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. 2024 Feb;21(2):191-199.
doi: 10.30773/pi.2023.0299. Epub 2024 Feb 22.

Embitterment in Vietnam War Veterans Predicted by Symptoms of Posttraumatic Stress Disorder

Seung-Hoon Lee  1   2 , Changsu Han  1 , Junhyung Kim  1 , Hyun-Ghang Jeong  1 , Moon-Soo Lee  1   3 , Jin Hee Choi  2 , Hayun Choi  2
Affiliations

Embitterment in Vietnam War Veterans Predicted by Symptoms of Posttraumatic Stress Disorder

Seung-Hoon Lee et al. Psychiatry Investig. 2024 Feb.

Abstract

Objective: Research on the association between posttraumatic embitterment disorder (PTED) and other psychopathologies in veterans and adults aged ≥65 years is lacking. This study aimed to assess embitterment among elderly war veterans and its association with major psychopathological factors.

Methods: Participants included Vietnam War veterans who visited a psychiatric clinic. Based on the Posttraumatic Embitterment Disorder Self-Rating Scale (PTEDS) score, the participants were divided into the embitterment (PTED(+), mean score of PTEDS items [mPTEDS] ≥1.6) and non-embitterment (PTED(-), mPTEDS <1.6) groups. Demographic characteristics, combat exposure severity, depression, anxiety, sleep, and alcohol use disorder symptom scores of the participants were collected and compared between the PTED(+) and PTED(-) groups. A correlation analysis between symptom measure scores and the mPTEDS was conducted. The influence of psychopathology on embitterment was investigated using stepwise multiple linear regression analysis.

Results: In total, 60 participants (28 in PTED(+) and 32 in PTED(-)) were included. Among those in PTED(+), 21 (35.0%) showed mild embitterment symptoms (1.6≤ mPTEDS <2.5) and 7 (11.7%) reported moderate or severe embitterment symptoms (mPTEDS ≥2.5). The mean scores of posttraumatic stress disorder (PTSD), depression, and anxiety were significantly higher in the PTED(+) than in the PTED(-) group. The mPTEDS were significantly correlated with PTSD, depression, anxiety, and sleep disorder scores. The PTSD symptoms significantly explained the higher mPTEDS score in a regression model.

Conclusion: Embitterment symptoms were associated with PTSD, depression, anxiety, and insomnia symptoms in elderly veterans, similar to the results of prior studies involving only the general population.

Keywords: Adjustment disorders; Anxiety; Depression; Stress disorders, Post-traumatic; Veterans health.

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Conflict of interest statement

Conflicts of Interest

Changsu Han, a contributing editor of the Psychiatry Investigation, was not involved in the editorial evaluation or decision to publish this article. All remaining authors have declared no conflicts of interest.

Figures

Figure 1.
Figure 1.
The comparison of psychological measure mean score between PTED(+) and PTED(-); PTSD, depression, and sleep disturbance symptom scales. PTED, posttraumatic embitterment disorder; PCL-5, Posttraumatic Stress Disorder Check List-5; BDI, Beck Depression Inventory; PSQI, Pittsburgh Sleep Quality Index; PTSD, posttraumatic stress disorder.
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