Hunter Coury

Dr. Ethan Whittet

July 23rd, 2017

Applying the Theory of Constructed Emotion to the Psychopathology of

Post-Traumatic Stress Disorder and Hypothesizing Its Etiology as an
Exemplar Prediction Error
Table of Contents

- Abstract
- Introduction
- A Review of PTSD
I. Diagnosis
II. Theory
III. Treatment
- An Integration of PTSD and The Theory of Constructed Emotion
I. PTSD as a Disorder of
a. Affective Realism and Emotional Granularity
b. Failed Predictions and Unutilized Prediction Loops
c. Failed Comparisons in Prediction Loops
d. Body Budget and
e. A Cessation of Predictions
II. The Exemplar Predictive Error Hypothesis

- Discussion
Abstract

Post-Traumatic Stress Disorder (PTSD) is a psychological disorder characterized by various,

debilitating symptoms. Its psychopathology is comprehended through various paradigms:
Emotional Processing Theory, Dual-Representation Theory, and Behavioral Theory. However,
this paper presents a new standpoint trough which to interpret the etiology and the
psychopathology of PTSD. In Lisa Feldman Barretts book, How Emotions Are Made: The Secret
Life of the Brain, she presents evidence to support the newly founded Theory of Constructed
Emotion. In this profound theory on emotion, I find a new instance in which to address the
manifestations of PTSD. This paper first reviews the present diagnosis, theories, and treatment
of PTSD. I then reissue the Theory of Constructed Emotion and apply its notions to each
symptom cluster currently provided by the DSM V. The Theory of Constructed Emotion provides
the foreground of a paradigmatic shift on the view of PTSD. To explain for the causation of
PTSD, I take both theory in cognition and the theory provided by Barrett to produce the
Exemplar Prediction Error Hypothesis. In a theoretical review, I establish an emphasis of
emotion and cognition to reason about Post-Traumatic Stress Disorder. In consequence, I
originate a necessary assembly of each justification given to explain for both the cause and the
symptoms to support a more comprehensive hypothesis. I reasonably title it, The Exemplar
Construction Hypothesis of PTSD.

Key Words: Post-Traumatic Stress Disorder, PTSD, Barrett, Theory of Constructed Emotion,
How Emotions Are Made: The Secret Life of the Brain, Psychopathology, Etiology,
Exemplar Concepts, Cognition, Exemplar Construction Hypothesis of PTSD
Introduction

Theories in cognitive psychology speculate the various parts that make up perception. In such

instances of object recognition, a top-down perspective might assume that it takes matching a

pre-existing concept to a particular stimulus so that one may be able to identify an object.

These mechanisms of perception allow for (what feels like) an automatic organization and

conceptualization of what is truthfully incoherent stimuli. In her new book, How Emotions Are

Made, Lisa Feldman Barrett, borrows the framework of the top-down perspective and applies it

to emotions. In her writing, she considers a far-reaching range of new evidence that completely

uproots the classical understanding of emotion. Barrett argues that humans do not have

inherent neural circuits that bring about the perceptual feeling of emotion and the subsequent

expression of emotion. Instead, humans construct emotions with active intent. This is the

basic premise of the theory, the Theory of Constructed Emotion. Besides its intricacies that

state how emotion is made, where it comes from, and how emotion physically manifests, the

theory infers a lot about the seemingly never-ending debates in psychology. The Theory of

Constructed Emotions posits that the mind does not exist as a separate entity from the body. In

light of this shift in mind-body dualism, her arguments hold that the individuals take a very

active role in creating emotion as opposed to a passive role. According to the theory, humans

acquire concepts of emotion through a dynamic interplay of physical sensations, past

experience and categorization. The effects of this theory stretch far beyond the singular

discipline of emotion. By recognition of this, I examine how its theoretical content fits as a

model for the psychopathology of Post-Traumatic Stress Disorder (PTSD). To do so, I have

broken down several concepts brought to the table by Barretts book, How Emotions Are Made
and interpret them as possible justifications for the currently accepted symptom clusters of

PTSD. In addition to this, I used related concepts in cognition to assert my Exemplar Prediction

