Foa, Steketee, and Rothbaum (1989) proposed that a traumatic event is represented in memory as a fear structure that is characterized by a large number of harmless stimulus elements erroneously associated with the meaning of danger. These erroneous associations are reflected in the perception of the world as entirely dangerous. In a further development of emotional theory for PTSD, Foa and Jaycox (1999) suggested that the physiological and behavioral responses that occurred during and after the event, including the PTSD symptoms themselves, are interpreted as signs of personal incompetence, leading survivors to the erroneous perception about themselves as entirely incompetent. The erroneous cognitions about the world and the self underlie PTSD symptoms, which in turn reinforce the erroneous cognitions in a vicious cycle (for a more detailed discussion, see Foa & Rothbaum, 1998). PTSD symptoms are further maintained by cognitive and behavioral avoidance strategies that prevent exposure to corrective information and the incorporation of such information into fear structure. For example, by avoiding safe reminders of the trauma, the person does not have the opportunity disconfirm the belief that feared consequences will occur (e.g., being assaulted again, not being able to cope with the distress produced by the situation). Overcoming the tendency to avoid trauma-related stimuli and countering the erroneous cognitions are seen as critical mechanisms of natural recovery from trauma as well as recovery through therapy.
Was this article helpful?