Center for Lifespan Psychology, Max Planck Institute for Human Development.
Institute of Psychology, Humboldt-Universität zu Berlin.
Psychol Trauma. 2018 Jan;10(1):51-57. doi: 10.1037/tra0000287.
Posttraumatic embitterment disorder (PTED) comprises a stress-related response to a negative life event that violates the belief system of the individual. Characteristic symptoms involve repeated intrusive thoughts, emotional arousal when reminded of the event, and decreases in well-being.
Within the scope of the present study, embitterment was treated as a continuous rather than categorical concept, and we investigated its psychological and brain structural correlates in a sample of healthy older adults.
We found a negative association between the PTED self-rating score and self-reported well-being, life satisfaction, and future time perspective and a positive association with loneliness, perceived stress, chronic strain, and external control beliefs. We found no significant association between embitterment and brain regions that have been associated with stress exposure and posttraumatic stress disorder (PTSD)-hippocampus and the medial prefrontal cortex. This may emphasize the fundamental difference between PTED and PTSD. In a whole-brain analysis, we found a positive correlation between embitterment and gray matter volume in the precuneus and white matter volume in the bilateral uncinate fasciculus.
The precuneus and uncinate fasciculus are brain regions that have been related to episodic memory retrieval, matching well to the symptoms of intrusive thoughts and an overwhelming preoccupation with the event that caused the PTED. Further longitudinal research is needed to unravel whether these structural correlates represent preconditions or rather the consequence of embitterment. (PsycINFO Database Record
创伤后痛苦障碍（PTED）是一种与压力相关的反应，源于个体信仰系统受到负面生活事件的侵犯。其特征症状包括反复出现的侵入性思维、回忆事件时的情绪唤起，以及幸福感下降。
在本研究范围内，我们将痛苦视为一种连续而非分类的概念，并在健康老年人样本中研究了其与心理和大脑结构的相关性。
我们发现，PTED 自评得分与自我报告的幸福感、生活满意度和未来时间观呈负相关，与孤独感、感知压力、慢性压力和外部控制信念呈正相关。我们没有发现痛苦与与应激暴露和创伤后应激障碍（PTSD）相关的大脑区域（海马体和内侧前额叶皮质）之间存在显著关联。这可能强调了 PTED 与 PTSD 的根本区别。在全脑分析中，我们发现痛苦与后扣带回的灰质体积和双侧钩束的白质体积呈正相关。
后扣带回和钩束是与情景记忆检索相关的大脑区域，这与侵入性思维和对导致 PTED 的事件过度关注的症状非常吻合。需要进一步的纵向研究来阐明这些结构相关性是痛苦的前提条件还是后果。
