Abstract
Psychological theories have been developed to explain why certain trauma survivors go on to develop posttraumatic stress disorder and others do not. These theories try to capture what happens at the level of the trauma survivor’s personal experiences, in terms of thoughts, memory, emotions, behaviours, and underlying processes of which the person is unaware. Moreover, psychological theories are essential to understanding the working mechanisms of psychotherapy for posttraumatic stress disorder. In this chapter, we successively focus on learning theories, dual representation theory, cognitive theory and ‘hotspots’, reconsolidation, psychodynamic theories, and posttraumatic stress disorder from a social and societal perspective. Some theories focus on fear as the primary emotional network involved, whereas others propose that emotions such as anger, grief, shame, and guilt are equally important. Some theories emphasize the role of negative appraisals; others focus on the role of different representations or the malleability of the traumatic memory. The social perspective is also important, as traumatic experiences happen in the context of responses of others and societal views on trauma, and these influence symptom expression. The most important concepts used by these theories are discussed, followed by their accounts of natural recovery and their proposed working mechanisms for psychological treatments.
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References
Abraham K (1921) Symposium on psychoanalysis and the war neurosis held at the fifth international psycho-analytical congress Budapest, September 1918. Int Psycho-Anal Library 2:22–29
Allen JB, Fonagy P (2015) Trauma. In: Luyten P, Mayes LC, Target M, Fonagy P, Blatt S (eds) Handbook of psychodynamic approaches to psychopathology. Guilford Press, New York, pp 165–198
American Psychiatric Association (1980) Diagnostic and statistical manual of mental disorders, 3rd edn. APA, Washington, DC
American Psychiatric Association (2013) Diagnostic and statistical manual of mental disorders, 5th edn. APA, Washington, DC
American Psychological Association (2017) Clinical practice guideline for the treatment of posttraumatic stress disorder (PTSD) in adults. APA, Washington, DC. https://www.apa.org/ptsd-guideline/ptsd.pdf
Barazzone N, Santos I, McGowan J, Donaghay-Spire E (2019) The links between adult attachment and post-traumatic stress: a systematic review. Psychol Psychother 92:131–147
Basoglu M, Mineka S, Paker M, Aker T, Livanou M, Gok S (1997) Psychological preparedness for trauma as a protective factor in survivors of torture. Psychol Med 27(6):1421–1433
Becker D (1995) The deficiency of the concept of posttraumatic stress disorder when dealing with victims of human rights violations. In: Kleber R, Figley C, Gersons B (eds) Beyond trauma. Plenum Press, New York, pp 99–110
Becker D (2007) Die Erfindung des Traumas—Verflochtene Geschichten [The invention of trauma—twisted stories]. Freitag Mediengesellschaft, Berlin
Besser A, Neria Y (2010) The effects of insecure attachment orientations and perceived social support on posttraumatic stress and depressive symptoms among civilians exposed to the 2009 Israel-Gaza war: a follow-up cross-lagged panel design study. J Res Pers 44:335–341
Bettelheim B (1943) Individual and mass behavior in extreme situations. J Abnorm Soc Psychol 38(4):417–452
Borges LM, Barnes SM, Farnsworth JK, Drescher KD, Walser RD (2020) A contextual behavioral approach for responding to moral dilemmas in the age of COVID-19. J Contextual Behav Sci 17:95–101
Bowlby J (1969/1982) Attachment and loss 2nd edn, vol 1. Basic Books, New York
Bradley R, Greene J, Russ E, Dutra L, Westen D (2005) A multidimensional meta-analysis of psychotherapy for PTSD. Am J Psychiatr 162:214–227
Brewin CR (2003) Posttraumatic stress disorder: malady or myth? Yale University Press, New Haven
