2001a,b).


Anxiety Disorder Stressful Life Event Posttraumatic Stress Disorder Negative Life Event Basic Belief 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Achberger M, Linden M, Benkert O (1999) Psychological distress and psychiatric disorders in primary health care patients in East and West Germany 1 year afer the fall of the Berlin wall. Soc Psychiatry Psychiatric Epidemiol 34:195–201CrossRefGoogle Scholar
  2. American Psychiatric Association (1994) Diagnostic and statistical manual of mental disorders, 4th edn. American Psychiatric Association, WashingtonGoogle Scholar
  3. Andreasen NC, Wasek P (1980) Adjustment disorders in adolescents. Arch Gen Psychiatry 37:1166–1170PubMedGoogle Scholar
  4. Baltes PB LONGINGGoogle Scholar
  5. Basoglu M, Mineka S, Paker M, Aker T, Livanou M, Gok S (1997) Psychological preparedness for trauma as a protective factor in survivors of torture. Psychol Med 27:1421–1433PubMedCrossRefGoogle Scholar
  6. Beck AT, Rush AJ, Shaw B, Emery G (1979) Cognitive therapy of depression. Guilford, New YorkGoogle Scholar
  7. Blanchard EB, Hickling EJ, Buckley TC, Taylor AE, Vollmer A, Loos WR (1996) Psychophysiology of posttraumatic stress disorder related to motor vehicle accidents: replication and extension. JConsultClin Psychol 64:742–751Google Scholar
  8. Bolby J (1969) Attachment and loss. Attachment, vol 1. Basic Books, New YorkGoogle Scholar
  9. Bronisch T, Hecht H (1989) Validity of adjustment disorder: comparison with major depression. J Affect Disord 17:229–236PubMedCrossRefGoogle Scholar
  10. Bronisch T (1991) Adjustment reactions: a long-term prospective and retrospective follow-up of former patients in a crisis intervention ward. Acta Psychiatrica Scandinavica 84:86–93PubMedCrossRefGoogle Scholar
  11. Brown GW, Bifulco A, Harris TO (1987) Life events, vulnerability and onset of depression. Brit J Psychiatry 150:30–42CrossRefGoogle Scholar
  12. Brown GW, Harris TO (1989) (eds) Life Events and Illness. Guilford Press, LondonGoogle Scholar
  13. Casey P, Dorwick C, Wilkinson G (2001) Adjustment disorders: Fault line in the psychiatric glossary. Brit J Psychiatry 179:479–481CrossRefGoogle Scholar
  14. Collins Rl, Taylor SE, Skokan LA (1990) A better world or a shattered vision?: Changes in life perspectives following victimization. Soc Cogn 8:263–85CrossRefGoogle Scholar
  15. Creamer M, Burgess P, Pattison P (1992) Reaction to trauma: A cognitive processing model. J Abnorm Psychol 101:452–459PubMedCrossRefGoogle Scholar
  16. Davidson JRT, Foa EB, Blank AS, et al (1996) Posttraumatic stress disorder. In: TA Widiger, Frances AJ, Pincus HA, et al (eds) DSM-IV sourcebook, vol 2. American Psychiatric Press, Washington, pp 577–606Google Scholar
  17. Dehlinger E, Ortmann K (1992) Zufriedenheit mit dem Gesundheitsstatus in der Bundesrepublik Deutschland und der ehemaligen Deutschen Demokratischen Republik. Ein Vergleich. Gesundheitswesen 54:88–94Google Scholar
  18. Derogatis LR (1992) The Symptom Checklist-90-revised. NCS Assessments, MinneapolisGoogle Scholar
  19. Despland JN, Monod L, Ferrero F (1995) Clinical relevance of adjustment disorder in DSM-III-R and DSM-IV. Compr Psychiatry 36:454–460PubMedCrossRefGoogle Scholar
  20. Dobricki M, Maercker A (2010) (Posttraumatic) Embitterment Disorder: Critical evaluation of its stressor criterion and a proposed revised classification. Nordic J Psychiatry, in pressGoogle Scholar
  21. Dohrenwend BS, Dohrenwendt BP (1974) (eds) Stressful life events: Their nature and effects. John Wiley & Sons, New YorkGoogle Scholar
  22. Dyer KE, Dorahy MJ, Hamilton G, Corry M, Shannon M, MacSherry A, McRobert G, Elder R, McElhill B (2009) Anger, aggression, and self-harm in PTSD and complex PTSD. J Clin Psychol 65:1099–1114PubMedCrossRefGoogle Scholar
