Cognitive-Emotional Theories and Trauma Meagan L. Howell, M.S. Saint Louis University

Theories of PTSD  Cognitive Models Changes in memory function Automatic processing Shattered core beliefs  Janoff-Bulman

Stress Response Theory  Initial emotional reaction to trauma  Efforts to “assimilate” new info from the trauma into knowledge base

Information Processing Theory  Trauma memories processed in separate & distinct way  Incomplete processing leads to PTSD

Cognitive Behavioral Theory  Aaron T. Beck  Examine the interactions between thoughts, emotions, and behaviors.  Experience over time impacts the patterns we develop EMOTION BEHAVIOR THOUGHT

CBT and Trauma  Focus is on victim’s: Memory functioning Information processing Shattered or challenged core beliefs Avoidance strategies Self-criticism

Social Learning Theory  Albert Bandura  Observational learning  Modeling  Key for Learning:

Learned Helplessness  Martin Seligman  Lack control in environment  Related to depression and anxiety responses

Attributions / Locus of Control Internal v. External Internal: External:

Attributions / Locus of Control  Global v. Unique  Global:  Unique/Situational:

Attributions / Locus of Control  Stable v. Unstable  Stable:  Unstable:

Maladjustment  DEPRESSION  Internal  Global  Stable  ANXIETY  External  Global  Unstable

Victim’s Appraisals  Negative appraisals that develop can be either external or internal: External appraisals are typically related to viewing the world and others as potentially dangerous and harmful Internal appraisals are more often related to a sense of responsibility for the trauma

Types of Appraisals  Overgeneralization of the traumatic event into normal events  Appraisals of one’s emotional and behavioral responses during the event These appraisals are thought to lead to feelings of shame, responsibility, and guilt

Kubany’s Model  Connects PTSD to social psychological elements including hindsight bias, responsibility, and determinism  The key is the symptom of post- traumatic guilt

Post-Traumatic Guilt  Define guilt as, “an unpleasant feeling with an accompanying belief (or beliefs) that one should have thought, felt, or acted differently” (p.429).  Guilt is an important factor in the development and maintenance of PTSD symptoms in combat veterans, victims of domestic violence, rape, child sexual abuse, and reckless drivers  Hindsight bias cognitions “should have, could have, if only” contribute to post-traumatic guilt  Guilt tends to be tied to one’s behaviors

Shame  Sense of public exposure of some mistake or failure, accompanied by feelings of disapproval in the eyes of others and a negative evaluation of the self (Tangney, Miller, Flicker, & Barlow, 1996).  Shame is tied more closely to the Self