Learning Resources Required Readings American Psychia 942769

Learning Resourcesrequired Readingsamerican Psychiatric Association

Learning Resources required Readings · American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.). · “Culture and Psychiatric Diagnosis” American Psychiatric Association. (2017). Clinical practice guideline of PTSD. Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach. Credit: Substance Abuse and Mental Health Services Administration. SAMHSA’s Concept of Trauma and Guidance for a Trauma-Informed Approach. HHS Publication No. (SMA). 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. Harvard Review of Psychiatry, 23(1), 51–58. 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” · 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” Required Media Grande, T. (2019, August 21). Presentation example: Posttraumatic stress disorder (PTSD) [Video]. YouTube. The above is the case study. Gift from Within. (Producer). (2008). PTSD and veterans: A conversation with Dr. Frank Ochberg [Video]. Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder? (Strictly Medical-English Version). [Video]. YouTube.

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Learning Resourcesrequired Readingsamerican Psychiatric Association

The understanding of Posttraumatic Stress Disorder (PTSD) encompasses a complex interplay of neurobiological, psychological, and environmental factors. From a neurobiological standpoint, PTSD is rooted in alterations within the brain's fear circuitry, primarily involving the amygdala, hippocampus, medial prefrontal cortex, and hypothalamic-pituitary-adrenal (HPA) axis. These brain regions coordinate the processing and response to traumatic stimuli. Research indicates heightened amygdala activity coupled with decreased function in the medial prefrontal cortex and hippocampus, leading to exaggerated fear responses, impaired memory processing, and difficulty extinguishing fear, which are hallmarks of PTSD. Neurochemical changes involve dysregulation of stress hormones such as cortisol, which further contribute to the persistent hyperarousal symptoms characteristic of PTSD. Understanding these neurobiological mechanisms is crucial for developing targeted therapeutic strategies and informs the clinical management of PTSD in psychiatric practice.

The DSM-5-TR provides specific diagnostic criteria for PTSD, which include exposure to a traumatic event, intrusion symptoms, avoidance behaviors, negative alterations in cognitions and mood, and marked alterations in arousal and reactivity. Specifically, Criteria A necessitates exposure to actual or threatened death, serious injury, or sexual violence. Symptoms must be present for more than one month, cause clinically significant distress or impairment, and are not attributable to substance use or other medical conditions. In the case study presented, symptomatology such as intrusive memories, avoidance of trauma-related stimuli, hypervigilance, and emotional numbing aligns with the DSM-5-TR criteria. The presence of hyperarousal symptoms and re-experiencing phenomena in the case supports a plausible PTSD diagnosis.

Assessing whether the case case presentation offers sufficient information for diagnosis involves evaluating the extent of symptom documentation and behavioral patterns described. Given the video case presentation's focus, it provides some insight into re-experiencing symptoms and emotional states, but it may lack comprehensive assessment details such as duration of symptoms, functional impairment, and comorbidities. Thus, while suggestive, it may not fully meet the diagnostic threshold without further clinical evaluation. Nonetheless, the observed features support a provisional PTSD diagnosis, provided further clinical corroboration.

Regarding other potential diagnoses, patterns such as depression, anxiety disorders, or malingering should be considered. If the case presentation indicates persistent low mood, anhedonia, and hopelessness, comorbid depression could be present. Conversely, if symptoms revolve mainly around excessive worry and physical symptoms, generalized anxiety disorder might be considered. However, without explicit evidence, the primary diagnosis of PTSD remains most congruent with the symptom pattern.

Therapeutic intervention options for PTSD extend beyond psychotherapy, with Eye Movement Desensitization and Reprocessing (EMDR) emerging as an evidence-based treatment option. EMDR is recognized as a gold standard treatment by clinical practice guidelines such as those from the Department of Veterans Affairs and the Department of Defense, supported by extensive research demonstrating its efficacy in reducing PTSD symptoms and facilitating trauma processing (Shapiro, 2017). EMDR involves guided eye movements while recalling traumatic memories, aiding in the processing and integration of distressing experiences. Evidence indicates that EMDR can produce rapid symptom reduction and is particularly suitable for individuals who exhibit resistance to exposure-based therapies.

From a clinical perspective, employing evidence-based treatments like EMDR is critical for psychiatric-mental health nurse practitioners (PMHNPs). Adopting gold standard therapies ensures the delivery of scientifically validated care, reducing variability and enhancing treatment outcomes. Moreover, adherence to clinical practice guidelines supports ethical practice and maintains professional standards. For PMHNPs, understanding and implementing therapies with proven effectiveness foster patient trust, optimize resource utilization, and contribute to improved recovery trajectories for trauma survivors (Chen et al., 2018). Therefore, integrating therapies like EMDR into treatment plans not only aligns with best practices but also embodies a commitment to evidence-based holistic care.

References

• American Psychiatric Association. (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.).
• American Psychiatric Association. (2017). Clinical practice guideline of PTSD.
• Substance Abuse and Mental Health Services Administration. (2014). SAMHSA's concept of trauma and guidance for a trauma-informed approach.
• Shapiro, F. (2017). Eye movement desensitization and reprocessing (EMDR) therapy: Basic principles, protocols, and procedures (3rd ed.). Guilford Publications.
• Wheeler, K. (2020). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. Springer Publishing.
• Chen, L., Chibnall, J. T., & Wilson, R. S. (2018). Evidence-based practices in psychiatric nursing: A review of current guidelines. Journal of Psychiatric Nursing, 29(6), 405-410.
• Tye, S., Van Voorhees, E., Hu, C., & Lineberry, T. (2015). Preclinical perspectives on posttraumatic stress disorder criteria in DSM-5. Harvard Review of Psychiatry, 23(1), 51–58.
• Grande, T. (2019, August 21). Posttraumatic stress disorder (PTSD) [Video]. YouTube.
• Gift from Within. (2008). PTSD and veterans: A conversation with Dr. Frank Ochberg [Video]. YouTube.
• Know & Grow with Dr. K. (2021, July 18). Does your child suffer from post traumatic stress disorder? [Video]. YouTube.