Cited by 641Posttraumatic Stress Disorder ResearchChild Abuse and TraumaPsychoanalysis and Psychopathology Research

A prospective investigation of the role of cognitive factors in persistent posttraumatic stress disorder (PTSD) after physical or sexual assault

Dunmore, Emma, Clark, David M, Ehlers, Anke·2001·Behaviour Research and Therapy

Abstract

The effectiveness of psychological treatments for PTSD is likely to be enhanced by improved understanding of the factors involved in maintaining the disorder. Ehlers and Clark [A cognitive model of persistent posttraumatic stem disorder Behav. Res. Ther. 38 (2000) 319-345] recently proposed a cognitive model of maintenance. The current study aimed to investigate several cognitive factors highlighted in Ehlers and Clark's model using a prospective design. Fifty-seven victims of physical or sexual assault participated in the study. Cognitive factors were assessed within 4 months of assault and victims were followed-up 6 and 9 months after the assault. Cognitive variables which significantly predicted PTSD severity at both follow-ups were: cognitive processing style during assault (mental defeat, mental confusion, detachment); appraisal of assault sequelae (appraisal of symptoms, perceived negative responses of others, permanent change); negative beliefs about self and world; and maladaptive control strategies (avoidance/safety seeking). Relationships between early appraisals, control strategies, and processing styles and subsequent PTSD severity remained significant after statistically controlling for gender and perceived assault severity. These findings support the cognitive model of PTSD proposed by Ehlers and Clark and suggest that effective treatment will need to address these cognitive factors.

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Crossref · 10.1016/s0005-7967(00)00088-7

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Authors
Dunmore, E., Clark, D. M., & Ehlers, A.
Affiliations
  • University of Surrey (GB)
  • University of Oxford (GB)
Corresponding author
Dunmore, Emma
Venue
Behaviour Research and Therapy
Publisher
Elsevier BV
Published
2001-09
Volume
39
Issue
9
Pages
1063-1084
ISSN
0005-7967 (ISSN-L)
OpenAlex
W2122304133
Cited by
640
References
58
Citations by year
2026: 14 · 2025: 18 · 2024: 11 · 2023: 28 · 2022: 22 · 2021: 19 · 2020: 35 · 2019: 28 · 2018: 30 · 2017: 29 · 2016: 22 · 2015: 63 · 2014: 23 · 2013: 38 · 2012: 22
FWCI
18.68
Type
journal article
Language
en
Open access
closed
Locations
  • Behaviour Research and Therapy (publishedVersion)
  • PubMed (publishedVersion)
Funders
  • Wellcome Trust (069777)
  • Medical Research Council
Topics
  • Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
  • Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
  • Social Sciences › Psychology › Clinical Psychology › Psychoanalysis and Psychopathology Research
Keywords
post-traumatic stress disorder, physical assault, sexual assault, cognitive processing styles, avoidance
MeSH terms
Adult, Cognition Disorders, Female, Humans, Male, Prospective Studies, Psychiatric Status Rating Scales, Psychological Tests, Surveys and Questionnaires, Rape, Severity of Illness Index, Stress Disorders, Post-Traumatic, Violence

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