Assignment: NRNP 6645 Week 9 Psychotherapy with Multiple Modalities

Assignment: 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.

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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.

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.
Utilize SafeAssign Drafts to generate an originality report before final submission. SafeAssign percentage must be 35% or lower.

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.

Submit your Assignment. Also attach and submit PDFs of the sources you used.

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Name: NRNP_6645_Week9_Assignment_Rubric

Succinctly, in 1–2 pages, address the following:
• Briefly explain the neurobiological basis for PTSD illness.–

Levels of Achievement:

Excellent

90%–100% 14 (14.00%) – 15 (15.00%)

Good

80%–89% 12 (12.00%) – 13 (13.00%)

Fair

70%–79% 11 (11.00%) – 11 (11.00%)

Poor

0%–69% 0 (0.00%) – 10 (10.00%)

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?–

Levels of Achievement:

Excellent

90%–100% 23 (23.00%) – 25 (25.00%)

Good

80%–89% 20 (20.00%) – 22 (22.00%)

Fair

70%–79% 18 (18.00%) – 19 (19.00%)

Poor

0%–69% 0 (0.00%) – 17 (17.00%)

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.–

Levels of Achievement:

Excellent

90%–100% 27 (27.00%) – 30 (30.00%)

Good

80%–89% 24 (24.00%) – 26 (26.00%)

Fair

70%–79% 21 (21.00%) – 23 (23.00%)

Poor

0%–69% 0 (0.00%) – 20 (20.00%)

Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached.–

Levels of Achievement:

Excellent

90%–100% 14 (14.00%) – 15 (15.00%)

Good

80%–89% 12 (12.00%) – 13 (13.00%)

Fair

70%–79% 11 (11.00%) – 11 (11.00%)

Poor

0%–69% 0 (0.00%) – 10 (10.00%)

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.–

Levels of Achievement:

Excellent

90%–100% 5 (5.00%) – 5 (5.00%)

Good

80%–89% 4 (4.00%) – 4 (4.00%)

Fair

70%–79% 3.5 (3.50%) – 3.5 (3.50%)

Poor

0%–69% 0 (0.00%) – 3 (3.00%)

Written Expression and Formatting – English writing standards:
Correct grammar, mechanics, and proper punctuation–

Levels of Achievement:

Excellent

90%–100% 5 (5.00%) – 5 (5.00%)

Good

80%–89% 4 (4.00%) – 4 (4.00%)

Fair

70%–79% 3.5 (3.50%) – 3.5 (3.50%)

Poor

0%–69% 0 (0.00%) – 3 (3.00%)

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.–

Levels of Achievement:

Excellent

90%–100% 5 (5.00%) – 5 (5.00%)

Good

80%–89% 4 (4.00%) – 4 (4.00%)

Fair

70%–79% 3.5 (3.50%) – 3.5 (3.50%)

Poor

0%–69% 0 (0.00%) – 3 (3.00%)

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Assignment: Posttraumatic Stress Disorder

PTSD is characterized by persistent, intrusive recollection of a traumatic incident, lasting for more than a month. PTSD symptoms start manifesting within six months of the traumatic incident (Sherin & Nemeroff, 2022). The purpose of this paper is to discuss the neurobiological cause of PTSD, diagnostic criteria, and psychotherapy approaches.

Neurobiological Basis for PTSD Illness

The neurobiological cause of PTSD is associated with endocrine and neurochemical factors. Low cortisol production during the period of trauma causes maladaptive stress responses and predisposes an individual to PTSD. Besides, patients with PTSD exhibit a decreased volume of the hippocampus, which is the major brain region that hinders the HPA axis (Sherin & Nemeroff, 2022). In addition, PTSD occurs due to abnormal regulation of serotonin, catecholamine, peptide, amino acid, and opioid neurotransmitters. These transmitters are found in the brain circuits that regulate stress and fear responses and thus, their dysregulation impairs the stress response (Sherin & Nemeroff, 2022). Furthermore, alteration in the activity of norepinephrine and stress hormone is associated with development of PTSD since norepinephrine regulates encoding of fear memories, while glucococorticoids hinder retrieval of emotional memories.

DSM-5 Diagnostic Criteria for PTSD

The DSM-5 criteria for PTSD require a person to have had a direct or indirect exposure to a traumatic event and have features from each of these categories for at least one month: Intrusion symptoms, Negative impact on cognition and mood, Avoidance symptoms, and impaired arousal and reactivity (Miao et al., 2018). The symptoms should create significant distress or impairment in social or occupational functioning that is not attributed to a medical condition or substance use. The video case has adequate data supporting PTSD since the patient symptoms are connected to exposure to a traumatic incident (car crash). The patient has Intrusion symptoms such as having distressing dreams about the car crash and Avoidant symptoms like avoiding memories. Besides, the boy has impairment in arousal and reactivity evidenced by anger outbursts, irritability, and destructive behavior (Miao et al., 2018). His cognition and mood are affected since he cannot remember key details about the accident.

The patient was given other diagnoses like Separation Anxiety disorder, MDD, ODD, and Conduct disorder. Although, the patient has clinical features that occur in ODD, MDD, and conduct disorder like anger outbursts, irritability, and aggression, these symptoms are due to the negative effects of PTSD on mood and cognition. Furthermore, the boy’s anxiety attributed to parental separation is due to intrusion symptoms and not separation anxiety. Thus, I would disagree with these diagnoses since the symptoms are documented features of PTSD and they are due to exposure to a traumatic event.

Additional Psychotherapy Treatment Option

Cognitive Processing Therapy (CPT) is a psychotherapy approach that I would recommend for this client. Watkins et al. (2018) explain that CPT is highly recommended by the APA and VA/DoD guidelines in managing PTSD. It is a trauma focused therapy that hypothesizes that after a traumatic event, individual try to make sense of what occurred. This often causes distorted cognitions about oneself, others, and the world. CPT is considered gold standard therapy since it cognitively triggers the memory, while enabling the patient to recognize maladaptive cognitions related to the traumatic incident. PMHNPs should use evidence-based interventions since they have been established to be safe and effective in promoting the best possible outcomes for a particular patient population.

Conclusion

PTSD is associated with endocrine factors like reduced cortisol production and abnormal regulation of neurochemical factors. Clinical features in the DSM-5 criteria for PTSD include Intrusion symptoms, Negative impact on cognition and mood, Avoidance symptoms, and impaired arousal and reactivity. CPT is extensively supported as an effective psychotherapy approach for PTSD.

References

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), 32. https://doi.org/10.1186/s40779-018-0179-0

Sherin, J. E., & Nemeroff, C. B. (2022). Post-traumatic stress disorder: the neurobiological impact of psychological trauma. Dialogues In Clinical Neuroscience. https://doi.org/10.31887/DCNS.2011.13.2/jsherin

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions. Frontiers in Behavioral Neuroscience, 12, 258. https://doi.org/10.3389/fnbeh.2018.00258