NRNP 6640 Discussion: Posttraumatic Stress Disorder

NRNP 6640 Discussion: Posttraumatic Stress Disorder

NRNP 6640 Discussion Posttraumatic Stress Disorder

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.

NRNP 6640 Discussion: Posttraumatic Stress Disorder 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.

 

NRNP 6640 Discussion: Posttraumatic Stress Disorder 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

It is estimated that more than 6% of the U.S. population will experience posttraumatic stress disorder (PTSD) in their lifetime (National Center for PTSD, 2010). This debilitating disorder often interferes with an individual’s ability to function in daily life. Common symptoms of anxiousness and depression frequently lead to substance abuse issues and even physical ailments. For this Discussion, as you examine the Thompson Family Case Study in this week’s Learning Resources, consider how you might assess and treat clients presenting with PTSD.

Learning Objectives

Students will:

  • Assess clients presenting with posttraumatic stress disorder
  • Analyze therapeutic approaches for treating clients presenting with posttraumatic stress disorder
  • Evaluate outcomes for clients with posttraumatic stress disorder

    NRNP 6640 Discussion Posttraumatic Stress Disorder
    NRNP 6640 Discussion Posttraumatic Stress Disorder

To prepare:

  • Review this week’s Learning Resources and reflect on the insights they provide.
  • View the media Academic Year in Residence: Thompson Family Case Study, and assess the client in the case study.
  • For guidance on assessing the client, refer to pages 137–142 of the Wheeler text in this week’s Learning Resources.

Note:To complete this Discussion, you must assess the client, but you are not required to submit a formal Comprehensive Client Assessment.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click Submit, you cannot delete or edit your own posts, and cannot post anonymously. Please check your post carefully before clicking Submit!

 

By Day 3

Post on or before Day 3 an explanation of your observations of the client William in Thompson Family Case Study, including behaviors that align to the PTSD criteria in DSM-5. Then, explain therapeutic approaches you might use with this client, including psychotropic medications if appropriate. Finally, explain expected outcomes for the client based on these therapeutic approaches. Support your approach with evidence-based literature.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by providing one alternative therapeutic approach. Explain why you suggest this alternative and support your suggestion with evidence-based literature and/or your own experiences with clients.

Submission and Grading Information

NRNP 6640 Discussion: Posttraumatic Stress Disorder Grading Criteria

To access your rubric:

Week 5 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 5 Discussion

Week in Review

Now that you have:

  • Assessed clients presenting with posttraumatic stress disorder
  • Analyzed therapeutic approaches for treating clients presenting with posttraumatic stress disorder
  • Evaluated outcomes for clients with posttraumatic stress disorder

Next week, you will:

  • Assess clients presenting with addictive disorders
  • Analyze therapeutic approaches for treating clients with addictive disorders
  • Evaluate outcomes for clients with addictive disorders
  • Assess knowledge of concepts and principles related to the psychotherapy of individuals

NRNP 6640 Discussion: Posttraumatic Stress Disorder Grading Rubric Guidelines

Performance Category 10 9 8 4 0
Scholarliness

Demonstrates achievement of scholarly inquiry for professional and academic decisions.
  • Provides relevant evidence of scholarly inquiry clearly stating how the evidence informed or changed professional or academic decisions
  • Evaluates literature resources to develop a comprehensive analysis or synthesis.
  • Uses valid, relevant, and reliable outside sources to contribute to the threaded discussion
  • Provides relevant evidence of scholarly inquiry but does not clearly state how the evidence informed or changed professional or academic decisions.
  • Evaluates information from source(s) to develop a coherent analysis or synthesis.
  • Uses some valid, relevant, reliable outside sources to contribute to the threaded discussion.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) with some interpretation/evaluation, but not enough to develop a coherent analysis or synthesis.
  • Little valid, relevant, or reliable outside sources are used to contribute to the threaded discussion.
  • Demonstrates little or no understanding of the topic.
  • Discusses using scholarly inquiry but does not state how scholarly inquiry informed or changed professional or academic decisions.
  • Information is taken from source(s) without any interpretation/evaluation.
  • The posting uses information that is not valid, relevant, or reliable
  • No evidence of the use of scholarly inquiry to inform or change professional or academic decisions.
  • Information is not valid, relevant, or reliable
Performance Category  10 9 8 4 0
Application of Course Knowledge –

