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PSY 350 Links Psych Resources Association for Psychological Science American Psychological Association The National Institute of Mental Health Computer & Web Training at Illinois State The IRB at Illinois State University |
This model provides a framework for understanding how a variety of factors are related to the development of PTSD. It also summarizes much of the material related to the stress-coping-adaptation process and the biopsychosocial model. Remember that these are interacting factors. The general framework is based on an article by Jones and Barlow (1990), and more recent research summarized in the text is consistent with it. There are three sets of variables: Contributing Factors, Buffering factors, and Psychological Processes that lead to the development of PTSD. Contributing Factors increase the probability of experiencing the Psychological Processes leading to PTSD: 1. Biological Vulnerability: e.g., an especially reactive H-P-A axis or autonomic nervous system, more active brain circuits that may be involved in intrusive imagery/flashbacks 2. Psychological Vulnerability: e.g., weak sense of control over life is associated with more severe reaction to a particular traumatic stressor, tendency to ruminate or catastrophize (could be genetic or socially learned), previous psychopathology or personality risk (e.g., neuroticism, higher levels of trait anxiety) NOTE: Biological Vulnerability and Psychological Vulnerability are both DIATHESES: They are pre-existing dispositions that create risk of disorder. 3. Negative Life Events: More "ordinary" stress in recent past is associated with more severe reaction to a particular traumatic stressor; "legacies" of having traumatized parents (e.g., children of Holocaust survivors) or 4. The Nature of the Traumatic Stressor: Extent and severity of combat exposure is related to severity of symptoms; more uncontrollable & unpredictable traumas are associated with stronger "Initial Alarm" (see below under Psychological Processes), it is very clear that the degree of threat to one's life is the strongest predictor of whether an individual develops PTSD. NOTE: Negative Life Events and Aspects of the Traumatic Event are both CONTEXTUAL or SITUATIONAL Factors that INTERACT with diatheses to create more risk of disorder. Buffering Factors decrease the probability of experiencing the Psychological Processes leading to PTSD--they reduce risk: 1. Coping strategies: Although a traumatic stressor may preclude the use of some coping strategies, individuals who seem to have more coping strategies at their disposal, whether through circumstance or past social learning, seem to develop less severe symptoms. For example, torture victims appear to do better if they expected that they were risking torture, had experience in coping with severe stress stoically, and interpreted their torture experience as a form of repression (which gave their resistance meaning and purpose). 2. Social support: definitely helps by providing coping options or through the benefits of emotional expression and enhanced social connections. "Opening up" seems to help in treatment of PTSD and its prevention in the short-term aftermath of a traumatic event, and opening up is more likely to happen naturally (without intervention of professionals) for those who perceive a supportive social network to be available. Psychological Processes leading to PTSD: 1. Initial Alarm: the natural anxiety response to a dangerous event 2. Learned Alarm: anxiety/arousal becomes a conditioned response, associated with internal stimuli (memories) and external stimuli, like backfiring trucks, tornado sirens, thunder, etc. But, Learned Alarm is still not enough... 3. Anxious Apprehension: learned alarms themselves become feared because they seem unpredictable & uncontrollable. That is, the person spends much of the time in an anxious state, literally fearing "fear itself." This creates a chronic condition of overarousal & hypervigilance about physical signs of anxiety. This, in turn, ensures further conditioning of learned alarm to more memories & external stimuli, and motivates avoidance behavior. Because brain structures are active in the processing of these associations and memories, the brain differences associated with PTSD described on p. 190 may be the physical aspect of these psychological processes. In other words, the cognitive and conditioning
processeses that create Learned Alarm and Anxious Apprehension
MEDIATE the link between Contributing Factors and the symptoms
of PTSD. http://www.cas.ilstu.edu/psychology/catanzar/Psy350Handouts/PTSD_model.html |
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Salvatore J. Catanzaro, Illinois State University, Department of Psychology |