NRNP_6645_Week9_Post Traumatic Stress Disorder Essay
NRNP_6645_Week9_Post Traumatic Stress Disorder Essay
NRNP_6645_Week9_Post Traumatic Stress Disorder Essay
Neurobiological Basis for PTSD
After a stressful occurrence, PTSD can debilitate a person. The disease is characterized by intense and upsetting memories, avoidance of trauma reminders, negative mood and cognition alterations, and hyperarousal symptoms. Complex brain areas and chemical messengers cause PTSD. PTSD develops in the amygdala. Fear and other negative emotions activate the amygdala. PTSD patients’ amygdalas overreact to distressing stimuli. This amplifies fear in a non-threatening situation. The PFC controls impulses, decisions, and emotions. PTSD patients’ underactive PFCs make it hard to manage emotions and make bad decisions.
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PTSD also affects the hippocampus. The hippocampus does new memories and knowledge integration. PTSD patients had smaller, less active hippocampi. This can hinder memory formation and cause intrusive recollections and flashbacks. Chemical messengers and brain areas contribute to PTSD (American Psychiatric Association, 2022). The stress hormone cortisol is one. Cortisol levels can be greater or lower in PTSD patients. This disturbance may cause disorder-related hyperarousal. PTSD also involves dopamine. Dopamine helps motivate and process rewards. Dopamine disruptions in PTSD can cause anhedonia and poor emotion. Inflammation may cause PTSD. Stress can cause inflammation, in which the body reacts to damage or infection. Inflammation may cause PTSD symptoms, including headaches and gastrointestinal issues.
PTSD is a complicated neurobiological condition that involves several brain areas and chemical messengers. The disorder develops in the amygdala, PFC, hippocampus, cortisol, dopamine, and inflammation. Understanding the neurobiology of PTSD helps create effective treatments and reduce mental illness stigma.
Diagnosis for PTSD using the DSM-5 Criteria
The DSM-5-TR defines PTSD as intrusion, avoidance, negative cognitions and mood, and arousal and reactivity changes. In the case study, Joe has intrusive recollections of the accident and pursuit, avoids stimuli that remind him of it, and has negative mood, cognitive, arousal, and reactivity changes. Joe has PTSD. The video case presentation is not enough to diagnose PTSD. Before diagnosing Joe, acquire more information regarding his symptoms and severity. Accurate diagnosis requires a thorough evaluation. In the case study, PTSD patients often have comorbid conditions. Joe’s Oppositional Defiant Disorder and Conduct Disorder may be linked to his experiences (Grande, 2019). His tragedy may have caused Major Depressive Disorder and Separation Anxiety Disorder. Before diagnosing, examine family history and environmental factors. Joe’s PTSD symptoms may be related to his ADHD and spider fear, the only diagnosis before the assault.
Treatment Options the Client can Explore
This case study’s client could receive CBT. CBT helps people modify negative thoughts and behaviors. It treats depression, anxiety, and PTSD. CBT follows a structured method that links thoughts, feelings, and behaviors. The therapist helps the client discover negative thoughts and beliefs that may be causing their symptoms and replace them with good, realistic ones. The therapist may also teach coping and behavioral strategies to manage symptoms.
Clinical practice guidelines consider CBT a “gold standard treatment” since it has been widely investigated and proven beneficial for many mental health disorders (Grande, 2019). Clinical practice guidelines are established by expert committees of healthcare professionals who evaluate treatment evidence and offer recommendations based on the best evidence. The gold standard for therapy efficacy is randomized controlled trials.
Psychiatric-mental health nurse practitioners should employ clinical practice guidelines to provide patients with the most effective therapies. These treatments have been carefully investigated and proven successful for certain disorders, improving patient outcomes and reducing the risk of side effects and problems from ineffective treatments. Psychiatric-mental health nurse practitioners can also gain confidence in their treatment decisions by employing evidence-based treatments that have been proven helpful in research studies. Nurse practitioners can follow best practices, improving patient care. It is possible to treat the client in this case study using CBT. Clinical practice guidelines consider CBT a “gold standard treatment” for PTSD and other mental health issues because it has been widely investigated and proven effective.
References
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders. https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD). [Video]. YouTube. https://www.youtube.com/watch?v=RkSv_zPH-M4
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POSTTRAUMATIC STRESS DISORDER
It is estimated that more almost 7% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Institute of Mental Health, 2017). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to behavioral issues, adolescent substance abuse issues, and even physical ailments. For this Assignment, you examine a PTSD video case study and consider how you might assess and treat clients presenting with PTSD.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
WEEKLY RESOURCES
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.
