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Ehler and Clarke’s cognitive model of PTSD states that persistent PTSD only occurs if individuals process the traumatic event and/or consequences in a way which produces a sense of serious, current threat. People with persistent PTSD are unable to see the trauma as a time-limited event that does not have global implications for their future. There are two key processes that lead to this sense of threat:Individual differences in the appraisal of trauma and its consequences.Individual differences in the nature of the memory for the event and its link to other autobiographical memories.The perception of current threat is accompanied by intrusions and other re-experiencing symptoms when activated. This motivates a series of behavioural and cognitive responses that are intended to reduce perceived threat and distress in the short-term but prevent cognitive change. This maintains the disorder. There are several types of appraisal which can produce a sense of current threat:Overgeneralization of the event (i.e. perceive a range of normal activities as more dangerous than they really are, such as driving).Exaggerate the probability of further traumatic event (e.g. avoiding driving after car crash).Negative appraisal of one’s behaviour during the trauma (e.g. blaming oneself for not seeing the signs of the traumatic event earlier).The interpretation of one’s initial PTSD symptoms (1), other people’s reactions in the aftermath of the trauma (2) and the appraisal of the consequences of the trauma in other life domains (e.g. physical consequences) (3) are important and can produce a sense of current threat. Initial PTSD symptoms are normal after a traumatic event. If people appraise this as being an integral part of the self, then they may conclude that the trauma has permanently changed them. These appraisals maintain PTSD by directly producing negative emotions and by encouraging individuals to engage in dysfunctional coping strategies. The...
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