PTSD severity among emergency personnel: An investigation based on the Ehlers and Clark cognitive model

The relevance of both cognitive and interpersonal processes in predicting adjustment to potentially traumatic events has been highlighted in the literature. The aim of the present study was to investigate whether dysfunctional disclosure mediates the relationship between excessive negative appraisals and posttraumatic stress disorder (PTSD) symptomatology that is proposed in the cognitive PTSD model of Ehlers and Clark (2000).

A sample of 134 emergency service workers was interviewed to gain in-depth information regarding their experience of potentially traumatic events, and the following social interactions. Additionally, participants responded to the Disclosure of Trauma Questionnaire, the Posttraumatic Cognitions Inventory, and the Impact of Event Scale-Revised.

Bootstrap mediation analyses revealed that the effect of negative trauma related appraisals on PTSD symptoms is partly mediated by dysfunctional disclosure. In particular, the two aspects of dysfunctional disclosure "reluctance to talk" and "excessive emotional reactions during disclosure" were of relevance in this model. The results remained stable even when controlling for potentially relevant sociodemographic and situational characteristics.

Our results stress the importance of not only cognitive factors, but also interpersonal behavior in the development and maintenance of PTSD symptoms because we identified interpersonal risk factors (i.e., dysfunctional communicative strategies) to be relevant for PTSD elevation. (PsycINFO Database Record (c) 2019 APA, all rights reserved).