Neurobiological Basis Of PTSD, DSM V Criteria, The Patients case, And The Therapeutic Approaches For Treating The Condition Assignment
Neurobiological Basis Of PTSD, DSM V Criteria, The Patients case, And The Therapeutic Approaches For Treating The Condition Assignment
WK9 PTSD
Post-traumatic stress disorder develops after an individual faces a traumatic event by experiencing, witnessing, learning, or through repeated exposure that causes negative emotions, fear, and helplessness (Brewin et al., 2019). Individuals can develop PTSD, resulting in cognitive and functional impairment, which can interfere with various activities of daily living. It is vital to ensure early diagnosis and interventions to prevent the complications that result from PTSD. This essay seeks to explain the neurobiological basis of PTSD, DSM V criteria, the patient’s case, and the therapeutic approaches for treating the condition Neurobiological Basis Of PTSD, DSM V Criteria, The Patients case, And The Therapeutic Approaches For Treating The Condition Assignment.
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Neurobiological basis for PTSD
It comprises neuroanatomical, neurochemical, and neuroendocrine changes. Patients with PTSD have an altered circuit in the brain, and therefore, they cannot adapt to stress and fear. The neurotomical alterations in the brain are present in the hippocampus, amygdala, and media frontal cortex. The hippocampus, which plays a role in stress response, has a decreased volume and size in the case of PTSD (Andrewes & Jenkins, 2019). The amygdala and media prefrontal cortex is also altered; therefore, it becomes hard for people from traumatic events to respond to stress.
The neurochemical features are present in various chemicals, including serotonin, noradrenaline, dopamine, and GABA, and play a role in responding to fear and regulating stress. Alterations such as increased noradrenaline cause increased fear and anxiety in PTSD. Changes in the neuroendocrine system mainly surround the hypothalamic-pituitary-adrenal axis, which responds to stress in the body. The hypothalamus releases corticotropin hormone, which then causes the secretion of adrenocorticotropin hormone, which causes the release of corticosteroids such as cortisol from the adrenal cortex (Andrewes & Jenkins, 2019). Cortisol then plays a role in decreasing the non-adrenergic response to stress and also causes negative feedback to the HPA. Low levels of cortisol due to trauma can expose an individual to PTSD.
DSM-5 Diagnostic criteria and relation to the case study.
- Experiencing a traumatic event- Joe was with his father when they experienced the minor vehicle accident
- Recurrence of distressing and intrusive memories of the traumatic event- He keeps having flashbacks and thoughts of the event and also has nightmares.
- Avoidance of memories and reminders of the event- Joe does not like talking about the minor vehicle accident.
- Alterations in mood and cognition negatively, which start after exposure to a traumatic event- Joe keeps experiencing alterations in cognition and experiences negative emotions and fights with his classmates.
- Alteration in reactivity and arousal behavior- Joe has angry outbursts and fights his colleagues.
Joe has met the DSM-V criteria for post-traumatic stress disorder, as evidenced by the above manifestation.
Case Presentation
The video provides adequate information that is used to make a diagnosis of PTSD. The events that caused trauma are clear, as the behaviors of Joe after the traumatic event. The information is, therefore, enough for making the diagnosis for Joe’s situation. The other diagnosis of conduct disorder and major depressive disorder are on point. Patients with PTSD have an increased risk of developing depression (Brewin et al., 2019). Joe presents irritability ad poor sleep patterns, which are also present in MDD. PTSD can coexist with other conditions, such as conduct disorder, and it can present with aggression. Joe presents with the symptoms of conduct disorder Neurobiological Basis Of PTSD, DSM V Criteria, The Patients case, And The Therapeutic Approaches For Treating The Condition Assignment.
Psychotherapy treatment
Eye movement desensitization and reprocessing (EMDR) is another psychotherapy treatment that can be effective for Joe. It is an individual therapy that is usually one to two minutes weekly for over six sessions. It mainly involves a model known as Adaptive Information Processing, which focuses on distress symptoms that are not adequately processed from past disturbances. The presence of unprocessed memories has beliefs, thoughts, and emotions that were present during the traumatic event. The therapy focuses on causing alterations in the responses to emotions and thoughts; therefore, it intends to eliminate the symptoms by changing the memories (Civilotti et al., 2021). It involves a bilateral stimulation where a client can focus on trauma memory resulting decrease in emotions in the memory.
