Assignment: Posttraumatic Stress Disorder Paper

Assignment: Posttraumatic Stress Disorder Paper

Assignment: Posttraumatic Stress Disorder

The media ‘Presentation Example: Posttraumatic Stress Disorder (PTSD)’ demonstrates a case presentation of an eight-year-old boy who was involved in a minor motor vehicle accident with his father. The patient was not injured. However, his father sustained a minor injury to his knee. The driver of the other vehicle involved in the accident however threatened the patient’s father, following him in a pursuit to the point that the patient’s father had to call the police. The patient displayed avoidance behavior of the stimuli, sleeping problems, nightmares, physical aggression, outburst in the middle of class at school, dangerous behaviors frightening others, and fighting. The patient was diagnosed with PTSD in addition to comorbidities such as ODD, CD, MDD, ADHD, SAD, and phobia for spiders. The purpose of this paper is to analyze the process of diagnosis and management of PTSD as demonstrated in the provided media, in addition to the neurological basis involved with the development of this mental disorder.

ORDER A PLAGIARISM-FREE PAPER HERE

Neurobiological Basis for PTSD

The neurobiology of PTSD is a complex process involving the neurochemical, neuroanatomical, and neuroendocrine changes in the neural pathways. Regarding the neuroendocrine features, the hypothalamic-pituitary-adrenal axis (HPA) is considered the central coordinator of the response mechanism of individuals to stress (Dunlop & Wong, 2019). Cortisol, a stress hormone, on the other hand, exerts negative feedback on the HPA. The hormone also reduces the noradrenergic stress response. As such, a sustained release of cortisol as a result of PTSD leads to adverse effects on the brain, especially the hippocampal neurons, leading to impaired neuroplasticity and neurogenesis (Jaworska-Andryszewska& Rybakowski,2019). Neurochemical features such as noradrenaline, serotonin, and dopamine are also associated with stress responses contributing to PTSD symptoms.

DSM-5 Diagnostic Criteria for PTSD

            According to the DSM-V diagnostic criteria, the patient requires to be exposed to a traumatic experience which in this case was a minor motor vehicle accident. He also needs to display at least one intrusion symptom such as nightmares, recurrent memories, and flashbacks, for the past one month (Grant et al., 2020). At least one persistent avoidance symptom and two negative alterations in mood and cognition such as inability to recall key features and persistent negative beliefs are also required. Alteration in reactivity and arousal by displaying reckless behavior and hyper-vigilance has also been reported in the case study. Lastly, the presenting symptoms must have a functional significance on the patient’s psychological and social life. The video provides an adequate amount of information necessary to support the diagnosis of PTSD as demonstrated above.

The other diagnoses such as ODD, CD, MDD, and SAD which were made after the accident are quite ambiguous since most of these disorders display the same symptoms as PTHD and should have not been considered as comorbidities during this time (Miao et al., 2018). However, ADHD and phobia for spiders were diagnosed before the incidence, hence the psychiatrist must have had adequate reasons to support these diagnoses.

Psychotherapy Treatment Option

Other than CBT, I would consider the use of prolonged exposure (PE) therapy which is recommended as first-line therapy for PTSD in most clinical practice guidelines (Bastien et al., 2020). PE is a gold standard treatment approach for PTSD as it has been subjected to several clinical trials reporting great effectiveness in managing PTSD symptoms even among complex and comorbid patients. PE mainly entails psychoeducation, imaginal exposure, in vivo exposure, and emotional processing.

Conclusion

The media presentation demonstrates the relevance of adopting the appropriate psychiatric practice in diagnosing and managing patients with mental health problems. The patient described in the video was poorly diagnosed with several comorbidities, which complicated the choice of treatment. However, with PTSD as the primary diagnosis, the patient could benefit greatly from PE therapy.

References

Bastien, R. J. B., Jongsma, H. E., Kabadayi, M., & Billings, J. (2020). The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents, and young adults: a systematic review and meta-analysis. Psychological Medicine, 50(10), 1598-1612. https://doi.org/10.1017/S0033291720002007

Dunlop, B. W., & Wong, A. (2019). The hypothalamic-pituitary-adrenal axis in PTSD: Pathophysiology and treatment interventions. Progress in neuro-psychopharmacology and biological psychiatry, 89, 361-379. https://doi.org/10.1016/j.pnpbp.2018.10.010

Grant, B. R., O’Loughlin, K., Holbrook, H. M., Althoff, R. R., Kearney, C., Perepletchikova, F., … & Kaufman, J. (2020). A multi-method and multi-informant approach to assessing post-traumatic stress disorder (PTSD) in children. International Review of Psychiatry, 32(3), 212-220. https://doi.org/10.1080/09540261.2019.1697212

Jaworska-Andryszewska, P., & Rybakowski, J. K. (2019). Childhood trauma in mood disorders: neurobiological mechanisms and implications for treatment. Pharmacological Reports, 71(1), 112-120.DOI: 10.1016/j.pharep.2018.10.004.

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

BUY A CUSTOM- PAPER HERE

Assignment: Posttraumatic Stress Disorder

Photo Credit: Getty Images/iStockphoto

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 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.