The Diagnostic and Statistical Manual of Mental Disorders estimated 9-11 % of the general population experience traumatic distress and about half of the people who experienced trauma continue to develop Posttraumatic stress disorder (PTSD). PTSD is an anxiety disorder for which cognitive-behavioural therapy (CBT) is employed to treat or prevent maladaptive behaviour, beliefs and thought processes. According to the diagnostic criteria for PTSD, individuals exposed to trauma experience three distinct types of persistent post-trauma symptoms. The arousal symptom clusters describe re-experiencing traumatic moments, nightmares, flashbacks and sleep-disturbances. The second clusters of symptoms describe physiological responses such as helplessness, anger outbursts, concentration problems, hyper vigilance and exaggerated startle responses. The third cluster of symptoms describes avoidance and emotional numbing symptoms that leads to avoidance of people, trauma reminders, emotional dissociation and trouble recalling trauma events.
The persistent PTSD symptoms detrimentally affect mental health, social behaviour and occupational functioning. The issue whether PTSD symptoms own their existence to biological and learning or whether they are entirely cognitively determined has been the subject of much debate. Each approach provides evidence supporting fear activation and problems in emotion regulation leading to various symptoms of PTSD but these findings do not settle the issue for the maintenance of persistent symptoms of PTSD. In fact, it is posited that individual differences in the appraisal of trauma events and emotion regulation strategies determine the maintenance of the PTSD symptoms. Hence, the existing cognitive-behaviour therapy for PTSD was conceptualised to provide clinicians and therapists with an evidence-based framework that addresses individualised case formulation and treatment needs. The purpose of this essay is to discuss and evaluate the theoretical findings and treatment models, which contributed to the understanding of persistent symptoms of PTSD.
Table of Contents
1. Introduction to PTSD and Theoretical Perspectives
2. Early Research Evidence and Behavioral Theories
3. Cognitive Processes and Models of PTSD
3.1 Horowitz Stress Response Syndrome
3.2 Janoff-Bulman’s Shattered Assumptions Model
3.3 Foa and Kozak’s Emotional Processing Network
3.4 Brewin’s Dual Representation Theory
3.5 Ehlers and Clark’s Cognitive Model
4. Clinical Applications and Assessment Tools
5. Conclusion
Research Objectives and Themes
This essay aims to analyze and evaluate various theoretical frameworks and treatment models that have contributed to our understanding of the persistence of PTSD symptoms, focusing specifically on the interplay between cognitive processing and behavioral interventions.
- Epidemiology and societal burden of Posttraumatic Stress Disorder.
- Behavioral theories of fear conditioning and avoidance learning.
- Cognitive models of trauma, including dual processing and cognitive schemas.
- Clinical frameworks for case formulation and cognitive behavioral therapy.
Excerpt from the Book
Ehler and Clark (2000) argued the importance of individual differences in the appraisal of long- held beliefs, characteristics of trauma, differences in emotional responses and the nature of traumatic events. The model adopted evidence from large body of findings to support the cognitive behaviour processes and treatment explanations. Negative assessments of trauma events (Foa et.al.) hinder elaboration and integration of trauma- related information with other episodic information in the long-term autobiographical memories (Foa, Riggs, Massie & Yarczoer, 1995). The inadequately processed information causes poor recall of unintentional memories and retrieval of information without context. Consequently contributing to symptoms such as increased sensitivity towards the threat, re-experiencing the trauma, hyper-arousal, memory intrusion and negative affective reactions (Foa et. al. 1995; Dunmore, Clark & Ehlers, 2000). Avoidance and emotion suppression strategies further increase the frequency of intrusive memories of trauma causing poor concentration (Dunmore et al., 2000; 2001). Feelings of hopelessness, rumination, guilt and self-blame conditions the patients with PTSD to avoid events and activities that remind of trauma (Steil & Ehlers, 2000; Lee, Scrag & Turner, 2001).
Summary of Chapters
1. Introduction to PTSD and Theoretical Perspectives: This chapter outlines the diagnostic criteria for PTSD and introduces the debate regarding whether symptoms are biologically or cognitively determined.
2. Early Research Evidence and Behavioral Theories: This section explores how behaviorists explain PTSD through classical and operant conditioning, highlighting the two-factor theory of fear and avoidance.
3. Cognitive Processes and Models of PTSD: This chapter reviews major cognitive models, including the stress response syndrome, shattered assumptions, emotional processing networks, dual representation, and the Ehlers-Clark cognitive model.
4. Clinical Applications and Assessment Tools: This part details the practical application of cognitive models in therapy and introduces the Posttraumatic Cognitions Inventory (PTCI).
5. Conclusion: This chapter summarizes the contributions of the discussed theories to the understanding and treatment of PTSD and suggests areas for future research.
Keywords
Posttraumatic Stress Disorder, PTSD, Cognitive Behavioral Therapy, CBT, Trauma, Fear Network, Emotional Processing, Dual Representation Theory, Cognitive Model, Ehlers-Clark, Avoidance, Intrusive Memories, Case Formulation, PTCI, Mental Health.
Frequently Asked Questions
What is the primary focus of this work?
The work provides a comprehensive discussion and evaluation of various theoretical perspectives and treatment models regarding the persistence of PTSD symptoms.
Which central thematic fields are addressed?
It covers the history of behavioral learning theories, cognitive models of memory processing, and the clinical implementation of evidence-based cognitive therapy.
What is the core objective of this study?
The aim is to evaluate how specific theoretical frameworks inform our understanding of why PTSD symptoms persist and how these models translate into effective clinical case formulation.
Which scientific methods are analyzed in the context of treatment?
The essay analyzes Cognitive Behavioral Therapy (CBT), prolonged exposure therapy, and the use of Socratic questioning as evidence-based approaches.
What does the main body of the text cover?
The main body systematically examines the evolution of psychological theories from classical conditioning to modern cognitive schemas and brain processing systems.
How would you characterize this work through keywords?
The work is defined by themes of trauma-related cognitive appraisal, memory processing, emotional habituation, and evidence-based clinical practice.
How does Brewin’s Dual Representation Theory explain PTSD?
It proposes two parallel brain systems—Verbally Accessible Memory (VAMs) and Situationally Accessible Memory (SAMs)—and argues that encoding problems between these systems contribute to the complexity of PTSD.
What role does the Posttraumatic Cognitions Inventory (PTCI) play?
The PTCI is an assessment tool used to identify dysfunctional cognitive themes and problematic appraisals in patients, aiding in the development of case formulations.
- Quote paper
- Raja Sree R Subramaniam (Author), 2015, Post Traumatic Stress Disorder (PTSD). Theoretical Findings and Treatment Models, Munich, GRIN Verlag, https://www.hausarbeiten.de/document/313310
