NRNP 6645 POSTTRAUMATIC STRESS DISORDER
A Sample Answer For the Assignment: NRNP 6645 POSTTRAUMATIC STRESS DISORDER
Title: NRNP 6645 POSTTRAUMATIC STRESS DISORDER
Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is one of the most common anxiety disorders characterized by anxiousness and restlessness. PTSD commonly occurs when an individual witnesses or experiences a traumatic event. The purpose of this paper is to describe the neurobiological basis of PTSD, review a case study and diagnostic criteria, and a psychotherapeutic treatment.Neurobiological Basis of PTSD
Psychological stressors have been noted to induce neuronal remodeling and regional reductions and increases in synaptic density in several regions of the brain that affect mood and behavior. For example, a single stressor can up regulate brain-derived neurotrophic factor (BDNF) and increase synaptogenesis in the basolateral amygdala, resulting in anxiety (Toledo et al., 2022). Additionally, stress causes an increase in cortisol, resulting in increased basolateral amygdala hypertrophy and anxiety. In some instances, synaptic loss in the hippocampus and prefrontal cortex and down regulation of BDNF has been associated with behavioral disturbances. Furthermore, prolonged stress exposure has been associated with a reduced uptake of glutamate at the receptors leading to increased extracellular glutamate and excitotoxicity. The excitotoxicity in the receptors has been seen to precipitate neuronal atrophy and reduce the dendritic length, synaptic density and neurotransmission strength, causing behavioral abnormalities such as mood and anxiety dysregulation.DSM-V Diagnostic Criteria
DSM-V criteria diagnosis of PTSD includes many entities related to direct or indirect exposure to the traumatic event. The entities include one intrusive symptom, including distressing memories or dreams and flashbacks (Schrader et al., 2021). The diagnosis also includes avoidance symptoms of the traumatic event. In addition, the patient may have symptoms related to negative alterations to cognition or mood related to the trauma, such as amnesia, persistent negative emotional state and anhedonia. Furthermore, patients can experience alterations in arousal and reactivity, such as irritability, anger outbursts, recklessness, hypervigilance, problems with concentration, and sleep disturbance (Al Jowf et al., 2022).According to the video, Joe meets the DSM-V criteria for PTSD diagnosis. Joe was directly exposed to the event, and since then, he has been having intrusive memories, trouble sleeping, nightmares, avoidance symptoms, anger outbursts, and anxiety whenever the street or car involved is mentioned. Other diagnoses given after the event include conduct, oppositional defiant, major depression, and separation anxiety disorders. I would agree with conduct disorder, as Joe has become physically violent and hostile both at school and at home (Al Zomia et al., 2023). I would also agree with the diagnosis of separation anxiety disorder, as Joe has been experiencing nightmares about the event, as well as feeling the need to sleep with his father. The reaction would be due to fear of losing his only remaining parent. However, the diagnosis of oppositional defiant disorder may be inaccurate as Joe’s irritability and mood symptoms may have been a result of PTSD or previously diagnosed attention deficit hyperactive disorder (Burke et al., 2022). In addition, Joe does not meet the diagnostic criterion of major depression as he has not had a depressed mood, weight changes, or fatigue, among other depression symptoms.Psychotherapy for PTSD
Another form of psychotherapy for PTSD includes Cognitive Processing Therapy (CPT). It focuses on how the traumatic event happened and the patient’s coping mechanisms (Moring et al., 2020).The cognitive therapy techniques utilized focus on faulty thoughts related to traumatic events and involve the patient’s need to identify and analyze emotions related to the trauma as well as identify thoughts that are preventing recovery. After identifying the thoughts that prevent recovery, the stuck points, the patients are engaged in a cognitive process where the therapists help them address the stuck points by having them gather evidence for and against those thoughts as a road to recovery. However, trauma-focused cognitive behavioral therapy (CBT) is the goal standard treatment option for PTSD (Schrader et al., 2021). It is crucial to use goal-standard treatment as it reflects evidence-based practices from research to ensure patients receive the most effective interventions that have positive outcomes, thus minimizing the risks of poor outcomes.Conclusion
PTSD is one of the most common anxiety disorders that follow exposure to a traumatic event. DSM-V diagnosis of PTSD includes avoidance, intrusive, and arousal symptoms, amongst others. The mainstay treatment for PTSD is trauma-focused CBT, as it has shown better results amongst PTSD patients.Post-Traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a common mental health problem that affects patients exposed to traumatic events. PTSD treatment largely entails the use of pharmacological and non-pharmacological interventions. Therefore, this paper explores neurobiology of PTSD, diagnostic criteria, and psychotherapy for its management.Neurobiology of Post-Traumatic Stress Disorder
