NRNP 6635 Assignment: Posttraumatic Stress Disorder

NRNP 6645 Week 9 Posttraumatic Stress Disorder

NRNP 6645 Week 9: Posttraumatic Stress Disorder

Posttraumatic Stress Disorder (PTSD) is a syndrome that is caused by exposure to actual or threatened serious injury or sexual assault. It is diagnosed after one month has passed since the traumatic incident. This paper seeks to discuss the neurobiological basis, diagnostic criteria, and psychotherapy treatment for PTSD.

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 catecholamine, serotonin, amino acids, peptide, and opioid neurotransmitters (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. Besides, they negatively affect fear conditioning as well as encoding and response to fear memories (Stojek et al., 2018). The endocrine theory explains that PTSD occurs due to abnormal hormone regulation in the HPA axis, the center 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 diagnostic criteria for PTSD as per the DSM V include: An individual must have been exposed to actual or threatened death, severe injury, or sexual violence. The traumatic event is constantly re-experienced through: Intrusive thoughts of the traumatic event; Nightmares; Flashbacks; Significant emotional distress when exposed to traumatic reminders; Strong physiologic reaction when exposed to traumatic reminders (APA, 2017). Persistent avoidance of stimuli linked with the traumatic event (APA, 2017). There should be adverse alterations in mood and cognition associated with the traumatic event. In addition, there are marked alterations in arousal and reactivity attributed to the traumatic event (APA, 2017). The disturbance should contribute to clinically significant impairment or distress in social, occupational, or other areas of functioning.

The client in the case study presents with adequate, pertinent symptoms supporting PTSD. Joe has PTSD symptoms attributed to being exposed to a threatened injury during the car crash. He persistently re-experiences the traumatic event through intrusion symptoms and distressing dreams about the accident (APA, 2017). In addition, Joe has a persistent avoidance of stimuli, as seen by avoiding memories about the accident. He also exhibits negative alterations in cognitions and mood attributed to the accident, such as difficulties recalling important aspects of the crash and exaggerated negative beliefs about the world (APA, 2017). Besides, Joe exhibits a marked alteration in arousal and reactivity as evidenced by angry outbursts, irritable behavior, and self-destructive behavior.

The other diagnoses, including major depressive disorder, Oppositional defiant disorder, Conduct disorder, and Separation Anxiety disorder, do not fit this patient’s symptoms. This is because the symptoms of physical aggression, irritability, and anger outbursts started after the crash and are due to negative alterations in arousal and reactivity from the traumatic event. In addition, the client’s anxiety seen when he is separated from the father can be connected to the intrusion symptoms associated with the crash rather than from separation anxiety.

Psychotherapy Treatment Option

Prolonged Exposure (PE) is a psychotherapy approach highly recommended to treat PTSD. PE is regarded as a gold standard treatment.  It is based on the emotional processing theory, which explains that traumatic events are not processed emotionally during a traumatic event (Foa et al., 2018). PE relies heavily on behavioral therapy strategies to help PTSD patients manage trauma-related memories, emotions, and situations progressively (Foa et al., 2018). It aims at changing fear structures to ensure they are not causing problems. Clinicians are advised to utilize evidence-based treatments from clinical guidelines because they are effective and safe for different patient populations.

Conclusion

The neurological basis of PTSD explains that PTSD occurs due to abnormal regulation of transmitters, which regulate and integrate fear and stress responses. It is also caused by the abnormal hormone regulation in the HPA axis, which controls the neuroendocrine stress response. PTSD is characterized by: Persistent re-experiencing of the event, avoidance of traumatic triggers, Negative alterations in cognition and mood, and increased arousal. PE is used to address trauma-related memories, emotions, and situations.

 

 


 

References

American Psychiatric Association. (2017). Clinical practice guideline of PTSDhttps://www.apa.org/ptsd-guideline

Foa, E. B., McLean, C. P., Zang, Y., Rosenfield, D., Yadin, E., Yarvis, J. S., … & STRONG STAR Consortium. (2018). Effect of prolonged exposure therapy delivered over 2 weeks vs. 8 weeks vs. present-centered therapy on PTSD symptom severity in military personnel: A randomized clinical trial. Jama319(4), 354-364. https://doi.org/10.1001/jama.2017.21242

Stojek, M. M., McSweeney, L. B., & Rauch, S. A. (2018). Neuroscience informed prolonged exposure practice: Increasing efficiency and efficacy through mechanisms. Frontiers in behavioral neuroscience12, 281. https://doi.org/10.3389/fnbeh.2018.00281

 

 

 

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.
    NRNP 6645 Week 9 Posttraumatic Stress Disorder

    NRNP 6645 Week 9 Posttraumatic Stress Disorder

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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 and Grading Information

To submit your completed Assignment for review and grading, do the following:

  • Please save your Assignment using the naming convention “WK9Assgn+last name+first initial.(extension)” as the name.
  • Click the Week 9 Assignment Rubric to review the Grading Criteria for the Assignment.
  • Click the Week 9 Assignment link. You will also be able to “View Rubric” for grading criteria from this area.
  • Next, from the Attach File area, click on the Browse My Computer button. Find the document you saved as “WK9Assgn+last name+first initial.(extension)” and click Open.
  • If applicable: From the Plagiarism Tools area, click the checkbox for I agree to submit my paper(s) to the Global Reference Database.
  • Click on the Submit button to complete your submission.
Grading Criteria

To access your rubric:

Week 9 Assignment Rubric

Check Your Assignment Draft for Authenticity

To check your Assignment draft for authenticity:

Submit your Week 9 Assignment draft and review the originality report.

