Post-Traumatic Stress Disorder assignment paper

Post-Traumatic Stress Disorder assignment paper

Brief Description Of The Patient

The patient presents reports of experiencing rape in the recent past. Since the incident, she has been experiencing recurring involuntary memory of the events, stressing dreams and nightmares, avoidance of the traumatic triggers by avoiding the conversation, and meeting strangers.  She has persistent negative beliefs and blames herself for the trauma. she cannot sleep at night due to nightmares and flashbacks of the events. On mental state examination, the patient was unable to engage with the care provider. She is restless and does not maintain eye contact. Her speech staggered with a normal tone and volume. She has in a sad mood and expresses anger and bitterness. She has distorted thoughts for self and the consequences. Post-Traumatic Stress Disorder assignment paper

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Psychiatric Diagnosis

My psychiatric diagnosis is post-traumatic stress disorder PTSD. PTSD is a mental health disorder as a result of real threatening injury or sexual assault. According to the American psychiatric diagnostic criteria, PTSD presents with persistent recurring memory of the events, avoidance of traumatic triggers and people, negative emotional alternations, and increased arousal. The patient must meet the criteria by directly experiencing the events, witnessing them in person, repeated thoughts or nightmares of the event, avoidant behavior, hyperarousal, and decreased cognitive function (Bryant, R. A. 2019). The client meets the criteria because she experiences a sexual assault or rape. She states that she experiences recurrent flashbacks and nightmares. She avoids meeting with strangers because she does not trust them and assumes that they could cause harm. She has hyperarousal when she experiences insomnia, anger outbursts, and irritable behavior.

Differential Diagnosis

Bipolar disorder is a mood disorder with alternating high and low moods. The mood changes affect the patients sleeping patterns, concentration, and energy that impact their work, relationships, and behavior. The mood changes can be mania or hypomania and depressive mood. The manic phase presents with increased energy, high levels of self-confidence, engaging in risky behaviors, and racing thoughts. Episodes of the depressive bipolar present with sadness, insomnia, fatigue, anxiety, feeling of hopelessness, and a sense of guilt. However, this is not the actual diagnosis because the patient does not present with alternating maniac mood symptoms.

Dysthymic disorder is a persistent depressive disorder caused by recurrent stressful life events and genetic predisposition. The clinical presentation includes sadness, loss of enjoyment, insomnia, fatigue, hopelessness, and difficulties in concentration. This is not the patient’s diagnosis because the patient has had no other associated personality disorders in her lifetime.

Depressive mood disorder is a mental illness that disrupts interpersonal relationships, work performance, and the patient’s medical outcome. The American psychiatric association DSM-5 criteria for depression includes sleep disturbance, eating disorders, suicidal ideation, hopelessness, loss of concentration, fatigue, loss of interest, and psychomotor agitation or retardation (Voros, et al, 2020). This is not the actual diagnosis because the patient denies suicidal attempts and ideation.

Suicide Or Homicidal Risk Assessment

The patient has an acute crisis from rape. However, she has no history of suicide attempts, has no imminent signs, and has social protection from her family. Therefore, she has a low risk for suicide

What Psychiatric Tools Or Scales For Diagnosis

Davidson trauma scale DTS is a scale of self-report with 17 DCM-IV symptoms. It helps identify the frequency and severity of the scale. It has four main psychological aspects, arousal, anxiety, and numbness (Jeffrey, et al, 2021). The PTSD checklist has 20 items of self-reported instrument that helps in screening PTSD and making a provisional diagnosis. It monitors symptoms during and after treatment. The impact event scale and Mississippi scale for combat assess the subjective distress to make a preliminary diagnosis. Post-Traumatic Stress Disorder assignment paper

Treatment

Sertraline 25mg PO once daily. Sertraline is an antidepressant; selective serotonin reuptake inhibitor FDA approved for post-traumatic stress disorder. It may be taken in the morning together with food (Liu, et al, 2021). It is contraindicated in disulfiram. It has a US black box warning for use by children less than 18 years old because it may cause suicidal ideation and attempt.

Non-Pharmacological Treatments

Trauma-focused cognitive-based therapy and eye movement and reprocessing are the most effective in treating PTSD. Cognitive-behavioral therapy helps in improving daytime symptoms and sleeping patterns.

Labs Or Medical Tests That Need To Rule Out Organic Causes

There are no specific diagnostic tests for PTSD, however, cortisol levels, norepinephrine, and CRF levels are important to assess substance use disorder.

Questions That You Would Ask To Further Solidify Your Diagnosis

• How has trauma affected your life?
• Are you still able to love?
• Have your friendships suffered?
• Do you still feel numb?
• How has that trauma affected your interest in activities?

Post-Traumatic Stress Disorder assignment paper

PLEASE READ ASSIGNMENT INSTRUCTIONS CAREFULLY

Module Assignments:
Change the directions to read as follows:

For this assignment, you will watch an assigned video clip that depicts a patient needing psychiatric/mental health treatment. You then will complete a treatment plan for this patient, following the attached formatting. You are required to follow APA 7, which includes, a title page, your typed treatment plan, and a references page. Each video case that is assessed should result in a treatment plan
that is a minimum of 2 pages in length, in addition to the title page and references page. This is a treatment plan, not a research paper. Follow the rubric guidelines for grading criteria.
Just like in practice, there are times when all the preferred information may not be available, yet you still will need to formulate a treatment plan for the patient. Your treatment plan must include in-text citations and proper APA 7 formatting.
The following reference materials are required to be utilized and referenced:
– DSM-5
– Course Textbook
– Drug guide of your choice (text or online)
– 1 scholarly peer reviewed journal article, dated within the last 5 years, that supports your
treatment plan. UptoDate is a wonderful site, but it is not considered a scholarly peer
reviewed journal article.
The APA 7 style of writing is required. This includes (but is not limited to):
– Proper grammar and composition, capitalization and sentence structure
– APA 7 approved font (such as 12-point Times New Roman)
– Double spaced paper with 1” margins
– Paragraphs are to be left margin justified only
– Paragraph indentions
– Heading Levels (see APA p. 47-48)
– References that are formatted as per APA 7. See chapter 9 of the APA 7.
How to properly cite and reference the DSM-5.
For electronic versions:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
https:doi.org/10.1176/appi.books.9780890425596
For printed version:
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
American Psychiatric Association.
Basic in-text citation for the DSM-5: (American Psychiatric Association, 2013).

