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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.

Type

Journal article

Journal

Behav Res Ther

Publication Date

04/2000

Volume

38

Pages

319 - 345

Keywords

Adaptation, Psychological, Association, Chronic Disease, Cognitive Therapy, Humans, Imagery (Psychotherapy), Memory, Models, Psychological, Negativism, Stress Disorders, Post-Traumatic, Stress, Psychological, Thinking