Brewin CR (2005) Implications for psychological intervention. In: Vasterling JJ, Brewin CR (eds) Neuropsychology of PTSD: biological, cognitive and clinical perspectives. Guilford Press, New York, pp 271–291
Brewin CR (2008) What is it that a neurobiological model of PTSD must explain? Prog Brain Res 167:217–228
Brewin CR (2015) Reconsolidation versus retrieval competition: rival hypotheses to explain memory change in psychotherapy. Behav Brain Sci 38:e4. https://doi.org/10.1017/S0140525X14000144
Brewin CR (2021) Tilting at windmills: why attacks on repression are misguided. Perspect Psychol Sci 16:443–453
Brewin CR, Burgess N (2014) Contextualisation in the revised dual representation theory of PTSD: a response to Pearson and colleagues. J Behav Ther Exp Psychiatry 45:217–219
Brewin CR, Holmes EA (2003) Psychological theories of posttraumatic stress disorder. Clin Psychol Rev 23:339–376
Brewin CR, Dalgleish T, Joseph S (1996) A dual representation theory of posttraumatic stress disorder. Psychol Rev 103:670–686
Brewin CR, Gregory JD, Lipton M, Burgess N (2010) Intrusive images in psychological disorders: characteristics, neural mechanisms, and treatment implications. Psychol Rev 117:210–232
Brunet A, Poundja J, Tremblay J, Bui É, Thomas É, Orr SP et al (2011) Trauma reactivation under the influence of propranolol decreases posttraumatic stress symptoms and disorder: 3 open-label trials. J Clin Psychopharmacol 31(4):547–550
Brunet A, Saumier D, Liu A, Streiner DL, Tremblay J, Pitman RK (2018) Reduction of PTSD symptoms with pre-reactivation propranolol therapy: a randomized controlled trial. Am J Psychiatr 175:427–433
Clarkin JF, Yeomans FE, Kernberg OF (2006) Psychotherapy for borderline personality: focusing on object relations. American Psychiatric Publishing, Arlington
Crowder RG (1976) Principles of learning and memory. Erlbaum, Hillsdale
Ehlers A, Clark DM (2000) A cognitive model of posttraumatic stress disorder. Behav Res Ther 38:319–345
Ehlers A, Maercker A, Boos A (2000) Posttraumatic stress disorder following political imprisonment: the role of mental defeat, alienation, and perceived permanent change. J Abnorm Psychol 109:45–55
Ehlers A, Hackmann A, Steil R, Clohessy S, Wenninger K, Winter H (2002) The nature of intrusive memories after trauma: the warning signal hypothesis. Behav Res Ther 40:995–1002
Ehlers A, Hackmann A, Michael T (2004) Intrusive re-experiencing in post-traumatic stress disorder: phenomenology, theory and therapy. Memory 12:403–415
Enning B (2009) De oorlog van Bastiaans. De LSD-behandeling van het kampsyndroom [Bastiaans’ war. The LSD-treatment of the concentration camp syndrome]. Augustus, Amsterdam
Figley CR (1978) Stress disorders among Vietnam veterans. Brunner/Mazel, New York
Figley CR (ed) (1995) Compassion fatigue. Coping with secondary stress disorder in those who treat the traumatized. Brunner-Routledge, New York
Foa EB, Riggs DS (1995) Posttraumatic stress disorder following assault: theoretical considerations and empirical findings. Curr Dir Psychol Sci 5:61–65
Foa EB, Rothbaum BO (1998) Treating the trauma of rape. Guilford Press, New York
Foa EB, Street GP (2001) Women and traumatic events. J Clin Psychiatry 62:29–34
Foa EB, Steketee G, Rothbaum BO (1989) Behavioral/cognitive conceptualisation of post-traumatic stress disorder. Behav Ther 20:155–176
Foa EB, Hembree EA, Rothbaum BO (2007) Prolonged exposure therapy for PTSD. Emotional processing of traumatic experiences. Oxford University Press, New York
Freud S (1920/1955) Beyond the pleasure principle. The standard edition of the complete psychological works of Sigmund Freud (Beyond the pleasure principle, group psychology and other works, vol XVIII (1920–1922), pp. 1–64). Hogarth Press and the Institute of Psycho-Analysis, London
Freud S, Breuer J (1895/1987) Studien über Hysterie [Studies on hysteria]. S. Fischer, Frankfurt a.M
