The cascade model: An alternative to comorbidity in the pathogenesis of posttraumatic stress disorder

Author(s): Glover, S. G., Deering, C. G.

Journal/Book: Psychiatry. 1999; 62: 72 Spring Street, New York, NY 10012, USA. Guilford Publications Inc. 114-124.

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.

Note: Article Alarcon RD, VA Med Ctr, Mental Hlth Serv, 1670 Clairmont Rd, Atlanta,GA 30033 USA

Keyword(s): VIETNAM COMBAT VETERANS; PSYCHIATRIC-DISORDERS; HIPPOCAMPAL VOLUME; SEXUAL ABUSE; CHRONIC PTSD; DSM-IV; TRAUMA; SYMPTOMS; PATTERNS; WAR

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