Assignment: Posttraumatic Stress Disorder Essay

Assignment: Posttraumatic Stress Disorder Essay

Assignment  Posttraumatic Stress Disorder Essay

PTSD is characterized by persistent, intrusive recollection of a traumatic incident, lasting for more than a month. PTSD symptoms start manifesting within six months of the traumatic incident (Sherin & Nemeroff, 2022). The purpose of this paper is to discuss the neurobiological cause of PTSD, diagnostic criteria, and psychotherapy approaches.

Neurobiological Basis for PTSD Illness

The neurobiological cause of PTSD is associated with endocrine and neurochemical factors. Low cortisol production during the period of trauma causes maladaptive stress responses and predisposes an individual to PTSD. Besides, patients with PTSD exhibit a decreased volume of the hippocampus, which is the major brain region that hinders the HPA axis (Sherin & Nemeroff, 2022). In addition, PTSD occurs due to abnormal regulation of serotonin, catecholamine, peptide, amino acid, and opioid neurotransmitters. These transmitters are found in the brain circuits that regulate stress and fear responses and thus, their dysregulation impairs the stress response (Sherin & Nemeroff, 2022). Furthermore, alteration in the activity of norepinephrine and stress hormone is associated with development of PTSD since norepinephrine regulates encoding of fear memories, while glucococorticoids hinder retrieval of emotional memories.

DSM-5 Diagnostic Criteria for PTSD

The DSM-5 criteria for PTSD require a person to have had a direct or indirect exposure to a traumatic event and have features from each of these categories for at least one month: Intrusion symptoms, Negative impact on cognition and mood, Avoidance symptoms, and impaired arousal and reactivity (Miao et al., 2018). The symptoms should create significant distress or impairment in social or occupational functioning that is not attributed to a medical condition or substance use. The video case has adequate data supporting PTSD since the patient symptoms are connected to exposure to a traumatic incident (car crash). The patient has Intrusion symptoms such as having distressing dreams about the car crash and Avoidant symptoms like avoiding memories. Besides, the boy has impairment in arousal and reactivity evidenced by anger outbursts, irritability, and destructive behavior (Miao et al., 2018). His cognition and mood are affected since he cannot remember key details about the accident.

The patient was given other diagnoses like Separation Anxiety disorder, MDD, ODD, and Conduct disorder. Although, the patient has clinical features that occur in ODD, MDD, and conduct disorder like anger outbursts, irritability, and aggression, these symptoms are due to the negative effects of PTSD on mood and cognition. Furthermore, the boy’s anxiety attributed to parental separation is due to intrusion symptoms and not separation anxiety.  Thus, I would disagree with these diagnoses since the symptoms are documented features of PTSD and they are due to exposure to a traumatic event.

Additional Psychotherapy Treatment Option

Cognitive Processing Therapy (CPT) is a psychotherapy approach that I would recommend for this client. Watkins et al. (2018) explain

that CPT is highly recommended by the APA and VA/DoD guidelines in managing PTSD. It is a trauma focused therapy that hypothesizes that after a traumatic event, individual try to make sense of what occurred. This often causes distorted cognitions about oneself, others, and the world. CPT is considered gold standard therapy since it cognitively triggers the memory, while enabling the patient to recognize maladaptive cognitions related to the traumatic incident. PMHNPs should use evidence-based interventions since they have been established to be safe and effective in promoting the best possible outcomes for a particular patient population.

Conclusion

PTSD is associated with endocrine factors like reduced cortisol production and abnormal regulation of neurochemical factors. Clinical features in the DSM-5 criteria for PTSD include Intrusion symptoms, Negative impact on cognition and mood, Avoidance symptoms, and impaired arousal and reactivity. CPT is extensively supported as an effective psychotherapy approach for PTSD.

 

Assignment: Posttraumatic Stress Disorder Essay References

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

Sherin, J. E., & Nemeroff, C. B. (2022). Post-traumatic stress disorder: the neurobiological impact of psychological trauma. Dialogues In Clinical Neuroscience. https://doi.org/10.31887/DCNS.2011.13.2/jsherin

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://doi.org/10.3389/fnbeh.2018.00258

Explanation of my Observation of William

William, a war veteran previously based in Iraq, is a 38-year-old African American male who became homeless after failure to pay his mortgage. He lives with his wife and works as a lawyer with a specialty in finance law. However, his career is in a jeopardy due to his habit of alcohol consumption, which he uses as a survival mechanism from posttraumatic stress disorder (PTSD).

From my analysis of the client, he is experiencing stressful events based on the evaluation using the Diagnostics and Statistical Manual of Mental Disorders fifth edition (DSM-5) tool (Moskowitz et al., 2019). William exhibits re-occurring symptoms of irritability, concentration problems as well as sleep disturbances, which arise from nightmares, flashbacks, and hallucinations. These

are exacerbated by thoughts about the traumatic experiences he encountered as an American soldier in Iraq. Even though William’s depression and PTSD scores reveal a low level of distress, his current life experiences affect how he functions at work (Sareen, 2014). Mainly, he reports intense fear, horror, and sometimes helplessness, which makes him self-medicate with alcohol. However, William is consistently connected to his wife and closest friends, which is mainly achieved through texting rather than direct communication. This is an indication of avoidant coping indicating that he prefers to manage his affairs in isolation.

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As I use the PTSD explorer to examine William, his mood and energy keep on fluctuating from moderate status to worst condition. He is mainly stressed about his previous encounters in the military environment (Zamorski et al., 2015). The client is mainly concerned about the nature of his work as a lawyer in which in some instances, he handles customers whose reprimanding demands reminds him about the nature of the military encounters in Iraq. His mood scores fluctuate and this calls for the need for medications to manage such dilapidating mood disorder.

Therapeutic Approaches for the Client

Due to anxiety, I will administer Klonopin 0.25mg PO x 2 daily (Moskowitz et al., 2019). The patient will be expected to take the medication for one month until panic stops. However, I might increase the dosage of 0.125mg to the 0.25mg of Klonopin every three days to ensure that anxiety and panic are under control. I will also prescribe Ziprasidone 40mg PO BID for the client. This medication will be used in a combination with Lorazepam 1mg PO BID to address hallucinations and nightmares that occur to the patient due to a flashback about the experiences of the military environment (Moskowitz et al., 2019). However, in the event the patient does not realize improvement in perceptual disturbances, I will increase Ziprasidone gradually up to 80mg PO BID within three days of medication. I will also administer Duloxetine 60mg PO x 1 daily to restore positive mood in the patient.

Expected Outcomes

I will expect William to adhere to the prescribed medication regimen for him to realize a positive change in his psychotic disorder. Upon completion of the drugs, I anticipate to observe a remarkable improvement in the patient particularly in how he relates with the family and friends (Sareen, 2014). This means that his habit of isolation will reduce. I also expect William’s mood to change and his anxiety to drop following the use of the medication after one month. This will mean that his depression will drop based on the analysis using the depression survey score tool (Zamorski et al., 2015). A positive outcome from the psychotropic medication suggests that patient is responding well to the therapy and this provides a valuable understanding of the character dynamics for these clients which guide the decision on medication adjustment or withdrawal.

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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