week 9 response on trauma

Thanks for your post, it is informative. Trauma is a physical or emotional response to a. dangerous or upsetting event. A situation can be deemed traumatic if it exceeds the individual coping capacity (silver et al, 2018). The impact of trauma can be insidious, subtle, or outright destructive. The way an event affects an individual depends on the characteristic and type of event, the characteristics of the individual, sociocultural factors, and the meaning of the trauma (Trauma-Informed Care in Behavioral Health Services, 2014). Post-traumatic stress disorder (PTSD) is a stress-related disorder from trauma. The diagnostic criteria for PTSD are direct exposure or witnessing trauma, presence of intrusive memories of the trauma, recurrent nightmare, flashbacks, persistent avoidance of stimuli associated with the trauma, mark arousal, and reactivity, and alterations in cognition and mood related to the trauma (Trauma-Informed Care in Behavioral Health Services, 2014). I agree with you that psychotherapy such as cognitive-behavioral therapy (CBT), cognitive processing therapy (CPT), cognitive therapy (CP), and prolonged exposure is strongly recommended. Although eye movement desensitization and reprocessing therapy (EMDR), Brief eclectic therapy, narrative exposure therapy, and medication are conditionally recommended (APA, 2017).

Reference:

Silver, K. E., Kumari, M., Conklin, D., & Karakurt, G. (2018). Trauma and Health Symptoms in a Community Sample: Examining the Influences of Gender and Daily Stress. The American Journal of Family Therapy, 46(2), 153–167. https://doi.org/10.1080/01926187.2018.1461031

Trauma-Informed Care in Behavioral Health Services. (2014). Rockville (MD): Substance Abuse and Mental Health Services Administration (US); (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 4, Screening and Assessment. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207188/

American Psychological Association. (2017). Clinical practice guidelines for the Treatment of PTSD. Retrieved June 30, 2022, https://www.apa.org/ptsd-guideline/ptsd.pdf

I appreciated your thorough description and therapeutic intervention plan for people suffering from PTSD. PTSD is one of the trauma- and stressor-related disorders outlined by the DSM-V (APA, 2013). As you touched upon, symptoms can result in a variety of symptoms including distress, depersonalization, derealization, fear, guilt, socially withdrawn behaviour, avoidance, hypervigilance, sleep disturbances, and problems with concentrating, just to name a few (APA, 2013). Some possible differential diagnoses for PTSD could include traumatic brain injury, substance abuse disorder, panic disorder, borderline personality disorder, factitious disorders, major depressive disorder, and dissociative identity disorder (Wheeler, 2022).

The topic of trauma and trends in trauma awareness touched on how many of us are surrounded by traumatic events in our everyday lives. Examples include the pandemic, sexual assault, school shootings, cyber-bullying, racial and minority inequities and abuse, community violence, financial despair, as well as maltreatment at home. An event can be considered traumatic if it involved a significant physical, psychological, or emotional threat involving self or loved ones and is shocking and overwhelming (Raja et al., 2021). In order to effectively address trauma in the healthcare setting, programs need to incorporate universal screening (e.g., suicidal), targeted screening (e.g., sexual assault), and current functioning screening (e.g., depression and PTSD) (Raja et al., 2021). However, privacy in sharing screening results should be in the forefront of the primary caregiver’s mind, including guarding against adverse reactions of multiple caregivers (e.g., PCP, RNs, and technicians) as well as protecting the client against insurance discrimination (Raja et al., 2021).

References

American Psychiatric Association (APA). (2013). Diagnostic and Statistical Manual of Mental Disorders, 5th ed. Washington, DC: American Psychiatric Association.

Raja, S., Rabinowitz, E. P., & Gray, M. J. (2021). Universal screening and trauma informed care: Current concerns and future directions. Families, Systems, & Health, 39(3), 526-534. https://doi.org/10.1037/fsh0000585

Wheeler, K. (2022). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice (3rd ed.). Springer Publishing Company.