PSychology and Psychiatry in Nursing
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PTSDFINALPREReview.docxRunning Head: PTSD 1
PTSD 2
What is PTSD?
Abstract
Post-traumatic Stress Disorder (PTSD) is the mental health disorder that triggers a horrifying experience either experiencing. The trauma experienced by the victim is leading to the tearing of their mental anchors. According to approximation, PTSD affects 3.5 percent of the United States population every year. Studies have shown that in the past years, PTSD has affected about 3.6 percent of the America adults of ages 18 years. The management of the PTSD is focused on the management of the symptoms and improvement in the behaviors. The behavioral changed is addressed using trauma-focused cognitive behavioral therapy. Evidence-based approaches such as clinical practice guidelines (CPGs) are used to inform healthcare personnel with the framework needed for the assessment, treatment, and management of the individual needs and the preferences.
What is PTSD?
Post-traumatic Stress Disorder (PTSD) is the mental health disorder that triggers a horrifying experience either experiencing. It is a psychiatric trauma that is being instigated by an event associated with an acute and devastating threat. As the events take place, the inner agency of the mind of the affected individual leads to the loss capability of controlling the disorganization of the effects caused by the experience thus leading to the disequilibrium. The trauma experienced by the victim is leading to the tearing of their mental anchors. Some of the symptoms associated with PTSD include severe severity, nightmares, and flashbacks, and the uncontrollable thoughts about the event. The common traumas leading to PTSD can include sexual abuse and battering among many others. Individuals with PTSD also face other problems such as drug addiction since the majority of them are using substances to cope with the symptoms of PTSD. PTSD is turning into a gang war with a host of other comorbid issues which makes it harder for the victims of patients to deal with them (James & Gilliland).
A person may experience or may witness any horrible event, and he/she can be the victim of PTSD.
The causes of this syndrome may vary from person to person. It may occur after a single traumatic event or maybe a result of many sudden and horrifying events. Even though PTSD is linked to the experience of wartime trauma, it can also occur due to exposure to traumatic events. PTSD is developing in response to exposure to natural disasters and violent experiences
Statistics
Diagnosis of Post-traumatic Stress Disorder
The symptoms of PTDS may vary from person to person, depending upon the actual cause of this syndrome (Jonas et al., 2019). If someone notices a serious change in behavior, attitude, and level of interest after any trauma. He/she must consult immediately to a medical expert to determine the causes and intensity of this disorder. A delay and negligence may increase the severity of disorder and cam led the victim to the suicidal attempts. That is why an early diagnosis is very important. To diagnose PTSD, DSM-5 criteria are used by most of the psychologists.
DSM-5 stands for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (2013). The version of DMS got revised in 2013 and introduced the criteria for the diagnosis of disorders caused by any trauma or stress. This criterion is valid for victims of more than 6 years old. For under 6 years, another DMS version is used and designed for children only (Ibrahim et al., 2018). DMS-5 criterion covers the following aspects.
A. Stressor
A stressor is a person who was victimized through any sexual assault or threatened to death. He may be witness any murder or death of any loved one, and he may get seriously injured in an accident. Such injury may result in losing any body part etc. in the following ways.
· Directly exposed to death or any accident.
· Witnessing any horrifying situation or trauma.
· Watching any friend who has witnessed any trauma.
· Interacting with a loved one who has gone through any major disease or horrible event (Ibrahim et al., 2018).
B: intrusion symptoms
The appearance of traumatic events may be any one of the following.
· Any upsetting event or memory related to the past.
· Nightmares
· Flashbacks
· Emotionally disturbed after any trauma
· Extreme psychological distress for a longer time span (Ibrahim et al., 2018).
C: avoidance
Avoiding the trauma-related stimuli after observing any stressful event in any way are given below.
· Making an effort to avoid the reoccurring thoughts about the trauma
· Avoidance for the external reminders related to the trauma (Tyler et al., 2019).
· Neglecting the events or situations that can be similar to any stressful event.
D: negative alterations in cognitions and mood
This section covers all the thoughts and unnatural emotions that start appearing after that trauma in the following ways.
· Trouble encountering positive effect
· Blaming own self or others (who were directly or indirectly involved or present during that trauma) for causing the injury (Tyler et al., 2019)
· Decreasing enthusiasm for doing any sort of work
· Excessively negative thoughts and presumptions about oneself or the world.
