(Post-traumatic) embitterment disorder: critical evaluation of its stressor criterion and a proposed revised classification.
BACKGROUND
In 2003, the German psychiatrist Michael Linden proposed the new mental disorder concept of "post-traumatic embitterment disorder (PTED)". PTED is defined as the mental reaction to a critical event that is normal, but not everyday, such as conflict at work. The patient sees this event as unjust and as a violation of basic beliefs. The principal aspect of the reaction pattern is a prolonged feeling of embitterment.


OBJECTIVE
In the present paper, the concept of PTED is systematically evaluated. Moreover, future developments in terms of diagnostic systems of mental disorders (ICD-11, DSM-V) are addressed.


RESULTS
The evaluation of critical points concerning PTED revealed that the question of whether PTED is a mental disorder of the post-traumatic type cannot be finally answered. It is not possible to specify an empirical criterion by means of which traumatic and non-traumatic life events can be differentiated. An empirical criterion for determining the traumatic nature of a given event depends on whether this event has already been classified as traumatic (i.e. circular argument).


CONCLUSIONS
For the purpose of a clear classification of embitterment disorders, the new concept of adjustment disorders of Andreas Maercker and co-workers is introduced. Based on the criteria and their findings, the best and most viable possibility to classify embitterment disorders in accordance with the current adjustment disorder and post-traumatic stress disorder definitions of ICD and DSM is by regarding embitterment disorders as a subtype of adjustment disorders.
Dobricki
Martin
M
Department of Psychopathology and Clinical Intervention, University of Zurich, Switzerland. dobricki@hispeed.ch
Maercker
Andreas
A
D000275:Adjustment Disorders / Q000145:classification* / Q000175:diagnosis*; D000328:Adult; D003220:Conflict, Psychological; D003469:Culture; D003866:Depressive Disorder / Q000145:classification / Q000175:diagnosis; D003937:Diagnosis, Differential; D039721:Diagnostic and Statistical Manual of Mental Disorders; D019263:Dysthymic Disorder / Q000145:classification / Q000175:diagnosis; D005260:Female; D006801:Humans; D038801:International Classification of Diseases; D007398:Interpersonal Relations; D008016:Life Change Events; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012935:Social Justice; D013313:Stress Disorders, Post-Traumatic / Q000145:classification* / Q000175:diagnosis*; D040921:Stress Disorders, Traumatic / Q000145:classification / Q000175:diagnosis / Q000523:psychology