THE ETIOLOGY OF POSTTRAUMATIC-STRESS-DISORDER

In search of a more thorough understanding of Posttraumatic Stress Disorder (PTSD), theories of etiology have emerged from virtually every theoretical persuasion. Many provide a framework useful for understanding certain facets of the disorder. However, based on current knowledge, a model must be comprehensive enough to encompass the constellation of symptoms that comprise the disorder, the differential severity of symptoms, the presence of PTSD in some individuals but not others experiencing similar trauma, and recent empirical research bearing on these factors. In this paper, we review etiological models of PTSD and propose a new model based on a recent conceptualization of the process and origins of anxiety and panic. This model includes consideration of the role of biological and psychological vulnerabilities, negative life events, alarms (fear reactions), perceptions of control, social support, and coping strategies. Empirical research supporting the inclusion of these components is presented. Finally, etiological and phenomenological similarities between anxiety disorders, specifically panic disorder and PTSD, are discussed. © 1990.