Error hypothesis to explain for the etiology of PTSD. After conceptualizing my hypothesis for its

etiology, I argue for its evident connections to my previously discussed claims for the

manifestations of each symptom criterion for PTSD. I then utilize the remaining portions of the

paper to assert an amalgamated hypothesis that accounts for both the symptoms and cause of

PTSD: The Exemplar Construction Hypothesis of PTSD. I review the importance of this new

model as compared to past theory and discuss its implications for treatment.
A Review of PTSD

I. Diagnosis

The DSM-V classifies Post-Traumatic Stress Disorder as a Trauma and Stressor-Related

Disorder. This means that in order to provide a diagnosis, a client must have

experienced a trauma once in their life. A trauma is any type of experience related to

actual or threatened death, serious injury, or sexual violence by directly experiencing

the event or witnessing the event (American Psychiatric Association, 2013). Following a

traumatic experience, a person will not in all likelihood develop PTSD. A person who has

PTSD will express various clusters of symptoms, all of which are identifiable given the

criteria of the DSM-V. Individuals diagnosed with PTSD experience at least one intrusion

symptom (re-experiencing of trauma through flashbacks or nightmares, etc.), at least

one avoidance symptom (active avoidance of stressful cues related to the trauma, etc.),

at least two negative alterations in mood (persistent emotion related to trauma, limited

capacity to perceive positive emotions, distorted cognitive beliefs, etc.), and at least two

alterations in arousal and reactivity (hypervigilance, problems with concentration,

aggressive behavior, etc.) (American Psychiatric Association, 2013). The diagnosis must

be provided only if the symptoms last longer than a month (American Psychiatric

Association, 2013).
II. Theory

Mental health researchers have provided a few prominent psychological theories to

explain for the development of PTSD. Some of these include the Emotional Processing

Theory, Conditioning Theory, the Dual-Representation Theory and Cognitive Theory.

These theories guide research on PTSD and have largely impacted current treatment

options. The Emotional Processing Theory has remained perhaps the most prominent

theory and for that reason (among others) will be the theory most often reviewed in this

paper.

In 1986, Foa and Kozak introduced the Emotional Processing Theory. Their theory

proposes that fear structures proposed by Lang (1977) are to explain for the cause of

PTSD. Foa maintained that fear structures are inherent structures of the brain that

represent fear and they are composed of stimuli, meaning elements and response

behaviors (as cited in Lang, 1977, p. 2). These fear structures encourage the

development of PTSD once they become pathological. Fear structures become

pathological once the fear network begins to elicit avoidance behaviors in response to

any stimuli associated with the trauma (Rauch & Foa 2006). The avoidance behaviors

happen so frequently that a victim of a trauma would never be able to judge the

trauma-related cues to be safe and not a genuine predictor of the trauma reoccurring.

Rauch & Foa (2006) claim that the meaning elements of the fear structures maintain this

type of behavior by addressing the world as dangerous as well as addressing the self
 as incompetent (as cited in Foa & Riggs, 1993, p. 2). PTSD develops as a consequence

of this. Prolonged Exposure Theory is a psychological therapy congruent to this view on

the etiology of PTSD.

III. Treatment

Treatment for PTSD is a widely-discussed topic. The reason for this, other than it is a

health concern, is that there are a few reasons to suggest that the efficacy of the

psychological treatments is reputable, but not completely air tight (Najavits, 2015).

Some treatments for PTSD are trauma-focused. Trauma-focused therapies make the

general assumption that treating PTSD requires the patient to safely reassess the

trauma by purposefully discussing it with a given mental health professional. This is

completed through any variation of exposure such as in vivo or imaginal exposure. In an

all-purpose sense, there is a final expectation that restructuring the emotional context

of the entire traumatic memory will allow the client to be relieved of their debilitating

symptoms. Trauma-focused therapies include Prolonged Exposure Therapy (PE), Eye

Movement Desensitization and Reprocessing (EDMR), and Trauma-Focused Cognitive

Behavioral Therapy (TF-CBT). Rauch and Foa (2006) propose that the basic component

of Prolonged Exposure Therapy requires that two criteria are needed to properly

address the trauma (as cited in Foa & Kozak, 1986, p. 2). First, the trauma must be

activated in a safe environment. Second, the trauma must be re-experienced with the
 intention to redirect the very disabling meaning elements and avoidance patterns and

replaced with more realistic ones.

