Assignment: Pathophysiology of Post-Traumatic Stress Disorder

Assignment: Pathophysiology of Post-Traumatic Stress Disorder

Assignment Pathophysiology of Post-Traumatic Stress Disorder

Post-traumatic stress disorder is an anxiety disorder that occurs due to repeated and prolonged exposure to stressful situations. The pathophysiology of this disorder mainly involves the central nervous system. Accordingly, magnetic resonance imaging studies have shown that there is the reduction in the volume of the left amygdala, hippocampus, and anterior cingulate cortex in individuals who are suffering from the disorder. The reduction in the size of the amygdala results in over-expression of emotions and modulation of fear responses (Benedek, 2018). There is also the reduction in the size of the medial prefrontal cortex that controls the stress and emotional response of the amygdala. The reduction in size lowers its control over amygdala, hence, hypersensitivity to emotional stimulation. Studies have also revealed that there is down-regulation of the central adrenergic receptors with increased or up-regulation of the central norepinephrine levels. The levels of glucocorticoids are also reduced in chronically diseased patients, which might point towards the association of the disorder with autoimmune disease. The reduction in the levels of the neurotransmitters and neurohormonal functioning imply that there is reduced response to stress, hence, the over-excitation of the central nervous system in the disease (Casey & Strain, 2015). Magnetic resonance imaging scans have also revealed the hemispheric lateralization, which implies failure of the left hemispheric function. The consequence of this failure is increased risk of confusion related to time due to repeated exposure to traumatic events.

Moreover, there is an increased risk of one developing post-traumatic stress disorder due to the influence of genetics. In this case, post-traumatic stress disorder in individuals with susceptible genes occurs through environmental interaction. For instance, there is an increased risk of post-traumatic stress disorder in individuals having one of the four polymorphisms that are located at the stress-related gene FKPB5 (Friedman, 2015).

Pharmacological Treatments

There exists a wide range of pharmacological treatments for post-traumatic stress disorder in my state. One of them is the use of selective serotonin reuptake inhibitors such as sertraline and paroxetine. The use of this group of drugs is effective in reducing the symptoms of post-traumatic stress disorder. It also improves the functioning of the patients suffering from the disorder. The other group of drugs that are used in treating the disorder is serotonin-norepinephrine reuptake inhibitors. An example is the use of venlafaxine extended release, which reduces the symptoms of the disorder. However, fewer studies have explored the use of this group of drugs. Second generation antipsychotics such as Quetiapine are also prescribed to patients suffering from post-traumatic stress disorder. The drugs result in the improvement in functioning and symptoms of the disorder (Forman-Hoffman et al., 2018). However, they are associated with side effects that include metabolic abnormalities and weight gain.

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Alpha-adrenergic blockers such as prazosin have also demonstrated some efficacy in the treatment of post-traumatic stress disorder.

This group of drugs reduces the symptoms of the disorder, nightmares, as well as sleep disturbance. However, they are associated with side effects that include rebound hypertension in patients with history of orthostatic hypotension. The use of benzodiazepines has also been explored in studies. However, they are not largely utilized due to its effect on impairing the effectiveness of other treatments such as exposure therapy in these patients (Landolt, Cloitre & Schnyder, 2017). Other medications that might be considered in treating post-traumatic stress disorder, though with insufficient recommendation, include antidepressants besides SSRI/SNRIs, beta-adrenergic blockers, and mood stabilizers.

Clinical Guidelines

The clinical guideline by the American Psychological Association and Veterans Affairs Clinical Practice Guideline are utilized in the assessment, diagnosis, and patient education in relation to post-traumatic stress disorder in my state. According to the guidelines, the assessment should be comprehensive including the assessment of the psychological physical and social needs as well as risk assessment of the patient. The assessment comprises of a wide range of aspects. They include safety assessment, relevant medical history, history of trauma and duration, current medication use, mental status examination, physical exam, laboratory tests, and signs of substance abuse, co-occurring disorders, and trauma (American Psychological Association, 2017).

The diagnosis of post-traumatic stress disorder is done using DSM-V. Eight-criterion system is used in the process. In criterion A, the patient must have a history of direct exposure to trauma in ways that include witnessing, participating, learning about the experience of a close person, and being exposed indirectly in the course of professional duties. In criterion B, one must have persistently experienced traumatic events in one or more of ways that include nightmares, intrusive thoughts, emotional distress, and physical reactivity following reminders of traumatic exposure. In criterion C, one must have history of avoidance of trauma due to stimuli related to traumatic events. It can occur through avoidance of thoughts and reminders associated with the trauma. In criterion D, the patient must meet at least two requirements that include negative thoughts being felt after trauma in any of the ways such as negative affect, feeling isolated, difficulties in positive affect, and exaggerated blame of others and self.  In criterion E, the patient must experience arousal due to trauma in at least two of the ways such as irritability, destructive behavior, hypervigilance, difficulty in sleeping, and difficulty in concentrating. In criterion F, the symptoms of post-traumatic stress disorder should last for a period of more than a month. In criterion G, the symptoms of the disorder should cause functional impairment and significant distress. In criterion H, the symptoms should not be attributed to medication, other illnesses or substance abuse (Card, 2017). The guidelines also have provisions on patient education. Accordingly, patients should be educated on stress control, trauma reactions, imaginal exposure to the traumatic experiences, and medication adherence as well as effects, side effects, and adverse events. The family should also be educated on the essential support to provide patients with the disorder (American Psychological Association, 2017).