· Negative effect
E: alterations in arousal and reactivity
Trauma-related arousal and reactivity can make the situation worse. This can cause serious depression and stress in a victim. It may appear in the following ways.
· Irritation for trauma-related stuff
· Difficulty concentrating and focus on anything (in terms of social and personal life as well) (Tyler et al., 2019).
· Difficulty in sleeping. A changed sleep cycle.
· Rude and hard behavior
· Frustrated attitude towards everything.
F: Time period of stress
In DSM-5 criteria, the time span for the symptoms matters a lot. These symptoms may appear or reappear for a minimum of 2 weeks to 1 month.
This DSM-5 method is used by the experts to diagnose the nature, extent, and causes of post-traumatic stress disorder (Tyler et al., 2019). This syndrome is mostly associated with stress and depression caused as the end result of any trauma.
Physiological response to PTSD
Post-traumatic stress disorder affects both the mind and body of a patient. The physiological responses to PTSD may vary from person to person. It depends on the immunity of the person, the intensity of the stress, and the nature of the trauma that caused the stress (Tang et al., 2018). Any sort of Injury and stress for a longer time period directly or indirectly has negative effects, by and large, a person’s physical and mental health. PTSD has been connected to more doctor visits in veteran populaces that means you need regular consultation if this issue has been diagnosed once. It can highly influence a person’s personal, social and even economic position of a patient.
The impacts of PTSD may entirely change the way of lifestyle. It actually influences human health and can disturb him/her. Sentiments of loneliness, sadness, stress, and consistent tension may lead the PTSD sufferers towards any illegal act or smoking. They will in general, smoke more than non-PTSD sufferers just to make others realize that they are fine. Moreover, some cardiovascular diseases can be a result of PTSD (Jonas et al., 2019).
Maladaptive patterns
PTSD likewise appears to have suggestions for the safe framework of analysis. The patients of this stress regularly include a more aggressive mindset and a higher white platelet, which, thus, can prompt a blood issue or genuine disease. At the point when the body is in a steady condition of battle or has to fight against a continuous stressful condition, likewise with PTSD, the invulnerable framework needs to make a little more effort (Jonas et al., 2019). It pursues that PTSD sufferers may skip more working days than the individuals who do not endure with PTSD. They may likewise observe a higher danger of malignant growth and problems related to their immune system, just as early as mentioned (Tang et al., 2018). In the last few years, in the area of traumatic stress, some admirable works have published by luminaries. They are highlighting the inter-dependent relationship between body and mind, the process of recovery and wounding.
Pharmacological and Non-pharmacological treatments of PTSD.
Post-traumatic stress disorder can be a result of different sudden and traumatic events. In 2017, an updated Clinical Practice Guideline was released by the Department of Defense and the Department of Veterans Affairs. This published guideline is all about the treatment of PTSD. This report is actually based on all the information which was available since 2016. It involves non-Pharmacological and pharmacological treatments of PTSD. The pharmacological treatment of PTSD actually begins by targeting the discovery (Jonas et al., 2019). It is quite a difficult and challenging process for the treatment as compare too pharmacological treatments of PTSD. If a patient goes for the pharmacological treatment of PTSD, that totally depends upon the nature of stress and the medical history of the patient.
Non-pharmacological treatments may involve proper counseling sessions through which the actual reason can be found. Some psychotherapies are also used as a non-pharmacological treatment of PTSD (Furukawa, 2016). For example, exposure therapy, EMDR (Eye movement desensitization and reprocessing), and Cognitive therapy. The details of these therapies are given below.
Cognitive therapy
This is a therapy used during counseling sessions to determine the cognitive patterns of the patients of PTSD. It actually helps to recognize the thinking pattern of any person. Through the responses of the patients, experts analyze and determine the change in cognitive patterns of a patient as compared to a normal person (Furukawa, 2016). For example, the psychologists may ask the patient to tell them about himself and his feelings for his own self. By asking some questions, they try to analyze his speech and the actual reason, intensity of trauma, and patient’s emotions regarding the trauma.
Exposure therapy
This therapy assists the patients to face the situation and all the associated memories related to that trauma. It may teach the patients what to do when to do and how to do in a particular situation that makes him/her frightened (Furukawa, 2016). It is all about giving the patient a certain level of confidence and courage to cope with his/her fear that he/she has linked with that trauma and increasing the level of stress.
Eye movement desensitization and reprocessing
This therapy consists of exposure therapy, along with some guidance regarding eye movement. It helps the patient to change their perspective about the trauma and their contemporary reaction towards that ((Furukawa, 2016).
