Dalgleish Tim, Power Michael J
Emotion Research Group, Cognition and Brain Sciences Unit, Medical Research Council, 15 Chaucer Road, Cambridge CB2 2EF, UK.
Behav Res Ther. 2004 Sep;42(9):1069-88. doi: 10.1016/j.brat.2004.05.001.
Many cognitive theories of posttraumatic stress disorder (PTSD), including our own SPAARS model, propose that one basis of the disorder is the cognitive system's persistent failure to resolve discrepancies between trauma-related information and the content of pre-existing mental representations, such as schemas. This leads to the characteristic PTSD symptom pattern of re-experiencing and avoidance of trauma-related material. Furthermore, the nature of this unresolved discrepancy revolves around appraisals of threat and the corresponding emotion profile in PTSD is therefore predominantly intense fear and anxiety. This paper argues that this general framework can be extended to discrepancies around other appraisal dimensions such as loss, and consequently to other emotions such as sadness. A localized taxonomy is therefore proposed comprising emotional disorders that resemble PTSD in their basic patterns of re-experiencing and avoidance symptoms--what we call their 'emotion-non-specific component'--but that differ from PTSD in terms of the core emotions involved--what we call their 'emotion-specific component'. The clinical and nosological implications of this argument are discussed.
许多创伤后应激障碍（PTSD）的认知理论，包括我们自己的SPAARS模型，都认为该障碍的一个基础是认知系统持续无法解决创伤相关信息与预先存在的心理表征（如图式）内容之间的差异。这导致了PTSD的特征性症状模式，即反复体验和回避与创伤相关的材料。此外，这种未解决差异的本质围绕着威胁评估，因此PTSD中相应的情绪特征主要是强烈的恐惧和焦虑。本文认为，这个总体框架可以扩展到围绕其他评估维度（如损失）的差异，进而扩展到其他情绪（如悲伤）。因此，提出了一种局部分类法，包括在反复体验和回避症状的基本模式上类似于PTSD的情绪障碍——我们称之为它们的“情绪非特异性成分”——但在涉及的核心情绪方面与PTSD不同——我们称之为它们的“情绪特异性成分”。讨论了这一观点的临床和疾病分类学意义。
