Doctorate in Clinical Psychology : Main Research Portfolio
: 1) The development and maintenance of Post Traumatic Stress Disorder (PTSD) in people who have perpetrated violent acts: A review of the literature; 2) Life is a rollercoaster…How parents cope with the Neonatal Unit experience; 3) An exploration of the construct of bitterness.

  • Sarah Mills

Student thesis: Doctoral ThesisDoctor of Clinical Psychology (DClinPsy)


Objectives: Bitterness has been suggested to be a common psychological reaction to persistentadversity; however it has thus far been understudied. The objectives of the current study weretherefore to: i) Develop a reliable and valid English language measure of bitterness, ii) Pilot thisnew measure within a clinical population, iii) Explore how the construct of bitterness relates totreatment outcome in psychological therapy, and iv) Determine whether bitterness accuratelypredicts suicidal ideation in clinical populations. Design: a cross sectional questionnaire designwas used. Method: A new bitterness measure was developed incorporating ideas from existingliterature and suggestions from experienced clinicians. This measure was completed by a nonclinical group (n = 313) and factor analysis was carried out on these data. The measure was then completed by a group of secondary care mental health service users (n = 31) and compared with the non clinical sample,. Additional symptom focussed measures were also completed by the clinical group. Results: Factor analysis showed that the bitterness measure was comprised off our subscales (labelled here as “experience of a negative event”,” nihilism”, “unfairness” and “negative interpersonal experiences”). Good internal consistency and acceptable test-retest reliability was found. Bitterness was found to be related to rumination, in particular the brooding / analytical subtype of rumination. A significant relationship was found with some measures of anger, but no significant relationship was found between bitterness and depression. Conclusions: Bitterness may be a unique construct, conceptually distinct from anger and depression and closely associated with analytical rumination.
Date of Award10 Sept 2014
Original languageEnglish
Awarding Institution
  • University of Bath
SupervisorPaul Salkovskis (Supervisor), Claire Lomax (Supervisor) & Josie Millar (Supervisor)


  • Bitterness

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