Psychological and Social Theories of PTSD

Psychological theories have been developed to explain why certain trauma survivors go on to develop posttraumatic stress disorder and others do not. These theories try to capture what happens at the level of the trauma survivor’s personal experiences, in terms of thoughts, memory, emotions, behaviours, and underlying processes of which the person is unaware. Moreover, psychological theories are essential to understanding the working mechanisms of psychotherapy for posttraumatic stress disorder. In this chapter, we successively focus on learning theories, dual representation theory, cognitive theory and ‘hotspots’, reconsolidation, psychodynamic theories, and posttraumatic stress disorder from a social and societal perspective. Some theories focus on fear as the primary emotional network involved, whereas others propose that emotions such as anger, grief, shame, and guilt are equally important. Some theories emphasize the role of negative appraisals; others focus on the role of different representations or the malleability of the traumatic memory. The social perspective is also important, as traumatic experiences happen in the context of responses of others and societal views on trauma, and these influence symptom expression. The most important concepts used by these theories are discussed, followed by their accounts of natural recovery and their proposed working mechanisms for psychological treatments.