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.
Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, USA.
R D
RD
Alarcon
S G
SG
Glover
C G
CG
Deering
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