NRNP 6635 Assignment: Posttraumatic Stress Disorder
Walden University NRNP 6635 Assignment: Posttraumatic Stress Disorder-Step-By-Step Guide
This guide will demonstrate how to complete the Walden University NRNP 6635 Assignment: Posttraumatic Stress Disorder assignment based on general principles of academic writing. Here, we will show you the A, B, Cs of completing an academic paper, irrespective of the instructions. After guiding you through what to do, the guide will leave one or two sample essays at the end to highlight the various sections discussed below.
How to Research and Prepare for NRNP 6635 Assignment: Posttraumatic Stress Disorder
Whether one passes or fails an academic assignment such as the Walden University NRNP 6635 Assignment: Posttraumatic Stress Disorder depends on the preparation done beforehand. The first thing to do once you receive an assignment is to quickly skim through the requirements. Once that is done, start going through the instructions one by one to clearly understand what the instructor wants. The most important thing here is to understand the required format—whether it is APA, MLA, Chicago, etc.
After understanding the requirements of the paper, the next phase is to gather relevant materials. The first place to start the research process is the weekly resources. Go through the resources provided in the instructions to determine which ones fit the assignment. After reviewing the provided resources, use the university library to search for additional resources. After gathering sufficient and necessary resources, you are now ready to start drafting your paper.
How to Write the Introduction for NRNP 6635 Assignment: Posttraumatic Stress Disorder
The introduction for the Walden University NRNP 6635 Assignment: Posttraumatic Stress Disorder is where you tell the instructor what your paper will encompass. In three to four statements, highlight the important points that will form the basis of your paper. Here, you can include statistics to show the importance of the topic you will be discussing. At the end of the introduction, write a clear purpose statement outlining what exactly will be contained in the paper. This statement will start with “The purpose of this paper…” and then proceed to outline the various sections of the instructions.
How to Write the Body for NRNP 6635 Assignment: Posttraumatic Stress Disorder
After the introduction, move into the main part of the NRNP 6635 Assignment: Posttraumatic Stress Disorder assignment, which is the body. Given that the paper you will be writing is not experimental, the way you organize the headings and subheadings of your paper is critically important. In some cases, you might have to use more subheadings to properly organize the assignment. The organization will depend on the rubric provided. Carefully examine the rubric, as it will contain all the detailed requirements of the assignment. Sometimes, the rubric will have information that the normal instructions lack.
Another important factor to consider at this point is how to do citations. In-text citations are fundamental as they support the arguments and points you make in the paper. At this point, the resources gathered at the beginning will come in handy. Integrating the ideas of the authors with your own will ensure that you produce a comprehensive paper. Also, follow the given citation format. In most cases, APA 7 is the preferred format for nursing assignments.
How to Write the Conclusion for NRNP 6635 Assignment: Posttraumatic Stress Disorder
After completing the main sections, write the conclusion of your paper. The conclusion is a summary of the main points you made in your paper. However, you need to rewrite the points and not simply copy and paste them. By restating the points from each subheading, you will provide a nuanced overview of the assignment to the reader.
How to Format the References List for NRNP 6635 Assignment: Posttraumatic Stress Disorder
The very last part of your paper involves listing the sources used in your paper. These sources should be listed in alphabetical order and double-spaced. Additionally, use a hanging indent for each source that appears in this list. Lastly, only the sources cited within the body of the paper should appear here.
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Sample Answer for NRNP 6635 Assignment: Posttraumatic Stress Disorder
The media ‘Presentation Example: Posttraumatic Stress Disorder (PTSD)’ demonstrates a case presentation of an eight-year-old boy who was involved in a minor motor vehicle accident with his father. The patient was not injured. However, his father sustained a minor injury to his knee. The driver of the other vehicle involved in the accident however threatened the patient’s father, following him in a pursuit to the point that the patient’s father had to call the police. The patient displayed avoidance behavior of the stimuli, sleeping problems, nightmares, physical aggression, outburst in the middle of class at school, dangerous behaviors frightening others, and fighting. The patient was diagnosed with PTSD in addition to comorbidities such as ODD, CD, MDD, ADHD, SAD, and phobia for spiders. The purpose of this paper is to analyze the process of diagnosis and management of PTSD as demonstrated in the provided media, in addition to the neurological basis involved with the development of this mental disorder.
