NRNP 6645 Week 9 Assignment: Posttraumatic Stress Disorder
NRNP 6645 Week 9 Assignment: Posttraumatic Stress Disorder
Post-traumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is a mental health problem diagnosed in people with a history of traumatic experiences. The symptoms of PTSD affect functioning and the patient’s quality of life. Psychiatric practitioners prescribe different treatments for symptom management. Therefore, this paper discusses the neurological basis for PTSD, its diagnostic criteria, and a psychotherapy intervention that can be used for the patient in the assigned video.
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Neurobiological Basis for PTSD Illness
PTSD has a neurobiological basis. Studies show that PTSD develops due to an interplay between endocrinology, brain circuitry, and neurochemistry factors. The endocrine factors associated with PTSD include abnormal regulation of thyroid hormones and cortisol. The abnormal hormone levels develop due to altered functioning of the hypothalamic-pituitary-adrenal axis, which regulates stress response systems, and the hypothalamic-pituitary-thyroid axis, which regulates metabolic and anabolic states (Dossi et al., 2020; Ressler et al., 2022). Neurochemical factors also contribute to PTSD development. This includes abnormal regulation of neurotransmitters such as serotonin, catecholamine, peptide, amino acid, and opioid neurotransmitters. These neurotransmitters regulate mood and stress responses. Changes in brain circuitry also contribute to PTSD development. Brain imaging studies show that patients with PTSD have alterations in the amygdala and hippocampus (Kube et al., 2020). There are also changes in the insular, anterior cingulate, and orbitofrontal brain regions, which imply that brain changes lead to the development of PTSD.
DSM-5-TR Diagnostic Criteria for PTSD
The DSM-5 tool is used for PTSD diagnosis. A patient is diagnosed with PTSD if he or she presents to the hospital with a range of symptoms. The patient must have been exposed to a traumatic event (s) and have symptoms of intrusion associated with the traumatic experience. Patients report intrusion symptoms such as recurrent and distressing memories that relate to the trauma, frequent nightmares, flashbacks, psychological distress, and psychological symptoms whenever the patient is exposed to symbols related to the trauma. Patients should also demonstrate avoidance of any stimuli associated with the trauma. This includes avoiding any thoughts, memories, feelings, or reminders associated with the traumatic events (Kube et al., 2020). Patients also demonstrate mood and cognition alterations and significant changes in reactivity and arousal associated with the trauma.
Joe has the above symptoms of PTSD. He has direct experience with traumatic events, intrusive memories of the accident, altered understanding of the accident, distress when exposed to cues related to the accident, difficulty sleeping, nightmares, and behavioral changes. These behaviors affected his social and academic functioning. Therefore, he meets the diagnostic criteria for PTSD. The other diagnoses in the video are appropriate since Joe demonstrated symptoms that aligned with the diagnoses.
Psychotherapy Treatment
Cognitive processing therapy is the other psychotherapy treatment option that can be considered for Joe. Cognitive processing therapy is a treatment that helps patients develop effective skills for challenging and modifying negative beliefs associated with trauma. A therapist helps Joe create a new understanding of the traumatic event to lower its negative effects on mental health and functioning. The therapist also helps patients understand their negative thoughts and emotions related to the trauma and identify effective skills to address unhelpful thoughts and emotions (Haynes et al., 2020; Holder et al., 2020). Through it, patients recover progressively from PTSD. Cognitive processing therapy is not a standard intervention for treating PTSD. Psychiatric mental health practitioners should use evidence-based treatments because they are associated with optimum safety, quality, and efficiency outcomes. The sources used in this paper are scholarly. They are peer-reviewed articles. Experts in psychiatry authored them. The articles provide evidence-based data that inform clinical management of PTSD.
Conclusion
In summary, Joe’s symptoms meet the diagnostic criteria for PTSD. PTSD has a neurobiological basis. Cognitive processing therapy can be used in Joe’s case despite it not being considered a gold treatment for PTSD. Psychiatric mental health nurse practitioners should use gold-standard, evidence-based treatments to achieve optimum outcomes in managing psychiatric conditions.
