PREDICTORS

When we say predcitors, so these are the factors that risk a person to develop a PTSD.

So according to studies,

PTSD is associated with disturbances in a wide range of psychological processes including memory,
attention, cognitive–affective reactions, beliefs, coping strategies, and social support. At present, it
appears that what is most likely unique to PTSD, compared to other psychological disorders, are the
unusual and inconsistent memory phenomena centered on the event itself and the recruiting of a variety of
dissociative responses. In contrast, the findings concerning other processes have much in common with
the results of research on depression and other anxiety disorders, with which PTSD is frequently
comorbid. It is clear that the emotions involved in PTSD are not by any means restricted to fear,
helplessness, and horror, or to what was actually experienced at the time of the trauma. Beliefs, too, are
not restricted to those concerning the event itself but may involve much more general aspects of the
person, the social world, and the future. Theories of PTSD, therefore, need to incorporate explanations of
processes that are both specific to PTSD and more general, as well as processes that are relatively
automatic (such as helplessness and dissociation) or relatively strategic (such as individual appraisals and
choice of coping strategy).

Theories are formulated to explain, predict, and understand phenomena and, in many cases, to
challenge and extend existing knowledge within the limits of critical bounding assumptions

Peritraumatic dissociation potentially involves disturbed awareness, impaired memory, or altered

STRESS RESPONSE THEORY

[Early theory]
Key tenants:
-Horowitz
-when faced with trauma, people's initial response is outcry at the realization of the trauma.
-A second response is to try to assimilate the new trauma information with prior knowledge.
-At this point, many individuals experience a period of information overload during which they are
unable to match their thoughts and memories of the trauma with the way that they represented meaning
before the trauma.
-In response to this tension, psychological defense mechanisms (e.g. denial, numbing, avoidance) are
brought into play to avoid memories of the trauma and pace the extent to which it is recalled.

Denial as a defense mechanism was originally conceptualized by Freud as the refusal to acknowledge
disturbing aspects of external reality, as well as the existence of disturbing psychological (internal)
events, such as thoughts, memories, or feelings
Avoidance: Dismissing thoughts or feelings that are uncomfortable or keeping away from people,
places, or situations associated with uncomfortable thoughts or feelings.

-the fundamental psychological need to reconcile new and old information means that trauma memories
will actively break into consciousness in the form of intrusions, flashbacks, and nightmares.
-These consciously experienced trauma memories provide the individual with an opportunity to try to
reconcile them with pre-trauma representations.
-two opposing processes at work:
1. One to defend the individual by the suppression of trauma information
2. One to promote the working through of the traumatic material by bringing it to mind.
-the individual oscillates between avoidance and intrusions of the trauma. -This oscillation allows the
traumatic information to be worked through, and as this happens, the intensity of each phase decreases.
Failure to process the trauma information is proposed to lead to persistent posttraumatic reactions as the
information remains in active memory and continues to intrude and be avoided.
-"social-cognitive"

THEORY OF SHATTERED ASSUMPTIONS

[Early theory]
Key tenants:
-Janoff-Bulman
-The three common assumptions regarded as the most significant in influencing response to trauma are: 1.
that the world is benevolent, 2. the world is meaningful, 3. and the self is worthy.
individuals develop fundamental, yet unarticulated, assumptions about the world and themselves (i.e.,
worldviews) that allow for healthy human functioning. The most important assumptions include beliefs in
a just, benevolent, predictable world in which the individual possesses competence and worth. The
worldview’s primary function is to provide the individual with meaning, self-esteem, and the illusion of
invulnerability.According to shattered assumptions theory, when individuals experience an event that
damages their worldview (i.e., traumatic material that cannot be easily integrated with previously held
worldviews), they no longer perceive the world as benevolent and predictable or themselves as competent
and invulnerable. The subsequent state of defenseless, terrifying, and confusing awareness of personal
vulnerability gives rise to the anxiety and physiological reactivity that characterize PTSD.

CONDIITONING THEORY

[Early theory]
Key tenants:

 an initial phase of fear acquisition through classical conditioning results in neutral stimuli present in the
traumatic situation acquiring fear-eliciting properties through their association with the unconditioned
stimulus (in this case, those elements of the traumatic situation that directly arouse fear). It proposed that
a wide variety of associated stimuli would acquire the ability to arouse fear through the processes of
stimulus generalization and higher order conditioning. Although repeated exposure to spontaneous
memories of the trauma would normally be sufficient to extinguish these associations, extinction would
fail to occur if the person attempted to distract themselves or block out the memories, rendering the
exposure incomplete.

