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Embitterment 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...
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The Patient Health Questionnaire (PHQ-9) is a self-report questionnaire commonly used to screen for depression, with ≥8-11 generally recommended as the cut-off. In Japan, studies of the validity of the PHQ-9 and PHQ-2 have been limited. In this study, we examined the utility of the PHQ-9 and PHQ-2 at an outpatient clinic in a Medical University Hos...
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... According to data from the Prosecutor-General's Office (Yonhap News, 2017b), approximately 54 cases of "Don't Ask" crimes were committed in the 2012-2016 period. Combined with the enduring stigma towards mental illness and therapy in Korea (Choi & Doh, 2019;Kim & Yon, 2019), scholars have identified the rise of an "Embitterment Society" with widespread Post-Traumatic Embitterment Disorders (PTED) (Shin et al., 2012). According to a survey by the Center for Happiness Studies, Seoul National University, approximately 54% of respondents (N = 2,000) showed symptoms of severe or dangerous levels of embitterment. ...
Politics around the world has become polarized over values and perceptions of equality and fairness. How are values and subjective socioeconomic status related to happiness? This paper uses national survey data of 15,148 Korean adults to see how an individual’s emphasis on social values, such as freedom, rule of order, social responsibility for individual wellbeing, and equality are related to happiness. We also explore whether and how subjective socioeconomic status affects this relationship. Lastly, the paper will explore how an individual’s evaluations of various aspects of the local community (human capital, economy, social, environment, infrastructure, local services) shape happiness. Path analysis results show that an individual’s emphasis on freedom, order, and social responsibility for individual wellbeing have a positive relationship with happiness, but not equality. Having a low subjective socioeconomic status dampens the positive effect of freedom and order on happiness, but does not matter for the effects of social responsibility and equality on happiness. In terms of community evaluations, economic factors had the largest positive effect on happiness. Overall, low subjective socioeconomic status, freedom, and order were the strongest predictors of happiness. Social values and subjective socioeconomic status matter for happiness.
... A scale developed byLinden et al. (2009) and standardized for Koreans byShin et al. (2012) was used to measure embitterment. The scale consists of 19 items, and evaluates psychological state, social functions, emotional reaction to events, and revenge ideation. ...
... Each item was rated on a 5-point Likert scale. Cronbach's α of all items was 0.96 in the study byShin et al. (2012) and 0.96 in the current study. ...
This study examined the moderated mediation effect of heightened vigilance and Korean culture acceptance attitude on the relationship between microaggressions and embitterment in multicultural young adults aged 25 to 34 in South Korea. A total of 329 multicultural young adults aged 25 to 34 living in South Korea were surveyed. All participants had acquired Korean nationality, even if one of their parents was a non-Korean. First, a significant correlation was found between microaggressions and heightened vigilance, embitterment, and Korean culture acceptance attitude. Second, heightened vigilance partially mediated the relationship between microaggressions and embitterment. Third, Korean culture acceptance attitude moderated the relationship between heightened vigilance and embitterment. Fourth, heightened vigilance and Korean culture acceptance attitude had a moderated mediation effect on the relationship between microaggressions and embitterment. The present study is meaningful in that it examined the mechanisms of discrimination and psychological maladjustment among multicultural young adults and explored the factors that can be overcome in the context of the increasing immigrant population in Korea.
... The internal consistency of the Korean version of the PTEDS, represented by the Cronbach α, was 0.962. 26 We considered PTED to be present in individuals displaying a mean score of ≥1.6 on the PTEDS (PTED(+)). Participants who did not display PTED comprised the control group (PTED(-)). ...
... Symptom scales based on self-report measures of major psychiatric disorders were used to examine symptoms of depression, anxiety, PTSD, and insomnia, allowing us to infer the extent of participants' symptoms, but a limitation is that clinician diagnoses were not investigated. Despite the fact that several studies on Korean population [11][12][13][14]26 consider a PTEDS score of 1.6 or higher as significant embitterment symptoms and 2.5 or higher as moderate to severe embitterment symptoms following the result from Linden et al. ' s study, 25 a cutoff score according to symptoms severity of PTEDS has not been defined in Korean population. This limits the reliability of the cutoff points. ...
Objective 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.Methods 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.Results 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.Conclusion 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.
... Meanwhile, a considerably high prevalence of embitterment in the public has been reported in cross-sectional studies in South Korea (J. Shin & You, 2022;C. Shin et al., 2012;You & Ju, 2020). Specifically, more than half (54.6%) of the lay population were in a significant state of embitterment (PTED mean ≥1.6), including 14.7% who were experiencing a clinically relevant state of embitterment (PTED mean ≥2.5; You & Ju, 2020). A substantial number of young adults (45.2%) were reported to be experiencing a clini ...