Pharmacological treatments of PTSD
Non-pharmacological treatments are considered as the best ways for the treatment of Post-traumatic disorders. Hence, the failure of non-pharmacological treatments may lead to the medication to control the intensity of stress, to prevent the stability of stress for a longer period of time, and to treat the stress at the end (Hering et al., 2015). Mostly, these medicines are used to reduce the intensity of stress to make non-pharmacological treatment possible. Using medicines to treat Post-traumatic disorders is not supposed to be an effective way.
Some Antidepressant drugs are mentioned by the writers that are being used most and may be any one of these, dual serotonin and noradrenaline reuptake inhibitors, like the 5-HT2A/2C antagonist/5-HT reuptake inhibitor nefazodone, tricyclic antidepressants such as amitriptyline and imipramine, reversible monoamine oxidase A inhibitors (RIMAs) such as moclobemide, monoamine oxidase inhibitors (MAOIs) like phenelzine, such as venlafaxine as well as drugs with other mechanism of action (Furukawa, 2016).
Nursing management of the PTSD
One of the focuses of the nursing management of the PTSD is on the behavior. The behaviors of patients with PTSD are managed through trauma-focused cognitive behavioral therapy. This approach involves long term exposure and cognitive processing therapy, reprocessing, and eye movement desensitization. Families and caregivers have a key role in giving support to individuals with PTSD. Therefore, while recommending family care to patients with PTSD, the nurse needs to consider the impacts of PTSD on the whole family due to the trauma associated impacts. The families are therefore notified about the general reactions of the traumatic experiences. Families are also made aware of the self-help groups and the support groups available (Rose, 2017).
Evidence-based practice guidelines for adults with PTSD
One of the evidence-based practices was the one which was developed by the Department of the Veteran Affairs (VA) and the Department of Defense (DOD) is the clinical practice guidelines (CPGs). This guideline is used in providing healthcare personnel with the framework that is required to help in the assessment, treatment, and management of the individual needs and the preferences of the patient with PTSD and acute stress disorder (ASD).
Other considerations in the management of PTSD
Managing a patient of PTSD is not as easy as it seems to be. Sometimes, the patient can be aggressive and can harm him/herself or anyone around him/her. It is very important for the doctor to indicate the actual reasons for stress/trauma, symptoms, and preventions to the patients and his family members as well (Jonas et al., 2019). If post-traumatic stress disorder remained neglected, it might urge the patient to even commit suicide. That is why this must be managed with extra care and attention. Do not let the patient think that he/she is useless. Give some time to him/her and try to involve the patient in some creative activities.
References
James, R. K., & Gilliland, B. E. (n.d.). Introduction to posttraumatic stress disorder (PTSD). Retrieved from Book Crisis Intervention Strategies. References
Furukawa, A, Toshi. (2016). Which Psychotherapy for PTSD?. Evidence-Based Mental Health, 19(4), 118-119.
Hering, D., Lachowska, K., & Schlaish, M. (2017). Role of the Sympathetic Nervous System in stress-mediated Cardiovascular Disease. Current Hypertension Reports, 17(6).
Ibrahim, H., Ertl, V., Catani, C., Ismail, A, A., & Neuner, F. (2018). The validity of the Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5) as screening instrument with Kurdish and Arab displaced populations living in the Kurdistan region of Iraq. BMC Psychiatry, 18(259).
Jonas, D., Cusack, K., Forneris, C., Wilkins, T., Sonis, J., & Middleton, J. et al. (2019). Psychological and Pharmacological Treatments for Adults with Posttraumatic Stress Disorder (PTSD). Retrieved 30 October 2019, from https://europepmc.org/abstract/med/23658937
Tang, W., Lu, Y., & Xu, J. (2018). Post-traumatic stress disorder, anxiety, and depression symptoms among adolescent earthquake victims: comorbidity and associated sleep-disturbing factors. Social Psychiatry and Psychiatric Epidemiology, 53(11), 1241-1251.
Tyler, M, P., Mason, A, W., Chmelka, B, M., Patwardan, I., Dobbertin, M., Pope, K., Shah, N., Rahim, A, H., Johnson, K., & Blair, J, R. (2019). Psychometrics of a Brief Trauma Symptom Screen for Youth in Residential Care. Journal of Traumatic Stress, 32(5), 753-763.
