NRNP 6645 Week 9 Assignment: Posttraumatic Stress Disorder

NRNP 6645 Week 9 Assignment: Posttraumatic Stress Disorder

NRNP 6645 Week 9 Assignment: Posttraumatic Stress Disorder

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.

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_Week9_Assignment_Rubric

Criteria 1 (15 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.

13 to >11.0 pts. Good 80%–89%

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

11 to >10.0 pts. Fair 70%–79%

The response includes a somewhat vague or inaccurate explanation of the neurobiological basis for PTSD illness.

10 to >0 pts. Poor 0%–69%

The response includes a vague or inaccurate explanation of the neurobiological basis for PTSD illness. Or, response is missing.

Criteria 2 (25 points

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 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.

22 to >19.0 pts. Good 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 pts. Fair 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 pts. Poor 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.

Criteria 3 (30 points

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 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.

26 to >23.0 pts. Good 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 pts. Fair 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 pts. Poor 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 inappropriate. 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.

 Criteria 4 ( 15 points)

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 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.

13 to >11.0 pts. Good 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 pts. Fair 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 pts. Poor 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.

Criteria 5 (5 points

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 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.

4 to >3.5 pts. Good 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 pts. Fair 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 pts Poor 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.

Criteria 6 (5 points

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 pts.  Excellent 90%–100%

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

4 to >3.5 pts. Good 80%–89%

Contains 1 or 2 grammar, spelling, and punctuation errors.

3.5 to >3.0 pts. Fair 70%–79%

Contains 3 or 4 grammar, spelling, and punctuation errors.

3 to >0 pts. Poor 0%–69%

Contains many (≥ 5) grammar, spelling, and punctuation errors that interfere with the reader’s understanding.

Criteria 7 (5 points

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 pts

Excellent 90%–100%

Uses correct APA format with no errors.

4 to >3.5 pts. Good 80%–89%

Contains 1 or 2 APA format errors.

3.5 to >3.0 pts. Fair 70%–79%

Contains 3 or 4 APA format errors.

3 to >0 pts. Poor 0%–69%

Contains many (≥ 5) APA format errors.

Total Points: 100

A Sample Of This Assignment Written By One Of Our Top-rated Writers

Posttraumatic Stress Disorder

Posttraumatic stress disorder (PTSD) is a syndrome that occurs following exposure to a real or threatened injury or assault. It is characterized by intrusive thoughts, avoidance of associated stimuli, negative alterations in mood, and alterations in arousal. The purpose of this paper is to describe PTSD including its neurobiological basis, diagnostic criteria, and psychotherapy.  

The Neurobiological Basis for PTSD Illness

Neuropeptide Y (NPY) is an anxiolytic endogenous peptide linked with the hypothalamic-pituitary-adrenal (HPA) axis and its levels can be modulated by stress. Reduced levels of NPY increase susceptibility to PTSD.  Corticotropin-releasing hormone receptors (CRHR) are vital mediators in response to stress (El-Mallakh, 2020). They bind corticotropin-releasing hormone and help in integrating autonomic, behavioral, and immune responses to stress. The HPA axis coordinates the hormonal response to stress (Speer et al.., 2019). Dysregulation of the HPA axis and increased activity of the central and peripheral noradrenergic systems have been identified in patients with PTSD.

The DSM-5-TR Diagnostic Criteria for PTSD

The DSM-5 criteria for PTSD require the person to have been exposed to actual or threatened serious injury, death or threatened death, or actual/threatened sexual violence. The exposure occurs through Direct exposure, Witnessing, Learning that a loved one was exposed to trauma, or Indirect exposure to horror details of the trauma (Wang et al., 2023). The criteria also require the presence of at least one intrusion symptom; one avoidance symptom; two symptoms of negative alterations in cognition and mood; alterations in arousal and reactivity (Miao et al., 2018). The symptoms should have a duration of at least one month and should result in distress or functional impairment.  

The video case depicts Joe who has been diagnosed with PTSD, ODD, MDD, Conduct disorder, and Separation Anxiety disorder. Joe meets the diagnostic criteria for PTSD since he presents with PTSD symptoms that occurred after being involved in a car crash.  Joe has intrusion symptoms as he constantly has unwanted memories and nightmares of the car crash. He exhibits avoidance symptoms as he avoids memories of the crash. In addition, he exhibits negative alterations in mood and cognition. For instance, he is unable to remember essential details about the crash and he conveys overly negative worldly assumptions (Wang et al., 2023). He also exhibits alteration in arousal and reactivity as evidenced by episodes of irritability, angry outbursts, and being destructive.

ODD and Conduct disorder are inappropriate diagnoses since the physical aggression, irritability, and anger outbursts started after being exposed to the traumatic events. Joe’s mood symptoms do not justify the MDD diagnosis. Furthermore, Separation Anxiety disorder is not appropriate for this patient since his anxiety when separated from his father is secondary to the intrusive symptoms and started after the car crash. Therefore, PTSD is the only diagnosis of concern for this case.

Other Psychotherapy Treatment Option For The Client

Trauma-focused cognitive-behavioral therapy (TF-CBT) can be used for this patient. TF-CBT is a gold-standard therapy and has received the most empirical support for treating PTSD in pediatric populations (Brown et al., 2020). Clients are trained in stress-management skills to prepare for the exposure-based interventions that seek to provide mastery over trauma reminders.

Conclusion

PTSD is associated with neurobiological changes in Neuropeptide Y, Corticotropin-releasing hormone receptors, and dysregulation of the HPA axis.  Joe meets the criteria for PTSD as he has intrusion, avoidance, negative alterations in mood and cognition, and alteration in arousal and reactivity. Trauma-focused CBT can be used in the patient to help in the resolution of traumatic symptoms.

References

Brown, E. J., Cohen, J. A., & Mannarino, A. P. (2020). Trauma-Focused Cognitive-Behavioral Therapy: The role of caregivers. Journal of Affective Disorders, 277, 39–45. doi:10.1016/j.jad.2020.07.123 

El-Mallakh, R. S. (2020). Posttraumatic stress disorder: from pathophysiology to pharmacology. Current Psychiatry, 19(5), 33-39.

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

Speer, K. E., Semple, S., Naumovski, N., D’Cunha, N. M., & McKune, A. J. (2019). HPA axis function and diurnal cortisol in post-traumatic stress disorder: A systematic review. Neurobiology of stress, 11, 100180. https://doi.org/10.1016/j.ynstr.2019.100180

 Wang, L., Fang, R., Chen, C., & Cao, C. (2023). A comparison of ICD-11 and DSM-5 criteria of PTSD among Chinese trauma-exposed adolescent samples. Frontiers in Psychiatry, 14, 1186138. https://doi.org/10.3389/fpsyt.2023.1186138