In today’s society, human beings are contracting many differentdiseases. Doctors are involved in the study of these diseases todevelop a cure for the patients, determine whether there are anyprevention mechanisms, and to have a deeper understanding of itsaetiology. They tend to use different aetiological models to theprincipal diagnosis during their study. The approach is significantin the medical field because it allows the scientists to gatheradequate information regarding a disorder that may be helpful infinding the most appropriate treatment or for further research(Rector, Man &amp Lerman, 2014). One of the aetiological modelsimplemented in the principal diagnosis of a disorder is the Cognitivebehavioural approach. The cognitive-behavioural model explains whysome people develop anxiety as the primary diagnosis of PostTraumatic Stress Disorder (PTSD) while others do not by also focusingon the merits and demerits of the aetiological model by drawing onthe Self Regulation Theory.

The cognitive behavioural model focuses on human thoughts andbehaviour. According to the model, the human mind works in a way thatit influences human behaviour (Dunsmoor &amp Paz, 2015). One of thecauses of PTSD is believed to be mental health risks such asdepression and anxiety that arise from exposure to traumatic eventssuch as terrorist attacks, fighting in the war, sexual assault, roadtraffic accidents, disaster workers, and refugee status. Thecognitive behavioural model states that people who experience anxietymay suffer from PTSD because of two behavioural factors that includegeneralisation and higher-order conditioning (Mundy, et al.,2015). Anxiety can be aroused by both internal factors like thoughtsand memories as well as external factors such as places and sounds.The self-regulation theory argues that a person may try to regulatefeelings such as anxiety using internal strength that enables them todevelop coping skills (Jarvenpaa &amp Majchrzak, 2016). For example,a sexual assault who was maybe raped at night may fear to be outdoorsat night, which is the original cause of her anxiety. Additionally,she may also fear any place, which is dark even if it is not duringthe night because she has generalised in her mind any dark placeconstitutes the conditions for being raped. The victim may have beenattending therapy so she comes to fear the therapy office where shewas discussing the ordeal due to higher-order conditioning(Fleurkens, Rinck &amp Minnen, 2011). Therefore, some people maydevelop the primary diagnosis of PTSD based on how they generalisetheir thoughts and memories and higher-order conditioning.

Another aspect of the cognitive-behavioural model is that when asituation occurs, it is interpreted and a feeling occurs due to thethought that responds through behaviour. The perspective helps inunderstanding the aetiology of PTSD by focusing on the emotions thatarise from the ideas (Padesky &amp Mooney, 2012). Human beings tendto portray different feelings that are based on their thinking. PTSDvictims may represent different primary diagnosis due to theavoidance aspect that occurs during the cognitive process as per theSelf Regulation Theory (Jarvenpaa &amp Majchrzak, 2016). Avoidanceis a form of operant conditioning whereby PTSD victims may decide toavoid that external or internal factor that generates the symptoms ofthe disorder (Dyer, et al., 2009). For instance, a person whowas involved in a train crash may decide to travel using alternativetransportation such as buses or aeroplanes to avoid being anxiousthat they might be included in another accident when using the train.Avoidance becomes a way of coping with the effects of a traumaticevent, but some of the victims may only apply the strategy. Thecognitive behavioural model thus explains the reason some peopledevelop the primary diagnosis while others do not, through theavoidance principle as a form of operant conditioning.

Although the aetiological model argues that avoidance and responsemechanisms may enable PTSD victims to develop a varying primarydiagnosis, when a person tries to avoid a process that revives thememories, it becomes difficult to be assimilated or accommodated inthose environments. However, with time they attempt re-experiencingthe ordeals, which revives the memories and negative emotions (Chu,Skriner &amp Zandberg, 2014). The behaviour is explained under theSelf Regulation model whereby a person monitors a situation todetermine whether it meets their standards (Jarvenpaa &ampMajchrzak, 2016). For instance, a soldier may decide never to returnto a war zone area. Unfortunately, clashes erupt in the area he isresiding in and he tries to survive like other neighbours who have noidea how to act during conflicts. The fights do not end and herealises that he has to assist in the war and once they get involvesall the memories flash back to him. The soldier may have failed toportray the primary diagnosis of PTSD because of applying theavoidance principle, but since he re-experienced the traumatic event,he reveals the diagnosis. The cognitive behavioural model thusbecomes an ineffective approach to understanding the principaldiagnosis in PTSD because of the fluctuating causes.

