NRNP 6645 POSTTRAUMATIC STRESS DISORDER ESSAY
NRNP 6645 POSTTRAUMATIC STRESS DISORDER ESSAY
NRNP 6645 POSTTRAUMATIC STRESS DISORDER ESSAY
Neurological Basis of PTSD
A Neurological Basis
Post-traumatic stress disorder (PTSD) can be caused by exposure to real or possible harm, death, or sexual abuse. PTSD is linked to higher mortality, functional impairment, and comorbidity with suicidal thoughts and attempts (Mann & Marwaha, 2022). Invading memories, distressing dreams, disjointed reactions, dodging trauma-related stimuli, negative thoughts and mood, increased alertness and irritability, clinically significant pain, and functional limitations are all characteristics of PTSD, according to Abdallah et al. (2019). PTSD has a neurological base that alters how the body’s stress response system functions. Trauma activates the HPA axis and sympathetic nervous system, producing stress hormones like cortisol and epinephrine (Hinds & Sanchez, 2022). Even without a traumatic incident, the HPA axis is dysregulated in those with PTSD, leading to an excessive stress response. Therefore, the aberrant control of brain neurotransmitters like catecholamine that regulate stress and anxiety reactions is one of the core neurochemical characteristics of PTSD.
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Individuals with post-traumatic stress disorder (PTSD) experience persistent stress, but their cortisol levels are almost normal, while their corticotropin-releasing factor (CRF) levels are high. CRF stimulates the anterior cingulate cortex, producing norepinephrine that increases sympathetic response, causing an increase in blood pressure, pulse, arousal, and startle reaction. Derealization and separation are also easier when GABA activity decreases and glutamate levels increase. Also, the smaller amount of serotonin in the dorsal/median raphe probably changes how the hippocampus and amygdala work together. There is a drop in the amount of neuropeptide Y in the plasma (Tural & Iosifescu, 2020), which causes chronic hyperarousal symptoms like irritability, increased awareness, and trouble sleeping.
Diagnostic Criteria
A person can be diagnosed with PTSD if they exhibit at least one avoidance symptom, one intrusion symptom, and two hyperarousal symptoms, according to the DSM-5-TR diagnostic criteria. Eight-year-old Joe experienced a traumatic event, including being in a car accident, witnessing his father being threatened with physical harm and involvement in the ensuing chase. The patient has bothersome symptoms like remembering the accident, avoiding things, having trouble falling asleep, having nightmares, being overly alert, feeling anxious, and having physical aggression. The case scenario offers sufficient proof that the patient might have PTSD. Still, it’s vital to remember that a careful evaluation by a skilled healthcare practitioner can only determine a condition diagnosis. The information in the video presentation is sufficient to diagnose PTSD (Dr. Todd Grande, 2019). The patient is eight years old; thus, the diagnosis would be different if he was an adult. As a result, when treating the patient, a multidisciplinary strategy that uses evidence-based therapy alternatives would be crucial.
I concur with the diagnosis put forth for this case. The client presented in the video has symptoms of both anxiety and depression at this time. Depression symptoms include trouble focusing, sleeping, and maintaining a positive mood. Additionally, the client struggles to control their tension and is quickly startled, all indicating anxiety. The patient also has trouble controlling his rage.
Psychotherapy treatment
Cognitive-behavioral therapy (CBT) is regarded as the gold standard treatment for PTSD. CBT has been proven effective in reducing PTSD symptoms through experimental studies and is the recommended first-line treatment in clinical guidelines (Mann & Marwaha, 2020). Exposure treatment and cognitive restructuring are both parts of CBT for PTSD. In exposure therapy, the client is slowly exposed to painful recollections in a safe setting. In cognitive restructuring, limiting beliefs that might trigger PTSD symptoms are challenged and changed. Psychiatric-mental health nurse practitioners should adhere to clinical practice guidelines for optimal patient treatment. Bisson et al. (2019) found that scientifically proven treatments for PTSD are effective in minimizing the symptoms, improving functioning, and decreasing the risk of chronic PTSD. Clinicians should use treatments that have been shown to help people with PTSD.
References
Abdallah, C. G., Averill, L. A., Akiki, T. J., Raza, M., Averill, C. L., Gomaa, H., Adikey, A., & Krystal, J. H. (2019). The Neurobiology and Pharmacotherapy of Posttraumatic Stress Disorder. Annual Review of Pharmacology and Toxicology, 59(1), 171–189. https://doi.org/10.1146/annurev-pharmtox-010818-021701
Bisson, J. I., Berliner, L., Cloitre, M., Forbes, D., Jensen, T. K., Lewis, C., Monson, C. M., Olff, M., Pilling, S., Riggs, D. S., Roberts, N. P., & Shapiro, F. (2019). The International Society for Traumatic Stress Studies New Guidelines for the Prevention and Treatment of Posttraumatic Stress Disorder: Methodology and Development Process. Journal of Traumatic Stress, 32(4), 475–483. https://doi.org/10.1002/jts.22421
Dr. Todd Grande. (2019). Presentation example: Posttraumatic stress disorder (PTSD). In YouTube. https://www.youtube.com/watch?v=RkSv_zPH-M4
Hinds, J. A., & Sanchez, E. R. (2022). The role of the hypothalamus–pituitary–adrenal (HPA) axis in test-induced anxiety: Assessments, physiological responses, and molecular details. Stresses, 2(1), 146–155. https://doi.org/10.3390/stresses2010011
Mann, S. K., & Marwaha, R. (2022, February 7). Posttraumatic stress disorder (PTSD). PubMed; StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK559129/
Tural, U., & Iosifescu, D. V. (2020). Neuropeptide Y in PTSD, MDD, and chronic stress: A systematic review and meta‐analysis. Journal of Neuroscience Research, 98(5), 950–963. https://doi.org/10.1002/jnr.24589
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To prepare:
- Review this week’s Learning Resources and reflect on the insights they provide about diagnosing and treating PTSD.
- View the media Presentation Example: Posttraumatic Stress Disorder (PTSD)and assess the client in the case study.
- For guidance on assessing the client, refer to Chapter 3 of the Wheeler text.
Note: To complete this Assignment, you must assess the client, but you are not required to submit a formal comprehensive client assessment.
THE ASSIGNMENT
Succinctly, in 1–2 pages, address the following:
- Briefly explain the neurobiological basis for PTSD illness.
- Discuss the DSM-5-TRdiagnostic 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.
- Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD)Links to an external site.[Video]. YouTube. https://www.youtube.com/watch?v=RkSv_zPH-M4
- Gift from Within. (Producer). (2008). PTSD and veterans: A conversation with Dr. Frank OchbergLinks to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/ptsd-and-veterans-a-conversation-with-dr-frank-ochberg
- Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder?Links to an external site.(Strictly Medical-English Version). [Video]. YouTube. https://www.youtube.com/watch?v=o98ilXH5gto
