Behavioral/cognitive conceptualizations of post-traumatic stress disorder

Abstract

The paper reviews and considers the existing cognitive and behavioral accounts for the acquisition and maintenance of post-traumatic stress disorder. Mowrer's two-stage theory as applied to rape victims and Vietnam veterans is critically reviewed. It was concluded that traditional S-R learning theories can adequately account for fear and avoidance consequent to a traumatic event, as well as the greater generalization as compared to simple phobics. However, these theories do not explain the remaining PTSD symptoms. The literature on experimental neurosis predicts that uncontrollable and unpredictable events produce responses that are highly reminiscent of PTSD irrespective of stimulus intensity and complexity. An additional shortcoming of S-R theory is the difficulty in incorporating meaning concepts which are so central to PTSD. Evidence for the necessity of a theory to accommodate meaning concepts is the finding that perceived threat is a better predictor of PTSD than actual threat. Therefore, we have presented a theoretical framework developed by Foa & Kozak (1986) which accommodates meaning concepts in explaining mechanisms of fear reduction and adapted this theory to PTSD.