... Respondents' embitterment was assessed using the Korean version of the posttraumatic embitterment disorder (PTED) self-rating scale, which is a reliable and valid measure for screening and assessing the severity of reactive and event-related embitterment (Linden et al., 2009;C. Shin et al., 2012). Originally introduced as a "pathological reaction to a negative life event" (i.e., PTED), subsequent investigations of embitterment among general populations resulted in the development and use of the PTED Self-Rating Scale (Linden et al., 2009). The PTED scale consists of 19 items asking how often individuals experienced extremely str ...
... Cronbach's α [Wave 2] = .97). Test-retest was carried out with reference to C. Shin et al. (2012) who performed the standardization of the Korean version of the PTED self-rating scale. Pearson's correlation coefficient was .62 for the sum score, with a range of .40-.52 for individual items. ...
Objective: To examine the prevalence of embitterment by following individuals over time and to statistically evaluate how factors known as correlates of embitterment affect different groups with or without changes in embitterment over time. Method: Responses for the posttraumatic embitterment disorder (PTED) self-rating Scale were collected from the same 1,153 adults who participated in a follow-up survey delivered 14 months apart. Suggested cutoff points were applied to identify changes in embitterment and four groups were identified. For each group, the relative impacts of factors that affect changes in or maintenance of embitterment, such as negative life events (NLEs), belief in a just world (BJW), social support, relative deprivation, and resilience, were statistically analyzed. Results: The average PTED scores were relatively high for both surveys (M = 1.73 and 1.58, respectively). “Persistent” or “increased” in embitterment was seen for 47.3% of the participants. In particular, 15.3% (Wave 1) and 12.1% (Wave 2) of participants experienced clinically relevant levels of embitterment. NLEs, BJW, relative deprivation, and resilience showed significant associations with the risk of persistence or deterioration of embitterment. Conclusions: Our study highlights embitterment as a dynamic emotion that can either be aggravated or moderated over time. Embitterment can be elicited by joint effects of multiple social and interactional factors including known embitterment correlates, and relative deprivation is confirmed as a possible core elicitor of embitterment in the context of comparative justice. These findings imply that additional longitudinal research and development of practices for mental health prevention in general populations are needed.
... Thus, embitterment seems to be caused by injustice and degradation experienced by both individuals and society (Pirhačova, 1997;Shin et al., 2012). ...
Embitterment is an emotion that can be triggered on an individual and a societal level. It is a reactive emotion , comparable to fear, as a result of a negative life event characterized by grievance and experience of injustice. Often core basic beliefs and values are hurt, and negative evaluations arise when thinking about the event or conditions. Entire populations can also be seized with embitterment as a result of experiences of injustice, belittlement and resentment, by other groups or entire countries. Examples can be seen after past episodes of war, conflict and the shattering of identity, resources and life values. Against this background, the question arises whether and to what extent embitterment can be induced by negatively toned information of historical events. The experimental study conducted here investigates whether a short negatively colored historical report concerning the Franco-German or the German-German relationship is able to induce embitterment. Participants (N 1 =206, N 2 =257) were randomly assigned to receive a neutral (control group) or a negatively framed (experimental group) information text on the countries' relationship in past decades. Levels of em-bitterment reaction were assessed using a version of the PTED scale adjusted to the historical relationship. Increased levels of embitterment could not be evoked by the short negatively colored text. However, preconceived attitudes about the neighboring country (Is the country a good or bad partner?) and self-transcen-dence contributed significantly to variance explanation of the embitterment response. Age, gender, education level, place of residence, or hometown did not contribute to embitterment explanation. The data show that social and political experiences and attitudes may be associated with embitterment, but are not modifiable by short-term information.
... This test reveals that reactive embitterment is pervasive among psychiatric inpatients, with about 56% demonstrating clinically relevant embitterment compared to only 2.5% of the general population (Linden et al., 2009). The PTED scale was validated in different cultures (Shin et al., 2012;Ünal, Güney, Kartalcı, & Reyhani, 2011) and was used among woman victims of February 28 post-modern coup of Turkey after two decades, young people, CKD inpatients, and so on (Görmez, Yeni, & Karatepe, 2020;Lee, Song, Choi, Pae, & Kim, 2019). Embitterment may result in many of the same serious outcomes as depression and anxiety, so it is essential to screen for PTED as part of routine psychiatric evaluations. ...
Embitterment and in some cases also post‐traumatic embitterment disorder (PTED) is a relevant problem in the general population an 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 non‐psychiatric inpatients, reporting major negative life events, were recruited through convenience sampling to evaluate test performance. Ninety patients were selected for retest two weeks 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.