  23. Ehlers A, Maerker A, Boos A (2000) Posttraumatic stress disorder following political imprisonment: The role of mental defeat, alienation, and perceived permanent change. J Abnorm Psychol 109:45–55PubMedCrossRefGoogle Scholar
  24. Epstein S (1973) The self-concept revisited, or a theory of a theory. Am Psychol 28:404–416PubMedCrossRefGoogle Scholar
  25. Epstein S (1980) The self-concept: A review and the proposal of an integrated theory of personality. In: Staub E (ed) Personality: Basic issues and current research. Prentice-Hall, Engelwood CliffsGoogle Scholar
  26. Epstein S (1991) The self-concept, the traumatic neurosis, and the structure of personality. In: Ozer D, Healy JM, Steward AJ (eds) Perspectives on personality, vol 3. Jessica Kingsley, LondonGoogle Scholar
  27. Erikson E H (1968) Identity: Youth and crisis. Norten, New YorkGoogle Scholar
  28. Fabrega H, Mezzich JE, Mezzich AC (1987) Adjustment disorder as a marginal or transitional illness category in DSM-III. Arch Gen Psychiatry 44:567–572PubMedGoogle Scholar
  29. Fard F, Hudgens RW, Welner A (1979) Undiagnosed psychiatric illness in adolescents. A prospective and seven year follow-up. Arch Gen Psychiatry 35:279–281Google Scholar
  30. Filipp G (1995) Ein allgemeines Modell für die Analyse kritischer Lebensereignisse. In: Filipp G (ed) Kritische Lebensereignisse. Beltz, München, pp 3–52Google Scholar
  31. Finlay-Jones R, Brown GW (1981) Types of stressful life event and the onset of anxiety and depressive disorder. Psychol Med 11:803–815PubMedCrossRefGoogle Scholar
  32. Foa EB (2000) Psychosocial treatment of posttraumatic stress disorder. J Clin Psychiatry 61:43–8PubMedGoogle Scholar
  33. Forstmeier S, Maercker A (2007) Comparison of two diagnostic systems for complicated grief. J Affect Dis 99:203–211PubMedCrossRefGoogle Scholar
  34. Foster P, Oxman T (1994) A descriptive study of adjustment disorder diagnoses in general hospital patients. Irish J Psychol Med 11:153–157Google Scholar
  35. Fullerton CS, McCarroll JE, Ursano RJ, Wright KM (1992) Psychological response of rescue workers: firefighters and trauma. Am J Orthopsychiatry 62:371–378PubMedCrossRefGoogle Scholar
  36. Golub Y, Mauch CP, Dahlhoff M, Wotjak CT (2009) Consequences of extinction training on associated and non-associated fear in mouse model of Posttraumatic Stress Disorer (PTSD). Behav Brain Res, Aug 222, Epub ahead of printGoogle Scholar
  37. Greenberg WM, Rosenfeld DN, Ortega EA (1995) Adjustment disorder as an admission diagnosis. Am J Psychiatry 152:459–461PubMedGoogle Scholar
  38. Hillen T, Schaub R, Hiestermann A, Kirschner W, Robra BP (2000) Self rating of health is associated with stressful life events,social support and residency in East and West Berlin shortly after the fall of the wall. J Epidemiol Communal Health 54:575–580CrossRefGoogle Scholar
  39. Horowitz MJ, Wilner N, Alvarez W (1979) Impact of Event Scale: A measure of subjective stress. Psychosomat Med 41:209–218Google Scholar
  40. Janoff-Bulman R (1985) The afermath of victimization: Rebuilding shattered assumptions. In: Figley (ed) Trauma and its wake, vol 1. Bruner/Mazel, New YorkGoogle Scholar
  41. Janoff-Bulman R (1989) Assumptive world and the stress of traumatic events: Applications of the schema construct. Soc Cogn 7:113–136CrossRefGoogle Scholar
  42. Janoff-Bulman R (1990) Understanding people in terms of their assumptive worlds. In: Ozer D, Healy JM, Steward AJ (eds) Perspectives on personality: Self and emotion. JAI, GreenwichGoogle Scholar
  43. Janoff-Bulman R (1992) Shattered assumptions: Towards a new psychology of trauma. Free Press, New YorkGoogle Scholar
  44. Janoff-Bulman R (1998) From terror to appreciation: Confronting chance afer extreme misfortune. Psychol Inquiry 9:99–101CrossRefGoogle Scholar