Other therapies do not adopt trauma-focused procedures and do not guide their

sessions by practicing exposure. These types of therapies include Cognitive Processing

Therapy (CPT) or Cognitive-Behavioral Therapy (CBT). These therapies aim to treat the

cognitive distortions and perceptions related to the trauma. Behavioral ideologies also

guide their practice. By this method, clients are often more successful at managing their

PTSD symptoms (Monson et al, 2006, p. 903).

An Integration of PTSD and Constructed Emotion

I. A Summarized Theory of Constructed Emotion

Barrett begins her book by explaining how psychologists and neuroscientists have classically

viewed emotion. She explains that theories previous to hers have made general arguments

that the basic elements of emotion, like happiness, sadness, fear, etc., are made by innate

neural circuits of the brain and body; they are called fingerprints (2017, p. x). As a result,

emotions are generally thought of as passive occurrences or purely automatic reactions to

our daily experience. Previous research aimed to provide a connection between biological

markers and the emotion expressed (Barret, 2017, p. x). Barrett found this research to be
unconvincing (2017, p. xiii). She still appreciates biological sensations as a necessary factor

needed to understand emotion; she just has a different explanation for it.

Emotions happen to be a result of our perception, not an innately biological incidence.

Barrett (2017) writes, Emotions are real, but not in the objective sense that molecules or

neurons are real. They are real in the sense that money is real that is, hardly an illusion,

but a product of human agreement (p. xiii). Emotions are concepts used with discrete

intentions to bring meaning to our very basic and unembellished physical sensations. She

names these physical sensations, interoception. Interoception allow one to feel arousal and

relaxation, and pleasure and displeasure. By the integration of a conceptual understanding

of ones (current and past) interoception and the comprehension of ones given context, the

individual assembles an instance of an emotion (Barrett, 2017, p.30). Concepts only exist as

a product of experience. Through continual reinforcement from parents, social

environments, and context-dependent drives, the variations in ones perception of

interoception is broken down and provided meaning (Barrett, 2017, p. 33). The past

consequences and reinforcement given to ones interoception provides meaning to the

given sensation. From ones experience and their apparent context, the individual evaluates

this sensation either a physical or emotional concept. When the concept is deemed

emotional, the meaning manifests into what we perceive as a singular occurrence of

emotion (Barrett, 2017, p. 31). This theory establishes a nomothetic approach to

understanding emotion, and has not been given enough attention in light of abnormal

psychology. As a result, one must question: what happens when a singular instance of
 emotion becomes intensely recurrent and eventually pathological? Barrets Theory of

Constructed Emotion reaches much farther than what has already been discussed. I will use

the Theory of Constructed Emotion as well as other portions of Barretts book to suggest

the ways in which her theory fits as a model for the foremost symptom clusters of PTSD.

II. PTSD as a Disorder of

Affective Realism and Emotional Granularity

Individuals with PTSD experience negative alterations in mood and cognition

(American Psychiatric Association, 2013). This phrase umbrellas many different

difficulties a given individual with PTSD might have. In terms of mood, individuals

very often have trouble experiencing positive emotions (American Psychiatric

Association, 2013). Their mood may often feel consistent with their perceptions

of the trauma and are persistently unable to experience positive emotion

(American Psychiatric Association, 2013). Individuals also experience cognitive

distortions. Very often, these distortions direct an untruthful representation of

the world (such as The world is unsafe.) and the self (I am going to lose

control.) (American Psychiatric Association, 2013). To explain for these cognitive

distortions, I speak to the role of affective realism. Additionally, I substantiate

the role of emotional granularity as a partial reason for negative mood.

Affective realism refers to the patterns of cognitive views as influenced by

emotion and perception (Barrett, 2017, p. 75). Cognitive distortions are defined

by the act of an individual who defines their environment by illogical and far-

reaching generalizations. In an example of those with PTSD, the world is

unsafe. These cognitive distortions occur as a result of affect. Individuals often

base their perceptions by adherence to their general affect (Barrett, 2017, p. 78).

