Problem III: The Symposium (A Cognitive Model of Posttraumatic Stress…
Problem III: The Symposium
A Cognitive Model of Posttraumatic Stress Disorder (Ehlers, A., & Clark, D. M., 2000)
Memory for the traumatic event
Fragmented, poorly organized, absence of details and temporal order.
Consists of sensory impression.
Is not contextualize e.g. time and place.
Strong S-S and S-R association.
Strong priming association.
Does not elaborate and properly integrate into other memories.
Avoidance of remainders.
Appraisal of traumatic event
Over-generalization of fear.
Appraisal of trauma sequelae
A sense of current threat.
Previous Trauma and Coping Style.
Predictability and Duration of trauma.
State factor e.g. level of arousal.
Appraisals of trauma and its sequelae.
Features of PTSD by model
Delayed onset .
Frozen in time.
No advantages of talking/thinking about the trauma.
Sense of doom.
In vivo exposure.
Identify triggers of memories.
3 Main Implications
Elaboration and Integration of memory.
Modification of appraisal.
Elimination of inappropriate strategies.
Psychological Theories of Stress and Trauma (Resick, P. A., 2001)
Conservation of resources (COR)
Psychological stress occurs as a result of loss.
PTSD arose from the conflict between peace-time ego versus war-time ego.
Defence mechanism is repression.
PTSD leads to the development of fear structure in memory.
Fear network leads to escape and avoidance behaviour.
Prolonged exposure to traumatic memory leads to habituation and extinction.
McCann and Pearlman
PTSD develops if a person's schema matches trauma.
Trauma destroys a person's 3 major assumption.
A belief in personal invulnerability.
The world is meaningful.
A perception of oneself as worthy.
Dual Representation Theory (Brewin)
2 types of memories: SAMs and VAMs.
If SAM is strongly activated, flashback will occur.
Mower's two factor theory
High level of distress arose from classical conditioning.
Maintenance and avoidance of PTSD arose from operant conditioning.
Wagner and Lineman's concept of dissociation
Function of dissociation is to regulate traumatic experience.
Eye Movement Desensitisation Reprocessing (EMDR): information processing in the treatment of trauma. (Shapiro, F., & Maxfield, L.,2002)
It's based on information-processing model.
Accesses full history of patient.
Education: Teach self-calming techniques.
Processing the trauma.
Focus on imagery and "Let whether happens happen".
Promote the consolidation of the new insight.
Askt the clients to pay attention to bodily sensation.
Instructs client about homework assignment.
EMDR is an adaptive processing.
This occurs when associations are combined with autobiographical memories.
The association results in learning emotional relief.
Psychological theories of posttraumatic stress disorder (Brewin, C.R., & Holmes, E.A.,2003)
Classical Conditioning: Fear Acquisition
Extinction would fail if a person suppresses traumatic memories.
A fear memory consists of stimuli,response and meaning of response.
A person must integrate traumatic memories and other memories altogether.
Theory of Shattered Assumption
3 basic assumptions of a person is shaken.
The world is benevolent.
The world is meaningful.
The self is worthy.
Anxious Apprehension Model
Emotional alarm triggers hyperarousal symptoms
Attempts to combine new traumatic information with autobiographical memory
If the assimilation fails, traumatic reactions remain.
Psychological Processes and PTSD
Belief and basic assumptions are shaken.
Cognitive-Affective reactions e.g. helplessness and intense fear.
Negative social support.
Dissociation e.g. emotional numb and depersonalisation.
Attentional bias toward traumatic remainders.
Retrieval bias toward traumatic memories.
Ehlers and Clark's Cognitive Model
Response to trauma is problematic when trauma is perceived as threat.
Negative appraisal comes from mental defeat.
Traumatic memories are cue-drive and unintentional due to poorly elaborated memory.
Selective attention to remainders and rumination are maladaptive coping strategies.
Dual Representation Theory
2 types of memory: VAMs and SAMs.
VAMs are accountable for flashbacks.
Creating or blocking SAM reduces negative emotion.
Emotional Processing Theory
Previous rigid pre-trauma view is a vulnerability factor of PTSD.
Prolonged exposure is an effective treatment.
Neuropsychology and Dual Representation Theory
VAM is encoded in hippocampus, while SAM is not.
High level of cortisol interfere the function of hippocampus.