Cognitive Approaches to Posttraumatic Stress Disorder: The Evolution of Multirepresentational Theorizing.

Abstract

The evolution of multirepresentational cognitive theorizing in psychopathology is illustrated by detailed discussion and analysis of a number of prototypical models of posttraumatic stress disorder (PTSD). Network and schema theories, which focus on a single, explicit aspect/format of mental representation, are compared with theories that focus on 2 or more explicit representational elements. The author argues that the latter theories provide a more complete account of PTSD data, though are not without their problems. Specifically, it is proposed that at least 3 separate representational elements-associative networks, verbal/propositional representations, and schemas-are required to generate a comprehensive cognitive theory of PTSD. The argument that the development of multirepresentational cognitive theory in PTSD is a paradigm case for the development of similar theories in other forms of psychopathology is elaborated, and a brief agenda is proposed promoting 2 levels of theorizing-deep, formal theory alongside more localized, applied theory.

Translating the Cognitive Model of PTSD to the Treatment of Very Young Children: A Single Case Study of an 8‐Year‐Old Motor Vehicle Accident Survivor

“…A central tenet of cognitive theories of PTSD is that the nature of the trauma memory is critical to the development of the disorder (Dalgleish, 2004). Those suffering with PTSD often have difficulty retrieving information about the traumatic event, and the recollection is often disjointed and fragmented (Brewin, Dalgleish, & Joseph, 1996).…”

“…Intentional retrieval can therefore be disrupted when the trauma memory is not sufficiently elaborated and poorly contextualized in time and place. Involuntary intrusive recollections, in contrast, reflect the operation of sensory‐based trauma representations with minimal propositional content that can be activated by encountering sensory cues reminiscent of the trauma—triggers–in the environment (Brewin et al., 1996; Dalgleish, 2004). …”

“…There is now a substantive body of research supporting the cognitive model of PTSD in adults (see Brewin & Holmes, 2003, and Dalgleish, 2004, for reviews). Central to the current article, Meiser‐Stedman has advanced the model for youth (Meiser‐Stedman, 2002) using the core elements that Brewin et al.…”

Developing an Emotion- and Memory-Processing Group Intervention for PTSD with complex features: a group case series with survivors of repeated interpersonal trauma

“…Cognitive models of PTSD emphasize these dimensions as foci of change in cognitive-behavioural interventions (Dalgleish, 2004). The three factors have good test-retest reliability and discriminate well between traumatized individuals with and without PTSD (Foa et al, 1999).…”

“…Based on our clinical experience, with this client group, we considered 50% of homework tasks to be the minimum someone could complete and still engage satisfactorily between sessions); (2) Participants would show a reduction in core symptoms of PTSD and associated complex features from pre- to post-treatment. Hypotheses for our secondary outcomes were: (3) Participants would show a reduction in associated symptoms of depression and anxiety from pre- to post-treatment; (4) Participants would show a reduction in scores on process measures of maladaptive cognitions and emotion processing associated with the onset and maintenance of PTSD (Dalgleish, 2004). …”