Neurobiological Basis for PTSD
The neurobiology of PTSD is a complex process involving the neurochemical, neuroanatomical, and neuroendocrine changes in the neural pathways. Regarding the neuroendocrine features, the hypothalamic-pituitary-adrenal axis (HPA) is considered the central coordinator of the response mechanism of individuals to stress (Dunlop & Wong, 2019). Cortisol, a stress hormone, on the other hand, exerts negative feedback on the HPA. The hormone also reduces the noradrenergic stress response. As such, a sustained release of cortisol as a result of PTSD leads to adverse effects on the brain, especially the hippocampal neurons, leading to impaired neuroplasticity and neurogenesis (Jaworska-Andryszewska& Rybakowski,2019). Neurochemical features such as noradrenaline, serotonin, and dopamine are also associated with stress responses contributing to PTSD symptoms.
DSM-5 Diagnostic Criteria for PTSD
According to the DSM-V diagnostic criteria, the patient requires to be exposed to a
traumatic experience
which in this case was a minor motor vehicle accident. He also needs to display at least one intrusion symptom such as nightmares, recurrent memories, and flashbacks, for the past one month (Grant et al., 2020). At least one persistent avoidance symptom and two negative alterations in mood and cognition such as inability to recall key features and persistent negative beliefs are also required. Alteration in reactivity and arousal by displaying reckless behavior and hyper-vigilance has also been reported in the case study. Lastly, the presenting symptoms must have a functional significance on the patient’s psychological and social life. The video provides an adequate amount of information necessary to support the diagnosis of PTSD as demonstrated above.
The other diagnoses such as ODD, CD, MDD, and SAD which were made after the accident are quite ambiguous since most of these disorders display the same symptoms as PTHD and should have not been considered as comorbidities during this time (Miao et al., 2018). However, ADHD and phobia for spiders were diagnosed before the incidence, hence the psychiatrist must have had adequate reasons to support these diagnoses.
Psychotherapy Treatment Option
Other than CBT, I would consider the use of prolonged exposure (PE) therapy which is recommended as first-line therapy for PTSD in most clinical practice guidelines (Bastien et al., 2020). PE is a gold standard treatment approach for PTSD as it has been subjected to several clinical trials reporting great effectiveness in managing PTSD symptoms even among complex and comorbid patients. PE mainly entails psychoeducation, imaginal exposure, in vivo exposure, and emotional processing.
Conclusion
The media presentation demonstrates the relevance of adopting the appropriate psychiatric practice in diagnosing and managing patients with mental health problems. The patient described in the video was poorly diagnosed with several comorbidities, which complicated the choice of treatment. However, with PTSD as the primary diagnosis, the patient could benefit greatly from PE therapy.
References
Bastien, R. J. B., Jongsma, H. E., Kabadayi, M., & Billings, J. (2020). The effectiveness of psychological interventions for post-traumatic stress disorder in children, adolescents, and young adults: a systematic review and meta-analysis. Psychological Medicine, 50(10), 1598-1612. https://doi.org/10.1017/S0033291720002007
Dunlop, B. W., & Wong, A. (2019). The hypothalamic-pituitary-adrenal axis in PTSD: Pathophysiology and treatment interventions. Progress in neuro-psychopharmacology and biological psychiatry, 89, 361-379. https://doi.org/10.1016/j.pnpbp.2018.10.010
Grant, B. R., O’Loughlin, K., Holbrook, H. M., Althoff, R. R., Kearney, C., Perepletchikova, F., … & Kaufman, J. (2020). A multi-method and multi-informant approach to assessing post-traumatic stress disorder (PTSD) in children. International Review of Psychiatry, 32(3), 212-220. https://doi.org/10.1080/09540261.2019.1697212
Jaworska-Andryszewska, P., & Rybakowski, J. K. (2019). Childhood trauma in mood disorders: neurobiological mechanisms and implications for treatment. Pharmacological Reports, 71(1), 112-120.DOI: 10.1016/j.pharep.2018.10.004.
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), 1-7. https://doi.org/10.1186/s40779-018-0179-0
Sample Answer 2 for NRNP 6635 Assignment: Posttraumatic Stress Disorder
Post-Traumatic Stress Disorder (PTSD) refers to a psychiatriccondition which follows encounter with a terrifying event like violence, sexual assault, natural calamities. PTSD is associated with several neurobiological changes that usually alters one’s brain functioning leading to re-experiencing, avoidance arousal, cognition and mood symptoms. The paper aims to expound on the evaluation and management of patients with PTSD.
