Cognitive-Emotional Theories and Trauma

Theories of PTSD
Cognitive Models

Changes in memory function

Automatic processing
Shattered core beliefs

Stress Response Theory

Initial emotional reaction to trauma
Efforts to assimilate new info from the

trauma into knowledge base

Information Processing Theory

Trauma memories processed in

separate & distinct way

Incomplete processing leads to PTSD

Cognitive Behavioral Theory

Aaron T. Beck
Examine the

interactions between thoughts, emotions, and behaviors. Experience over time impacts the patterns we develop

THOUGHT

EMOTION

BEHAVIOR

CBT and Trauma

Focus is on victims:

Memory functioning Information processing Shattered or challenged core beliefs Avoidance strategies Self-criticism

Hierarchy of Negative Cognitions/Beliefs in PTSD

Responsibility - It was my fault, I should

have done something victims of CSA often present with this NC

Safety - I am in danger/ I cannot protect

myself/ I cannot trust my judgement/ I cant trust anyone resulting in hypervigilance and often following Rape/RTA/ War

 Choice & Control Im

powerless/ Im not in control

Self-Defectiveness I am a

failure/ I am permanently damaged / Im a bad person /Im a disappointment / I am shameful/ Im good enough

Hindsight Bias (Brewin, 2003)

The tendency for someone to assume, once

something is known to have happened, that it could and should have been anticipated So pervasive that not only onlookers but also victims often blame themselves for not acting differently

 HB also relates to the tendency to

blame victims for their misfortunes = Maintains Psychological Distance from the trauma in other people
Victims of trauma arouse discomfort

in others by their mere presence, particularly when the victim does not make a speedy recovery
Victims of trauma shatter our

illusions of invulnerability

Social Learning Theory

Albert Bandura
Observational learning Modeling Key for Learning:

Learned Helplessness
Martin Seligman
Lack control in

environment Related to depression and anxiety responses

Attributions / Locus of Control

Internal

v. External Internal: External:

Attributions / Locus of Control

Global v. Unique
Global: Unique/Situational:

Attributions / Locus of Control

Stable v. Unstable
Stable: Unstable:

Maladjustment
DEPRESSION
Internal Global Stable ANXIETY External Global Unstable

Victims Appraisals
Negative appraisals that develop can

be either external or internal: External appraisals are typically related to viewing the world and others as potentially dangerous and harmful Internal appraisals are more often related to a sense of responsibility for the trauma

Types of Appraisals
Overgeneralization of the traumatic

event into normal events Appraisals of ones emotional and behavioral responses during the event These appraisals are thought to lead to feelings of shame, responsibility, and guilt

Kubanys Model
Connects PTSD to social

psychological elements including hindsight bias, responsibility, and determinism The key is the symptom of posttraumatic guilt

Post-Traumatic Guilt
Define guilt as, an unpleasant feeling with an

accompanying belief (or beliefs) that one should have thought, felt, or acted differently (p.429). Guilt is an important factor in the development and maintenance of PTSD symptoms in combat veterans, victims of domestic violence, rape, child sexual abuse, and reckless drivers Hindsight bias cognitions should have, could have, if only contribute to post-traumatic guilt Guilt tends to be tied to ones behaviors

Shame
Sense of public exposure of some mistake

or failure, accompanied by feelings of disapproval in the eyes of others and a negative evaluation of the self (Tangney, Miller, Flicker, & Barlow, 1996). Shame is tied more closely to the Self