So it is reasonable to assume that ones poor affect can lead to faulty cognitions

and directly represent ones strong held beliefs in the world. By this logic, it is no

wonder that someone with PTSD would view the world as dangerous and

uncompromising. I argue that cognitive distortions are based on the affect

provided by the emotional content of the trauma and therefore, have related

concepts from which they stem. Cognitions concerning ones perception of the

world are based on the emotions related to the trauma (an experience that

happens as a result of ones environment). For an example, people are

considered unsafe to be around since it is quite common that an individual

caused the trauma. However, the distortions of the self heavily rely on the

appraisals of ones experiences of hyperarousal symptoms and re-experiencing

symptoms (personal and inward related experiences). The self is helpless

because of uncontrollable intrusions and relentless feelings of unpleasant

arousal. These claims are well substantiated especially when we consider that

the type of mood that occurs with PTSD is consistently negative and related to

the trauma. But this then begs the question, what substantiates negative mood?
Barrett (2017) observes that people of various different psychological disorders,

all tend to exhibit lower granularity for negative emotion (p. 183). This refers

to a common observation among individuals who express psychopathology. I

argue this stance remains true in regards to PTSD. Victims of PTSD will construct

emotional concepts relevant to the trauma. This has two effects. An individual

with PTSD with will evaluate their interoception with low emotional granularity.

They will most often assume negative emotions related to the trauma as

opposed to an emotion congruent to the present context. Second, the affected

individual will more often construct instances of emotion that are emotional, as

opposed to physical. For instance, physiological sensations (or interoception),

synonymous with tiredness could be mistaken for a more proximate belief in the

concept of sadness (Barrett, 2017, p.31). Individuals with low emotional

granularity (such as people with apparent psychopathology; PTSD) engage with

emotions that do not allow one to project a perception of the world that is

either positive or incongruent with the trauma. In a reciprocal interaction, the

cognitive distortions are representative of one who is unable to construct

emotion outside the given repertoire of emotions provided by the trauma.

 Failed Predictions and Unutilized Prediction Loops

People diagnosed with PTSD often show chronic avoidance of any stimuli that

have come to be associated with the trauma (American Psychiatric Association,

2013). Associated stimuli could include reminders of the trauma by the related

cues between the trauma and the ones present environment. An individual may

also try to avoid thoughts and emotions related to the trauma (American

Psychiatric Association, 2013). What causes one to address these stimuli as

unsafe, even though these associated stimuli no longer represent real danger?

Behavioral accounts address this question by assuming that habituation of fear

learning cannot occur unless someone with PTSD actually remains in the

presence of a trauma reminder long enough to learn it does not precede the

reoccurrence of trauma (Gillihan, Cahill & Foa, 2014). I argue that this theory

upholds similarities to the arguments proposed by Barrett, but there is a

difference in terminology that implies that we engage in a more active role in

our perception. Instead of US-CR contingency, I address the role of predictions.

Predictions are essential to the active experience of the world, and frankly, plays

a major role in avoidance. Barret (2017) refers to the function of predictions

when she writes, You might think that your perceptions of the world are driven

by events in the world, but really, they are anchored in your predictions...

(p.62). They help people to continually use past experience to make

assumptions about the immediate stimuli in our percept (Barrett, 2017, p. 62). It
makes ones experience organized and less disordered. Sometimes however,

individuals make predictions that dont end up becoming absolutely synonymous

with sensory input. When this occurs, an individual will make countless

predictions until their assumptions about the stimuli finally match the actual

incoming stimuli. Barrett (2017) refers to this as a prediction loop (p. 62). It is a

constantly corrective process that helps guide our learning progression. Barrett

(2017) asserts that these systems are sometimes imperfect and that,

predictions arent always correct (p. 62). I claim that when the predictions

are misguided and consequentially uncorrected, one will express the avoidance

symptoms that are fitting to PTSD.