LEARNING RESOURCES
Required Readings
• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disordersLinks to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
o “Culture and Psychiatric Diagnosis”
• American Psychiatric Association. (2017). Clinical practice guideline of PTSDLinks to an external site.. https://www.apa.org/ptsd-guideline
• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach Download SAMHSA’s concept of trauma and guidance for a trauma-informed approach. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
Credit: Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
• Tye, S., Van Voorhees, E., Hu, C., & Lineberry, T. (2015). Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5 Download Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5. Harvard Review of Psychiatry, 23(1), 51–58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542003/
Credit: Preclinical Perspectives on Posttraumatic Stress Disorder Criteria in DSM-5 by Susannah Tye, PhD, Elizabeth Van Voorhees, PhD, Chunling Hu, MD, PhD, and Timothy Lineberry, MD, in HARVARD REVIEW OF PSYCHIATRY, Vol. 23/Issue 1. Copyright 2015 by ROUTLEDGE. Reprinted by permission of ROUTLEDGE via the Copyright Clearance Center.
• Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
o Chapter 3, “Assessment and Diagnosis” (Previously read in Week 2)
o Chapter 7, “Eye Movement Desensitization and Reprocessing Therapy”
o Chapter 11, “Trauma Resiliency Model Therapy”
o Chapter 15, “Trauma-Informed Medication Management”
o Chapter 17, “Stabilization for Trauma and Dissociation”
o Chapter 18, “Dialectical Behavior Therapy for Complex Trauma”
Required Media
• 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
THE ASSIGNMENT
Succinctly, in 1–2 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.
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| Criteria | Ratings | Pts | |||
| Succinctly, in 1–2 pages, address the following:• Briefly explain the
neurobiological basis for PTSD illness. |
15 to >13.0 pts
Excellent 90%– 100% The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness. |
13 to >11.0 pts
Good 80%–89% The response includes an accurate explanation of the neurobiological basis for PTSD illness. |
11 to >10.0 pts
Fair 70%–79% The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness. |
10 to >0 pts
Poor 0%–69% The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing. |
15 pts |
| • 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? |
25 to >22.0 pts
Excellent 90%– 100% The response includes an accurate and concise description of the DSM-5-TR diagnostic criteria for PTSD and an accurate explanation of how they relate to the symptomology presented in the case study….. The response includes a concise explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates strong diagnostic reasoning and critical thinking skills. |
22 to >19.0 pts
Good 80%–89% The response includes an accurate description of the DSM-5-TR diagnostic criteria for PTSD and an adequate explanation of how they relate to the symptomology presented in the case study….. The response includes an explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates adequate diagnostic reasoning and critical thinking skills. |
19 to >17.0 pts
Fair 70%–79% The response includes a somewhat vague or inaccurate description of the DSM-5-TR diagnostic criteria for PTSD and a somewhat vague or inaccurate explanation of how they relate to the symptomology presented in the case study….. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates somewhat inadequate diagnostic reasoning and critical thinking skills. |
17 to >0 pts
Poor 0%–69% The response includes a vague or inaccurate description of the DSM-5-TR diagnostic criteria for PTSD and a vague or inaccurate explanation of how they relate to the symptomology presented in the case study. Or, response is missing….. The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates poor diagnostic reasoning and critical thinking skills. Or, response is missing. |
25 pts |
| • Discuss one other psychotherapy treatment option for the client in this case study. Explain whether your treatment option is | 30 to >26.0 pts
Excellent 90%– 100% The response includes an accurate and concise |
26 to >23.0 pts
Good 80%–89% The response includes an accurate explanation of one other |
23 to >20.0 pts
Fair 70%–79% The response includes a somewhat vague or incomplete explanation of one |
20 to >0 pts
Poor 0%–69% The response includes a vague and inaccurate explanation of one other |
30 pts |
| Criteria | Ratings | Pts | |||||||
| considered a “gold | explanation of | psychotherapy | other | psychotherapy | |||||
| standard” treatment | one other | treatment option | psychotherapy | treatment option | |||||
| from a clinical | psychotherapy | for the client in | treatment option | for the client in | |||||
| practice guideline | treatment option | this case study…. | for the client in | this case study, or | |||||
| perspective, and | for the client in | The response | this case study…. | the treatment | |||||