 Avoidance of the conditioned stimuli, whether through distraction, blocking of memories, or

INFORMATION PROCESSING THEORY

Early theory]
Key tenants:
the central idea is that there is something special about the way the traumatic event is represented in
memory and that if it is not processed in an appropriate way, psychopathology will result. Like social-
cognitive theories, this approach emphasizes the need for information about the event to be integrated
within the wider memory system. However, the difficulty in achieving this is attributed more to
characteristics of the trauma memory itself than to conflict with preexisting beliefs and assumptions.
Frightening events were represented within memory as interconnections between nodes in an associative
network. A fear memory consisted of interconnections between different nodes representing three types
of propositional information: Stimulus information about the traumatic event, such as sights and sounds,
information about the person’s emotional and physiological response to the event, and meaning
information, primarily about the degree of threat. Thus, cognition and affect were integrated within an
overall response program designed to rapidly escape or avoid danger

ANXIOUS APPREHENSION

[Early theory]
Key tenants:

Jones and Barlow

In PTSD, the focus of people’s anxious apprehension is on cognitive and physiological cues from the time
of the actual trauma as they wish to avoid the distress generated by alarms. The learned alarms generate
hyperarousal symptoms, which through their association to cues present at the time of the original trauma
(the real alarm) result in a negative feedback loop ensuring successive reexperiencing symptoms. To
prevent the triggering of alarms, the person will tend to avoid emotional interoceptive information, for
example, through emotional numbing, as well as avoid external trauma-related stimuli. Jones and Barlow
argued that coping styles and social support can, as in other anxiety disorders, moderate the expression of
PTSD.

Hyperarousal symptoms include irritability or aggression, risky or destructive behaviour,

[Recent theory]
Key tenants:
-Foa & Rothbaum
- proposed that individuals with more rigid pre-trauma views would be more vulnerable to PTSD. These
could be rigid positive views about the self as being extremely competent and the world as extremely
safe, which would be contradicted by the event, or rigid negative views about the self as being extremely
incompetent and the world as being extremely dangerous, which would be confirmed by the event. It has
also an emphasis on negative appraisals of responses and behaviors which could exacerbate perceptions
of incompetence. This disruption leads to the formation of a disjointed and fragmented fear structure that
is resistant to modification and to trauma narratives that are relatively brief, simplistic, and poorly
articulated.
 Key tenants:
-Brewin et al.
- two separate pathological processes,

 one involving the resolution of negative beliefs and their accompanying emotions and one
involving the management of flashbacks. Recovery depends on the outcome of both these
processes. One requirement is to reduce negative emotions generated by cognitive appraisal of the
trauma, by consciously reasserting perceived control, reattributing responsibility, and achieving
an integration of the new information with preexisting concepts and beliefs. The second
requirement is to prevent the continued automatic reactivation of situationally accessible
knowledge about the trauma.

-two memory systems continue to operate in parallel, but one may take precedence over the other at
different times.
-Verbally Accessible Memory (VAM):
higher level processing, oral or written narrative memory; autobiographical memory: represent a personal
context of past, present, & future; can be retrieved as required, include both primary emotions (emotions
you felt at time of trauma) & secondary emotion (emotions you felt after cognitive appraisal of trauma)
-Situationally Accessible Memory (SAM):
where flashback memories are stored;
lower level of perceptual processing, eg. Sights & sound, restricted to primary emotion; The SAM system
also stores information about the person's bodily response to the trauma, such as changes in heart rate,
flushing, temperature changes, and pain. This results in flashbacks being more detailed and emotion-laden
than ordinary memories.

[Recent theory]
Key tenants:
-Ehlers and Clark

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.

-pathological responses to trauma arise when individuals process the traumatic information in a way that
produces a sense of current threat, either an external threat to safety or an internal threat to the self and the
future.
-The two major mechanisms that produce this effect involve negative appraisals of the trauma or its
sequelae (a condition which is the consequence of a previous disease or injury) and the nature of the
trauma memory itself.

the process through people evaluate or appreciate a particular negative encounter in the
environment, which is relevant to his or her well- being.