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2 Post-Traumatic Stress Disorder Case Study Post-traumatic stress disorder (PTSD) is normally experienced by individuals who have been exposed to a traumatic event such as brutal personal assaults, terroristic attacks, severe accidents, or cataclysms. 3 Some of the symptoms characterizing PTSD are negative thoughts, avoiding behaviors, intrusive thoughts, and hyperarousal symptoms like hypervigilance, sleep disorders, and irritability, which may result in impairments in numerous cognitive domains such as attention, memory, and autonomic arousal (Dossi et al., 2020). 4 In this regard, PTSD’s symptoms and signs usually appear to reflect an abnormal and persistent adaptation of neurobiological systems towards the stress associated with the traumatic event experienced. According to Watkins, Sprang & Rothbaum (2018), the neurobiological systems that help in regulating stress responses include specific neurotransmitter and endocrine pathways and brain region’s network whose function is regulating fear behavior at conscious as well as unconscious levels. In addition, recent research by Dossi et al. (2020) has linked neurobiological changes among PTSD patients to such clinical features as altered extinction/learning, intermittent dissociative behavior, and heightened arousal.
DSM-5 defines PTSD as a psychiatric disorder occurring among individuals who experience a traumatic event such as a brutal personal assault, terroristic attack, or severe accident (Watkins, Sprang & Rothbaum, 2018). According to Pai, Suris & North (2017), the DSM-5 criteria for PTSD includes: 5 exposure to threatened or actual death, sexual violence or serious injury; 6 presence of intrusion symptoms related to traumatic events such as distressing memories, recurrent distressing dreams, dissociative reactions like flashbacks, prolonged or intense psychological distress, or psychological reactions to cues that symbolize the traumatic event; persistent avoidance to stimuli related to the traumatic experience; 3 negative alterations in mood and cognitions related to the traumatic event; market changes in reactivity and arousal associated with the traumatic event; duration of the above experiences exceeding one month; 7 disturbance causing clinically significant impairment or distress in such areas of functioning as occupational and social aspects; and disturbance that cannot be attributed to physiological impact of a medical condition or substance use.
3 After an analysis of the symptomatology presented in the case study and comparing it with the DSM-5 criteria for PTSD, it may be argued that the case presentation provides sufficient information to derive a PTSD diagnosis. For instance, Joe would become very anxious when presented with anything that would remind him of the accident, the stretch of road that the accident occurred, the type of car that hit them, and news about the incident. In addition, he experienced difficulties in falling asleep, had a lot of nightmares, became physically aggressive at home and school, would even have outbursts in class, and even had fights with older siblings at home.
8 The psychotherapy treatment for Joe is prolonged exposure, which is effective in treating PTSD. According to Watkins, Sprang & Rothbaum (2018), prolonged exposure seeks to alter fear structures among patients such that they are not problematic anymore. Prolonged exposure involved psychoeducation regarding PTSD as well as other common responses to trauma, breathing retraining, as well as imaginal exposure and in vivo exposure. Imaginal exposure is associated with clients approaching emotions, thoughts, and memories related the traumatic event while in vivo exposure helps clients in approaching people, places, and situations that tend to avoid due to the traumatic event (Pai, Suris & North, 2017). Notably, personal exposure may be considered to be the “gold standard treatment” from a clinical perspective. 9 Gold standard, evidence-based treatments from clinical practice guidelines are instrucmental in psychiatric-mental health nurse practitioners as they are able to separate one mental condition from another, thus choosing the best course of treatment action.