A cognitive model of posttraumatic stress disorder

Author(s): Ehlers A, Clark DM


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.

Similar Articles

Autobiographical memory disturbance in combat-related posttraumatic stress disorder

Author(s): McNally RJ, Lasko NB, Macklin ML, Pitman RK

Cultural differences in autobiographical memory of trauma

Author(s): Jobson L, O’Kearney R

Trauma centrality and PTSD in veterans returning from Iraq and Afghanistan

Author(s): Brown AD, Antonius D, Kramer M, Root JC, Hirst W

The cognitive-affective crossfire: when self-consistency confronts self-enhancement

Author(s): Swann WB Jr, Griffin JJ Jr, Predmore SC, Gaines B

PsycholAssessment 4: 445-451

Author(s): Foa EB, Cashman LA, Jaycox L, Perry K (l997) The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale

A longitudinal study of personality change in young adulthood

Author(s): Robins RW, Fraley RC, Roberts BW, Trzesniewski KH

The Hopkins Symptom Checklist (HSCL): a self-report symptom inventory

Author(s): Derogatis LR, Lipman RS, Rickels K, Uhlenhuth EH, Covi L

Misunderstanding analysis of covariance

Author(s): Miller GA, Chapman JP

Diagnostic and Statistical Manual of Mental Disorders, 4th ed

Author(s): American Psychiatric Association