Post-traumatic stress disorder has neurobiological basis. Studies have established that specific regions in the brain contribute to the development as well as maintenance of the disorder. They include hippocampus, amygdala, and medial prefrontal cortex. Studies on human and animal models show that the medial prefrontal cortex in PTSD patients is overactive due to the inability of the other brain parts to regulate its functions effectively. There is also the finding that patients with PTSD have reduced hippocampal volumes, which may explain the cause and persistence of PTSD. Stressors that contribute to PTSD cause hippocampal cell loss and damage, which worsen the associated symptoms of the disorder. The HPA-axis has also been associated with the development and maintenance of PTSD. Accordingly, patients with PTSD have an over-sensitive negative feedback system, which lower the levels of cortisol and inhibit the release of ACTH from the anterior pituitary gland (Malikowska-Racia & Salat, 2019; Ressler et al., 2022). These changes alter the functioning of the sympathetic response, hence, the consolidation of traumatic memories that cause PTSD.DSM-5 TR Diagnostic Criteria for PTSD
The DSM-5 provides criteria that healthcare practitioners adopt when diagnosing patients with PTSD. According to the diagnostic tool, the diagnosis is based on symptoms in eight categories. Criteria A is at least one symptom such as direct exposure, witnessing, learning about, or indirect exposure to trauma. Criteria B encompasses symptoms that include the re-experience of the traumatic event in ways such as nightmares, upsetting memories, flashbacks, physical, and emotional distress when the patient is exposed to the trauma. The patient should have at least one symptom from category B (Cénat et al., 2020; Li et al., 2020). The patient must also have a symptom in category C of the symptoms, which include avoidance of trauma-related stimuli in ways that include reminders and feelings of the trauma. A patient must have at least two symptoms of category D symptoms characterized by negative thoughts after the trauma. The thoughts exhibit in ways such as difficulties in recalling the key aspects of the trauma, negative affect, feeling isolated, hardships in experiencing positive affect, and exaggerated blame on self or others for the trauma. The patient should also have at least two symptoms of category E, which include irritability or aggression, hypervigilance, engaging in destructive or risky behavior, difficulty in sleeping and concentrating, and increased startle reaction. The additional categories of symptoms that must be met for PTSD diagnosis include symptoms lasting for at least one month, causing functional impairment, and not attributed to substance use, medication, or other illnesses (Cénat et al., 2020; Li et al., 2020). The video provides sufficient information to derive PTSD diagnosis since the information given align with those of PTSD. I agree with the other diagnoses since they align with those of the disorders, as stated in DSM-5.Psychotherapy Treatment Option
The other psychotherapeutic treatment option for the patient that can be considered is prolonged exposure therapy. Prolonged exposure therapy entails exposing the patient to trauma-related reminders until there is a reduction in the perceived anxiety level and autonomic responses by at least half. The decrease implies the desensitization or extinction of the fear pathways. Prolonged exposure therapy is not considered a gold standard treatment but can be used in combination with other psychotherapeutic treatments such as cognitive behavioral therapy (Kothgassner et al., 2019). It is important to use gold standard evidence-based treatments from clinical practice guidelines because they contribute to outcomes such as safety, quality, and efficiency in nursing practice.Conclusion
In summary, PTSD has neurobiological basis. The DSM-5 provides the criteria for diagnosing patients with PTSD as well as other mental health problems. Psychotherapy interventions such as prolonged exposure therapy may be effective for PTSD patients. However, nurse practitioners should ensure the adopted interventions are evidence-based.Sample Answer for NRNP 6645 POSTTRAUMATIC STRESS DISORDER Included After Question
NRNP 6645 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.
- 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.
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.
BY DAY 7
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Rubric
| Criteria | Ratings | Pts | ||||
|---|---|---|---|---|---|---|
| Succinctly, in 1–2 pages, address the following:• Briefly explain the neurobiological basis for PTSD illness. |
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| • 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? |
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| • 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. |
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| · Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached. |
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| Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria. |
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| Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
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| 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. |
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| Total Points: 100 | ||||||
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