Individuals with PTSD consistently avoid reminders of the trauma as a result of

false predictions. In the presence of a stimulus associated with the trauma, the

afflicted person will use the trauma memory (their past experience) to predict an

instance of fear. In this instance of fear, the individual will subsequently avoid

the trauma reminder. Escape behaviors are common to fear. Predictions

founded by trauma-related emotions are false predictions since the stimulus that

elicited the prediction does not actually precede any danger or the trauma re-

occurring. It is essential to stipulate that predictions are only false if they do not

accurately predict authentic instances of danger. This instance is uncommon but

essential to the definition. In this act of avoidance, the individual will never be

able to conceptualize a different instance of emotion related to the trauma

 reminder. Put differently, a person with PTSD is not able to address the

associated stimuli with a prediction loop, effectively never correcting the

prediction. In turn, the individual will never be able to construct an environment

that is free of illegitimate predictors of reoccurring trauma. In a rapid sequence

of prediction errors, based in trauma-related concepts of fear, an individual with

PTSD will avoid reminders of the trauma.

Failed Comparisons in Prediction Loops

A discerned symptom in individuals with PTSD is intrusion. Intrusion regards any

unwanted and unwarranted re-experiencing of the trauma (American Psychiatric

Association, 2013). Re-experiencing may occur in flashbacks which is a vivid

recall of the trauma that mistakes the individual to believe the trauma is

reoccurring all over again (American Psychiatric Association, 2013). Another type

of intrusion may occur by the means of dreams, or in this case, nightmares

(American Psychiatric Association, 2013). The incidence of these symptoms may

be a result of similar reasons given to validate the avoidance cluster of

symptoms.

I argue that re-experiencing the trauma is the result of a failure in the steps

necessary to complete a prediction loop. It is much like the cause of avoidance

symptoms, if I only consider that the process begins with a prediction error. Re-
experiencing the trauma, however, requires all of the procedures necessary to

produce a prediction loop to explain for it. Prediction loops have four steps

(Barrett, 2017, p.63). First an individual makes a prediction about their given

environment using past experience. The individual then uses these predictions as

a simulation to conceptualize the given bodily sensations and context. In a

comparison of the sensory input to the simulation, the individual resolves all of

the errors by the incongruences between the simulation and the actual,

incoming sensory input. Predictions readily occur over and over again till ones

experience is accurately represented. In the case of PTSD, the pathology of re-

experiencing begins with a false prediction and goes henceforth. False

predictions, in the case of PTSD, are creating instances of fear without the

presence of actual threat. To refer to the next step, simulation, Barret (2017)

writes, The interoceptive network issues predictions about your body, tests the

resulting simulations against sensory input from your body, and updates your

brains model of your body in the world (p.62). This is the ideal procedure in

which you construct your experience. However, re-experiencing in PTSD does

not allow for accurate, corrective feedback. Instead, ones temporal perception

diminishes and perceives the trauma to be happening all over again (Gillihan,

Cahill & Foa, 2014). Once an afflicted person has created a false prediction in

response to trauma-related stimuli, the simulation becomes activated, as long as

one does not actively avoid the stimuli following the prediction. This simulation

is never accurately compared to the actual context of ones environment.

 Instead, the simulation is compared an environment that is riddled with threat.

An individual perceives the environment inaccurately for two reasons. First, the

individual is simulating an instance of fear and expects the actual environment to

confirm that. Second, the trauma-related stimuli, which originally issued the

prediction, is perceived to take on a meaning identical to the trauma. When

individuals with PTSD compare the stimulus to an instance of fear, they

perpetuate that the outside environment will also resolve in the re-experiencing

of trauma. Since the sensory input is consistent to trauma-related stimuli, the

instances of fear which is based in memory perpetuates without an ability to

resolve the errors. In this perpetuated cycle, one is unable to perceive their

instance of emotion as incorrect. Consequentially, the emotions and its

supporting memory are fully reinforced over and over again; as a result, the fear

memory and its simulation becomes ones reality. The uncorrected simulation

becomes the symptom understood as re-experiencing.

