Cognitive processing theories of post-traumatic adaptation (Horowitz, 1986a; Janoff-Bulman, 1992) propose that repeated comparisons of trauma content with preexisting cognitive schemas result in trauma reappraisal or schematic revision. Thus, intrusive ruminations should facilitate cognitive integration and resolution of past traumas. However, research has shown that some survivors become stuck in endless, repetitive rumination cycles. This raises the issue of how to differentiate ruminations that promote cognitive integration from those that merely prolong or exacerbate psychological distress. Identifying substantive dimensions for categorizing cognitions about past traumas could enhance prediction of their effects on adjustment and inform clinical treatment interventions. This paper seeks to: (a) Assess the current state of theoretical knowledge concerning cognitive adaptation to trauma, (b) integrate theoretical postulates with empirical research findings, (c) define gaps or inconsistencies in our understanding of the cognitive adaptation process, and (d) identify foci for future theory and research.