Demonstrate the ability to analyze, synthesize, and/or apply principles and concepts learned in the course lesson and outside readings and relate them to real-life professional situations
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources;
  • Applies concepts to personal experience in the professional setting and or relevant application to real life.
  • Posts make direct reference to concepts discussed in the lesson or drawn from relevant outside sources.
  • Applies concepts to personal experience in their professional setting and or relevant application to real life
  • Interactions with classmates are relevant to the discussion topic but do not make direct reference to lesson content
  • Posts are generally on topic but do not build knowledge by incorporating concepts and principles from the lesson.
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Does not demonstrate a solid understanding of the principles and concepts presented in the lesson
  • Posts do not adequately address the question posed either by the discussion prompt or the instructor’s launch post.
  • Posts are superficial and do not reflect an understanding of the lesson content
  • Does not attempt to apply lesson concepts to personal experience in their professional setting and or relevant application to real life
  • Posts are not related to the topics provided by the discussion prompt or by the instructor; attempts by the instructor to redirect the student are ignored
  • No discussion of lesson concepts to personal experience in the professional setting and or relevant application to real life
Performance Category  5 4 3 2 0
Interactive Dialogue

Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days.

(5 points possible per graded thread)
  • Exceeds minimum post requirements
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts three or more times in each graded thread, over three separate days.
  • Replies to a post posed by faculty and to a peer
  • Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Replies to each graded thread topic posted by the course instructor, by Wednesday, 11:59 p.m. MT, of each week, and posts a minimum of two times in each graded thread, on separate days
  • Replies to a question posed by a peer

Summarizes what was learned from the lesson, readings, and other student posts for the week.
  • Meets expectations of 2 posts on 2 different days.
  • The main post is not made by the Wednesday deadline
  • Does not reply to a question posed by a peer or faculty
  • Has only one post for the week
  • Discussion posts contain few, if any, new ideas or applications; often are a rehashing or summary of other students’ comments
  • Does not post to the thread
  • No connections are made to the topic
  Minus 1 Point Minus 2 Point Minus 3 Point Minus 4 Point Minus 5 Point
Grammar, Syntax, APA

Note: if there are only a few errors in these criteria, please note this for the student in as an area for improvement. If the student does not make the needed corrections in upcoming weeks, then points should be deducted.

Points deducted for improper grammar, syntax and APA style of writing.

The source of information is the APA Manual 6th Edition
  • 2-3 errors in APA format.
  • Written responses have 2-3 grammatical, spelling, and punctuation errors.
  • Writing style is generally clear, focused, and facilitates communication.
  • 4-5 errors in APA format.
  • Writing responses have 4-5 grammatical, spelling and punctuation errors.
  • Writing style is somewhat focused.
  • 6-7 errors in APA format.
  • Writing responses have 6-7 grammatical, spelling and punctuation errors.
  • Writing style is slightly focused making discussion difficult to understand.
  • 8-10 errors in APA format.
  • Writing responses have 8-10 grammatical, spelling and punctuation errors.
  • Writing style is not focused, making discussion difficult to understand.
  • Post contains greater than 10 errors in APA format.
  • Written responses have more than 10 grammatical, spelling and punctuation errors.
  • Writing style does not facilitate communication.
  • The student continues to make repeated mistakes in any of the above areas after written correction by the instructor
0 points lost       -5 points lost
Total Participation Requirements

per discussion thread

 The student answers the threaded discussion question or topic on one day and posts a second response on another day. The student does not meet the minimum requirement of two postings on two different days
Early Participation Requirement

per discussion thread

 The student must provide a substantive answer to the graded discussion question(s) or topic(s), posted by the course instructor (not a response to a peer), by Wednesday, 11:59 p.m. MT of each week. The student does not meet the requirement of a substantive response to the stated question or topic by Wednesday at 11:59 pm MT.