Submit your Assignment by Day 7

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Week 9 Assignment

Name: NRNP_6645_Week9_Assignment_Rubric

Excellent

90%–100%

Good

80%–89%

Fair

70%–79%

Poor

0%–69%

Succinctly, in 1–2 pages, address the following: • Briefly explain the neurobiological basis for PTSD illness.
Points Range: 14 (14%) – 15 (15%)
The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness.
Points Range: 12 (12%) – 13 (13%)
The response includes an accurate explanation of the neurobiological basis for PTSD illness.
Points Range: 11 (11%) – 11 (11%)
The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness.
Points Range: 0 (0%) – 10 (10%)
The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing.
• 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?
Points Range: 23 (23%) – 25 (25%)

The response includes an accurate and concise description of the DSM-5 diagnostic criteria for PTSD and an accurate explanation of how they relate to the symptomology presented in the case study.

The response includes a concise explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates strong diagnostic reasoning and critical thinking skills.

Points Range: 20 (20%) – 22 (22%)

The response includes an accurate description of the DSM-5 diagnostic criteria for PTSD and an adequate explanation of how they relate to the symptomology presented in the case study.

The response includes an explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates adequate diagnostic reasoning and critical thinking skills.

Points Range: 18 (18%) – 19 (19%)

The response includes a somewhat vague or inaccurate description of the DSM-5 diagnostic criteria for PTSD and a somewhat vague or inaccurate explanation of how they relate to the symptomology presented in the case study.

The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates somewhat inadequate diagnostic reasoning and critical thinking skills.

Points Range: 0 (0%) – 17 (17%)

The response includes a vague or inaccurate description of the DSM-5 diagnostic criteria for PTSD and a vague or inaccurate explanation of how they relate to the symptomology presented in the case study. Or, response is missing.

The response includes a vague or inaccurate explanation of whether the case provides sufficient information to derive the PTSD and other diagnoses. Justification demonstrates poor diagnostic reasoning and critical thinking skills. Or, response is missing.

• 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.
Points Range: 27 (27%) – 30 (30%)

The response includes an accurate and concise explanation of one other psychotherapy treatment option for the client in this case study.

The response clearly and concisely explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs.

Points Range: 24 (24%) – 26 (26%)

The response includes an accurate explanation of one other psychotherapy treatment option for the client in this case study.

The response adequately explains whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs.

Points Range: 21 (21%) – 23 (23%)

The response includes a somewhat vague or incomplete explanation of one other psychotherapy treatment option for the client in this case study.

The response provides a somewhat vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs.

Points Range: 0 (0%) – 20 (20%)

The response includes a vague and inaccurate explanation of one other psychotherapy treatment option for the client in this case study, or the treatment option is innappropriate. Or, response is missing.

The response provides a vague or incomplete explanation of whether the recommended treatment option is a “gold standard” treatment and why using gold standard, evidence-based treatments from clinical practice guidelines is important for PMHNPs. Or, response is missing.

·   Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached.
Points Range: 14 (14%) – 15 (15%)
The response is supported by specific examples from this week’s media and at least three peer-reviewed, evidence-based sources from the literature that provide strong support for the rationale provided. PDFs are attached.
Points Range: 12 (12%) – 13 (13%)
The response is supported by examples from this week’s media and three peer-reviewed, evidence-based sources from the literature that provide appropriate support for the rationale provided. PDFs are attached.
Points Range: 11 (11%) – 11 (11%)
The response is supported by examples from this week’s media and two or three peer-reviewed, evidence-based sources from the literature. Examples and resources selected may provide only weak support for the rationale provided. PDFs may not be attached.
Points Range: 0 (0%) – 10 (10%)
The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing.
Written Expression and Formatting – Paragraph Development and Organization: Paragraphs make clear points that support well-developed ideas, flow logically, and demonstrate continuity of ideas. Sentences are carefully focused—neither long and rambling nor short and lacking substance. A clear and comprehensive purpose statement and introduction is provided which delineates all required criteria.
Points Range: 5 (5%) – 5 (5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity.

A clear and comprehensive purpose statement, introduction, and conclusion are provided that delineates all required criteria.

Points Range: 4 (4%) – 4 (4%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 80% of the time.

Purpose, introduction, and conclusion of the assignment are stated, yet are brief and not descriptive.

Points Range: 3.5 (3.5%) – 3.5 (3.5%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity 60%–79% of the time.

Purpose, introduction, and conclusion of the assignment are vague or off topic.

Points Range: 0 (0%) – 3 (3%)

Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time.

No purpose statement, introduction, or conclusion were provided.

Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation
Points Range: 5 (5%) – 5 (5%)
Uses correct grammar, spelling, and punctuation with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains 1 or 2 grammar, spelling, and punctuation errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains 3 or 4 grammar, spelling, and punctuation errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.
Written Expression and Formatting – The paper follows correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.
Points Range: 5 (5%) – 5 (5%)
Uses correct APA format with no errors.
Points Range: 4 (4%) – 4 (4%)
Contains 1 or 2 APA format errors.
Points Range: 3.5 (3.5%) – 3.5 (3.5%)
Contains 3 or 4 APA format errors.
Points Range: 0 (0%) – 3 (3%)
Contains many (≥ 5) APA format errors.
Total Points: 100

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