Comprehensive Assessment and Treatment Considerations for PTSD- A Case Study Analysis
Neurobiological Basis of PTSD
Abnormal regulation of thyroid and cortisol hormones are the key features of PTSD. Endocrine dysregulation has been noted in patients with traumatic brain injury due to damaging the pituitary stalk (Maeng & Milad, 2017). The hypothalamic-pituitary-adrenal axis plays a central role in human stress and is the major focus of PTSD. The HPA axis, which consists of the hypothalamus, anterior pituitary, and adrenal glands, releases the corticotropin-releasing hormone, adrenocorticotropin, and glucocorticoids (Maeng & Milad, 2017). Glucocorticoids control metabolism and brain function and thus regulate physiological and behavioral responses to stressors. The neurochemical features of PTSD involve abnormal regulation of serotonin, opioids, peptides, serotonin, and catecholamines. The neurotransmitters are located in brain circuits that integrate responses related to stress and fears (Maeng & Milad, 2017).
DSM-5 Diagnostic Criteria for PTSD
The DSM-V diagnostic criteria have several conditions that must be met to confirm a PTSD diagnosis. The patient must have witnessed or experienced the traumatic event (American Psychiatric Association (APA), 2013). The second criterion is that the patient should have intrusive symptoms after the traumatic events. The intrusive symptoms include dissociation, distressing memories, and recurring dreams (APA, 2013). The next criterion is avoidance of factors related to the trauma, such as avoiding trauma-related memories (APA, 2013). The fourth diagnostic criterion is negative cognition or mood. This alteration is evidenced by not remembering events related to the trauma, negative beliefs, distorted cognitions, anhedonia, and detachment, among others (APA, 2013). The other criterion is an alteration in reactivity related to the traumatic evidence, as evidenced by angry outbursts, sleep issues, hypervigilance, and recklessness, among others (APA, 2013). To meet the diagnostic criteria, the symptoms must be experienced for at least a month, social impairment, and the symptoms should not be caused by other medical conditions (APA, 2013). The information in the video presentation is enough to support PTSD diagnosis. I also agree with the other diagnosis since, according to the DSM-V diagnostic criteria, the patient meets the criteria for the mental disorders present in the video.
Psychotherapy Treatment Option
Prolonged exposure educates PTSD patients to progressively approach trauma-related situations, feelings, and memories. The patients learn that trauma-related feelings are not dangerous and should not be avoided (Hendriks et al., 2018). Prolonged exposure helps patients to confront their fears. Many PTSD patients prefer avoiding trauma-related memories, which leads to the reinforcement of the fear. By facing their fears, they can reduce PTSD symptoms. Prolonged exposure is greatly recommended in PTSD treatment and is hence considered a gold standard. PMNHPS should use evidence-based treatment strategies since this will enhance patient outcomes and improve the quality of care.
The three articles selected in this paper are scholarly. They have been posted in reputable journals. The Affiliations of the authors have been indicated. The language in the articles is professional. In addition to this, the information in these articles has been cited. The articles are peer-reviewed. They are divided into sections, and they are related to the discussion related to PTSD.
References
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.
Bryant, R. A. (2019). Post‐traumatic stress disorder: A state‐of‐the‐art review of evidence and challenges. World Psychiatry, 18(3), 259-269. https://doi.org/10.1002/wps.20656
Hendriks, L., Kleine, R. A., Broekman, T. G., Hendriks, G., & Minnen, A. V. (2018). Intensive, prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts. European Journal of Psychotraumatology, 9(1), 1425574. https://doi.org/10.1080/20008198.2018.1425574