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Implications of neuroscientific evidence for the cognitive models of post-traumatic stress disorder

机译:神经科学证据对创伤后应激障碍认知模型的影响

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摘要

Brewin's dual representation theory, Ehlers and Clark's cognitive appraisal model, and Dalgleish's schematic, propositional, analogue and associative representational systems model are considered in the light of recent evidence on the neural substrates of post-traumatic stress disorder (PTSD). The models' proposals about the cognitive mechanism of memory dysfunction in PTSD are described and evaluated against current knowledge about the neural pathways and functions disrupted in PTSD. A dual pathway model of memory is consistent with neuroscience of memory. The appraisal model also provides an account of the top-down modulation of memory and arousal problems consistent with current neuroscientific evidence of PTSD. Dalgleish's model is less consistent with the evidence because it relies upon assumptions that cannot yet be tested neuroscientifically. All three models under-specify the causal and maintaining influence of hyperarousal relative to the role it plays in current neuroscientific models of PTSD. Implications of the evidence for improving treatment and prevention are discussed.
机译:考虑到创伤后应激障碍(PTSD)的神经基础的最新证据,考虑了布鲁金的双重表示理论,埃勒斯和克拉克的认知评估模型以及达格勒什的示意图,命题,类似和联想表示系统模型。描述了有关PTSD记忆功能障碍的认知机制的模型建议,并根据有关PTSD的神经途径和功能的最新知识进行了评估。记忆的双重途径模型与记忆的神经科学相一致。评估模型还提供了与自上而下的PTSD的神经科学证据一致的记忆和唤醒问题的自上而下的调制方式。 Dalgleish的模型与证据不太一致,因为它依赖于尚无法通过神经科学检验的假设。相对于它在当前PTSD的神经科学模型中所起的作用,这三种模型都没有充分说明hyperaralal的因果关系和维持作用。讨论了改善治疗和预防证据的含义。

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