Bereaved families are still embittered after the Sewol ferry accident in Korea: A follow-up study 18 and 30 months after the disaster

Introduction: The Sewol ferry accident that occurred in April 2014 was one of the most tragic human-made disasters in Korean history. Due to the deaths of hundreds of children, bereaved families likely feel embittered; however, there is little extant research documenting embitterment among those who experienced the disaster. Consequently, we investigated bereaved family members' embitterment and other psychiatric symptoms 18 months and 30 months after the disaster. Methods: Data from a cross-sectional survey were obtained 18 months (Time 1) and 30 months (Time 2) after the disaster. We ascertained socio-demographic variables and variables obtained from a self-reporting questionnaire (i.e., depression, anxiety, posttraumatic stress disorder, complicated grief, and embitterment) among 56 bereaved family members. Results: Bereaved families showed substantial embitterment at Time 1 (643%), which increased at Time 2 (76.8%, t = 1.761, p = 0.084). The participants who displayed increased embitterment at Time 2 also increased in anxiety, post-traumatic stress symptoms, and complicated grief (but not depression). Furthermore, participants who displayed decreased embitterment at Time 2 also decreased in all other psychiatric symptoms. (time x group interaction in depression (F 0.644, p = 0.426), anxiety (F4.970, p = 0.030), PTSD (F 10.699, p = 0.002), and complicated grief (F 8389, p = 0.005)). Conclusions: Embitterment of bereaved families had not ceased after 18 months and even increased 1 year later. Additionally, as embitterment increased, many other psychiatric symptoms also increased, and vice versa. Our results suggest that embitterment is associated or can even influence other psychiatric symptoms; therefore, embitterment should be examined after disasters. (C) 2018 Elsevier Inc. All rights reserved.