Body Budgeting and Affective Niche

Individuals with PTSD experience hyperarousal and increased reactivity

(American Psychiatric Association, 2013). Hyperarousal means an excess of

arousal and results in the experience of constant alertness and is often

characterized as anxiety (American Psychiatric Association, 2013). Related

hypervigilance typically means a decreased ability to concentrate and a high

affinity for engaging with aggression (American Psychiatric Association, 2013).

In observation of the Constructed Theory of Emotion, I argue that hyperarousal

symptoms are a result of an amplified body budget. Both unutilized and failed

prediction loops lead to exhaustion of ones body budget, or parts of ones brain

that sends predictions to the body to control its internal environment: speed

up the heart, slow down breathing (Barrett, 2017, p. 73). If we consider the

coordination between predictions and body-budgeting, we see yet another

unregulated system of arousal. This unregulated system is initially related to

ones predictions. When an experience like trauma is consistently used as a

predictor, the body budget will send physiological signals to accommodate for

the predicted sense of fear. For someone who is chronically experiencing fear,

the body budget will constantly regulate ones body to be hyperaroused. Affect,

as claimed by Barrett (2017), primarily comes from prediction (p. 78). When

predictions are based in trauma(s), one may experience hyperarousal and

unpleasant valence. This is a considerably negative affect. By unutilized

prediction loops (or avoidance), the afflicted individual will predict fear and

utilize their body budget to escape the associated stimulus. The same is true for

re-experiencing symptoms. By constant, failed prediction loops, prediction of

fear becomes chronic, leaving an individual with PTSD to experience constant

hyperarousal. These states of arousal become chronic as a result of ones

 affective niche. An affective niche refers the particular pieces of ones

environment that one will estimate to have influence on their body budget

(Barrett, 2017, p. 73). When we consider PTSD, it is reasonable to assume that

ones affective niche becomes distinctly narrow and specifically keen on

identifying trauma-related stimuli. By a prediction of fear, ones body budget will

input the necessary physiological arousal related to fear. This state of high

arousal is kept persistent when ones affective niche develops a high affinity for

identifying fear in related-trauma stimuli. Hence, the afflicted individual

experiences continuous states of hyperarousal.

A Cessation of Predictions

PTSD may also occur with another criterion of symptoms, called dissociation

(American Psychiatric Association, 2013). Although this cluster is not required in

diagnosing PTSD, its maintains an apparent relation to predictions. Dissociation

can occur as depersonalization or derealization. Depersonalization is

characterized as an experience of being an outside observer or detached from

oneself (American Psychiatric Association, 2013). Derealization is characterized

as an experience of unreality, distance, or distortion (American Psychiatric

Association, 2013).
In relation to the previously discussed symptoms criterion, I argue that

dissociation is a cessation in ones predictions and as are result of a physiological

response to constant hyperarousal. When the chronicity of fear exhausts the

hyper-aroused physiological system, the body budget creates an instance in

which one is essentially disconnected from their interoception. Consequently,

the individual is unable to make prediction of fear, and unable to utilize the

body-budget for a fear response. In other words, the body budget demands an

instance of recovery from a what had been a chronic and unrelenting state of

fear predictions. The body gives a response to ensure that the physiologically

exhausting state of fear can no longer perpetuate. This disconnect from their

interoception is what causes dissociation. Under these circumstances, the

individual is subject to what is almost, purely sensory input. By the absence of

prediction, the given interoception and ones environment may no longer be

conceptualized by physical or emotional concepts. Dissociation is perception

without concepts or predictions to guide ones experience. Because of this, ones

experience of consciousness is disengaged and their environment is disordered.

Because of deficient concepts, an individual will perceive reality as distorted and

unreal (or derealization). By a relative disengagement form ones interoception,

an individual will feel disconnected from their body (or depersonalization).

III. The Exemplar Predictive Error Hypothesis

Each symptom criterion affirms the necessity of a fear based concept by relation to the

trauma. Therefore, I dedicate this section to argue how trauma exists as a precursor to

PTSD (etiology) and use this consistency in my previous arguments to support my claim.

