Posttraumatic Stress Disorder 509
The cognitive- personality constructs of sociotropy and autonomy, which Beck (1983)
originally proposed as vulnerability factors for depression, might have relevance for the
development of PTSD. Depending on the type of trauma, a person whose self-worth is
excessively dependent on receiving love and approval from others (i.e., high sociotropy)
might be more negatively affected by an interpersonal trauma, whereas a person who
values mastery and achievement (i.e., high autonomy) might be more affected by trauma
that threatens personal safety, being in control, and assumptions about the parameters
of achievement. A nonclinical study found that sociotropy and autonomy were signifi-
cantly related to self- reported PTSD symptoms, although there was no attempt to assess
congruence between personality and type of trauma (Kolts, Robinson, & Tracy, 2004).
Although speculative at this time, the close association between PTSD and major depres-
sion in response to trauma is consistent with the possibility that a common underlying
cognitive vulnerability could be evident in the two disorders.
Like other models of PTSD, occurrence of a traumatic event plays a key role in the
etiology of PTSD. Traum a has been defined as “any experience that by its occurrence
has threatened the health or well-being of the individual” (Brewin et al., 1996, p. 675).
This indicates that a broad range of events could be traumatic provided they violated
the individual’s core schemas about oneself, the world, and/or other people. As illus-
trated in Figure 12.1, the cognitive model proposes an interaction between trauma and
predisposing schemas that result in activation of the maladaptive schematic structures
of PTSD. A type of diathesis– stress relationship is suggested in which the nature and
severity of the trauma interacts with schematic vulnerability. For individuals who are
extreme on a vulnerability factor (i.e., beliefs that the world is dangerous), possibly
fewer and less severe experiences of a certain type will elicit PTSD symptoms, whereas
an individual who exhibits a mild form of the vulnerability will require a much more
intense or multiple threatening experiences in order to trigger persistent PTSD. Edward,
for example, had a strong belief in the importance of the rule of law, respect for human
life, and the effectiveness of control. The chaos and butchery he witnessed in Rwanda
shattered his assumptions about the world, human nature, and his ability to control life-
threatening events. These core schemas that characterize an autonomous personality
orientation may have interacted with the brutality he witnessed to increase his vulner-
ability to PTSD.
Clinician Guideline 12.11Cognitive theory proposes a diathesis– stress model of vulnerability for PTSD in which risk
is defined in terms of a match between the traumatic experience and preexisting cognitive-
personality factors such as high sociotropic or autonomous concerns.Automatic Processing
Enhanced Encoding during Trauma
The way in which a traumatic event is processed at the time of its occurrence will influ-
ence how the event is represented in working memory. An automatic, preconscious selec-
tive encoding bias for highly salient threat and danger elements of the trauma with a