Cognitive Therapy of Anxiety Disorders

508 TREATMENT OF SPECIFIC ANXIETY DISORDERS

variables discussed above, the cognitive model proposes that particular enduring beliefs
about personal threat, vulnerability, and the world might predispose to the persistence
of PTSD symptoms in response to a traumatic experience. Rigid beliefs that the world is
extremely dangerous or the opposite, extremely safe, and self- schemas representing ideas
of extreme competence or incompetence may be predisposing factors for PTSD (Foa &
Rothbaum, 1998). Ehlers and Clark (2000) suggested that beliefs about the importance
of maintaining control over thoughts and emotions might cause one to appraise reexpe-
riencing symptoms in a more negative and threatening manner.

MALADAPTIVE MEMORY

STRUCTURES (SCHEMAS) OF

TRAUMA, WORLD, SELF, AND

FUTURE

Enhanced Encoding

Bias for Threat and

Danger

Traumatic

Experience

Preexisting Personality/

Schema Vulnerability

Attentional

Threat Bias

Faulty Trauma

Memory Retrieval

Trauma-Related Intrusions and

Physiological Arousal

NEGATIVE APPRAISAL OF

IN TRUSIONS AND AROUSAL

AUTOMATIC

PROCESSING

ELABORATIVE

PROCESSING

Search for

Safety

(avoidance)

Control/Suppression

Efforts

Persistent Negative

Emotion

ETIOLOGICAL

LEVEL

X

figure 12.1. Cognitive model of posttraumatic stress disorder.