Neurobiological Basis for PTSD Illness
The neurobiological basis for PTSD is complex and not yet fully understood. However, research has shown that PTSD can be associated with alterations in structural and functioning in the prefrontal cortex, and other parts of the cortex such as the amygdala. The prefrontal cortex regulates emotions, thoughts, and behaviors, and changes in this area may contribute to PTSD symptoms such as hypervigilance and difficulty controlling emotions. The amygdala is involved in processing emotions and threat detection, and alterations in this area may contribute to hyperarousal symptoms in PTSD. The hippocampus is responsible for memory consolidation, and changes in this area may contribute to intrusive memories and flashbacks in PTSD. Additionally, research has shown that chronic stress, such as that experienced by individuals with PTSD, can lead to dysregulation of the hypothalamus associated with the body’s stress response. These changes may contribute to alterations in arousal and reactivity seen in PTSD.
Criteria forDiagnosis of PTSD
The DSM-5 (APA, 2013) diagnostic criteria for PTSD involves exposure to a terrifying experience, intrusive symptoms, avoidance symptoms, negative changes in cognition and mood, and alterations in arousal and reactivity. It requires the individual to either have experienced a death threat, physical injury, or offensive sexual advance through direct experience or learning about the dreadful event occurring in a loved one (Sherin et al., 2022). The patient must also experience at least one intrusive symptom, such as distressing memories, nightmares, or flashbacks. They also portray avoidance behavior, like avoiding memories of the traumatic event or the thoughts.
The case presented in the video meets the criteria for PTSD diagnosis. Joe was involved in a minor motor vehicle accident with his father, although he did not sustain injuries, and his father had a minor bruise on his knee which did not warrant treatment, the event that followed triggered the illness on Joe. He felt frightened when the guy who hit them started chasing them while threatening his father. Joe is reported to be experiencing intrusive symptoms such as nightmares and aggressive behavior at school and home. He also has trouble sleeping and has anxiety (Shiavone et al., 2018). Furthermore, Joe has negative alterations in cognition and mood; he has negative feelings that he should not be away from his father since something dreadful might happen to his father. He also has hyperarousal and poor memory of the accident and the following events, which he does not want to discuss.
I disagree with the diagnoses of Major Depressive Disorder, ADHD, ODD, conduct disorder, and Separate anxiety disorder. However, I agree with Specific Phobia, portrayed by his extreme fear of spiders. For MDD, he does not have a depressed mood, a loss of interest in pleasurable activities, or difficulty concentrating, though he has trouble sleeping (Barbano et al., 2019). For ADHD, he has no hyperactivity or impulsiveness, which have interfered with normal functioning.
Treatment of PTSD
Another treatment option for Joe is Eye Movement Desensitization and Reprocessing (EMDR), as ithelps patients negate the traumatic event and reduce their emotional distress. EMDR also involves identifying negative beliefs associated with the traumatic event and replacing them with more positive beliefs (Kuijpers et al., 2020).EMDR is considered the treatment of choicefor PTSD. EMDR is recommended by the American Psychiatric Association, and the World Health Organization as an effective psychotherapy for PTSD.By using evidence-based treatments, PMHNPs can be confident that they provide their patients with the most effective treatments. This is important not only for the patient’s recovery but also for the credibility and reputation of the PMHNP.
Conclusion
PTSD is a mental disorder that may arise after an individual experiences or witnesses a terrifying event like violence, sexual abuse, or a natural disaster. Structurally, it is associated with changes in the brain in areas associated with memory, emotional regulation, and fear processing. Psychotherapy with modalities such as trauma-focused therapy, EMDR, and behavioral activations form the gold standard for management of the condition. A better response is reported with other psychotherapies such as trauma-focused cognitive therapy.
