Department of Psychosomatic Medicine, Charité University Medicine Berlin, Berlin, Germany.
Int Rev Psychiatry. 2020 Aug-Sep;32(5-6):396-402. doi: 10.1080/09540261.2020.1747410. Epub 2020 May 19.
Injustice, breach of trust, and humiliation are social stressors which can result in embitterment, known to everybody and which has been described in the Bible (Cain and Abel) or by Aristotle in the Nicomachean Ethics. It has been discussed by several authors since the early days of psychiatric classification. In the textbook 'Psychiatry' by E. Kraepelin a full chapter is devoted to 'querulant delusion', named a reactive psychosis, which can be discriminated from endogenous psychosis or personality disorders. Core symptoms are embitterment, negativism, helplessness, self blame, unspecific somatic symptoms, phobic avoidance of persons or situations related to the event, intrusions, phantasies of revenge and aggression. Another name is 'Posttraumatic Embitterment Disorder' according to the leading emotion. This severe mental disorder has by and large been ignored over the years by health professionals. In ICD-11 the term embitterment is mentioned for the first time in the category '6B43 adjustment disorder'. Embitterment can be measured with the 'Bern Embitterment Inventory (BVI)' and the 'Post-Traumatic Embitterment Self-rating Scale (PTED scale)'. Treatment must take into account the special features of embitterment including often aggressive rejection of help. A promising treatment approach is, to refer to wisdom psychology and transfer this in 'wisdom psychotherapy'.
不公正、失信和羞辱是社会压力源，可导致人们熟知的怨愤情绪，《圣经》（该隐和亚伯）或亚里士多德在《尼各马可伦理学》中都曾描述过这种情绪。自精神病学分类的早期以来，就有几位作者讨论过这种情绪。在 E. 克雷佩林的《精神病学》教科书中，有一整章专门论述“抱怨妄想”，即一种反应性精神病，可与内源性精神病或人格障碍区分开来。核心症状是怨愤、消极、无助、自责、非特异性躯体症状、对与事件相关的人或情境的恐惧回避、闯入、复仇和攻击幻想。根据主导情绪，另一个名称是“创伤后怨愤障碍”。多年来，这种严重的精神障碍基本上一直被卫生专业人员忽视。在 ICD-11 中，“怨愤”一词首次在“6B43 适应障碍”类别中提及。可以使用“伯尔尼怨愤量表（BVI）”和“创伤后怨愤自评量表（PTED 量表）”来测量怨愤。治疗必须考虑到怨愤的特殊特征，包括通常对帮助的攻击性拒绝。一种有前途的治疗方法是借鉴智慧心理学，并将其转化为“智慧心理疗法”。
