10 - Promoting cognitive change in posttraumatic stress disorder

Summary

It has long been observed that traumatic experiences are often followed by a distinct pattern of distressing symptoms. Accounts of such reactions began to appear in the psychiatric literature with greater frequency after the Second World War, resulting in the inclusion of “gross stress reaction” in the first version of the American Psychiatric Association (APA) Diagnostic and Statistical Manual (DSM-I) in 1952. Although the DSM-I noted that exposure to extreme stress may trigger great psychological distress, it did not provide diagnostic criteria for the stress reaction. It was not until the third revision of the DSM(DSM-III; APA, 1980) that mental health experts first codified the pattern of posttrauma reactions as a distinct anxiety disorder, termed posttraumatic stress disorder (PTSD), and offered clear and specific diagnostic criteria.

A vast amount of research has been conducted on PTSD since its formal designation over 20 years ago. Although much of this research has been a theoretical, focusing on issues such as phenomenology, prevalence, and comorbidity, theories about the development and maintenance of PTSD have stimulated a number of studies investigating both the psychopathology and the treatment of the disorder. Among the most influential and fruitful models of PTSD are those offered by cognitive or information-processing theory and emotional-processing theory.

In this chapter we first review the diagnosis and prevalence of PTSD. Second, we review the history of the evolution of cognitive models of PTSD.