NKU MSN675 | 2022 Treatment Plans, DSM-5, Differentials
Treatment Plan: What to include and how to format the treatment plan
Your Treatment plan should include the following categories:
1. Title page
2. Content of treatment plan (The title of your treatment plan should be on line 1 of page 2).
a. Video # or Discussion Board Prompt #
b. Brief description of the patient
c. Brief explanation of the presenting symptoms
d. Any known medical history, allergies, etc.
e. Your psychiatric diagnosis (supported by the DSM-5).
f. List 3 of the differential diagnosis from the DSM-5, and briefly state why that was
chosen as a differential diagnosis, and not as the main diagnosis. (See course
materials on Differential Diagnosis) (supported by the DSM-5).
g. Suicide and/or homicidal risk assessment (this includes ideation, intent, plan,
means, etc.). Post-Traumatic Stress Disorder assignment paper
h. What psychiatric tools or scales you used (or that you would use) to help support
your diagnosis (include citations).
i. Medications being ordered
i. Include name of medication(s) and what the med is used for (include
citation)
ii. Include the route, dosage, frequency (include citation)
iii. Include black box warnings or what the pt needs to know/foods to avoid,
etc. (include citation)
j. Non-pharmacological treatments that are being ordered (include citation that
supports these).
k. Any labs or medical tests that need to be completed to rule out organic causes, for
medication monitoring, and so forth (include citation). (include a short line stating
why each lab/test is being ordered)
l. Questions that you would ask to further solidify your diagnosis (brief list)
m. Any further directives/resources for the patient (this would include, follow up with
primary doctor to monitor HTN or diabetes; directives to follow-up with other
members of the comprehensive treatment team; safety plan if you are sending the
pt home and they have suicidal or homicidal thoughts; return for medication
assessment in x number of weeks, etc. This also includes support group and hotline
phone numbers for things like SI and SUD).
3. References Page – include all citations used in the paper, formatted per APA 7, double
spaced and in alphabetical order. References are to include the DSM-5, the course textbook,
a drug book of your choice (text or online), and 1 scholarly journal article reference within
the last 5 years, for each of the videos or discussion board prompts being assessed.
Note:
Direct quotations should be kept to a minimum and properly cited as per the APA 7. It is imperative
that you synthesize the course information into your own words, using minimal direct quotations from scholarly
journal articles to support your treatment plan. Academic integrity is essential as proper citations give credence
and reliability to your treatment plan.

NKU MSN675 | 2022 Treatment Plans, DSM-5, Differentials
DSM-5 & Differential Diagnosis
In order to effectively treat patients, a reliable diagnosis and treatment recommendation is
essential. The DSM-5 provides a definition for each mental health disorder along with diagnostic
criteria that must be met for each diagnosis. These diagnoses are designed to “help clinicians to
determine prognosis, treatment plans, and potential treatment outcomes for their patients”
(American Psychiatric Association, 2013, p. 20). Diagnosis are then made after performing a
clinical interview with the patient, using DSM-5 descriptions, criteria, and using clinician

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judgment (American Psychiatric Association, 2013).
1. All psychiatric disorders have a categorical place in the DSM -5. It includes the
symptoms that must be present with specifiers that allow for a more specific
diagnosis that help with the development of a treatment plan. (Example: Major
depressive disorder with psychotic features).
2. Most psychiatric disorders (and psychiatric emergencies) require a thorough suicide
risk assessment. If the patient in the DB or video requires a suicide risk assessment
you must mention that clearly, as well as giving the side effects of any meds that may
make suicidal thinking worse, as well as a safety plan.
3. Differential diagnoses: A reliable diagnosis is required to effectively treat the patient
and to have positive treatment outcomes. The differentials provide for clinicians and
alternate diagnosis that could be considered if it is proven that the patient does meet
the criteria for the primary diagnosis that was chosen.
A clinician does not randomly come up with a differential diagnosis on their own. The
DSM-5 provides for clinicians, differential diagnosis for each primary diagnosis. They
are listed in the DSM-5 at the end of each diagnosis chapter. The differentials are listed in
order of prevalence. For example, of all the patients diagnosed with Bipolar 1, if that
diagnosis was proven not to be correct, most often the correct diagnosis is found to be
first, major depressive disorder, then second most frequent is the 2nd differential listed,
then the 3rd most frequent is the 3rd differential that is listed. So the differentials should be
alternate diagnosis that you considered or wrestled with as you were determining the
primary diagnosis for the patient.
For example, if you have a patient who appears with a mood disorder, you may be
considering depressive disorder or bipolar 1 disorder. Upon examining the diagnostic
criteria in the DSM-5 for bipolar 1 (page 123-131) you determine that bipolar 1 is the
diagnosis that the patient meets the criteria for. You must then look to the differential
diagnosis that are listed in the DSM-5 (for bipolar 1 the differentials are on page 131-
132) and you choose 2 or 3 of them that your patient closely matches the criteria for. You
then briefly explain why you chose bipolar 1, as opposed to the differential diagnosis of
major depressive disorder (for example). Post-Traumatic Stress Disorder assignment paper