Introduction
In general, the neurobiology of posttraumatic stress disorder (PTSD) may be regarded as a complex process that includes neurochemical, neuroanatomical, and neuroendocrine changes. The hypothalamus, responsible for the stress response, secretes corticotropin-releasing hormone that stimulates the production of adrenocorticotropin hormone and glucocorticoids from the adrenal glands. In PTSD, glucocorticoid signaling that ensures the smoothness of stress response is dysregulated (Quinones et al., 2020). As a result, a low level of cortisol may contribute to the development of PTSD if trauma occurs.
DSM-5-TR Diagnostic Criteria for PTSD
According to the Diagnostic and Statistical Manual of Mental Disorders-5th Edition-Text Revision (DSM-5-TR), there are several criteria for PTSD. They include direct or indirect exposure to stressors, intrusion symptoms, the persistent avoidance of trauma-related stressors, negative alterations in mood and the development of mental health comorbidities, aggression, and self-destructive behavior, the duration for not less than one month, and the risk of functional, psychological, and social impairment in the future (Watkins et al., 2018). In general, the majority of these criteria relate to Joe’s symptomology and support the presence of PTSD in his case. In addition, the video case presentation provides sufficient information to derive a PTSD diagnosis on the basis of described symptoms.
First of all, an 8-year-old boy was directly involved in a traumatic event, a minor road accident. After that, he developed intrusive memories, anxiety related to any reminders of road accidents, sleep issues, and nightmares (Dr. Todd Grande, 2020). In addition, he started to demonstrate highly aggressive behavior in school and at home, scaring his peers, school staff, and family members. Moreover, the boy developed additional mental health comorbidities, including oppositional defiant disorder, conduct disorder, depression, ADHD, and phobia related to spiders (Dr. Todd Grande, 2020). I agree that ADHD and phobia may be diagnoses, which do not relate to PTSD as they could exist prior to a traumatic event and were not connected with road accidents. However, all other symptoms clearly indicate the presence of PTSD due to their specificity and time of occurrence.
Psychotherapy Treatment Option
It goes without saying that trauma-focused cognitive therapy may be regarded as one of the most efficient treatment options for Joe. However, one more variant that may be tried is the eye movement desensitization and reprocessing (EMDR) therapy. It is based on the brain’s ability to reprogram distressing memories and thoughts to make them less vivid and stressful (Beer, 2018). The therapy stimulates memory systems and allows to remove the distress. From a clinical practice guideline perspective, EMDR therapy is considered to be a “gold standard treatment” as it is an evidence-based intervention supported by the World Health Organization, and its efficiency is supported by multiple peer-reviewed studies (Beer, 2018). In general, using reliable evidence-based treatments is important for psychiatric-mental health nurse practitioners. As quality medical assistance and healthcare delivery are crucial for positive patient outcomes, healthcare providers should be sure that they are based on in-depth research and successful application to practice.
Conclusion
In the diagnosis and treatment of PTSD, clinicians cannot rely on unproven theories and opinion-based interventions as they may lead to psychological and functional complications in the future. Thus, the efficiency of all therapies should be supported by scientifically recorded positive results before they may be applied to patients, especially minor ones.
References
Beer, R. (2018). Efficacy of EMDR therapy for children with PTSD: A review of the literature. Journal of EMDR Practice and Research, 12(4), 177-195. Web.
Dr. Todd Grande. (2020). Presentation example: Posttraumatic stress disorder (PTSD) [Video]. YouTube. Web.
Quinones, M. M., Gallegos, A. M., Lin, F. V., & Heffner, K. (2020). Dysregulation of inflammation, neurobiology, and cognitive function in PTSD: An integrative review. Cognitive, Affective, & Behavioral Neuroscience, 20(3), 455-480. Web.
Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in Behavioral Neuroscience, 12(258), 1-9. Web.