Cognitive strategies and the resolution of acute stress disorder

Information processing theories propose that resolution of posttraumatic stress is mediated by activation of traumatic memories and modification of threat-based beliefs. It is argued that this adaptive response is associated with reduced cognitive avoidance. Thought control strategies were assessed in civilian trauma survivors with acute stress disorder (N = 45) prior to and following either cognitive behavior therapy or supportive counseling. Participants completed the Acute Stress Disorder Interview, the Beck Depression Inventory, the State Trait Anxiety Inventory the Impact of Event Scale, and the Thought Control Questionnaire within 2 weeks of their trauma and 6 months following treatment. Receiving cognitive behavior therapy was associated with reductions in the use of punishment and worry, and increases in the use of reappraisal and social control strategies. Further reduced posttraumatic stress symptoms were associated with increased use of social control strategies and reappraisal strategies, and decreased use of worry. Findings are discussed in terms of the cognitive strategies that may mediate acute posttraumatic stress.