Comprehensive Assessment and Treatment Considerations for PTSD- A Case Study Analysis

Comprehensive Assessment and Treatment Considerations for PTSD- A Case Study Analysis

PTSD is a mental condition suffered by patients who experienced trauma such as natural disasters or the death of their family or friends (Bryant, 2019).  This is the most common mental disorder that happens after a traumatic event. There should be a prompt diagnosis and treatment to help patients recover from it since it reduces the quality of life.

Neurobiological Basis of PTSD

Abnormal regulation of thyroid and cortisol hormones are the key features of PTSD. Endocrine dysregulation has been noted in patients with traumatic brain injury due to damaging the pituitary stalk (Maeng & Milad, 2017). The hypothalamic-pituitary-adrenal axis plays a central role in human stress and is the major focus of PTSD. The HPA axis, which consists of the hypothalamus, anterior pituitary, and adrenal glands, releases the corticotropin-releasing hormone, adrenocorticotropin, and glucocorticoids (Maeng & Milad, 2017). Glucocorticoids control metabolism and brain function and thus regulate physiological and behavioral responses to stressors. The neurochemical features of PTSD involve abnormal regulation of serotonin, opioids, peptides, serotonin, and catecholamines. The neurotransmitters are located in brain circuits that integrate responses related to stress and fears (Maeng & Milad, 2017).

DSM-5 Diagnostic Criteria for PTSD

The DSM-V diagnostic criteria have several conditions that must be met to confirm a PTSD diagnosis. The patient must have witnessed or experienced the traumatic event (American Psychiatric Association (APA), 2013). The second criterion is that the patient should have intrusive symptoms after the traumatic events. The intrusive symptoms include dissociation, distressing memories, and recurring dreams (APA, 2013). The next criterion is avoidance of factors related to the trauma, such as avoiding trauma-related memories (APA, 2013). The fourth diagnostic criterion is negative cognition or mood. This alteration is evidenced by not remembering events related to the trauma, negative beliefs, distorted cognitions, anhedonia, and detachment, among others (APA, 2013). The other criterion is an alteration in reactivity related to the traumatic evidence, as evidenced by angry outbursts, sleep issues, hypervigilance, and recklessness, among others (APA, 2013). To meet the diagnostic criteria, the symptoms must be experienced for at least a month, social impairment, and the symptoms should not be caused by other medical conditions (APA, 2013). The information in the video presentation is enough to support PTSD diagnosis. I also agree with the other diagnosis since, according to the DSM-V diagnostic criteria, the patient meets the criteria for the mental disorders present in the video.

Psychotherapy Treatment Option

Prolonged exposure educates PTSD patients to progressively approach trauma-related situations, feelings, and memories. The patients learn that trauma-related feelings are not dangerous and should not be avoided (Hendriks et al., 2018). Prolonged exposure helps patients to confront their fears. Many PTSD patients prefer avoiding trauma-related memories, which leads to the reinforcement of the fear. By facing their fears, they can reduce PTSD symptoms. Prolonged exposure is greatly recommended in PTSD treatment and is hence considered a gold standard. PMNHPS should use evidence-based treatment strategies since this will enhance patient outcomes and improve the quality of care.

The three articles selected in this paper are scholarly. They have been posted in reputable journals. The Affiliations of the authors have been indicated. The language in the articles is professional. In addition to this, the information in these articles has been cited. The articles are peer-reviewed. They are divided into sections, and they are related to the discussion related to PTSD.

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Bryant, R. A. (2019). Post‐traumatic stress disorder: A state‐of‐the‐art review of evidence and challenges. World Psychiatry, 18(3), 259-269. https://doi.org/10.1002/wps.20656

Hendriks, L., Kleine, R. A., Broekman, T. G., Hendriks, G., & Minnen, A. V. (2018). Intensive, prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts. European Journal of Psychotraumatology, 9(1), 1425574. https://doi.org/10.1080/20008198.2018.1425574

Maeng, L. Y., & Milad, M. R. (2017). Post-traumatic stress disorder: The relationship between the fear response and chronic stress. Chronic Stress, 1, 247054701771329. https://doi.org/10.1177/2470547017713297

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Briefly explain the neurobiological basis for PTSD illness.
Discuss the DSM-5 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?

Comprehensive Assessment and Treatment Considerations for PTSD- A Case Study Analysis

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.