Posttraumatic Embitterment Disorder and Hwa-byung in the General Korean Population

Abstract

ObjectivePosttraumatic embitterment disorder (PTED) is characterized by states of “embitterment”, characteristically similar to “Hwa-byung”, which is a Korean culture-bound syndrome. The present study aimed to assess diagnostic relationships between PTED and Hwa-byung.MethodsA total of 290 participants completed our survey. PTED and Hwa-byung were diagnosed using a diagnostic interview and scale. Scales for depression, suicide ideation, and anger were used for evaluation. Fisher's exact tests and Mann-Whitney U tests were performed to evaluate diagnostic overlap between PTED and Hwa-byung, and associations of scale scores for depression, suicide ideation, and anger between the PTED, Hwa-byung, and non-diagnosed groups. Associations of these scales between the depressive and non-depressive groups, and suicidal and non-suicidal groups were also evaluated.ResultsAmong the participants, 1.7% of the sample fit the diagnostic criteria for PTED and 2.1% fit the criteria for Hwa-byung. No individual fit the criteria for both. Anger scores were significantly higher in the Hwa-byung group than in the non-diagnostic group. There were not any significant differences in anger scores between the PTED and non-diagnostic groups. Depression scores were significantly higher in the PTED than in the non-diagnostic groups. In contrast, no significant differences were observed between depression scores in the Hwa-byung and non-diagnostic groups.ConclusionThese results suggest that PTED may be a disorder category that is distinct from Hwa-byung.

Coping and rumination as mediators in the development of reactive embitterment in the general population.

“…It has been reported that embitterment is negatively related to self-reported well-being, life satisfaction, and future time perspective and positively related to loneliness, perceived stress, chronic strain, and external control beliefs (Kühn et al, 2018). It has also been associated with anxious attachment (Blom, van Middendorp, & Geenen, 2012); complicated grief (Yun, Huh, Han, Huh, & Chae, 2018); social support and meaning of life (Joe et al, 2017); and aggressive ideation and suicidal ideation (Kühn et al, 2018). Despite the various findings listed above, there has been little investigation of the relationship between embitterment and cognitive process such as rumination and coping strategies.…”

How Suppressed Anger Can Become an Illness: A Qualitative Systematic Review of the Experiences and Perspectives of Hwabyung Patients in Korea

“…A recent study (71) also found that Hwabyung patients (n = 58) scored significantly higher for depression, anger, hostility, and aggression than patients with clinical depression (n = 180). Another study (72) reported slightly different results, but this inconsistency may be due to small samples of Hwabyung group; the mean scores of STAXI were significantly higher in Hwabyung group (n = 6) than in the non-Hwabyung group (n = 283), 52.83 points vs. 39.8 points, but there was no significant difference in depression scores between the two groups.…”

Anger attacks and «anger disorders»: clinical relevance, problem of classification, comorbidity and therapy (review)

“…PTED было предло жено в качестве новой концепции для подгруппы расстройств адаптации (F43.2), а его частота оце нивается на уровне 2-3 % населения при средней продолжительность более 6 месяцев [39]. Пред ложенное в рамках PTED понятие «озлобление» очень похоже на основную психопатологическую концепцию HB, но патогенез этих расстройств представляется разным [31].…”