Cited by 640Posttraumatic Stress Disorder ResearchChild Abuse and TraumaPsychoanalysis and Psychopathology Research

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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

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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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Authors: Dunmore, E., Clark, D. M., & Ehlers, A.
Affiliations: University of Surrey (GB)
University of Oxford (GB)
Corresponding author: Dunmore, Emma
ORCID: Clark, David M
Ehlers, Anke
Venue: Behaviour Research and Therapy
Publisher: Elsevier BV
Published: 2001-09
Volume: 39
Issue: 9
Pages: 1063-1084
ISSN: 0005-7967 (ISSN-L)
DOI: 10.1016/s0005-7967(00)00088-7
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
Licence: www.elsevier.com/tdm/userlicense/1.0/ (tdm)
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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A prospective investigation of the role of cognitive factors in persistent Posttraumatic Stress Disorder (PTSD) after physical or sexual assault

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