Gill MM (1982) Analysis of transference (Theory and technique, vol 1). International Universities Press, New York
Gray R, Budden-Potts D, Bourke F (2019) Reconsolidation of traumatic memories for PTSD: a randomized controlled trial of 74 male veterans. Psychother Res 29(5):621–639
Gray RM, Budden-Potts D, Schwall RJ, Bourke FF (2020) An open-label, randomized controlled trial of the reconsolidation of traumatic memories protocol (RTM) in military women. Psychol Trauma Theory Res Pract Policy. https://doi.org/10.1037/tra0000986
Grey N, Holmes E (2008) “Hotspots” in trauma memories in the treatment of post-traumatic stress disorder: a replication. Memory 16:788–796
Grey N, Holmes E, Brewin C (2001) Peritraumatic emotional ‘hot spots’ in memory. Behav Cogn Psychother 29:367–372
Grey N, Young K, Holmes E (2002) Cognitive restructuring within reliving: a treatment for emotional ‘hotspots’ in posttraumatic stress disorder. Behav Cogn Psychother 30:37–56
Griffin BJ, Purcell N, Burkman K, Litz BT, Bryan CJ, Schmitz M et al (2019) Moral injury: an integrative review. J Trauma Stress 32:350–362
Herman JL (1992) Trauma and recovery. Basic Books, New York
Horowitz MJ (1976/1986) Stress response syndromes, 1st and 2nd edn. Jason Aronson, New York
Janoff-Bulman R (1992) Shattered assumptions. Towards a new psychology of trauma. Free Press, New York
International Society for Traumatic Stress Studies (2019) PTSD prevention and treatment guidelines methodology and recommendations. https://www.istss.org
James EL, Bonsall MB, Hoppitt L, Tunbridge EM, Geddes JR, Milton AL, Holmes EA (2015) Computer game play reduces intrusive memories of experimental trauma via reconsolidation-update mechanisms. Psychol Sci 26(8):1201–1215. https://doi.org/10.1177/0956797615583071
Kardiner A, Spiegel J (1947) War, stress, and neurotic illness. Hoeber, New York
Keane TM, Zimering RT, Caddell RT (1985) A behavioral formulation of PTSD in Vietnam veterans. Behav Ther 8:9–12
Keilson H (2005) Sequentielle Traumatisierung bei Kindern. Untersuchung zum Schicksal jüdischer Kriegswaisen, 2nd edn. Psychosozial-Verlag, Gießen
Khan MMR (1963) The concept of cumulative trauma. Psychoanal Study Child 18:286–306
Kindt M, Soeter M, Vervliet B (2009) Beyond extinction: erasing human fear responses and preventing the return of fear. Nat Neurosci 12:256–258
Kudler H (2012) A psychodynamic conceptualization of retraumatization. In: Duckworth MP, Follette VM (eds) Retraumatization: assessment, treatment, and prevention. Routledge, New York, pp 33–59
Lane RD, Ryan L, Nadel L, Greenberg L (2015) Memory reconsolidation, emotional arousal, and the process of change in psychotherapy: new insights from brain science. Behav Brain Sci 38:e1. https://doi.org/10.1017/S0140525X14000041
Lang PJ (1979) A bio-informational theory of emotional imagery. J Psychophysiol 16:495–512
Lang PJ (1985) The cognitive psychophysiology of emotion: fear and anxiety. In: Tuma AH, Maser J (eds) Anxiety and the anxiety disorders. Lawrence Erlbaum Associates, Hillsdale
Lifton RJ (1973) Home from the war: Vietnam veterans: neither victims nor executioners. Touchstone, New York
Lindsay DS, Read JD (1995) “Memory work” and recovered memories of childhood sexual abuse: scientific evidence and public, professional, and personal issues. Psychol Public Policy Law 1:846–908
Lissek S, van Meurs B (2015) Learning models of PTSD: theoretical accounts and psychobiological evidence. Int J Psychophysiol 98:594–605
Litz BT, Stein N, Delaney E, Lebowitz L, Nash WP, Silva C, Maguen S (2009) Moral injury and moral repair in war veterans: a preliminary model and intervention strategy. Clin Psychol Rev 29:695–706
Maercker A, Horn AB (2013) A socio-interpersonal perspective on PTSD: the case for environments and interpersonal processes. Clin Psychol Psychother 20:465–481