Effects of the Disease Process

Post-traumatic stress disorder has significant effect on the patient, patient’s family and significant others. Firstly, it lowers the productivity of the patients in their societies. Patients affected by the disorder lose their functional roles in the society. The disorder also increases dependence in the family. Patients are highly at a risk of developing functional disabilities. This increases the risk of patient dependence on others in meeting their needs of their daily living. Over time, the ability of the families to meet their needs is affected by the increasing demands from the patients suffering from the disorder. The family of a patient with post-traumatic stress disorder is also subjected to significant psychological stress. This is attributed to the challenges associated with meeting the needs of their sick relatives. The fear of the unknown outcomes of the disease also increases the stress levels among the family members and significant others (Michel, 2018).

The treatment of post-traumatic stress disorder is also associated with significant use of the available resources. This includes the use of resources such as time and money. The patient and the family have to use their financial resources in seeking quality care that will promote their recovery from the disorder. They also incur huge medical expenses if the patients are admitted in the hospital. There is also the loss of valuable time that would have been used in undertaking other productive social and economic activities. Therefore, the loss of resources is likely to increase the risk of poverty among those affected directly by the disorder. Post-traumatic stress disorder also predisposes the patients, their families and significant others to isolation in their societies. The risk of isolation is increased in societies where there are stereotypes associated with mental health problems (McKay, Abramowitz & Storch, 2017). Consequently, rather than recovering from the disease burden, the patient and the family are subjected to social problems that worsens their experiences.

Strategies to Implement Best Practices

One of the strategies that I would use to implement best practices in the management of post-traumatic stress disorder in my institution is training the healthcare providers on ways of providing best care to these patients. The ability of the healthcare providers to give care that matches the health needs of patients with the disorder is dependent on their knowledge, skills, and experience. It is therefore important that they be provided with up-to-date training on new developments in the management of post-traumatic stress disorder. It is also important that they receive training that aim at building the desired cultural competencies among them as a way providing care that meets the needs of the diverse populations they serve. The second way in which I will implement best practices in the hospital I work in is through advocating for the use of evidence-based practice. Evidence-based practice entails the utilization of best available clinical evidence in providing care to the patients. Through it, outcomes of care such as quality, safety, and efficiency are achieved. Therefore, I will strengthen the utilization of evidence-based practice in caring for the patients with post-traumatic stress disorder to ensure that their prioritized and perceived health needs are met. The last way in which I will ensure best practices are utilized in the provision of care is the adoption of teamwork. I will encourage the healthcare providers to utilize teamwork in assessing, planning, implementing, and evaluating the care given to the patients. Teamwork will ensure that the barriers to access to and utilization of care experienced by the patients with the disorder are eliminated (Hall & Hall, 2016). Consequently, the desired health outcomes are achieved by the patients and the healthcare providers.

Assignment: Pathophysiology of Post-Traumatic Stress Disorder Conclusion

Post-traumatic stress disorder is one of the health problems affecting a significant proportion of people in America. It arises from repeated exposure of an individual to traumatizing situations. The experience results in structural changes in the brain as well as neuro-hormonal and neurotransmitter imbalance in the brain. These changes predispose individuals to the disorder. Pharmacological therapies are effective in treating the disorder. Therefore, best strategies should be embraced in the clinical settings to reduce the burden of the disease to the patients, families and communities as a whole.

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Once you have received your report, please review it. This report will show you grammatical, punctuation, and spelling errors that can easily be fixed. Take the extra few minutes to review instead of getting counted off for these mistakes.

Review your similarities. Did you forget to cite something? Did you not paraphrase well enough? Is your paper made up of someone else’s thoughts more than your own?

Visit the Writing Center in the Student Success Center, under the Resources tab in LoudCloud for tips on improving your paper and SI score.

Late Policy

The university’s policy on late assignments is 10% penalty PER DAY LATE. This also applies to late DQ replies.

Please communicate with me if you anticipate having to submit an assignment late. I am happy to be flexible, with advance notice. We may be able to work out an extension based on extenuating circumstances.

If you do not communicate with me before submitting an assignment late, the GCU late policy will be in effect.