EMDR play a role in helping the patient relieve traumatic memories and desensitize the bad memories, allowing them to integrate and assimilate the events. The therapist needs to explain to the child the meaning of trauma. It consists of 8 phases: the history of trauma and the treatment plan, preparation, assessment, desensitization, installation, body scan, closure, and reevaluation (Civilotti et al., 2021). The therapist’s primary role is to provide emotional support and EMDR skills and help the patient achieve the required emotional regulation. As a result, EMDR is among the most excellent approaches for treating trauma in addition to trauma-focused CBT. Therefore, clinicians and therapists must adopt evidence-based treatments and gold standards during treatment because they are known to cause better patient outcomes.
Sources
The sources used in the article are publicly accepted and scholarly because they are peer-reviewed. They are also written by experts and greatly contribute to knowledge and understanding in various fields because they contain analysis theories and insights into current knowledge.
Week 9: Psychotherapy With Trauma and Stressor-Related Disorders
Disorders resulting from trauma are significantly different from other psychiatric-mental health issues. Unlike disorders such as schizophrenia or major depressive disorder, trauma-related disorders do not occur randomly in the population. Instead, trauma is something that occurs as a result of the lived experience of a traumatic event. According to the National Institute of Mental Health (2017), more than half of the population will experience a traumatic event during their lifetime. Although most people will recover from the trauma on their own, some require therapeutic interventions. While there are medications that can help individuals with trauma and posttraumatic stress disorder (PTSD), the foundation of treatment continues to be psychotherapy.
This week, you explore psychotherapy for trauma by assessing a case presentation for clients presenting with posttraumatic stress disorder. You also examine therapies for treating these clients and consider potential outcomes Neurobiological Basis Of PTSD, DSM V Criteria, The Patients case, And The Therapeutic Approaches For Treating The Condition Assignment.
Reference: National Institute of Mental Health. (2017). Post-traumatic stress disorder (PTSD). https://www.nimh.nih.gov/health/statistics/post-traumatic-stress-disorder-ptsd.shtml
Learning Objectives
Students will:
Explain the neurobiological basis for PTSD
Apply assessment and diagnostic reasoning skills to clients presenting with posttraumatic stress disorder
Recommend therapeutic approaches for treating clients presenting with posttraumatic stress disorder
Analyze the importance of using evidence-based psychotherapy treatments for clients with posttraumatic stress disorder
Learning Resources
Required Readings (click to expand/reduce)
American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (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 Diagnosisâ€
American Psychiatric Association. (2017). Clinical practice guideline of PTSD. 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. 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. 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 Therapyâ€
Chapter 11, “Trauma Resiliency Model Therapyâ€
Chapter 15, “Trauma-Informed Medication Managementâ€
Chapter 17, “Stabilization for Trauma and Dissociationâ€
Chapter 18, “Dialectical Behavior Therapy for Complex Traumaâ€
Required Media (click to expand/reduce)
Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD) [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 [Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/ptsd-and-veterans-a-conversation-with-dr-frank-ochberg
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Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder? (Strictly Medical-English Version). [Video]. YouTube. https://www.youtube.com/watch?v=o98ilXH5gto
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-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.
Submit your Assignment. Also ATTACH AND SUBMIT PDFs of the SOURCES you used.
References
Andrewes, D. G., & Jenkins, L. M. (2019). The role of the amygdala and the ventromedial prefrontal cortex in emotional regulation: implications for post-traumatic stress disorder. Neuropsychology review, 29(2), 220-243. https://doi.org/10.1007/s11065-019-09398-4
Brewin, C. R., Rumball, F., & Happé, F. (2019). Neglected causes of post-traumatic stress disorder. Bmj, 365. https://doi.org/10.1136/bmj.l2372
Civilotti, C., Margola, D., Zaccagnino, M., Cussino, M., Callerame, C., Vicini, A., & Fernandez, I. (2021). Eye Movement Desensitization and Reprocessing in Child and Adolescent Psychology: a Narrative Review. Current Treatment Options in Psychiatry, 8(3), 95–109. https://doi.org/10.1007/s40501-021-00244-0 Neurobiological Basis Of PTSD, DSM V Criteria, The Patients case, And The Therapeutic Approaches For Treating The Condition Assignment