Structured ambiguity and the definition of psychiatric illness: Adjustment disorder among medical inpatients

Pollock, Donald

doi:10.1016/0277-9536(92)90116-8

Cited by 14 publications

(9 citation statements)

References 26 publications

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“…Although there is some literature on psychopathological reactions to stressful events [4,5,6,7], the diagnostic category of adjustment disorders has always been controversial [3]. Diagnostic criteria are vague and specify that no diagnosis of adjustment disorder should be made if the criteria for another disorder are met [3,8,9,10,11,12,13,14,15,16,17]. In summary, the diagnosis of adjustment disorders only has a subordinated status with no clear profile of its own [17].…”

Section: Introductionmentioning

confidence: 99%

Posttraumatic Embitterment Disorder in Comparison to Other Mental Disorders

Lindén

Baumann

Rotter

et al. 2007

Psychother Psychosom

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Background: The term ‘posttraumatic embitterment disorder’ (PTED) was recently introduced to describe a subtype of adjustment disorders, characterized by prolonged embitterment, severe additional psychopathological symptoms and great impairment in most areas of life in reaction to a severe negative but not life threatening life event. The aim of this study is an empirical description and validation of the clinical concept of PTED, by comparing clinically defined PTED patients with patients suffering from other mental disorders on measures of posttraumatic stress and psychopathological distress. Methods: Fifty inpatients, suffering from PTED according to previously defined clinical diagnostic criteria, were compared with another 50 patients, matched by age and gender, who did not meet clinical criteria for PTED but for other mental disorders. Psychiatric diagnoses were assessed by the Mini International Neuropsychiatric Interview. Self-report measures included the Bern Embitterment Scale, the Impact of Event Scale, the PTED Self-Rating Scale and the SCL-90. Results: According to the Mini International Neuropsychiatric Interview both groups fulfilled the criteria for many disorders with a significantly higher occurrence of major depression and chronic adjustment disorder but less generalized anxiety disorder lifetime in PTED patients. Patients with PTED scored significantly higher on the global scores and on most subdimensions of the SCL-90, the Impact of Event Scale, the Bern Embitterment Scale and the PTED Self-Rating Scale. Conclusions: Clear differences were found between PTED patients and patients with other mental disorders in regard to the quality and intensity of psychopathological as well as posttraumatic stress symptoms. PTED can help further subclassify and specify adjustment and reactive disorders.

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Section: Introductionmentioning

confidence: 99%

Posttraumatic Embitterment Disorder in Comparison to Other Mental Disorders

Lindén

Baumann

Rotter

et al. 2007

Psychother Psychosom

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“…Das ICD-10 [WHO, 1992] unterteilt diese reaktiven psychischen Störungen im Kapitel F 43 (Reaktionen auf schwere Belastungen und Anpassungsstörungen) in die Kategorien der akuten Belastungsreaktion (F 43.0), der posttraumatischen Belastungsstörung (F 43.1) und der Anpassungsstörungen (F 43.2) sowie im Kapitel F 6 (Persönlichkeits-und Verhaltensstörungen) der andauernden Persönlichkeitsänderung nach Extrembelastung (F 62.1). Es handelt sich zwar um häufige, aber dennoch um vergleichsweise unscharfe Kategorien, die zudem nur dann diagnostiziert werden sollen, wenn nicht die Kriterien für eine andere Achse-I-Störung gegeben sind, was sie zu einer diagnostischen Restkategorie macht [Fabrega et al, 1987;Bronisch und Hecht, 1989;Snyder et al, 1990;Pollock, 1992; Van der Kolk et al, 1994Amiel-Lebigre et al, 1995;Despland et al, 1995;Spurrell und McFarlane, 1995;Strain et al, 1998;O'Brien, 1998;Fischer und Riedesser, 1999;Simon, 2000;Paykel, 2001;Fava et al, 2001]. Einzig die posttraumatische Belastungsstörung (posttraumatic stress disorder, PTSD) ist in den vergangenen Jahren zu einer eigenständigen Kategorie geworden [Maercker, 1997;Fischer und Riedesser, 1999].…”

Section: Reaktive Posttraumatische Und Anpassungsstörungenunclassified

Weisheitstherapie – kognitive Therapie der posttraumatischen Verbitterungsstörung

Lindén

Schippan

Baumann³

2004

Verhaltenstherapie

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Adjustment and posttraumatic disorders are frequent, but except for the posttraumatic stress disorder (PTSD) only vaguely defined mental disorders. A new subcategory of posttraumatic disorders is the posttraumatic embitterment disorder (PTED). Violation of basic beliefs leads to chronic disorders characterized by intrusive thoughts, hyperarousal, mood impairment, phobia and especially embitterment and aggression. These disorders are difficult to treat because patients often reject and devaluate any help. Therapeutic Approach: This article describes how to treat such disorders by cognitive behavior therapy that focuses on overcoming the critical life event and building new perspectives. Methods applied are reframing, exposition, increase of activities and self efficacy. A new treatment approach is ‘Wisdom therapy’. Based on modern wisdom psychology, special interventions are described to enhance change of perspectives, distancing of oneself, empathy, acceptance of emotions, serenity, sense of humor, knowledge about facts, contextualism, value relativism, self relativization, uncertainty acceptance, long-term perspective, reevaluation of problems and goals.

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“…"Yeterince iyi anne", çocuğunun gereksinimlerini karşılayabilen ve büyüyen çocuğun yaşamdaki en gellenmeleri kaldırabilmesini yeterince destekleye bilen kişidir (Jennings 1993). Çocukluk çağındaki ruhsal bir zedelenme; boşanma, işle ilgili sorunlar, bedensel hastalıklar gibi zorlanmalarla karşılaşıldı ğında normal bir kişiyi, Uyum Bozukluğu geliştirme ye yatkın kılabilir denmektedir (Pollock 1992 Psikoanalitik yaklaşıma göre Uyum Bozukluğu'na yol açtığı düşünülen güncel zorlanmanın, ço cuklukta yaşanmış zedelenme ve düş kırıklıklarını uyandırarak etkili olması önemli bir olasılıktır, bu nedenle Uyum Bozukluğu olan kişiler, şimdiki ola yın geçmişteki zedeleyici olaylara benzer yanlarını araştırmaları için cesaretlendirilmelidirler (Kaplan ve ark 1994).…”

Section: Etyolojiunclassified

“…Uyum bozukluğu'nun ayırıcı tanısında düşünül mesi gereken başlıca bozukluklar şunlardır (Fabrega 1981;Pollock 1992 Ayırıcı tanıda düşünülen yukarıdaki bozukluklar içinde majör depresyonun önemi büyüktür. Uyum Bozukluğu'nun tanımsal ve prediktif geçerliliği ile il gili çalışmaların çoğu Uyum Bozukluğu'nun majör depresyonlu ve normal kontrollerle karşılaştırılma sına dayanmaktadır.…”

Section: Ayırıcı Tanıunclassified

Uyum bozukluğu

ÖZGÜVEN¹

1997

Kriz Dergisi

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Structured ambiguity and the definition of psychiatric illness: Adjustment disorder among medical inpatients

Cited by 14 publications

References 26 publications

Posttraumatic Embitterment Disorder in Comparison to Other Mental Disorders

Posttraumatic Embitterment Disorder in Comparison to Other Mental Disorders

Weisheitstherapie – kognitive Therapie der posttraumatischen Verbitterungsstörung

Uyum bozukluğu

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