Valdes-Stauber Juan, Kämmerle Helen, Bachthaler Susanne
Zentrum für Psychiatrie Südwürttemberg, Klinik für Psychiatrie und Psychotherapie I, Universität Ulm.
Fakultät für angewandte Psychologie, SRH Hochschule Heidelberg.
Psychother Psychosom Med Psychol. 2015 Dec;65(12):467-75. doi: 10.1055/s-0035-1565087. Epub 2015 Dec 1.
Understanding of bitterness ranges from a negative general human emotion to a destructive complex affekt due to a non adequate processed affront or resentment.
Relevant associations between kinds of bitterness and clinical as well as personality-related variables in hospitalized psychosomatic patients were examined.
Prospective naturalistic study over 14 months of consecutive admitted psychosomatic patients without exclusion criteria (N=166). General bitterness and 4 subscales were investigated on the basis of the Berner Verbitterungs-Inventar (BVI), personality traits on the basis of BFI-10, and clinical variables mainly on the basis of validated instruments (HoNOS, BDI, HADS, GAF, CGI, IIP-D, BSCL, comorbidity, duration of illness and structure as well as conflict-load according to OPD-2). Differences among levels of bitterness were examined with ANOVA tests, relationships between bitterness and clinical as well as personality-related variables using multivariate linear and multinomial regression models.
The general bitterness falls within the average range. ANOVA models show higher scores for neuroticism, IIP, BDI, HADS, and BSCL when bitterness is above-average. In multivariate regression analyses, BDI, BSCL and neuroticism are positively associated with bitterness, whereas GAF, illness duration, and conscientiousness are negatively associated with bitterness. Diagnoses, severity of disease and burden of conflicts as well as level of organization of personality are not associated with bitterness. Models explain 11-39% of variance of bitterness.
Bitterness in psychosomatic patients is hardly associated with personality variables, diagnoses, and psychopathological burden with the exception of depressiveness and neuroticism. Burden of interpersonal concerns may better explain bitterness than psychopathology or personality.
Bitterness could be interpreted as a theoretical construct widely independent from severity of disease, personality, and diagnosis, showing importance in clinical practice.
对痛苦的理解范围从一种负面的普遍人类情绪到由于未充分处理的冒犯或怨恨而产生的具有破坏性的复杂情感。
研究住院心身疾病患者中不同类型的痛苦与临床及人格相关变量之间的相关联系。
对连续收治的14个月内无排除标准的心身疾病患者（N = 166）进行前瞻性自然主义研究。基于伯尔尼痛苦量表（BVI）调查总体痛苦及4个分量表，基于大五人格量表简版（BFI - 10）调查人格特质，主要基于经过验证的工具（健康与社会护理结果量表（HoNOS）、贝克抑郁量表（BDI）、医院焦虑抑郁量表（HADS）、总体功能评估（GAF）、临床总体印象量表（CGI）、人际问题量表 - 抑郁版（IIP - D）、简短症状清单（BSCL）、共病情况、病程以及根据门诊诊断量表 - 2（OPD - 2）的结构和冲突负荷）调查临床变量。使用方差分析检验痛苦水平之间的差异，使用多元线性和多项回归模型研究痛苦与临床及人格相关变量之间的关系。
总体痛苦处于平均范围。方差分析模型显示，当痛苦高于平均水平时，神经质、人际问题量表、贝克抑郁量表、医院焦虑抑郁量表和简短症状清单得分更高。在多元回归分析中，贝克抑郁量表、简短症状清单和神经质与痛苦呈正相关，而总体功能评估、病程和尽责性与痛苦呈负相关。诊断、疾病严重程度、冲突负担以及人格组织水平与痛苦无关。模型解释了痛苦变异的11% - 39%。
除了抑郁和神经质外，心身疾病患者的痛苦与人格变量、诊断和精神病理负担几乎没有关联。人际关注负担可能比精神病理学或人格更好地解释痛苦。
痛苦可被解释为一种在很大程度上独立于疾病严重程度、人格和诊断的理论结构，在临床实践中具有重要意义。
