Post-traumatic embitterment disorder

Post-traumatic embitterment disorder (PTED) is defined as a pathological reaction to a negative life event, which those affected experienced as a grave insult, humiliation, betrayal, or injustice. Prevalent emotions of PTED are embitterment, anger, fury, and hatred, especially against the triggering stressor, often accompanied by fantasies of revenge. The disorder commences immediately and without time delay at the moment of the triggering event. If left untreated, the prognosis of PTED presents as rather unfavorable, with those who have the disorder trapped in a vicious circle of strong negative emotions constantly intensifying one another and eventually leading into a self-destructive downward spiral. People affected by PTED are more likely to put fantasies of revenge into action, making them a serious threat to the stressor.

The concept of PTED as a distinct clinical disorder has been first described by the German psychiatrist and psychologist Michael Linden in 2003,^[1] who remains its most involved researcher. Even though it has been backed up by empirical research in the past years, it remains disputed as to whether embitterment should be included among psychological disorders.^{[2][3][4][5][6][7][8]} Therefore, PTED currently does not hold its own category in the ICD-10 but is categorized under F43.8 “Other reactions to severe stress”. It cannot be categorized as an adjustment disorder under F43.2, since “ordinary” adjustment disorders normally subside within six months, while PTED is much more likely to become chronic. A condition similar to PTED has already been described by Emil Kraepelin as early as 1915 by the name querulous paranoia as a form of traumatic neuroses, explicitly demarcating it from personality disorders.^[9]