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The cascade model: an alternative to comorbidity in the pathogenesis of posttraumatic stress disorder
R D Alarcon1, S G Glover, C G Deering
1Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA.
Abstract:
Comorbidity has been used extensively to explain the numerous co-occurring psychiatric syndromes accompanying chronic posttraumatic stress disorder (PTSD). A cascade model is proposed as an alternative to comorbidity for the pathogenesis and clinical course of the condition. This model allows for a dynamic, integrated conceptualization of disease progression in PTSD. Findings in the clinical, epidemiological, neurobiological, and psychosocial literature which might support this model are described. Conceptual and heuristic difficulties and/or potential objections to the model are also examined. Finally, diagnostic and treatment implications as well as potential research applications of the model are discussed.
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