References
Barbano, A. C., Der Mei, W. F., deRoon‐Cassini, T. A., Grauer, E., Lowe, S. R., Matsuoka, Y. J., O’Donnell, M., Olff, M., Qi, W., Ratanatharathorn, A., Schnyder, U., Seedat, S., Kessler, R. C., Koenen, K. C., Shalev, A. Y., & the International Consortium to Prevent PTSD. (2019). Differentiating PTSD from anxiety and depression: Lessons from the ICD‐11 PTSD diagnostic criteria. Depression and Anxiety, 36(6), 490–498. https://doi.org/10.1002/da.22881
Boyd, J. E., Lanius, R. A., & McKinnon, M. C. (2018). Mindfulness-based treatments for posttraumatic stress disorder: A review of the treatment literature and neurobiological evidence. Journal of Psychiatry & Neuroscience, 43(1), 7–25. https://doi.org/10.1503/jpn.170021
Cuijpers, P., Veen, S. C. V., Sijbrandij, M., Yoder, W., & Cristea, I. A. (2020). Eye movement desensitization and reprocessing for mental health problems: A systematic review and meta-analysis. Cognitive Behaviour Therapy, 49(3), 165–180. https://doi.org/10.1080/16506073.2019.1703801
Schiavone, F. L., Frewen, P., McKinnon, M., & Lanius, R. A. (2018). The dissociative subtype of PTSD: an update of the literature. PTSD Research Quarterly, 29(3), 1-13.
Sherin, J. E., & Nemeroff, C. B. (2022). Posttraumatic stress disorder: the neurobiological impact of psychological trauma. Dialogues in clinical neuroscience. https://doi.org/10.31887/DCNS.2011.13.2/jsherin
Sample Answer 3 for NRNP 6635 Assignment: Posttraumatic Stress Disorder
Post-traumatic stress disorder (PTSD) is one of the most common anxiety disorders characterized by anxiousness and restlessness. PTSD commonly occurs when an individual witnesses or experiences a traumatic event. The purpose of this paper is to describe the neurobiological basis of PTSD, review a case study and diagnostic criteria, and a psychotherapeutic treatment.
Neurobiological Basis of PTSD
Psychological stressors have been noted to induce neuronal remodeling and regional reductions and increases in synaptic density in several regions of the brain that affect mood and behavior. For example, a single stressor can up regulate brain-derived neurotrophic factor (BDNF) and increase synaptogenesis in the basolateral amygdala, resulting in anxiety (Toledo et al., 2022). Additionally, stress causes an increase in cortisol, resulting in increased basolateral amygdala hypertrophy and anxiety. In some instances, synaptic loss in the hippocampus and prefrontal cortex and down regulation of BDNF has been associated with behavioral disturbances. Furthermore, prolonged stress exposure has been associated with a reduced uptake of glutamate at the receptors leading to increased extracellular glutamate and excitotoxicity. The excitotoxicity in the receptors has been seen to precipitate neuronal atrophy and reduce the dendritic length, synaptic density and neurotransmission strength, causing behavioral abnormalities such as mood and anxiety dysregulation.
DSM-V Diagnostic Criteria
DSM-V criteria diagnosis of PTSD includes many entities related to direct or indirect exposure to the traumatic event. The entities include one intrusive symptom, including distressing memories or dreams and flashbacks (Schrader et al., 2021). The diagnosis also includes avoidance symptoms of the traumatic event. In addition, the patient may have symptoms related to negative alterations to cognition or mood related to the trauma, such as amnesia, persistent negative emotional state and anhedonia. Furthermore, patients can experience alterations in arousal and reactivity, such as irritability, anger outbursts, recklessness, hypervigilance, problems with concentration, and sleep disturbance (Al Jowf et al., 2022).According to the video, Joe meets the DSM-V criteria for PTSD diagnosis. Joe was directly exposed to the event, and since then, he has been having intrusive memories, trouble sleeping, nightmares, avoidance symptoms, anger outbursts, and anxiety whenever the street or car involved is mentioned.
Other diagnoses given after the event include conduct, oppositional defiant, major depression, and separation anxiety disorders. I would agree with conduct disorder, as Joe has become physically violent and hostile both at school and at home (Al Zomia et al., 2023). I would also agree with the diagnosis of separation anxiety disorder, as Joe has been experiencing nightmares about the event, as well as feeling the need to sleep with his father. The reaction would be due to fear of losing his only remaining parent. However, the diagnosis of oppositional defiant disorder may be inaccurate as Joe’s irritability and mood symptoms may have been a result of PTSD or previously diagnosed attention deficit hyperactive disorder (Burke et al., 2022). In addition, Joe does not meet the diagnostic criterion of major depression as he has not had a depressed mood, weight changes, or fatigue, among other depression symptoms.
