FC02.01 - New psychotherapeutic package for PTSD- patients without marked personality disorders

Abstract

Cognitive models suggest that PTSD becomes persistent when individuals process the trauma in a way that leads to a sense of threat, which arises as a consequence of excessively negative appraisals of the trauma and its sequelae, and of a disturbance of autobiographical memory characterised by poor elaboration and contextualization, strong associative memory and strong conceptual priming. Nevertheless, despite adequacy and pertinence of the cognitive model of PTSD, recent neurobiological evidence shows that emotions can be experienced without cortical interpretations of stimuli, and clinical evidence indicates that experiences can be stored as isolated affective fragments that function later to distort cognition. This suggests that cognitive therapies are based on a limited model of mental functions that sometimes must be supplemented by broader approach, combined with classical cognitive therapy. EMDR for instance may be a specific treatment for non-cognitive driven and primary emotions, derived from direct activation of the amygdala. The actual impact of CBT on PTSD may be considered a result of the well known efficacy of those treatments on comorbid personality disorders or unipolar depression, which are often associated with PTSD. However, the usually high failure rate in treating PTSD along the lines of CBT may be due to its inefficacy on primary emotions, not- linked to cognitive dysfunction. Therefore, a combination of treatments targeting primary emotional disorders as well as secondary affective disorders, linked to cognitive distortions, may enhance efficacy of therapeutic management in PTSD.