Not all traumatized people develop trauma-related psychopathology. For this reason, a predisposition can be seen in people who develop PTSD (Post Traumatic Stress Disorder), one of the psychopathologies of trauma. The predisposition can be seen later or genetically. Therefore, psychological theory has been put forward to explain how PTSD occurs. Cognitive approaches are suggested for a better understanding of PTSD. Why does post-traumatic psychopathology occur in some people but not in others? In addition to this, all of these theories contribute to understanding the course of the disease. These theories can also be helpful in the psychoeducation of the traumatized person and for people who want to learn about the causes of their mental problems. Stress-Response The human brain integrates the traumatic situation and its related features with the cognitive schemas seen in it. In other words, he wants to digest any event he has experienced in a way. This intimidation process is followed by the attitude of bewilderment initially seen after the traumatic event. He goes on the defensive in order to exclude this situation, which does not remain in any structure or scheme that he used to digest, know, and adapt to. Thus, the individual can experience a feeling of denial or infertility. On the other hand, as the brain tries to digest and assimilate, its fear and anxiety increase; the assimilation process may be interrupted. In this process of indigestion, images related to the traumatic situation may reappear, and they may come back to consciousness in the direction of unwanted thoughts and nightmares. As a result of the tension between assimilation or intimidation tendency and defense mechanisms, the individual oscillates between repetitive thoughts and denial-emotion sterility as he tries to combine his schemas with the information about the traumatic event. This, in turn, reveals post-traumatic attitudes.
Basic Assumptions
The basic hypotheses that the person has are discussed in three main clusters: the meaningfulness of the world, the well-being of the world, the self-worth of the person. Traumatic situations shake these hypotheses and cause the person to question his/her positive beliefs about the world and himself. i causes him to realize his fragility. Traumatic victims state that they never thought that the situation they experienced could happen to them, and that they felt vulnerable, unprotected and insecure after the trauma. This attitude of trauma victims informs us that the person who has not been traumatized usually lives on the basis of an "illusion of invulnerability (the thought 'it won't happen to me')". As a result of the traumatic experience affecting their own hypotheses, individuals face their illusions; In other words, he begins to understand that bad situations can happen to his loved ones and himself. Traumas break down these core beliefs and hypotheses. Thus, the world becomes a dangerous and unreliable place for an individual with mental trauma. Fear Conditioning The acquisition of anxiety in behavioral form is explained by Mowrer's two-factor theory, which emphasizes the learning of avoidance. From the perspective of this theory, fear is acquired through classical conditioning and maintained through operant conditioning. External and internal stimuli present at the time of traumatic experience become conditioned stimuli with the effect of their excessive response to trauma. Encountering with conditioned stimuli causes the fear attitude to be conditioned. This, in turn, becomes a repulsive attitude that gives fear and anxiety at the end of classical conditioning processes, which is an unbiased attitude, and reveals anxiety. The individual discovers that the anxiety that arises by a conditioned stimulus over time decreases with some behaviors that he cannot do or do. This behavior (in a sense, avoidance behavior) that reduces anxiety is reinforced over time. When the avoidance attitude is learned, it becomes more resistant than extinction. What is meant by extinction is the reduction of the conditioned response by constantly seeing the conditioned attitude in the absence of the unconditioned attitude. The two factor hypothesis helps explain the persistence of overstimulated and avoidance symptoms of PTSD.
Cognitive / Intellectual Errors
According to cognitive style, anxiety and similar emotional problems are incompatible and unrealistic. causes thinking patterns. Cognitive variables such as how the threat is viewed, control, and predictability. It is thought to be effective in the continuation and development of . The characteristics of the source of stress are also effective in the emergence of the response. The form gives importance to the response elements within the traumatic memory that elicits re-experiencing, arousal responses, and dreams as well as cognitive perception. In addition, different factors such as life events, social supports, ways of coping, psychopathological history and family history have protective or revealing roles. Individuals with anxiety disorders tend to overestimate the danger and underestimate their own resources and ways of coping with stressors. After trauma, misconceptions and attitudes such as thinking "all or nothing", overgeneralizing, magnifying negative situations and ignoring positive situations, personalizing and blaming oneself, and trying to appear stronger than they are, come to the fore. Such thoughts, beliefs and attitudes negatively affect the psychology of individuals. Another important point is the reference that the individual makes to the cause of the trauma and the value he attaches to the traumatic experience. Beliefs about danger or threat have an important role in the development of fear and anxiety. Even learning the level of the disaster experienced later, "what kind of disaster I was in, I could have lost everything", can lead to a change in the meaning of the trauma and a change in the psychology of the person. Beliefs about the protectiveness of different “safety inventories” not only reduce anxiety, but also pave the way for the continuation of psychopathology. The fact that traumatic stressors are uncontrollable and unpredictable has a sufficiently important role in the formation and maintenance of fear-oriented responses. People are controllable and predictable, but they prefer stressors to uncontrollable and unpredictable ones. Stressor predictability has been shown to play an important role against traumatization. Neutral and conditioned stimuli accompanying uncontrollable stressors generally create more fear. Being prepared for this situation and knowing the controllability of the situation reduces the stress caused by the stimulus. In the opposite case, learned helplessness, that is, a chronic fear, responds and the answers are effective. Associated disorders and difficulties in seeing Belief in control or loss of control may occur at the time of trauma as well as after it. Difficulties seen after trauma and steps taken to change the negative consequences or effects of life events are associated with a sense of control. It is thought that this situation also has a protective function for psychopathology.
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