Intrusion symptoms

SCHEMATIC MODELS LEVEL Threat-related appraisals

FEAR-RELATED PRODUCTS

ANALOGICAL LEVEL

TRAUMATIC Encoding of

EVENTS -smells, sounds, sights, tastes

ASSOCIATIVE LEVEL

of trauma

PROPOSITIONAL

LEVEL

Encoding of facts about trauma. Interpretations of the event

Figure 6.11 Experience of a traumatic event within SPAARS.

process the unintegrated information, and this information will continually be appraised as incompatible and as a threat to the existing configuration of schematic models (the first levels of appraisal in the generation of fear). This process is similar to Horowitz's completion tendency; however, in this instance it is the schematic-level models of self, world, and others that organise and provide a meaning structure for the information represented in memory at the different levels within SPAARS. This continual appraisal of the incompatibility and threatening nature of the trauma-related information in memory occurs on every appraisal cycle and means that the individual experiences constant activation and reactivation of the fear module. This process ensures that traumatised individuals are in an almost continuous existential state of "being in danger", even though they will not always be explicitly experiencing intrusive thoughts or images. In addition, information related to the trauma that is the object of such appraisals will intrude, by virtue of its activated state, into consciousness in a variety of ways ranging from intrusive thoughts to nightmares.

The second of the two routes to the generation of intrusion phenomena depends on the fact that the chronic activation of the fear module means the traumatised individual will exhibit a number of cognitive processing biases for information related to the trauma (see the brief review above) because that information is represented in memory as: (a) danger-related; and (b) related to current concerns because it has not been successfully integrated into the individual's models of the self, world, and others. This means that any cues in the environment that are related to the traumatic information are likely to be selectively processed and will themselves activate the trauma-related information in memory, thereby increasing the probability of intrusions.

We propose that because the trauma-related information across the different levels of representation within SPAARS remains unintegrated, it retains high levels of internal cohesion within memory. In other words, the representational links between different aspects of the traumatic memory are far stronger than the links between the traumatic memory representations and pre-existing memory structures. Furthermore, the representations of the trauma are very "true to life" because there has been little assimilation or blending with other information in memory. As a result of this high level of cohesion, we propose that external cues are able to activate the entire trauma memory much more easily than if the trauma-related information had been inter-meshed with existing information in memory. This results in such phenomena as flashbacks in which stimuli that represent fragments of the traumatic experience are able to trigger intrusive phenomena that involve re-experiencing the whole. Finally, as well as experiencing the generation of fear via repeated appraisal in these ways at the abstracted level of meaning, the individual who has been traumatised will experience the automatic activation of fear via the associative level of meaning as a function of the repetition during intrusions of the link between trauma-related information and fear. Consequently, external or internal trauma-related cues will lead to the generation of fear "out of the blue" and this feature, we suggest, is a characteristic of chronic post-traumatic stress states.

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