The Theory of Constructed Emotions posits that constructing emotion requires goal-

based concepts in creating an instance of emotion (Barrett, 2017, p. 90). By using past

experience, an individual will predict the meaning of their interoception by the given

context and particular goal in mind. In the particular circumstance of Post-Traumatic

Stress Disorder, interoception is not interpreted by these types of concepts. In an

occurrence of intrusion, avoidance, or negative mood, the only prediction used to create

an instance of emotion is based in trauma-related experience(s).

Experiencing a trauma is tragic, and very explicit to each person who has become victim

to a trauma. Trauma survivors very often perceive themselves to have been helpless and

perhaps passive perceivers to a situation that they could not control (Salcioglu, 2017, p.

117). These insights are well-learned, especially when one considers that the Theory of

Constructed Emotion deems that an individual takes a very active role in constructing

their perception of the world. Helplessness and a lack of control is what makes for the

outstanding and deleterious nature of a trauma. As a consequence of these two

perceptions, the memory and its associated emotion concepts do not have any purpose

for assisting in the active and meaningful construction of ones emotions. Trauma-

related memories create entirely novel concepts of fear and establish an unequivocally
idle concept of emotion in the category of fear. This is because it has no meaning in

relation to other fear-based concepts. When someone experiences a trauma, and goes

on to develop PTSD, it is because the trauma cannot be successfully integrated into their

preexisting emotional repertoire. For this reason, the emotion may not be

conceptualized by goals, like all other emotions are. When an individual has an

outstanding concept of an emotion that cannot be conceptualized with the means

necessary to incite active construction of the world, the individual may end up with a

different type of concept, an exemplar concept. An exemplar concept is a

representation of something that is neither abstract or goal-based, and instead

represented by a singular instance of memory. Producing instances of emotion with only

a singular form of concept is the key to understanding the psychopathology of PTSD.

I argue that the development of PTSD is a result of constructing ones perception of the

self and the world with one fundamental emotional concept: trauma-related fear. It

perhaps may be the most straightforward form of emotional granularity. Why however

would people with PTSD mostly interpret their interoception and environment using

only one concept? Typicality effects have significant reasoning for this. Kiran and

Thompson (2003) review that typicality effects in memory assume that people are more

likely to respond faster to information that is typical of a category as opposed to

information that is atypical (as cited in Hampton, 1979). Fear is a category of emotion

and an incredibly outstanding instance of fear would be a trauma. However, trauma

would be an atypical instance of an emotional concept. This is how a trauma is

represented initially, but predictions of fear amongst unutilized (and unregulated)

prediction loops ensure that it becomes typical. For example, an individual may predict

fear and instantly avoid it. As a result of this, the prediction related to the stimulus that

preceded it is never corrected. In a fixed cycle, the individual will frequently use the

trauma-related exemplar concept to predict fear. By continuous reinforcement of that

exemplar concept, I reason that the once atypical concept of emotion becomes typical.

Due to typicality effects, the trauma-related exemplar concept has exceedingly high

affinity to be conceptualized as an instance of emotion. Exemplar concepts can be

convincing much like anecdotal evidence can feel more convincing than empirical

evidence. When an atypical exemplar concept of trauma progresses into a typical

exemplar concept, an individual will consistently construct emotion in ways that are

consistent with the symptoms of PTSD.

This is what brings arise to the common held symptom criterion for PTSD. Alterations in

cognition and mood are a result partial to ones construction of the self and the world

through the use of emotions attached to experience of the trauma. The use of the

exemplar concept would seem especially true when we consider the criterion for

intrusions and re-experiencing since concepts of the trauma are used to create

predictions and subsequent simulations. As a consequence of predictions made from

trauma-related concepts, an individual will come to experience hyperarousal and

possibly dissociation. Trauma- related exemplar concepts elicit illegitimate predictions

of emotion. Consequentially, these predictive errors cause the provocation of the

symptoms that compose PTSD. This is Exemplar Prediction Error Hypothesis; this is how

Post-Traumatic Stress Disorder comes to be.

Discussion

By integrating the Constructed Theory of Emotion and PTSD, the understanding of PTSD

is guided by a top-down perspective. This is to be expected when referring to the Theory

of Constructed Emotion since it holds the same perspective. The use of past experience

to manage our perception assumes that people maintain a very active approach to

constructing reality. This stance however should not assume the presence of

psychopathology to be the fault of someone with a mental disorder. This ideology is

neither sufficient to explain for the psychopathology or beneficial to the recovery of

those who suffer from PTSD.