| why using gold | this case study…. | adequately | The response | option is | |||||
| standard, evidence- | The response | explains whether | provides a | innappropriate. | |||||
| based treatments | clearly and | the | somewhat vague | Or, response is | |||||
| from clinical | concisely explains | recommended | or incomplete | missing….. The | |||||
| practice guidelines | whether the | treatment option | explanation of | response provides | |||||
| is important for | recommended | is a “gold | whether the | a vague or | |||||
| psychiatric-mental | treatment option | standard” | recommended | incomplete | |||||
| health nurse | is a “gold | treatment and | treatment option is | explanation of | |||||
| practitioners. | standard” | why using gold | a “gold standard” | whether the | |||||
| treatment and | standard, | treatment and why | recommended | ||||||
| why using gold | evidence-based | using gold | treatment option is | ||||||
| standard, | treatments from | standard, | a “gold standard” | ||||||
| evidence-based | clinical practice | evidence-based | treatment and why | ||||||
| treatments from | guidelines is | treatments from | using gold | ||||||
| clinical practice | important for | clinical practice | standard, | ||||||
| guidelines is | PMHNPs. | guidelines is | evidence-based | ||||||
| important for | important for | treatments from | |||||||
| PMHNPs. | PMHNPs. | clinical practice | |||||||
| guidelines is | |||||||||
| important for | |||||||||
| PMHNPs. Or, | |||||||||
| response is | |||||||||
| missing. | |||||||||
| · Support your approach with specific examples from this week’s media and at least three peer-
reviewed, evidence- based sources. PDFs are attached. |
15 to >13.0 pts
Excellent 90%– 100% The response is supported by specific examples from this week’s media and at least three peer- reviewed, evidence-based sources from the literature that provide strong support for the rationale provided. PDFs are attached. |
13 to >11.0 pts
Good 80%–89% The response is supported by examples from this week’s media and three peer- reviewed, evidence-based sources from the literature that provide appropriate support for the rationale provided. PDFs are attached. |
11 to >10.0 pts
Fair 70%–79% The response is supported by examples from this week’s media and two or three peer- reviewed, evidence- based sources from the literature. Examples and resources selected may provide only weak support for the rationale provided. PDFs may not be attached. |
10 to >0 pts
Poor 0%– 69% The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing. |
15 pts |
||||
| Written Expression and Formatting – Paragraph
Development and Organization: Paragraphs make clear points that support well- developed ideas, flow logically, and |
5 to >4.0 pts
Excellent 90%– 100% Paragraphs and sentences follow writing standards for flow, continuity, and clarity….. A clear and comprehensive purpose statement, |
4 to >3.5 pts
Good 80%–89% Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time Purpose, introduction, and |
3.5 to >3.0 pts Fair 70%–79%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%– 79% of the time…. Purpose, introduction, and |
3 to >0 pts
Poor 0%–69% Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time….. No |
5 pts | ||||
| Criteria | Ratings | Pts | |||||||||
| demonstrate | introduction, and | conclusion of the | conclusion of the | purpose | |||||||
| continuity of ideas. | conclusion are | assignment are | assignment are | statement, | |||||||
| Sentences are | provided that | stated, yet are | vague or off topic. | introduction, or | |||||||
| carefully focused— | delineates all | brief and not | conclusion were | ||||||||
| neither long and | required criteria. | descriptive. | provided. | ||||||||
| rambling nor short | |||||||||||
| and lacking | |||||||||||
| substance. A clear | |||||||||||
| and comprehensive | |||||||||||
| purpose statement | |||||||||||
| and introduction is | |||||||||||
| provided which | |||||||||||
| delineates all | |||||||||||
| required criteria. | |||||||||||
| Written Expression and Formatting – English writing standards: Correct grammar,
mechanics, and proper punctuation |
5 to >4.0 pts
Excellent 90%– 100% Uses correct grammar, spelling, and punctuation with no errors. |
4 to >3.5 pts
Good 80%– 89% Contains 1 or 2 grammar, spelling, and punctuation errors. |
3.5 to >3.0 pts Fair 70%–79%
Contains 3 or 4 grammar, spelling, and punctuation errors. |
3 to >0 pts
Poor 0%–69% Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
5 pts |
||||||
| Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins,
indentations, page numbers, parenthetical/in-text citations, and reference list. |
5 to >4.0 pts
Excellent 90%– 100% Uses correct APA format with no errors. |
4 to >3.5 pts
Good 80%–89% Contains 1 or 2 APA format errors. |
3.5 to >3.0 pts Fair 70%–79%
Contains 3 or 4 APA format errors. |
3 to >0 pts
Poor 0%–69% Contains many (≥ 5) APA format errors. |
5 pts |
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|
Total Points: 100 |
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