Week 9 Assignment NRNP 6645
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.
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.
Learning Resources
• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders Links to an external site. (5th ed., text rev.). https://go.openathens.net/redirector/waldenu.edu?url=https://dsm.psychiatryonline.org/doi/book/10.1176/appi.books.9780890425787
o “Culture and Psychiatric Diagnosis”
• American Psychiatric Association. (2017). Clinical practice guideline of PTSD Links to an external site.. 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 Download 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 Download 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.
o Chapter 3, “Assessment and Diagnosis” (Previously read in Week 2)
o Chapter 7, “Eye Movement Desensitization and Reprocessing Therapy”
o Chapter 11, “Trauma Resiliency Model Therapy”
o Chapter 15, “Trauma-Informed Medication Management”
o Chapter 17, “Stabilization for Trauma and Dissociation”
o Chapter 18, “Dialectical Behavior Therapy for Complex Trauma”
• Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD) Links to an external site.[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 Links to an external site.[Video]. https://go.openathens.net/redirector/waldenu.edu?url=https://video.alexanderstreet.com/watch/ptsd-and-veterans-a-conversation-with-dr-frank-ochberg
• Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder? Links to an external site.(Strictly Medical-English Version). [Video]. YouTube. https://www.youtube.com/watch?v=o98ilXH5gto
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PTSD, or Posttraumatic Stress Disorder, is a mental illness that is characterized by the development of symptoms such as re-experiencing the traumatic event, avoidance of reminders of the event, negative changes in mood and cognition, and increased arousal and reactivity after experiencing or witnessing a traumatic event. The neurobiological basis for PTSD includes changes in the hippocampus, the amygdala, and the prefrontal cortex, which are all regions of the brain involved in the processing and regulation of emotions, memories, and stress responses.
According to the DSM-5-TR, the diagnostic criteria for PTSD include the following: exposure to actual or threatened death, serious injury, or sexual violence; the presence of at least one intrusion symptom (such as recurrent and distressing memories, nightmares, or flashbacks); at least one avoidance symptom (such as avoidance of reminders of the trauma, emotional numbing, or dissociation); at least two negative alterations in cognitions and mood (such as negative beliefs about oneself or the world, distorted blame of self or others, and persistent negative emotional states); and at least two hyperarousal symptoms (such as irritability, hypervigilance, or exaggerated startle response).
The video case presentation provides sufficient information to suggest that the client meets the criteria for PTSD. The client describes symptoms of re-experiencing the traumatic event, such as nightmares and flashbacks, avoidance of reminders of the event, emotional numbing, negative changes in mood and cognition, and increased arousal and reactivity. The client also meets criteria for depression and alcohol use disorder, which are common comorbid conditions in PTSD.
One other psychotherapy treatment option for the client in this case study could be Eye Movement Desensitization and Reprocessing (EMDR) therapy. EMDR is a form of psychotherapy that uses bilateral stimulation (such as eye movements, taps, or tones) to facilitate the processing of traumatic memories and reduce the emotional distress associated with them. EMDR is considered a “gold standard treatment” from a clinical practice guideline perspective, as it has been found to be effective in treating PTSD in multiple randomized controlled trials and has been recommended as a first-line treatment for PTSD by several national and international guidelines.
Using gold standard, evidence-based treatments from clinical practice guidelines is important for psychiatric-mental health nurse practitioners because it ensures that the treatment being provided is supported by the best available evidence and has been shown to be effective in treating the specific condition. This helps to ensure that the client receives the most appropriate and effective treatment, which can lead to better outcomes and a reduction in the risk of harm.