  45. Janoff-Bulman R, Frieze IH (1983) A theoretical perspective for understanding reactions to victimization. J Soc Issues 39:1–17CrossRefGoogle Scholar
  46. Jones R, Yates W R, Williams S, Zhou M, Hardman L (1999) Outcome for adjustment disorder with depressed mood: comparison with other mood disorders. J Affect Disord 55:55–61PubMedCrossRefGoogle Scholar
  47. Kelley GA (1955) The psychology of personal constructs. Norton, New YorkGoogle Scholar
  48. Kjaer Fuglsang A, Moergeli H, Hepp-Beg S, Schnyder U (2001) Who develops acute stress disorder afer accident injuries? Psychotherapy Psychosomat 71:214–222Google Scholar
  49. Kotter-Grühn D, Scheibe S, Blanchard-Fields F, Baltes PB (2009) Developmental emergence and functionality of Sehnsucht (life longings): The sample case of involuntary childlessness in middle-aged women. Psychol Aging 24:634–44PubMedCrossRefGoogle Scholar
  50. Kulka RA, Schlenger WE, Fairbank JA, Hough RL, Jordan BK, Marmar CR, Weiss DS (1990) Trauma and the Vietnam War generation. Report of findings from the national Vietnam veterans readjustment study. Brunner, New YorkGoogle Scholar
  51. Lazarus RS (1966) Psychological stress and the coping process. McGraw-Hill, New YorkGoogle Scholar
  52. Linden M (2003) The Posttraumatic Embitterment Disorder. Psychotherapy and Psychosomat 72:195–202CrossRefGoogle Scholar
  53. Linden M, Rotter M, Baumann K, Lieberei B (2007) Posttraumatic Embitterment Disorder. Hogrefe & Huber, TorontoGoogle Scholar
  54. Linden M, Baumann K, Rotter M, Lieberei B (2008) Diagnostic Criteria and the Standardized Diagnostic Interview for Posttraumatic Embitterment Disorder (PTED). Int J Psychiatry Clin Pract 12:93–96CrossRefGoogle Scholar
  55. Madianos MG, Papaghelis M, Ioannovich J, Dafni R (2001) Psychiatric disorders in burn-patients: a follow up study. Psychotherapy Psychosomat 70:30–37CrossRefGoogle Scholar
  56. Maercker A, Schützwohl M (1998) Erfassung von psychischen Belastungsfolgen: Die Impact of Event Skala — revidierte Version (IES-R). Diagnostica 44:130–141Google Scholar
  57. Maerker A (ed) (2003) Therapie der posttraumatischen Belastungsstörungen. Springer, BerlinGoogle Scholar
  58. Maercker A, Einsle F, Kollner V (2007) Adjustment disorders as stress response syndromes: a new diagnostic concept and its exploration in a medical sample. Psychopathology 40:135–146PubMedCrossRefGoogle Scholar
  59. Marris P (1975) Loss and change. Anchor/Doubleday, Garden CityGoogle Scholar
  60. Marshall RD, Spitzer R, Liebowitz MR (1999) Review and critique of the new DSM-IV diagnosis of acute stress disorder. Am J Psychiatry 156:1677–1685PubMedGoogle Scholar
  61. McFarlane AC (1992) Avoidance and intrusion in posttraumatic stress disorder. J Nerv Ment Dis 180:439–445PubMedCrossRefGoogle Scholar
  62. Monroe SM, Simons AD (1991) Diathesis-stress theories in the context of life stress research: Implications for the depressive disorders. Psychol Bull 110:406–425PubMedCrossRefGoogle Scholar
  63. Orth U Cahill SP, Foa EB, Maercker A (2008) J Consult Clin Psychol 76 208–218PubMedCrossRefGoogle Scholar
  64. Parkes CM (1975) What becomes of redundant world models? A contribution to the study of adaptation to change. Brit J Med Psychol 48:131–137PubMedGoogle Scholar
  65. Paykel ES (1974) Life stress and psychiatric disorder: Applications of the clinical approach. In: Dohrenwend BS, Dohrenwend BP (eds) Life events: Their nature and effects. John Wiley & Sons, New York, pp 135–150Google Scholar
  66. Paykel ES (2001a) Stress and affective disorders in humans. Sem Clin Neuropsychiatry 6:4–11CrossRefGoogle Scholar
  67. Paykel ES (2001b) The evolution of live events research in psychiatry. J Affect Disorders 62:141–149PubMedCrossRefGoogle Scholar
  68. Paykel ES (2003) Life events: effects and genesis. Psychol Med 33:1145–1148PubMedCrossRefGoogle Scholar
