Applying Lang's (1977, 1985) concept of fear structures (see the introduction to the present chapter and Chapter 3), Foa and her colleagues (Foa & Kozak, 1986; Foa & Rothbaum, 1998; Foa, Steketee, & Rothbaum, 1989) have put forward an information-processing theory of PTSD which centres on the formation of a so-called fear network in long-term memory. This fear network (cf. Lang) encompasses: stimulus information about the traumatic event; information about cognitive, behavioural, and physiological reactions to the trauma; and interoceptive information which links these stimulus and response elements together. Activation of the trauma-related fear network by triggering stimuli (i.e., reminders of the trauma), according to Foa et al., causes information in the network to enter conscious awareness (the intrusion symptoms of PTSD). Attempts to avoid and suppress such activation of the network lead to the cluster of avoidance symptoms of PTSD. Foa et al. argue that successful resolution of the trauma can only occur by integrating the information in the fear network with existing memory structures. Such assimilation requires, first, the activation of the fear network so that it becomes accessible for modification and, second, the availability of information that is incompatible with the fear network so that the overall memory structure can be modified. A number of factors mediate the course of such integration; for example, Foa et al. argue that the unpredictability and uncontrollability of the traumatic event can make it very difficult to assimilate into existing models in which the world is controllable and predictable. In addition, factors such as the severity of the event disrupt the cognitive processes of attention and memory at the time of the trauma, and Foa et al. argue that this disruption can lead to the formation of a disjointed and fragmented fear network which is consequently difficult to integrate with existing, more organised models. See Figure 6.9 for a diagrammatic summary of Foa et al.'s approach.
By outlining an information-processing architecture within which some of Horowitz's and Janoff-Bulman's social-cognitive ideas can be instantiated, Foa et al. have made considerable progress towards a greater understanding of how the
processes underlying PTSD might operate within a cognitive system. Furthermore, in stressing factors such as the predictability and controllability of the trauma, Foa et al. highlight one important role of the individual's attributions and interpretations of the traumatic event. Furthermore, the suggestion that the availability of information incompatible with the trauma is necessary for successful processing provides a framework for understanding both the role of social support as a vehicle for the provision of such incompatible information and also the processes underlying the success of exposure-based interventions for PTSD (Foa & Rothbaum, 1998). What is less clear, however, is whether network theory provides an architecture powerful enough to cope with the range of PTSD phenomenology. We have discussed the criticisms of network approaches to emotional order and disorder in Chapter 3 and we shall not reiterate them here; suffice to say that a network with a single level of representation struggles to explain how the existing meaning structures and models of the world that are such a feature of the social-cognitive models (Foa & Riggs, 1993) are represented and how integration of the trauma-related information with such models might take place, or why fear networks develop in some individuals and not others. In order to tackle some of the criticisms of network theories, Foa and Rothbaum (1998) have incorporated additional features into their network model, including the need for a higher level of representation in the form of schemas. However, Foa's extended model fails to overcome a number of limitations of the original model (Dalgleish, 2004).
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This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.