I do not accept assignments that are two or more weeks late unless we have worked out an extension.

As per policy, no assignments are accepted after the last day of class. Any assignment submitted after midnight on the last day of class will not be accepted for grading.

Communication

Communication is so very important. There are multiple ways to communicate with me:

Questions to Instructor Forum: This is a great place to ask course content or assignment questions. If you have a question, there is a good chance one of your peers does as well. This is a public forum for the class.

Individual Forum: This is a private forum to ask me questions or send me messages. This will be checked at least once every 24 hours.

Important information for writing discussion questions and participation

Welcome to class

Hello class and welcome to the class and I will be your instructor for this course. This is a -week course and requires a lot of time commitment, organization, and a high level of dedication. Please use the class syllabus to guide you through all the assignments required for the course. I have also attached the classroom policies to this announcement to know your expectations for this course. Please review this document carefully and ask me any questions if you do. You could email me at any time or send me a message via the “message” icon in halo if you need to contact me. I check my email regularly, so you should get a response within 24 hours. If you have not heard from me within 24 hours and need to contact me urgently, please send a follow up text to

I strongly encourage that you do not wait until the very last minute to complete your assignments. Your assignments in weeks 4 and 5 require early planning as you would need to present a teaching plan and interview a community health provider. I advise you look at the requirements for these assignments at the beginning of the course and plan accordingly. I have posted the YouTube link that explains all the class assignments in detail. It is required that you watch this 32-minute video as the assignments from week 3 through 5 require that you follow the instructions to the letter to succeed. Failure to complete these assignments according to instructions might lead to a zero. After watching the video, please schedule a one-on-one with me to discuss your topic for your project by the second week of class. Use this link to schedule a 15-minute session. Please, call me at the time of your appointment on my number. Please note that I will NOT call you.

Please, be advised I do NOT accept any assignments by email. If you are having technical issues with uploading an assignment, contact the technical department and inform me of the issue. If you have any issues that would prevent you from getting your assignments to me by the deadline, please inform me to request a possible extension. Note that working fulltime or overtime is no excuse for late assignments. There is a 5%-point deduction for every day your assignment is late. This only applies to approved extensions. Late assignments will not be accepted.

If you think you would be needing accommodations due to any reasons, please contact the appropriate department to request accommodations.

Plagiarism is highly prohibited. Please ensure you are citing your sources correctly using APA 7th edition. All assignments including discussion posts should be formatted in APA with the appropriate spacing, font, margin, and indents. Any papers not well formatted would be returned back to you, hence, I advise you review APA formatting style. I have attached a sample paper in APA format and will also post sample discussion responses in subsequent announcements.

Your initial discussion post should be a minimum of 200 words and response posts should be a minimum of 150 words. Be advised that I grade based on quality and not necessarily the number of words you post. A minimum of TWO references should be used for your initial post. For your response post, you do not need references as personal experiences would count as response posts. If you however cite anything from the literature for your response post, it is required that you cite your reference. You should include a minimum of THREE references for papers in this course. Please note that references should be no more than 5 years old except recommended as a resource for the class. Furthermore, for each discussion board question, you need ONE initial substantive response and TWO substantive responses to either your classmates or your instructor for a total of THREE responses. There are TWO discussion questions each week, hence, you need a total minimum of SIX discussion posts for each week. I usually post a discussion question each week. You could also respond to these as it would count towards your required SIX discussion posts for the week.

I understand this is a lot of information to cover in 5 weeks, however, the Bible says in Philippians 4:13 that we can do all things through Christ that strengthens us. Even in times like this, we are encouraged by God’s word that we have that ability in us to succeed with His strength. I pray that each and every one of you receives strength for this course and life generally as we navigate through this pandemic that is shaking our world today. Relax and enjoy the course!

Hi Class,

Please read through the following information on writing a Discussion question response and participation posts.

Contact me if you have any questions.

Important information on Writing a Discussion Question

• Your response needs to be a minimum of 150 words (not including your list of references)
• There needs to be at least TWO references with ONE being a peer reviewed professional journal article.
• Include in-text citations in your response
• Do not include quotes—instead summarize and paraphrase the information
• Follow APA-7th edition
• Points will be deducted if the above is not followed

Participation –replies to your classmates or instructor

• A minimum of 6 responses per week, on at least 3 days of the week.
• Each response needs at least ONE reference with citations—best if it is a peer reviewed journal article
• Each response needs to be at least 75 words in length (does not include your list of references)
• Responses need to be substantive by bringing information to the discussion or further enhance the discussion. Responses of “I agree” or “great post” does not count for the word count.
• Follow APA 7th edition
• Points will be deducted if the above is not followed
• Remember to use and follow APA-7th edition for all weekly assignments, discussion questions, and participation points.
• Here are some helpful links
• Student paper example
• Citing Sources
• The Writing Center is a great resource