  69. Popkin MK, Callies AL, Colón EA, Eduardo M, Stiebel L (1990) Adjustment disorders in medically ill patients referred for consultation in a university hospital. Psychosomatics 31:410–414PubMedGoogle Scholar
  70. Pollock D (1992) Structured ambiguity and the definition of psychiatric illness: adjustment disorder among medical inpatients. Soc Sci Med 35:25–35PubMedCrossRefGoogle Scholar
  71. Schnyder U, Buchi S, Sensky T, Klaghofer R (2000) Antonovsky’s sense of coherence: trait or state? Psychotherapy Psychosomat 69:296–302CrossRefGoogle Scholar
  72. Schützwohl M, Maerker A (2000) Anger in former East German political prisoners: relationship to posttraumatic stress-reactions and social support. J Nerv Ment Dis 188:483–489PubMedCrossRefGoogle Scholar
  73. Schwartzberg SS, Janoff-Bulman R (1991) Grief and the search for meaning: Exploring the assumptive worlds of bereaved college students. J Soc Clin Psychol 10:270–288CrossRefGoogle Scholar
  74. Schwarzer R, Jerusalem M (eds) (1994) Gesellschaflicher Umbruch als kritisches Lebensereignis. Psychosoziale Krisenbewältigung von Übersiedlern und Ostdeutschen. Juventa Verlag, WeinheimGoogle Scholar
  75. Schwarzer R, Schulz U (2002) The role of stressful life events. In: Nezu AM, Nezu CM, Geller PA (eds) Comprehensive handbook of psychology. Health psychology, vol 9. Wiley, New YorkGoogle Scholar
  76. Shalev AY (2009) Posttraumatic Stress disorder and stress-related disorders. Psychiatr Clin North Am 32:687–704PubMedCrossRefGoogle Scholar
  77. Smith EE, Bem DJ, Nolen-Hoeksema S (2001) Fundamentals of Psychology. Harcourt College Publishers, OrlandoGoogle Scholar
  78. Snyder S, Strain JJ, Wolf D (1990) Differentiating major depression from adjustment disorder with depressed mood in the medical setting. Gen Hosp Psychiatry 12:159–165PubMedCrossRefGoogle Scholar
  79. Strain JJ, Newcorn J, Fulop G, Sokolyanskaya M (1999) Adjustment disorder. In: Hales RE Yudofsky SC, Talbott JA (eds) Textbook of psychiatry, third edition. American Psychiatric Press, Washington, pp 759–771Google Scholar
  80. Staudinger UM, Freund AM, Linden M, Maas I (1999) Self, personality, and life regulation: Facets of psychological resilience in old age. In: Baltes PB, Mayer KU (eds) The Berlin Aging Study. Aging from 70 to 100. Cambridge University Press, Cambridge, pp 302–328Google Scholar
  81. Steil R, Ehlers A (2000) Dysfunctional meaning of posttraumatic intrusions in chronic PTSD. Behav Res Therapy 38:537–558CrossRefGoogle Scholar
  82. Taylor SE (1983) Adjustment to threatening events: A theory of cognitive adaptation. Am Psychol 38:1161–1173CrossRefGoogle Scholar
  83. Timko C, Janoff-Bulman R (1985) Attributions, vulnerability, and psychological adjustment: the case of breast cancer. Health Psychol 4:521–544PubMedCrossRefGoogle Scholar
  84. Van der Kolk BA, Herron N, Hostetler A (1994) The history of trauma in psychiatry. Psychiatric Clin N Am 17:583–600Google Scholar
  85. Van der Kolk BA, McFarlane AC, Weisaeth L (1996) (eds) Traumatic stress. Guilford, New YorkGoogle Scholar
  86. Winkler G (2002) Sozialreport. SozialwissenschaflichenForschungszentrums Berlin Brandenburg, BerlinGoogle Scholar
  87. Wittchen HU, Müller N, Pfister H, Winter S, Schmidtkunz B (1999): Affektive, Somatisierungs-und Angsterkrankungen in Deutschland. Gesundheitswesen 61:216–222Google Scholar
  88. World Health Organization (ed) (1992) International statistical classification of diseases and related health problems, 10th Rev. WHO, GenevaGoogle Scholar
  89. Znoj H-J (2009) Manual. Berner Verbitterungs-Inventar (BVI). Hogrefe, GöttingenGoogle Scholar

Copyright information

© Springer-Verlag Wien 2011

Authors and Affiliations

  • Michael Linden
    • 1
  1. 1.Research Group Psychosomatic RehabilitationRehabilitation Center Seehof LichterfelderTeltowGermany

Personalised recommendations