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USW1.4032.202250 - NRNP-6645-13/NRNP-6645S-13/NRNP-6645C-13-PSYCHOTHERAPY MULT MODALITIES-2022-SPRING-QTR-TERM-WKS-1-THRU-11-(02/28/2022-05/15/2022)-PT27

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Monica Castelao on Tue, May 03 2022, 11:37 PM

 

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· Monica.Castelaoweek9PosttraumaticStressDisorder.docx

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Citations (10/10)

1. 1 https://en.wikipedia.org/wiki?curid=3518068

2. 2Another student's paper

3. 3Another student's paper

4. 4Another student's paper

5. 5Another student's paper

6. 6 https://www.frontiersin.org/articles/10.3389/fnbeh.2018.00258/full

7. 7 https://anzaccentre.org.au/getting-better-outcomes-from-ptsd-treatments/

8. 8Another student's paper

9. 9 https://wildirismedicaleducation.com/courses/wv-ptsd-veteran-mental-health-nursing-ceu

10. 10Another student's paper

5

1 Post-Traumatic Stress Disorder

Monica Castelao

2 Walden University NRNP 6645 May 2, 2022

Post-Traumatic Stress Disorder Posttraumatic stress disorder is a mental disorder/syndrome caused by exposure to actual ordeals or threatening serious injuries such as fatal accidents, sexual assault, tragic death, and serious sufferings among war veterans. 3 It is diagnosed a month after the traumatic incident.  4 This paper discusses the neurobiological basis, diagnostic criteria, and psychotherapy treatment for PTSD.

3 Neurobiological Basis for PTSD Illness The neurobiological basis for PTSD falls under neurochemistry and endocrinology changes.  The neurochemistry theory describes that PTSD develops due to abnormal regulation of hormonal system (Stojek et al., 2018).  These neurotransmitters are responsible for regulating and integrating fear and stress responses.  Elevated Dopamine and Norepinephrine levels result in a rise in blood pressure and pulse and an increased startle response and arousal levels (Stojek et al., 2018).  The endocrine theory explains that PTSD occurs due to abnormal hormone regulation in the HPA axis, the centre of the neuroendocrine stress response (Stojek et al., 2018).  The activation of the HPA axis increases Hypocortisolism and Corticotrophin releasing hormone.  This results in an exaggerated response to stress, fear processing, and abnormal stress encoding.

DSM-5 Diagnostic Criteria for PTSD The American Psychiatric Association (APA) is the body mandated to diagnose and assess mental and psychological complications. It uses the DSM for diagnostic assessment of mental complications. The DSM has been revised from time to time to ensure that the diagnostic measures are in tandem with the current health conditions. The current DSM used by APA for diagnostic purposes is DSM-5. Under DSM-5, a patient is diagnosed with PTSD when the patient has been directly exposed to actual or threatening fatal conditions, including severe injuries, sexual violence, and IPV. Under DSM-5, the traumatic events must be recurring to be diagnosed with PTSD. PTSD provides that a patient who experiences nightmares, flashbacks, and significant emotional distress when exposed to events that remind them of the traumatic experiences. Again DSM-5 provides that a patient can only be diagnosed with PTSD when they demonstrate adverse alterations in their moods and cognition towards the traumatic event. Further, patients diagnosed with PTSD under DSM-5 also demonstrate alteration in arousal and reaction to the traumatic events (APA, 2017). For a patient to be declared suffering from PTSD under DSM-5 diagnosis procedures, the disturbances caused by the perceived changes in mood and behaviour must contribute to significant clinical impairment or distress to the patient's normal functioning that affects their social, occupational and psychological functioning.

3 The client in the case study presents adequate, pertinent symptoms supporting PTSD.  Joe has PTSD symptoms attributed to being exposed to a threatening injury during the car crash.  He persistently re-experiences the traumatic event through intrusion symptoms and distressing dreams about the accident (YouTube, 2021).  In addition, Joe has a persistent avoidance of stimuli, manifested in his efforts to avoid memories of the accident.  He also exhibits negative alterations in cognitions and mood attributed to the accident; for example, he has difficulty recalling the important aspects of the crash and exaggerated negative beliefs about the world. 3 Besides, he also exhibits a marked alteration in arousal and reactivity, as evidenced by angry outbursts, irritation, and self-destructive behaviour (YouTube, 2021).

The other diagnoses for PTSD, such as major depressive and separation anxiety disorders among others do not fit the symptoms manifested by the patient in the case study. 3 This is because the symptoms of physical aggression, irritability, and anger outbursts started after the crash and are due to negative changes in arousal and reactivity from the traumatic event.  Besides, the anxiety in the client manifested during moments of separation from the father can be connected to the intrusion symptoms associated with the crash rather than from separation anxiety.

Psychotherapy Treatment Option One of the recommended treatments for patients suffering from PTSD is prolonged exposure therapy (PET). PE is very effective in treating PTSD patients. 5 Psychotherapists consider PE as the standard gold treatment for PTSD.  3 PE is founded on the emotional processing theory, which posits that traumatic events are not processed emotionally during a traumatic event (Foa, McLean, Zang & Rosenfield et al., 2018).  The aithors contend that PET depends on behavioural therapeutic strategies in supporting patients to manage and overcome traumatic-related memories, emotions, and situations progressively. PET is founded on the understanding that when a person is exposed to situations that elicit negative reactions for a long time, they adjust to them to a level when they no longer elicit fear and negative reactions. Thus, PE aims to change the fear structures of the patient to ensure that they do not cause problems even when the patients are exposed to them.

References

3 American Psychiatric Association.  (2017). 6 Clinical practice guidelines of PTSD.  3 https://www.apa.org/ptsd-guideline

Foa, E. 3 B., McLean, C.  P., Zang, Y., Rosenfield, D., et al.  (2018). 7 Effect of prolonged exposure therapy delivered over 2 weeks vs 8 weeks vs present-centred therapy on PTSD symptom severity in military personnel:  3 A randomized clinical trial.  JAMA, 319(4), 354-364.  https://doi.org/10.1001/jama.2017.21242

Stojek, M. 3 M., McSweeney, L.  B., & Rauch, S.  A. (2018). 3 Neuroscience informed prolonged exposure practice:  Increasing efficiency and efficacy through mechanisms.  Frontiers in Behavioural Neuroscience, 12, 281.  https://doi.org/10.3389/fnbeh.2018.00281

8 YouTube (October 31, 2021).  9 PTSD and veterans:  A conversation with Dr Frank Ochberg Al. YouTube. 10 Retrieved https://www.youtube.com/watch?v=wZwa6X2RzHI