... The degree of feeling embitterment was measured using the post-traumatic embitterment disorder (PTED) scale developed by Linden et al. (2009). This measure has 19 items and was translated into Korean (Shin et al., 2012). Here we used the Korean version, which begins with the introduction, "The following are incidents that cause severe stress, which may or may not have occurred during the past year. ...
The media correlation function has mainly been evaluated in cognitive domains from theoretical perspectives, such as agenda-setting, framing, or priming. Here we examined the correlation function in an emotional domain by investigating the association between media use and the degree of embitterment, which is a psychological symptom that originates from the accumulation of negative life experiences. A survey of 1,720 South Koreans revealed that those who had higher frequencies of media use felt a greater degree of embitterment. When different media types were examined, frequent use of print newspapers was associated with a level of embitterment from personal experiences, whereas heavy consumption of the internet and TV news was associated with embitterment from mediated reality. The implications of these findings are addressed in the context of both communication function and social epidemiology.
... It has a good construct validity as well [15,16]. There is a scale known as the Bern Embitterment Inventory, which is in German and English, but has been used far more sparingly compared to the PTED self-rating scale [21]. ...
Embitterment is a construct that is vast and complex and may be seen in a variety of conditions and circumstances. The following paper reviews the construct of embitterment and tries to explain the concept from a psychological perspective. It also looks at the role of embitterment in the genesis of psychiatric disorders like depression, anxiety, and PTSD, while focusing on the nature and factors needed to make a diagnosis of Posttraumatic Embitterment Disorder. Situations due to the current pandemic where embitterment may develop are discussed and this is coupled with a need to manage embitterment when it develops, as it may progress to a chronic condition where its effects may be both physical and psychological. Embitterment and its management from a psychotherapy standpoint is also discussed and the same is done from a workplace perspective.
... To measure the level of embitterment, two types of post-traumatic embitterment disorder (PTED) scales were utilized (Linden et al., 2009;Znoj, 2008). The first, by Linden et al. (2008), was the Post-Traumatic Embitterment Disorder Self-Rating Scale, which was translated into Korean (Shin et al., 2012). The measure started with an introduction: "The following are incidents that cause severe stress, which may or may not have occurred during the past year. ...
... This state of mind has been described unter the heading of "posttraumatic embitterment disorder". [4][5][6][7][8] Previous studies suggest that hemodialysis patients suffer to an increased rate from depression, anxiety, or psychological impairment in general and that this is associated with a higher risk of morbidity and mortality. [9][10][11] Embitterment has so far not been taken into account, although the clinical impression is that this may be of relevance. ...
... We have used the Korean version of PTED scale which had been reported to stable and reliable. 4) Score greater than 30 is to suspect PTED and therefore we have used the cut-off score of 30. ...
... The Patient Health Questionnaire-9 (PHQ-9) PHQ-9 is a 9-item screening questionnaire asking for symptoms of depression in various clinical population which has also been validated and commonly used in clinical practice in Korea. 4,[13][14][15][16][17][18][19] As each item is rated on a scale from 0 to 3, the total score ranges from 0 to 27. ...
Objective:
Posttraumatic embitterment disorder (PTED), a subgroup of an adjustment disorder, is a feeling with anger and helplessness. Hemodialysis may be a trigger event leading to PTED. We investigated the prevalence of PTED in patients with each categorized stages of chronic kidney disease (CKD) and the association between PTED and depression and functional impairment.
Methods:
Patients were categorized into three groups according to the stages of CKD (stage I-II, III-IV, and V). CKD (I-II) group was defined as estimated glomerular filtration rate (eGFR) ＞60 ml/min/1.73 m2, CKD (III-IV) group as eGFR ＜60 ml/min/1.73 m2, and CKD (V) group as CKD stage V including patients ongoing hemodialysis. Patients were assessed for the prevalence of PTED, depression, and decreased quality of life by using the scale of PTED, Patient Health Questionnaire-9 (PHQ-9), and EuroQol Five Dimensional Questionnaires, Visual Analogue Scale (EQ-5D-VAS), respectively.
Results:
A total of 445 patients were analyzed. The number of patients in CKD (I-II) was 166, CKD (III-IV) was 172, and CKD (V) was 107. Multivariate analysis by binomial logistic regression demonstrated that CKD (V) was significantly associated with the prevalence of PTED (odds ratio, 4.13; 95% confidence interval, 1.56-15.6; p =0.006) after adjustment for age, gender, and diabetes mellitus. Also, a significant correlation existed between PTED and EQ-5D-VAS in all stages, but the correlation was nonsignificant between PTED and PHQ-9 score in group CKD (V).
Conclusion:
The findings suggest that PTED is underdiagnosed in CKD patients. Acknowledgment and diagnosis of PTED in CKD patients may lead to a better quality of life.