References
Dossi, G., Delvecchio, G., Prunas, C., Soares, J. C., & Brambilla, P. (2020). Neural Bases of Cognitive Impairments in Post-Traumatic Stress Disorders: A Mini-Review of Functional Magnetic Resonance Imaging Findings. Frontiers in Psychiatry, 11. https://doi.org/10.3389/fpsyt.2020.00176
Haynes, P. L., Skobic, I., Epstein, D. R., Emert, S., Parthasarathy, S., Perkins, S., & Wilcox, J. (2020). Cognitive Processing Therapy for Posttraumatic Stress Disorder Is Associated with Negligible Change in Subjective and Objective Sleep. Behavioral Sleep Medicine, 18(6), 809–819. https://doi.org/10.1080/15402002.2019.1692848
Holder, N., Shiner, B., Li, Y., Madden, E., Neylan, T. C., Seal, K. H., Lujan, C., Patterson, O. V., DuVall, S. L., & Maguen, S. (2020). Cognitive Processing Therapy for Veterans with Posttraumatic Stress Disorder: What is the Median Effective Dose? Journal of Affective Disorders, 273, 425–433. https://doi.org/10.1016/j.jad.2020.04.030
Kube, T., Berg, M., Kleim, B., & Herzog, P. (2020). Rethinking post-traumatic stress disorder – A predictive processing perspective. Neuroscience & Biobehavioral Reviews, 113, 448–460. https://doi.org/10.1016/j.neubiorev.2020.04.014
Ressler, K. J., Berretta, S., Bolshakov, V. Y., Rosso, I. M., Meloni, E. G., Rauch, S. L., & Carlezon, W. A. (2022). Post-traumatic stress disorder: Clinical and translational neuroscience from cells to circuits. Nature Reviews Neurology, 18(5), 273–288. https://doi.org/10.1038/s41582-022-00635-8
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.
WEEKLY RESOURCES
Learning Resources
Required Readings
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders
Links to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
“Culture and Psychiatric Diagnosis”
American Psychiatric Association. (2017). Clinical practice guideline of PTSD
Links to an external site.. https://www.apa.org/ptsd-guideline
Substance Abuse and Mental Health Services Administration. (2014). SAMHSA’s concept of trauma and guidance for a trauma-informed approach
Download SAMHSA’s concept of trauma and guidance for a trauma-informed approach. https://ncsacw.samhsa.gov/userfiles/files/SAMHSA_Trauma.pdf
Credit: Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA) 14-4884. Rockville, MD: Substance Abuse and Mental Health Services Administration, 2014.
Tye, S., Van Voorhees, E., Hu, C., & Lineberry, T. (2015). Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5
Download Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5. Harvard Review of Psychiatry, 23(1), 51–58. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4542003/
Credit: Preclinical Perspectives on Posttraumatic Stress Disorder Criteria in DSM-5 by Susannah Tye, PhD, Elizabeth Van Voorhees, PhD, Chunling Hu, MD, PhD, and Timothy Lineberry, MD, in HARVARD REVIEW OF PSYCHIATRY, Vol. 23/Issue 1. Copyright 2015 by ROUTLEDGE. Reprinted by permission of ROUTLEDGE via the Copyright Clearance Center.
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
Chapter 3, “Assessment and Diagnosis” (Previously read in Week 2)
Chapter 7, “Eye Movement Desensitization and Reprocessing Therapy”
Chapter 11, “Trauma Resiliency Model Therapy”
Chapter 15, “Trauma-Informed Medication Management”
Chapter 17, “Stabilization for Trauma and Dissociation”
Chapter 18, “Dialectical Behavior Therapy for Complex Trauma”
Required Media
Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD)
Links to an external site. [Video]. YouTube. https://www.youtube.com/watch?v=RkSv_zPH-M4
Gift from Within. (Producer). (2008). PTSD and veterans: A conversation with Dr. Frank Ochberg
Links to an external site. [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/ptsd-and-veterans-a-conversation-with-dr-frank-ochberg
Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder?
