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Posttraumatic Stress Disorder

Posttraumatic Stress Disorder

Neurobiological Basis for PTSD

PTSD results from a disruption of the typical functioning of certain regions of the brain, such as the amygdala, prefrontal cortex and hippocampus. The amygdala, involved in threat detection, is hyperactive and thus promotes exaggerated fear responses. The prefrontal cortex usually regulates emotional response and exhibits hypoactivity, resulting in a deficiency in suppressing the fear signals received from the amygdala (Toledo & Carson, 2022): Posttraumatic Stress Disorder.

The hippocampus plays a vital role in memory, establishing relationships between events. It often shrinks due to PTSD and, therefore, has trouble distinguishing between a past traumatic experience and whether one is currently safe. Furthermore, the HPA axis is disturbed, leading to abnormal cortisol levels and enhancing stress reactivity​.

DSM-5-TR Criteria and Symptomatology

DSM-5-TR diagnostic criteria of PSTD include the experience of a traumatic event, intrusions, avoidance, cognition/mood upset, and increased arousal/ reactivity, which lasts for over a month and causes functional impairment. All the specified criteria have been fulfilled in Joe’s case. He had a motor vehicle accident and later got chased, which met the trauma criterion. He meets the threshold domains, shown through symptoms such as intrusive memories, avoidance of reminders, difficulty sleeping, and emotional outbursts (Li et al., 2020).

The video evidence would suffice to diagnose PTSD for Joe, as he presents persistent symptoms in all diagnostic clusters. However, the additional diagnoses of Oppositional Defiant Disorder and Conduct Disorder do raise some concerns (Eskander, 2020). Generally, it is not common to diagnose both ODD and CD because these two diagnoses often overlap. A single focus on the treatment of PTSD would better address Joe’s presenting symptoms without associating with CD​.

Alternative Psychotherapy Treatment

EMDR is a straightforward psychotherapy approach that assists those affected by trauma to process traumatic memories alongside the use of bilateral stimulation, including eye movements. This helps to decrease the distress and to change maladaptive beliefs linked with the trauma. EMDR is recognized as a “gold standard” treatment alongside trauma-focused cognitive behavioral therapy and is indicated in the guidelines for clinical practice. (Schrader & Ross, 2021)​. Notably, evidence-based treatments ensure that psychiatric-mental health nurse practitioners provide the highest quality of care for better results as it is an ethical way of practicing their profession.

Scholarliness of the Articles

All of the articles are academic because they were published in peer-reviewed journals: Li et al. (2020) present a rigorous methodology in the European Journal of Psychotraumatology, Schrader and Ross (2021) offer a thorough review in Missouri Medicine, Toledo and Carson (2022) present evidence-based thinking in the International Journal of Environmental Research and Public Health, and Eskander (2020) presents a research study published in Cureus. Academic reliability is ensured by the fact that the writers of these works are reputable professionals.

References

Eskander, N. (2020). The Psychosocial Outcome of Conduct and Oppositional Defiant Disorder in Children With Attention Deficit Hyperactivity Disorder. Cureus, 12(8). https://doi.org/10.7759/cureus.9521

Li, G., Wang, L., Cao, C., Fang, R., Bi, Y., Liu, P., Luo, S., Hall, B. J., & Elhai, J. D. (2020). An exploration of the DSM-5 posttraumatic stress disorder symptom latent variable network. European Journal of Psychotraumatology, 11(1). https://doi.org/10.1080/20008198.2020.1759279

Schrader, C., & Ross, A. (2021). A Review of PTSD and Current Treatment Strategies. Missouri Medicine, 118(6), 546. https://pmc.ncbi.nlm.nih.gov/articles/PMC8672952/

Toledo, F., & Carson, F. (2022). Neurobiological Features of Posttraumatic Stress Disorder (PTSD) and Their Role in Understanding Adaptive Behavior and Stress Resilience. International Journal of Environmental Research and Public Health, 19(16), 10258. https://doi.org/10.3390/ijerph191610258

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Question

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.

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-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.

Posttraumatic Stress Disorder

Posttraumatic Stress Disorder

By Day 7
Submit your Assignment. Also attach and submit PDFs of the sources you used.

submission information
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  • Then, click on Start Assignment near the top of the page.
  • Next, click on Upload File and select Submit Assignment for review.

Readings:

Required Media:

Client’s Notes: