The cascade model: an alternative to comorbidity in the pathogenesis of posttraumatic stress disorder.
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.
Alarcon
R D
RD
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA.
Glover
S G
SG
Deering
C G
CG
D001143:Arousal / Q000502:physiology; D015897:Comorbidity; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008960:Models, Psychological; D011603:Psychophysiology; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology / Q000523:psychology