NRNP 6645 Exploring Post-Traumatic Stress Disorder (PTSD)
Post-Traumatic Stress Disorder (PTSD) is a prevalent mental health condition that afflicts individuals exposed to traumatic events. The treatment of PTSD encompasses a combination of pharmacological and non-pharmacological approaches. This paper delves into the neurobiology underpinning PTSD, the diagnostic criteria outlined in the DSM-5, and the role of psychotherapy in managing this disorder.
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Unraveling the Neurobiology of Post-Traumatic Stress Disorder
PTSD is firmly rooted in neurobiology, with specific brain regions playing pivotal roles in the development and perpetuation of the disorder. Key areas involved include the hippocampus, amygdala, and medial prefrontal cortex. Research conducted on both humans and animal models has unveiled an overactivity of the medial prefrontal cortex in individuals with PTSD. This overactivity is attributed to the limited regulation of its functions by other brain regions. Additionally, reduced hippocampal volumes have been identified in individuals with PTSD, offering insights into the origins and persistence of this condition. The stressors contributing to PTSD induce damage and cell loss in the hippocampus, exacerbating the associated symptoms. The hypothalamic-pituitary-adrenal (HPA) axis is also implicated in the development and maintenance of PTSD. Individuals with PTSD often exhibit an oversensitive negative feedback system within the HPA axis, leading to lower cortisol levels and the inhibition of adrenocorticotropic hormone (ACTH) release from the anterior pituitary gland. These alterations disrupt the functioning of the sympathetic response and contribute to the consolidation of traumatic memories, a hallmark of PTSD (Malikowska-Racia & Salat, 2019; Ressler et al., 2022).
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Diagnostic Criteria for PTSD in DSM-5
The DSM-5 provides healthcare professionals with a set of criteria for diagnosing PTSD. The diagnosis is based on the presence of symptoms falling into eight distinct categories. Criteria A involve experiencing at least one symptom related to direct exposure, witnessing, learning about, or indirect exposure to trauma. Criteria B encompass symptoms associated with re-experiencing the traumatic event, such as nightmares, distressing memories, flashbacks, and heightened emotional and physical distress when confronted with trauma-related stimuli. It is imperative for the patient to exhibit at least one symptom from category B. Additionally, the patient should manifest a symptom from category C, which includes avoidance of trauma-related cues, reminders, and an overall aversion to anything reminiscent of the trauma. For a PTSD diagnosis, the individual must present at least two symptoms from category D, characterized by persistent negative thoughts post-trauma. These thoughts may manifest as difficulties in recalling essential aspects of the trauma, negative affect, social isolation, challenges in experiencing positive emotions, and a tendency to ascribe exaggerated blame to themselves or others regarding the trauma. Category E encompasses irritability or aggression, hypervigilance, engagement in risky or self-destructive behaviors, difficulties in sleeping and concentrating, and an increased startle reaction. Additional diagnostic criteria include symptoms lasting for a minimum of one month, causing functional impairment, and not being attributable to substance use, medication, or other medical conditions. The information provided in this video aligns with the diagnostic criteria for PTSD in the DSM-5, supporting a valid diagnosis. Other co-occurring diagnoses also appear to be consistent with the criteria outlined in the DSM-5 (Cénat et al., 2020; Li et al., 2020).
Exploring Psychotherapeutic Treatment Options
An alternative psychotherapeutic approach for individuals with PTSD is prolonged exposure therapy. This intervention involves systematically exposing the patient to trauma-related reminders until there is a marked reduction in perceived anxiety levels and autonomic responses, typically by at least half. This decrease signifies the desensitization or extinction of fear responses. While prolonged exposure therapy may not be considered the gold standard for PTSD treatment, it can be employed in conjunction with other evidence-based psychotherapeutic methods such as cognitive-behavioral therapy (CBT) (Kothgassner et al., 2019). It is essential for nurse practitioners to select evidence-based interventions grounded in clinical practice guidelines, as these approaches contribute to the safety, quality, and efficiency of nursing care.
In Conclusion
In summary, PTSD has a neurobiological foundation, with specific brain regions playing key roles in its development and maintenance. The DSM-5 provides clear diagnostic criteria for identifying PTSD and other mental health conditions. Psychotherapy, including approaches like prolonged exposure therapy, holds promise as an effective treatment option for individuals with PTSD. However, it is crucial for nurse practitioners to ensure that the chosen interventions align with evidence-based practices to provide optimal care.
NRNP 6645 POSTTRAUMATIC STRESS DISORDER
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.
RESOURCES
Be sure to review the Learning Resources before completing this activity.
Click the weekly resources link to access the resources.
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.
BY DAY 7
Submit your Assignment. Also attach and submit PDFs of the sources you used.
SUBMISSION INFORMATION
Before submitting your final assignment, you can check your draft for authenticity. To check your draft, access the Turnitin Drafts from the Start Here area.
- To submit your completed assignment, save your Assignment as WK9Assgn_LastName_Firstinitial
- Then, click on Start Assignment near the top of the page.
- Next, click on Upload File and select Submit Assignment for review.
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