Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example

Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example

PSTD is a common mental health disorder characterized by an inability to recover from experiencing/experiencing traumatic events in individuals across different ages. The purpose of this assignment is to review PSTD diagnosis and neurological basis; reflect on the sufficiency of PSTD symptomology, discuss psychotherapy and gold standard treatment in psychotherapy.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

Neurobiological Basis for PTSD Illness.

PSTD affects the nervous system features, including neuroendocrine, neurochemical, and neuroanatomic (Sakellariou & Stefanatou, 2017). PSTD affects the hypothalamic-pituitary-adrenal axis in the neuroendocrine system, leading to impaired fear processing and stress regulation. Equally, PSTD causes abnormal effects on the hypothalamic-pituitary-thyroid axis, promoting hippocampal atrophy and increasing anxiety. In the neurochemical system, PSTD increases dopamine and norepinephrine levels, leading to an impaired mesolimbic system. Similarly, PSTD decreases 5HT concentration, leading to a disturbance between the amygdala and hippocampus, anxiolytic effects, impulsivity, and increased vigilance. Moreover, PSTD increases glutamate and GABA activity, leading to compromised anxiolytic effects, derealization, and dissociation. Lastly, PSTD increases CSF b-endorphin levels and decreases plasma NPY concentrations, leading to numbness, dissociation, and analgesia.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

In the neuroanatomic system, PSTD affects the volume and structure of the Hippocampus, Amygdala, and Cortex. PSTD reduces the volume and activity of the hippocampus, altering stress responses and extinction. Similarly, PSTD increases amygdala activity, increasing hypervigilance, and impairs threat discrimination. Lastly, PSTD reduces anterior cingulate and prefrontal volumes, leading to dysregulated executive function and impaired fear responses, respectively.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

The DSM-5 Diagnostic Criteria for PTSD.

The diagnostic criteria for PTSD for children above six years include re-experiencing exposure to threat or actual injury, death, or sexual violence (APA, 2013). Individuals also experience persistent intrusive symptoms, avoidance of stimuli associated with a traumatic event, and impaired cognition and negative mood.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

Does the video case presentation provide sufficient information to derive a PTSD diagnosis? Justify your reasoning.

Yes, the video provides crucial information for PSTD diagnosis. The presentation highlights crucial aspects of PSTD diagnosis such as the severity of the traumatic experience, prior experiences, individual perceptions of the traumatic event, cognitive processing, genetic and environmental factors. The presentation describes Joe’s (the case client) experience an accident and consequence chase by the perpetrator. While the accident was minor, the resultant pursuit by the perpetrator towards Joe and his father could be traumatic for Joe.  Besides, the authors describe Joe as anxious of stimuli reminding him of the event, be it TV stories or discussion, trouble sleeping, nightmares, physical aggression, outbursts of anger, fights, and slightly provoked. Although Joe had been diagnosed with ADHD and specified phobia, these symptoms began after the incident, justifying PSTD diagnosis.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

Do you agree with the other diagnoses in the case presentation? Why or why not?

I agree with the ODD diagnosis. The client presents symptoms that meet the threshold for ODD diagnosis, including anger, irritability, defiance, hyperactivity, and disturbance that affect individuals in his immediate context (APA, 2013). According to the American Psychological Association DSM-5 (2013), these symptoms are characteristic of ODD. However, I refute Conduct disorder and MDD diagnoses. The client’s symptoms do not meet the threshold for conduct disorders and MDD diagnosis. Moreover, MDD associated depressive episodes must be persistent nearly every day for most of the day for at least two weeks. While this information is lacking, the client’s condition is better explained by PSTD other than any other psychotic condition.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

Discuss one other psychotherapy treatment option for the client in this case study. Gold standard treatment

Alternative therapy to PSTD is cognitive processing therapy (CPT). CPT is a trauma-focused recommended by the American Psychological Association for PSTD treatment (Watkins, Sprang & Rothbaum, 2018). CPT helps clients learn how to adapt and challenge antisocial beliefs related to past trauma by providing crucial coping skills to handle distressing and intrusive thoughts and feelings to regain control of their former selves (Tran, Moulton, Santesso & Rabb, 2016; Wheeler, 2020). CPT is considered a gold standard treatment since it promotes the gold standards of mental health recovery, including hope, empowerment, self-responsibility, self-esteem, and purposeful life (Wheeler, 2020). CPT empowers, instills hope, purposefulness, self-esteem, and responsibility for an individual’s own maladaptive emotions and behaviors. It is imperative for PMHNPs to use Gold standard treatments such as CPT because they are evidence-based and of the best quality, contributing to relationship-based interventions crucial for mental health assessment and treatment.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

Conclusion

The DSM-5 tool highlights criteria for PSTD across different ages. The client presented is the case scenario present symptoms that meet the threshold for PSTD diagnosis.  CPT is a crucial behavioral therapy modality effective for PSTD treatment. CPT is well researched and evidence-based, thus considered a gold standard treatment intervention.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)

References

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example) https://doi.org/10.1176/appi.books.9780890425596  

Sakellariou, M. O., & Stefanatou, A. (2017). Neurobiology of PTSD and implications for treatment: An overview. Current Research: Integrative Medicine, 2(1)(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example). https://www.pulsus.com/scholarly-articles/neurobiology-of-ptsd-and-implications-for-treatment-an-overview.html

Tran, K., Moulton, K., Santesso, N., & Rabb, D. (2016). Cognitive processing therapy for post-traumatic stress disorder: a systematic review and meta-analysis.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example) https://pubmed.ncbi.nlm.nih.gov/27227199/

Tye, S., Van Voorhees, E., Hu, C., & Lineberry, T. (2015). Preclinical perspectives on post-traumatic stress disorder criteria in DSM-5. Harvard Review of Psychiatry, 23(1), 51–58.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example) https://doi.org/10.1097/hrp.0000000000000035

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://dx.doi.org/10.3389%2Ffnbeh.2018.00258 

Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.(Post-Traumatic Stress Disorder Comprehensive Solved Nursing Essay Example)