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.
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.
Ø Does the video case presentation provide sufficient information to derive a PTSD diagnosis?
Ø Justify your reasoning.
Ø Do you agree with the other diagnoses in the case presentation?
Ø Why or why not?
Ø Discuss one other psychotherapy treatment option for the client in this case study.
Ø 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.
Ø Support your approach with specific examples from this week’s media.
Support your response with specific examples from this week’s media.
At least three peer-reviewed, evidence-based sources.
Explain why each of your supporting sources is considered scholarly. Attach the PDFs of your sources.
Note: The School of Nursing requires that all papers submitted include a title page, introduction, summary, and references.
Wheeler, K. (Ed.). (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing.
Chapter 3, “Assessment and Diagnosis” (Previously read in Week 2)
Chapter 7, “Eye Movement Desensitization and Reprocessing Therapy”
Chapter 11, “Trauma Resiliency Model Therapy”
Chapter 15, “Trauma-Informed Medication Management”
Chapter 17, “Stabilization for Trauma and Dissociation”
Chapter 18, “Dialectical Behavior Therapy for Complex Trauma”
Post-traumatic stress, Neurobiology of PTSD, Treatment of PTSD
Traumatic events accompany our everyday life in the form subjective painful losses and wounding: It may be the loss of a home pet, the loss of a job, robbery, a car accident, natural disasters, severe illness, the death of a beloved person, emotional neglect and abuse, betrayal, bullying, sexual abuse, rape, an earthquake, war, a terrorist attack. According to statistics one out of two persons will be exposed to a life-threatening event during lifetime.
Some of them will be able to overcome this experience; some will be severely affected in the long term. Relevant studies indicate that about 7% of Americans have a prevalence to develop a Post-Traumatic Stress Disorder (PTSD) at some point of their lives. According to statistical data men are more often exposed to traumatic events than women, but women are more likely to suffer from a PTSD disorder. Respective data for Greece are at this time not available.
Nevertheless, the refugees’ crisis we are facing as a hosting country arises the issue of PTSD to a first line social problem that we have to face in terms of policy measures and treatment options. How can Neurobiology contribute to the understanding of what happens in body and mind of a person suffering from PTSD?
Can neurobiological findings reveal a new perspective in the treatment of PTSD beyond pharmacotherapy and classical psychotherapeutic approaches that might contribute to develop effective psychotherapeutic interventions? What does the experience of PTSD mean for the offspring of PTSD sufferers?
From a traumatic experience to PTSD
Extreme stressful situations in life are addressed by an instinctive “fight or flight” response in order to assure survival. Alerting sensory environmental information reaches the brain and enters the amygdala, the operation center of the brain in the case of extreme stressful situations that is responsible for the activation of the hypothalamic – pituitary adrenal axis (HPA) and the sympathetic nervous system (SNS).
This activation produces multiple effects in body and mind in order for the individual to cope with the stressors. Via the SNS system the adrenal glands release hormones called catecholamines into the blood causing increased blood pressure, glucose levels and heart rate in order to support the body to “fight or fly”. At the same time the hypothalamus, when stimulated releases neuropeptides that lead to the discharge of cortisol that binds the glucocorticoid receptors in the brain and reduces stress responses
. Usually the stress response function contributes to the adaptation to threat and restores the homeostasis of the organism with an extinction of these reactions when stimuli are not present any more. Traumatic experiences are triggered by perceived overwhelming danger and are accompanied by intense feelings of fear, horror and helplessness. Such situations may lead to a dysregulation of the described underlying biological stress mechanisms known as the “fear circuitry” leading to stress related symptoms like PTSD. The state of chemical dysregulation is also named “allostatic load” .
If a person is able to recover after a traumatic event or this event becomes disruptive and destructive for his life even though the threat has passed, depends on several external and internal factors, the later also known as “neurobiological markers for PTSD”.
The nature, severity, duration and recurrence of traumatization as well as the persons’ own heredity, childhood, medical history and resilience are decisive on his/ her ability to process physiologically and psychologically the experience. Processing and interpreting the event in a meaningful manner have an impact on whether the experience can be integrated by the person in his/her narrative or whether it causes great physiological and psychological damage.
Developmental trauma is one of the most important risk factors for PTSD. In the present study, it will not be addressed in detail, although we are aware of the fact that it’s occurrence in childhood leads to deficient organization and enduring dis-function of the right hemisphere in regulatory issues and to disorganized or broken attachment bonds.
For the purpose of this study we consider it a fact that early developmental trauma leads to maladaptive infant health that decreases its resilience and resources and increases the probability of developing PTSD as a maladaptive coping mechanism in adult life .
In the following we will focus on PTSD as a possible long term response to extreme traumatic experiences with devastating functional impairment and will search for the underlying neurobiological processes.