Psychotherapy for PTSD
Another form of psychotherapy for PTSD includes Cognitive Processing Therapy (CPT). It focuses on how the traumatic event happened and the patient’s coping mechanisms (Moring et al., 2020).The cognitive therapy techniques utilized focus on faulty thoughts related to traumatic events and involve the patient’s need to identify and analyze emotions related to the trauma as well as identify thoughts that are preventing recovery. After identifying the thoughts that prevent recovery, the stuck points, the patients are engaged in a cognitive process where the therapists help them address the stuck points by having them gather evidence for and against those thoughts as a road to recovery. However, trauma-focused cognitive behavioral therapy (CBT) is the goal standard treatment option for PTSD (Schrader et al., 2021). It is crucial to use goal-standard treatment as it reflects evidence-based practices from research to ensure patients receive the most effective interventions that have positive outcomes, thus minimizing the risks of poor outcomes.
Conclusion
PTSD is one of the most common anxiety disorders that follow exposure to a traumatic event. DSM-V diagnosis of PTSD includes avoidance, intrusive, and arousal symptoms, amongst others. The mainstay treatment for PTSD is trauma-focused CBT, as it has shown better results amongst PTSD patients.
References
Al Jowf, G. I., Ahmed, Z. T., An, N., Reijnders, R. A., Ambrosino, E., Rutten, B. P. F., de Nijs, L., & Eijssen, L. M. T. (2022). A public health perspective of post-traumatic stress disorder. International Journal of Environmental Research And Public Health, 19(11), 6474. https://doi.org/10.3390/ijerph19116474
Al Zomia, A. S., Alqarni, M. M., Alaskari, A. A., Al Qaed, A., Alqarni, A. M., Muqbil, A. M., Alshehri, D. M., Lahiq, L. A., Alhifthi, M. A., & Alshahrani, Y. (2023). Child anxiety, depression, and post-traumatic stress disorder following orthopedic trauma. Cureus, 15(7), e42140. https://doi.org/10.7759/cureus.42140
Burke, J. D., Evans, S. C., & Carlson, G. A. (2022). Debate: Oppositional defiant disorder is a real disorder. Child And Adolescent Mental Health, 27(3), 297–299. https://doi.org/10.1111/camh.12588
Moring, J. C., Dondanville, K. A., Fina, B. A., Hassija, C., Chard, K., Monson, C., LoSavio, S. T., Wells, S. Y., Morland, L. A., Kaysen, D., Galovski, T. E., & Resick, P. A. (2020). Cognitive Processing Therapy for Post-traumatic Stress disorder via telehealth: Practical considerations during the COVID-19 Pandemic. Journal Of Traumatic Stress, 33(4), 371–379. https://doi.org/10.1002/jts.22544
Schrader, C., & Ross, A. (2021). A review of PTSD and current treatment strategies. Missouri Medicine, 118(6), 546–551.
Toledo, F., & Carson, F. (2022). Neurobiological features of post-traumatic stress disorder (PTSD) and their role in understanding adaptive behavior and stress resilience. International Journal of Environmental Research And Public Health, 19(16), 10258. https://doi.org/10.3390/ijerph191610258
Sample Answer 4 for NRNP 6635 Assignment: Posttraumatic Stress Disorder
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.
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.
References
Moskowitz, A., Dorahy, M. J., & Schäfer, I. (Eds.). (2019). Psychosis, Trauma, and Dissociation: Evolving Perspectives on Severe Psychopathology. New Jersey, NJ: Wiley-Blackwell.
Sareen, J. (2014). Posttraumatic stress disorder in adults: impact, comorbidity, risk factors, and treatment. The Canadian Journal of Psychiatry, 59(9), 460-467. Doi: 10.1177/070674371405900902
Zamorski, M. A., Rolland-Harris, E., Jetly, R., Downes, A., Whitehead, J., Thompson, J., & Pedlar, D. (2015). Military deployments, posttraumatic stress disorder, and suicide risk in Canadian Armed Forces personnel and veterans. The Canadian Journal of Psychiatry, 60(4), 200-200.doi:10.1177/070674371506000407