McNally RJ (2003) Remembering trauma. The Belknap Press of Harvard University Press, Cambridge, MA
Miller A (1997/1979) The drama of the gifted child: the search for the true self. Revised edition. Basic Books, New York
Mikulincer M, Ein-Dor T, Solomon Z, Shaver PR (2011) Trajectories of attachment insecurities over a 17-year period: a latent growth curve analysis of the impact of war captivity and posttraumatiC stress disorder. J Soc Clin Psychol 30(9):960–984
Mitscherlich A (1954) Zur psychoanalytischen Auffassung psychosomatischer Krankheitsentstehung [On the psychoanalytic understanding of psychosomatic pathogenesis]. Psyche 7(10):561–578
Monfils MH, Holmes EA (2018) Memory boundaries: opening a window inspired by reconsolidation to treat anxiety, trauma-related, and addiction disorders. Lancet Psychiatry 5(12):1032–1042
Mowrer OH (1960) Learning theory and behavior. Wiley, New York
Mueller J, Moergeli H, Maercker A (2008) Disclosure and social acknowledgement as predictors of recovery from posttraumatic stress: a longitudinal study in crime victims. Can J Psychiatr 53(3):160–168
Myers CS (1940) Shell shock in France. Cambridge University Press, Cambridge
Nader K, Schafe GE, Le Doux JE (2000) Fear memories require protein synthesis in the amygdala for reconsolidation after retrieval. Nature 406(6797):722
National Institute for Health and Care Excellence (2018, December 5). Post-traumatic stress disorder (NICE Guideline NG 116). https://www.nice.org.uk/guidance/ng116
Neuner F, Schauer M, Karunakara U, Klaschik C, Robert C, Elbert T (2004) Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry 4:34
Nijdam MJ, Baas MAM, Olff M, Gersons BPR (2013) Hotspots in trauma memories and their relationship to successful trauma-focused psychotherapy: a pilot study. J Trauma Stress 26:38–44
Oei TPS, Lim B, Hennessy B (1990) Psychological dysfunction in battle: combat stress reactions and posttraumatic stress disorder. Clin Psychol Rev 10:355–388
Ozer EJ, Best SR, Lipsey TL, Weiss DS (2003) Predictors of posttraumatic stress disorder and symptoms in adults: a meta-analysis. Psychol Bull 129:52–73
Schiller D, Monfils MH, Raio CM, Johnson DC, Ledoux JE, Phelps EA (2010) Preventing the return of fear in humans using reconsolidation update mechanisms. Nature 463:49–53
Shay J (1995) Achilles in Vietnam: combat trauma and the undoing of character. Scribner, New York
Steblay NM, Bothwell RK (1994) Evidence for hypnotically refreshed testimony: the view from the laboratory. Law Hum Behav 18:635–651
Straker G, The_Sanctuaries_Counselling_Team (1987) The continuous traumatic stress syndrome: the single therapeutic interview. Psychol Soc 8:48–78
Terr LC (1991) Childhood traumas: an outline and overview. Am J Psychiatr 148(1):10–20
Ullman S, Townsend S, Filipas H, Starzynski L (2007) Structural models of the relations of assault severity, social support, avoidance coping, self-blame, and PTSD among sexual assault survivors. Psychol Women Q 31(1):23–37
van der Kolk BA (2007) The history of trauma in psychiatry. In: Friedman MJ, Keane TM, Resick PA (eds) Handbook of PTSD: science and practice. Guilford Press, New York, pp 19–36
Withuis J (2010) The management of victimhood: long term health damage from asthenia to PTSD. In: Withuis J, Mooij A (eds) The politics of war trauma: the aftermath of World War II in eleven European countries. The University of Chicago Press, Chicago
Woodhouse S, Ayers S, Field AP (2015) The relationship between adult attachment style and post-traumatic stress symptoms: a meta-analysis. J Anxiety Disord 35:103–117
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Nijdam, M.J., Wittmann, L. (2022). Psychological and Social Theories of PTSD. In: Schnyder, U., Cloitre, M. (eds) Evidence Based Treatments for Trauma-Related Psychological Disorders. Springer, Cham. https://doi.org/10.1007/978-3-030-97802-0_3
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