Neurological Basis of Post-Traumatic Stress Disorder

Neurological Basis of Post-Traumatic Stress Disorder

Post-traumatic stress disorder (PTSD) is a mental condition that occurs after witnessing a traumatic event such as assault, a life-threatening experience, or combat-related trauma. It occurs due to changes in neuro-hormones and neurotransmitters’ function (Kunimatsu et al., 2019). There is a continued increase of tissue and serum adrenaline with a reduction in the levels of serum glucocorticoids. Change in the hormone levels causes a heightened sympathetic response. Additionally, there is decreased size of the anterior cingulate cortex and hippocampus. The amygdala and dorsal anterior cingulate cortex are hypersensitive. All these changes lead to symptoms of re-experiencing, hyperarousal, numbness, and avoidance.

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DSM-5 Diagnostic Criteria and Psychotherapy Treatment Options

The fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) has criteria for the diagnosis of PTSD. All the criteria are required for the diagnosis of PTSD to be made (Miao et al., 2018). The following are the diagnostic criteria:

• Criterion A: An individual is exposed to actual or threatened death, sexual assault, or serious injury through direct or indirect exposure, witnessing the traumatic event, or learning that the stressful events happened to a close family member or friends.
• Criterion B: An individual repeatedly experiences recurrent, unwanted memories, dissociative reactions, nightmares, psychological and emotional distress after re-exposure to traumatic events.
• Criterion C: Continuous avoidance of trauma-associated stimuli.
• Criterion D: Negative changes in cognition and mood. For instance, forgetting important aspects of traumatic occurrences, negative view of the world and oneself, negative views on the consequences of traumatic events, continuous negative emotional state, lack of interest in daily activities, isolation from others in society, and difficulty experiencing negative emotions.
• Criterion E: Changes in reaction and arousal. Individuals can be highly irritable, self-destructive, hyper-vigilant, suffer from sleep disturbance, have poor concentration, and an exaggerated startle reaction.
• Criterion F: Symptoms in criteria B, C, D, and E last for one month. Criterion G: symptoms interfere with social and occupational activities. Criterion H: the symptoms have not occurred due to medication, alcohol, or medical conditions.

The video case presentation by Dr. Grande has provided adequate information to make a diagnosis of PTSD. Joe’s symptoms began after witnessing a traumatic event. This symptom falls in Criterion A of DSM-5 for diagnosis of PTSD. He also had flashbacks, nightmares, anxiety, irritability, sleep disturbance, and risky behavior. The symptoms he experienced are part of criteria B, C, D, and E of DSM-5 diagnostic criteria for PTSD. I concur with the diagnosis of the conductive disorder and major depressive disorder. Individuals with PTSD are likely to suffer from conductive disorders due to shared risk factors and symptoms (Bernhard et al., 2018). According to Habukawa et al. (2018), PTSD is also associated with major depressive disorder. Symptoms such as sleep disturbance present in PTSD and major depressive disorder.

Psychotherapy Treatment Option

Narrative exposure therapy can be used in the management of PTSD. Patients with PTSD come up with a narrative to examine traumatic life events. However, this method of therapy can only be used as an adjunct to definitive treatment. The gold standard is cognitive behavioral therapy which is more efficient because it focuses on thoughts, feelings, and behaviors (Bourdon et al., 2019). It changes an individual’s views towards traumatic events and restores them to normal functioning in society. Psychiatric mental health nurse practitioners should use cognitive behavioral therapy to treat PTSD as multiple studies prove its efficiency.

Sources

All the supporting articles by Benhard et al. (2017), Bourdon et al.’s (2019), Habukawa et al. (2018), and Kunimatsu et al. (2018) are found in Google Scholar, and the journals the articles appear in are peer-reviewed. Furthermore, the authors’ names and their relevant credentials have been provided. The universities or research institutes associated with the authors have also been mentioned. Accordingly, these sources are considered scholarly.

References

Bernhard, A., Martinelli, A., Ackermann, K., Saure, D., & Freitag, C. M. (2018). Association of trauma, post-traumatic stress disorder and conduct disorder: a systematic review and meta-analysis. Neuroscience & Biobehavioral Reviews, 91, 153-169. https://doi.org/10.1016/j.neubiorev.2016.12.019

Bourdon, D. É., El-Baalbaki, G., Girard, D., Lapointe-Blackburn, É., & Guay, S. (2019). Schemas and coping strategies in cognitive-behavioral therapy for PTSD: A systematic review. European Journal of Trauma & Dissociation, 3(1), 33-47. https://doi.org/10.1016/j.ejtd.2018.09.005

Habukawa, M., Uchimura, N., Maeda, M., Ogi, K., Hiejima, H., & Kakuma, T. (2018). Differences in rapid eye movement (REM) sleep abnormalities between post-traumatic stress disorder (PTSD) and major depressive disorder patients: REM interruption correlated with nightmare complaints in PTSD. Sleep medicine, 43, 34-39. https://doi.org/10.1016/j.sleep.2017.10.012

Kunimatsu, A., Yasaka, K., Akai, H., Kunimatsu, N., & Abe, O. (2020). MRI findings in post-traumatic stress disorder. Journal of Magnetic Resonance Imaging, 52(2), 380-396. https://doi.org/10.1002/jmri.26929

Miao, X. R., Chen, Q. B., Wei, K., Tao, K. M., & Lu, Z. J. (2018). Post-traumatic stress disorder: from diagnosis to prevention. Military Medical Research, 5(1), 1-7. https://doi.org/10.1186/s40779-018-0179-0

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Neurological Basis of Post-Traumatic Stress Disorder

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 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.