In consideration of the parallels between my reasoning for the etiology and symptom

criterion of PTSD, I implement a joint terminology to represent a complete argument.

My claim is composed of the Exemplar Predictive Error Hypothesis as well as the claims I

made to explain for the symptoms criterion of PTSD using the Theory of Constructed

Emotion. A union of these two models reason that the use of an exemplar (trauma)

emotional concept to be the reason for the development of the psychopathology of

PTSD. I identify this amalgamation as the Exemplar Construction Hypothesis of PTSD.

In this theoretical and psychological approach to explain the symptom criterion of PTSD,

I assume a relatively different perspective as compared to the Emotional Processing

Theory, the relative foundation to exposure therapies. Both models speculate fear as an
emotion that becomes pathological. However, the Emotional Processing Theory

suggests fear structures, an inherent structure of the brain, that guides fear responses.

The Exemplar Construction Hypothesis does not suppose a model of pathology based on

inherent structures. Instead, it hypothesizes a different approach, whereas the etiology

of PTSD resides in the interaction of memory (or past experience) and its use in

constructing emotion. My hypothesis does not consider structures of the brain when

considering fear. The Emotional Processing Theory conditions that one does not remain

present among trauma-related stimuli long enough to understand that it is no longer a

predictor of the trauma. The Exemplar Construction Hypothesis does not sufficiently

align with this since it does not address plentiful behavioral accounts of PTSD.

Behavioral perspectives are not well accounted for with in my hypothesis, and thus

becomes a comparatively contending model to the theoretical explanations of

emotional processing. These are some fundamental differences in the proposed theory.

As a consequence, the Exemplar Construction Hypothesis would have different

implications for treatment.

At this moment, I only suggest a few practices in counseling as supported by the

Exemplar Construction Hypothesis. In regards to psychological therapies, my theory

would emphasize the importance of educating and enhancing emotional granularity

with the clients. I suggest that this practice would be done in earlier parts of therapy

since it could potentially be useful in maximizing ones ability to successfully reinterpret

the trauma-related memories or other related matter. Applying terminology to emotion

concepts is essential to developing emotional granularity. In support of this framework

for psychological counseling, Barrett (2017) writes, Fine-grained categorizations have

been shown to beat two other popular approaches for regulating emotions, in a study

about fear of spiders. (p. 182). In relation to my hypothesis, the goal of emotional

granularity in therapy would be to find a way to identify the exemplar concept and to

reemerge it as a concretely atypical instance of fear. In this way, instances of fear

would not be predicted using trauma-related experiences. The role of predictions also

creates a new framework for the treatment of PTSD. My theory details re-experiencing

and intrusions to be complications related to predictions. Therefore, future research on

treatment should address particular ways in which one may falsify the connection

between sensory input and the misguided prediction and/or simulation. Treatment

methods should be further addressed in future papers, since it something that could not

be addressed properly within this paper alone.

In a review of my hypothesis and newly proposed theory, I could not help but notice a

few areas in need of further development. The given theory is not fully inclusive; it does

not provide evidence based in neuroscience. However, there are not many reasons to

suggest that neuroscience could uproot any piece of this hypothesis. The given evidence

for my hypothesis is abundantly theoretical. Furthermore, the emotional components

that make up the exemplar concept need to be further developed and detailed. Defining

this concept is up to further discussion and more investigation that could not yet be

established in this paper.

Assessing PTSD, in light of the Theory of Constructed Emotion, is essential to furthering

the progress needed to understand PTSD. This particular integration, The Exemplar

Construction Hypothesis of PTSD, investigates the nature of emotion and cognition to

explain for its psychopathology. An implementation of various, psychological theories is

essential to earning a comprehensive appreciation of any topic. This paper recognizes

and attributes to the importance of the newly proposed theory on emotion and its

effects on psychopathology. In consequence, a disorder understood to be complex is

further evaluated and advanced to a new level of comprehension.

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