Psychotherapy With Trauma and Posttraumatic Stress Disorder Essay Assignment

Psychotherapy With Trauma and Posttraumatic Stress Disorder Essay Assignment

The media ‘Presentation Example: Posttraumatic Stress Disorder (PTSD)’ shows a case presentation of an eight-year-old child who was in a minor car accident with his father. The patient was unharmed. His father, on the other hand, had a slight knee injury. The driver of the second car involved in the collision, on the other hand, intimidated the patient’s father and pursued him to the point that the patient’s father had to contact the police. The patient exhibited avoidance of stimuli, sleeping issues, nightmares, physical hostility, an outburst in the middle of a school class, unsafe conduct that scared others, and fights. In addition to PTSD, the patient was diagnosed with ODD, CD, MDD, ADHD, SAD, and spider phobia. This paper examines the process of PTSD diagnosis and management as shown in the available media, as well as the neurological underpinnings involved in the development of this mental condition.

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Neurobiological Basis for PTSD

PTSD neurobiology is a complicated process that involves neurochemical, neuroanatomical, and neuroendocrine alterations in brain networks. In terms of neuroendocrine properties, the hypothalamic-pituitary-adrenal axis (HPA) is regarded as the key coordinator of an individual’s stress response system (Dunlop & Wong, 2019). Cortisol, a stress hormone, has a negative feedback effect on the HPA. In addition, the hormone lowers the noradrenergic stress response. As a result, chronic cortisol release as a result of PTSD has negative effects on the brain, particularly the hippocampus neurons, resulting in decreased neuroplasticity and neurogenesis (Jaworska-Andryszewska & Rybakowski, 2019). Noradrenaline, serotonin, and dopamine are also connected with stress reactions that contribute to PTSD symptoms.

DSM-5 Diagnostic Criteria for PTSD

            The patient must have been subjected to a traumatic incident, which in this case was a small motor vehicle collision, according to the DSM-V diagnostic criteria. He must also have had at least one intrusion symptom, such as nightmares, recurring recollections, or flashbacks, in the previous month (Grant et al., 2020). At least one persistent avoidance symptom, as well as two unfavorable mood and cognition changes, such as failure to recall essential characteristics and persistent negative views, are necessary. The case study also found changes in reactivity and arousal as a result of hazardous conduct and hypervigilance. Finally, the presenting symptoms must be functional in the patient’s psychological and social lives. As stated above, the video has sufficient information to establish the diagnosis of PTSD.

Other diagnoses acquired after the accident, such as ODD, CD, MDD, and SAD, are extremely unclear because most of these diseases exhibit the same symptoms as PTSD and should not have been recognized as comorbidities at the time (Miao et al., 2018). However, ADHD and spider fear were diagnosed before the incident, therefore the psychiatrist must have had sufficient reasons to justify these diagnoses.

Psychotherapy Treatment Option

Aside from CBT, I would think about using extended exposure (PE) treatment, which is indicated as first-line therapy for PTSD in most professional practice recommendations (Bastien et al., 2020). PE is a gold standard therapy strategy for PTSD, having been submitted to multiple clinical trials that have found it to be highly helpful in treating PTSD symptoms even in complicated and comorbid individuals. Psychoeducation, imaginal exposure, in vivo exposure, and emotional processing are the major components of PE.

Conclusion

The media presentation emphasizes the need of using good psychiatric practice when diagnosing and treating people with mental health issues. The patient in the video was misdiagnosed and had multiple comorbidities, complicating treatment options. However, if PTSD is the major diagnosis, PE therapy might be quite beneficial.

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. DOI: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

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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

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.

 

NRNP_6645_Assignment_Rubric

Criteria Rating and Points

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 pts

Excellent 90%–100%

The response includes an accurate and concise explanation of the neurobiological basis for PTSD illness.

15 pts

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 pts

Excellent 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.

25 pts

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 pts

Excellent 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.

30 pts

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 pts

Excellent 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.

15 pts

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 pts

Excellent 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.

5 pts

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

5 to >4.0 pts

Excellent 90%–100%

Uses correct grammar, spelling, and punctuation with no errors.

5 pts

Written Expression and Formatting – The paper follows the correct APA format for title page, headings, font, spacing, margins, indentations, page numbers, parenthetical/in-text citations, and reference list.

5 to >4.0 pts

Excellent 90%–100%

Uses the correct APA format with no errors.

5 pts