A cognitive model of posttraumatic stress disorder.

Journal article

Posttraumatic stress disorder (PTSD) is a common reaction to traumatic events. Many people recover in the ensuing months, but in a significant subgroup the symptoms persist, often for years. A cognitive model of persistence of PTSD is proposed. It is suggested that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of serious, current threat. The sense of threat arises as a consequence of: (1) excessively negative appraisals of the trauma and/or its sequelae and (2) a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong perceptual priming. Change in the negative appraisals and the trauma memory are prevented by a series of problematic behavioural and cognitive strategies. The model is consistent with the main clinical features of PTSD, helps explain several apparently puzzling phenomena and provides a framework for treatment by identifying three key targets for change. Recent studies have provided preliminary support for several aspects of the model.

Authors: Ehlers, A; Clark, D

• Publication status: Published
• Journal: Behaviour research and therapy
• Volume: 38
• Issue: 4
• Pages: 319-345
• Publication date: 2000-04-01
• DOI: 10.1016/s0005-7967(99)00123-0
• EISSN: 1873-622X
• ISSN: 0005-7967
• Language: English
• Keywords: Models, Psychological; Memory; Association; Cognitive Therapy; Stress, Psychological; Adaptation, Psychological; Chronic Disease; Stress Disorders, Post-Traumatic; Imagery (Psychotherapy); Thinking; Negativism; Humans