THE SHAPING OF VULNERABILITY FACTORS INCLUDING CORE COGNITIVE 

BELIEFS AND THEIR SUBSEQUENT ROLE IN POSTTRAUMATIC STRESS DISORDER

AND GENERAL CLINICAL PSYCHOPATHOLOGY

Testa, Sandra

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THE SHAPING OF VULNERABILITY FACTORS INCLUDING CORE COGNITIVE BELIEFS AND THEIR SUBSEQUENT ROLE IN POSTTRAUMATIC STRESS DISORDER AND GENERAL CLINICAL PSYCHOPATHOLOGY

Open Access

Author:: Testa, Sandra
Graduate Program:: Psychology
Degree:: Doctor of Philosophy
Document Type:: Dissertation
Date of Defense:: December 07, 2007
Committee Members:: Thomas D Borkovec, Committee Chair/Co-Chair
William Ray, Committee Member
Louis Georges Castonguay, Committee Member
Dennis Edward Heitzmann, Committee Member
Keywords:: vulnerability schemas
vulnerability factors
cognitive schemas
core beliefs
PTSD anxiety depression
posttraumatic adjustment
Abstract:: ABSTRACT The present study examines the role of core beliefs in posttraumatic outcome including the development and maintenance of PTSD and general clinical psychopathology in a non-treatment seeking college-age population. Although trauma and clinical PTSD literatures are replete with references concerning the potential impact that traumatic and/or uncontrollable stressor(s) may have on cognitive schemata and their role in negative posttraumatic adjustment, little empirical research exists that delineates potentially important differences in the nature and quality of core belief systems for which both trauma and PTSD history are controlled. Unique aspects of the present study include: 1) the inclusion of two domains of core belief measures (i.e., early maladaptive schemas via the Schema Questionnaire as proposed by Young (1994) and the three basic personal belief systems as measured by the World Assumptions Scale (WAS) that have been posited by Janoff-Bulman (1985) as centrally related to traumatization experiences; 2) the examination of these broad ranging core belief systems in relation to other factors that have been found or proposed to be significantly related to PTSD development and/or maintenance, including aspects of the traumatic event(s), dissociation, and related areas of clinical symptomatology; and 3) the use of four specific study groups that controlled for both level of traumatization and PTSD symptomatology (no trauma; trauma without past or current PTSD; PTSD in remission; and PTSD current) to enhance conclusions regarding the most potent predictors of PTSD symptomatology by analyzing these factors simultaneously across progressive (i.e., continuous) levels of PTSD symptomatology, as well as between the discrete diagnostic groups. Three main overarching hypotheses were generated in this study, and related to: 1) the detection of general between-group differences between the four study groups on important indices of PTSD se verity, core beliefs, and measures of clinical symptomatology; 2) specific core beliefs that would predict PTSD symptomatology to a equal or greater extent than other important factors that have been related to posttraumatic adjustment, irrespective of depression status; and 3) cognitive specificity of core belief systems between major domains of clinical symptomatology (i.e., anxiety and depression) as well as within specific clinical domains (i.e., within types of anxiety). The results largely supported these hypotheses, where specific subtypes of core beliefs were strongly associated with posttraumatic outcome. In particular, the core belief of vulnerability demonstrated a highly consistent relationship with PTSD severity, as well as all domains of anxiety assessed within the study (i.e., state anxiety, anxiety sensitivity, and worry). This finding is consistent with Beck’s (1967) hypothesis that vulnerability schemata underlie the anxiety disorders. Furthermore, evidence was found both for the specificity of core cognitive beliefs between major domains of clinical symptomatology (i.e., anxiety, depression, dissociation) as well as within a given domain (i.e., between qualitatively different types of anxiety measured in the present study). Collectively, the results offer additional support for the further delineation and direct targeting of both traumacentric and broader underlying core beliefs in etiological models of PTSD, as well as anxiety and depression more generally. Further, preliminary results offer support for disorder and domain specific cognitive schemata that may reflect particularly salient domains for prevention and/or therapeutic intervention programs in both at-risk and general populations.

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