The Assignment
• View the media Presentation Example: Posttraumatic Stress Disorder (PTSD) below and assess the client in the case study.
• https://www.youtube.com/watch?v=RkSv_zPH-M4
Succinctly, in 2 pages, address the following:
• Briefly explain the neurobiological basis for PTSD illness.
• Discuss the DSM-5-TR diagnostic criteria for PTSD and relate these criteria to the symptomology presented in the case study. Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning. Do you agree with the other diagnoses in the case presentation? Why or why not?
• Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is considered a “gold standard treatment” from a clinical practice guideline perspective, and why using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners.
Support your Assignment with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Post-traumatic Stress Disorder
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Post-traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) refers to a psychiatric disorder, which occurs among people that have gone through traumatic experiences such as severe accidents, personal assaults, rape, terrorist attacks, and cataclysms among others. People suffering from PTSD show symptoms, which characterize abnormal adaptation of the neurological systems.
Neurological Basis for PTSD
The neurological systems, which are involved, include neurotransmitters, endocrine pathways, as well as brain regions that are used to regulate fear behavior both at the unconscious and conscious levels (Dossi et al., 2020). The neurochemical features that are involved in post-traumatic stress disorder include serotonin, catecholamine, amino acid, peptide, and opioid neurotransmitters. The above features tend to regulate the fear and stress responses. Patients diagnosed with post-traumatic stress disorder have hyperactivity of the nervous system resulting in elevated heart rate, skin conductance, and blood pressure.
Similarly, there are brain changes among people with PTSD, which include the amygdala, hippocampus, and cortical regions such as the insula, orbitofrontal region, and anterior cingulate. The above regions form a neutral circuit that coordinates functions such as fear and stress conditioning. Hippocampal deficits could result in the activation and failure to cut off stress responses, which could lead to deficits in discriminating between safe and unsafe environments.
DSM-5 TR Diagnostic Criteria for PTSD
According to the American Psychiatric Association (2013), the DSM-5 diagnostic criteria divides post-traumatic stress disorder into four categories namely intrusion, avoidance of thoughts and behaviors, negative changes, and changes in arousal. Each category is associated with distinct symptoms. Intrusion entails memories and thoughts of a traumatic event. The memories recur, are involuntary, and at the same time upsetting. The intrusive symptoms tend to increase the heart rate when a person remembers the event. The avoidance symptoms make people with PTSD avoid activities, people, or situations that bring the traumatic memories back. People may also tend to avoid thoughts, physical sensations, and feelings that remind them of the event.
Negative changes in mood and thoughts are the third category of PTSD symptoms. The emotions may include feelings of guilt and self-blame, constant evaluations of oneself, loss of pleasure in activities as well the inability to experience positive feelings. The fourth category of symptoms entails changes in a person’s arousal and reactivity. Notable changes that individuals might experience include an increase in a startle response, problems falling asleep, difficulty concentrating, engaging in self-destructive behavior, and high rates of irritability.
The video case supports a PTSD diagnosis. Immediately Joe and his father got into an accident and the other driver engaged them in pursuit, he started becoming anxious. He had hyper-arousal symptoms and intrusion symptoms such as having nightmares, having sleep issues, anxiety over car accidents, and similar car models, he became physically aggressive not only at home but also in school and verbal outbursts. Despite other diagnoses like major depression disorder, conduct disorder, attention deficit, hyperactivity disorder, and spider fear, PTSD is the most dominant one, which can be directly linked to the car accident incident.
One other Psychotherapy Treatment
Cognitive behavioral therapy is a treatment, which is considered the gold standard for the management of post-traumatic stress disorder. The therapy treatment enables individuals to modify their maladaptive behavior and thoughts that are linked with negative emotions and feelings (Nakao et al., 2021). Through cognitive behavioral therapy, patients can cope with the stress associated with traumatic life events. I, therefore, believe that if Joe has access to cognitive behavioral therapy; he could easily cope with his past trauma and experience a better quality of life.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
Dossi, G., Delvecchio, G., Prunas, C., Soares, J. C., & Brambilla, P. (2020). Neural Bases of Cognitive Impairments in Post-Traumatic Stress Disorders: A Mini-Review of Functional Magnetic Resonance Imaging Findings. Frontiers in psychiatry, 11, 176. https://doi.org/10.3389/fpsyt.2020.00176
Nakao, M., Shirotsuki, K., & Sugaya, N. (2021). Cognitive–behavioral therapy for management of mental health and stress-related disorders: Recent advances in techniques and technologies. BioPsychoSocial Medicine, 15(1), 1-4.