Cognitive theoretical models of PTSD

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A number of psychological paradigms provide frameworks for understanding PTSD, for example psychodynamic (e.g., Freud, 1919), learning theory (e.g., Keane, Zimmering, & Caddell, 1985), and cognitive (e.g., Horowitz, 1986). While all of these paradigms encompass theories that offer interesting insights into the nature of the disorder, it is the cognitive approach that we feel is the most fully developed and offers the greatest explanatory and predictive power.

Cognitive theories of PTSD have a certain theoretical family resemblance. They propose that individuals bring to the traumatic experience a set of pre-existing beliefs and models of the world and of themselves. The experience of trauma provides information that is not only highly salient but also incompatible with these preexisting meaning structures. The attempt to integrate the new trauma-related information with the existing models leads, it is argued, to the various phenomena that characterise post-traumatic reactions. Successful resolution of the trauma occurs when the new information is integrated into the existing set of beliefs or models (often by virtue of changes in those same beliefs or models). Unsuccessful resolution occurs when individuals are unable to bring the new trauma-related information into accord with their pre-existing beliefs or models of the world. This failure can lead to chronic post-traumatic reactions. In this section we review briefly a number of social-cognitive and information-processing theories of PTSD, before discussing how the SPAARS model might account for post-traumatic emotional experiences.

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Belief Change 101

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