Links to an external site. (Strictly Medical-English Version). [Video]. YouTube. https://www.youtube.com/watch?v=o98ilXH5gto
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
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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.
Rubric
NRNP_6645_Week9_Assignment_Rubric
NRNP_6645_Week9_Assignment_Rubric
| Criteria |
Ratings |
Pts |
| This criterion is linked to a Learning Outcome Succinctly, in 1–2 pages, address the following:• Briefly explain the neurobiological basis for PTSD illness. |
| 15 to >13.0 ptsExcellent 90%–100%
The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness. |
13 to >11.0 ptsGood 80%–89%
The response includes an accurate explanation of the neurobiological basis for PTSD illness. |
11 to >10.0 ptsFair 70%–79%
The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness. |
10 to >0 ptsPoor 0%–69%
The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing. |
|
15 pts |
| This criterion is linked to a Learning Outcome • 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? |
| 25 to >22.0 ptsExcellent 90%–100%
The response includes an accurate and concise description of the DSM-5-TR 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. |
22 to >19.0 ptsGood 80%–89%
The response includes an accurate description of the DSM-5-TR 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. |
19 to >17.0 ptsFair 70%–79%
The response includes a somewhat vague or inaccurate description of the DSM-5-TR 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. |
17 to >0 ptsPoor 0%–69%
The response includes a vague or inaccurate description of the DSM-5-TR 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. |
|
25 pts |
| This criterion is linked to a Learning Outcome • 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. |
| 30 to >26.0 ptsExcellent 90%–100%
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. |
26 to >23.0 ptsGood 80%–89%
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. |
23 to >20.0 ptsFair 70%–79%
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. |
20 to >0 ptsPoor 0%–69%
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. |
|
30 pts |
| This criterion is linked to a Learning Outcome · Support your approach with specific examples from this week’s media and at least three peer-reviewed, evidence-based sources. PDFs are attached. |
| 15 to >13.0 ptsExcellent 90%–100%
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. |
13 to >11.0 ptsGood 80%–89%
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. |
11 to >10.0 ptsFair 70%–79%
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. |
10 to >0 ptsPoor 0%–69%
The response is supported by vague or inaccurate examples from the week’s media and/or evidence from the literature, or is missing. |
|
15 pts |
| This criterion is linked to a Learning Outcome 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. |
| 5 to >4.0 ptsExcellent 90%–100%
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. |
4 to >3.5 ptsGood 80%–89%
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. |
3.5 to >3.0 ptsFair 70%–79%
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. |
3 to >0 ptsPoor 0%–69%
Paragraphs and sentences follow writing standards for flow, continuity, and clarity < 60% of the time…. No purpose statement, introduction, or conclusion were provided. |
|
5 pts |
| This criterion is linked to a Learning Outcome Written Expression and Formatting – English writing standards: Correct grammar, mechanics, and proper punctuation |
| 5 to >4.0 ptsExcellent 90%–100%
Uses correct grammar, spelling, and punctuation with no errors. |
4 to >3.5 ptsGood 80%–89%
Contains 1 or 2 grammar, spelling, and punctuation errors. |
3.5 to >3.0 ptsFair 70%–79%
Contains 3 or 4 grammar, spelling, and punctuation errors. |
3 to >0 ptsPoor 0%–69%
Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding. |
|
5 pts |
| This criterion is linked to a Learning Outcome 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. |
| 5 to >4.0 ptsExcellent 90%–100%
Uses correct APA format with no errors. |
4 to >3.5 ptsGood 80%–89%
Contains 1 or 2 APA format errors. |
3.5 to >3.0 ptsFair 70%–79%
Contains 3 or 4 APA format errors. |
3 to >0 ptsPoor 0%–69%
Contains many (≥ 5) APA format errors. |
|
5 pts |
| Total Points: 100 |