One of the assumptions of the cognitive behavioural model is that thehuman thinking process, unlike genetic factors, can only controlbehaviour (Clark &amp Beck, 2012). On the other hand, among thecauses of PTSD are the inherited aspects of a person’s personalitythat lead them to portray behaviours such as being temperamental(Kira, et al., 2015). If PTSD is caused by genetic factorsthat people inherit in their family, the cognitive-behavioural modelmay be inefficient in explaining how the primary disorder developssince it shall not focus on the genetic factors that are causing PTSDamong victims. For example, people who have been working in disastermanagement are exposed to shocking ordeals that lead them to sufferfrom PTSD (Alberts &amp Hadjistavropoulos, 2014). However, theaetiology of PTSD among the disaster workers may vary based onbehavioural and genetic factors. There are those who may be anxiousbecause of their thoughts while others due to genetic reasons, whichresult in the differences in the primary diagnosis. However, thecognitive behavioural model shall fail in identifying the geneticreason because of the assumption made regarding the approach.

In summary, the cognitive behavioural model sufficiently explains thereason as to why some people develop the primary diagnosis of PTSDwhile others do not. The variances in the main diagnosis are causedby generalisation that results in higher-order conditioning. It isalso caused by avoidance principle due to operant conditioning amongvictims of traumatic events. On the other hand, the application ofthe aetiological model in the principal diagnosis of PTSD may beaffected by re-experiencing the ordeals that change the primarydiagnosis that people had portrayed in the first instance.Additionally, the assumption of the model that genetic factors cannotcontrol the thinking process weakens the understanding of how thePTSD disorder develops. The assumption may cause the variation in theprimary diagnosis, but scientists may fail to understand thedifference because of the assumption made in thecognitive-behavioural model. Despite the limitations of the cognitivebehavioural model, it has made a significant contribution tounderstanding the variations in the principal diagnosis that doctorswitness among the PTSD victims.


Alberts, N. M., &amp Hadjistavropoulos, H. D. (2014). Parentalillness, attachment dimensions, and health beliefs: testing thecognitive-behavioural and interpersonal models of health anxiety.Anxiety, Stress &amp Coping, 27(2), 216-228.doi:10.1080/10615806.2013.835401

Chu, B. C., Skriner, L. C., &amp Zandberg, L. J. (2014). Trajectoryand Predictors of Alliance in Cognitive Behavioural Therapy for YouthAnxiety. Journal of Clinical Child &amp Adolescent Psychology,43(5), 721-734. doi:10.1080/15374416.2013.785358

Clark, D. A., &amp Beck, A. T. (2012). The anxiety and worryworkbook: The cognitive behavioural solution. New York: GuilfordPress.

Dunsmoor, J. E., &amp Paz, R. (2015). Fear Generalization andAnxiety: Behavioural and Neural Mechanisms. Biological Psychiatry,78(5), 336-343. doi:10.1016/j.biopsych.2015.04.010

Dyer, K. W., Dorahy, M. J., Hamilton, G., Corry, M., Shannon, M.,MacSherry, A., &amp … McElhill, B. (2009). Anger, aggression, andself-harm in PTSD and complex PTSD. Journal of ClinicalPsychology, 65(10), 1099-1114.

Fleurkens, P., Rinck, M., &amp Minnen, V. A. (2011). Specificity andgeneralization of attentional bias in sexual trauma victims sufferingfrom posttraumatic stress disorder. Journal of Anxiety Disorders,25(6), 783-787. doi:10.1016/j.janxdis.2011.03.014

Kira, I. A., Ashby, J. S., Omidy, A. Z., &amp Lewandowski, L.(2015). Current, Continuous, and Cumulative Trauma-Focused CognitiveBehaviour Therapy: A New Model for Trauma Counselling. Journal ofMental Health Counselling, 37(4), 323-340.

Mundy, E. A., Weber, M., Rauch, S. L., Killgore, W. S., Simon, N. M.,Pollack, M. H., &amp Rosso, I. M. (2015). Adult anxiety disorders inrelation to trait anxiety and perceived stress in childhood.Psychological Reports, 117(2), 473-489.doi:10.2466/02.10.PR0.117c17z6

Padesky, C. A., &amp Mooney, K. A. (2012). Strengths-BasedCognitive-Behavioural Therapy: A Four-Step Model to Build Resilience.Clinical Psychology &amp Psychotherapy, 19(4),283-290. doi:10.1002/cpp.1795

Rector, N. A., Man, V., &amp Lerman, B. (2014). The ExpandingCognitive-Behavioural Therapy Treatment Umbrella for the AnxietyDisorders: Disorder-Specific and Transdiagnostic Approaches. CanadianJournal of Psychiatry, 59(6), 301-309.

Jarvenpaa, S. L., &amp Majchrzak, A. (2016). InteractiveSelf-Regulatory Theory for Sharing and Protecting inInterorganizational Collaborations. Academy Of Management Review,41(1), 9-27. doi:10.5465/amr.2012.0005