Date of Award
Doctor of Philosophy
This current study empirically tested elements of Ehlers and Clark's (2000) cognitive model of Posttraumatic Stress Disorder (PTSD) symptom maintenance using path analysis and structural equation modeling (SEM). Ehlers and Clark's model suggests that a reciprocal relationship between cognitive appraisals of the traumatic event and characteristics of the trauma memory maintain symptoms by increasing one's sense of current threat. Participants in the current study were 405 undergraduates at a Midwestern university who each reported having experienced at least one traumatic event during his/her lifetime. Path analysis was utilized to examine the possibility that one's posttraumatic cognitions may mediate the relationship between the centrality of the traumatic event to one's sense of self and one's current level of PTSD symptoms. The reverse mediation was also tested for each of the PTSD symptom clusters. Results indicate that both event centrality and posttraumatic cognitions are unique and independent predictors of current symptom level. SEM procedures were used to examine possible mediation as well as to test a reciprocal relationship between these predictors. Results are generally consistent with those from the path analysis although additional research is necessary before any firm conclusions can be stated. Overall, the results of this study support aspects of the cognitive model of PTSD; cognitive appraisals of the self and memory characteristics of the event were highly related to levels of distress. However, the current study suggests that overly integrated trauma memories lead to greater distress and not poorly integrated ones as suggested by Ehlers and Clark. The relationship between trauma memories and PTSD is in need of further study as is the role of memory and cognitions in the temporal development of PTSD.
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