Recent neuroimaging studies have extensively explored the neurobiological underpinnings of PTSD illness. PTSD is associated with altered functions of the hypothalamic-pituitary-adrenal (HPA) axis that dictates cortisol hormone levels (Pant et al., 2022). The amygdalae stimulate the HPA axis, which processes stressful events, including fear and emotions. Once the HPA axis is disrupted due to chronic stress, feedback from the amygdala is obstructed, resulting in continuous secretion of the cortisol hormone. Moreover, the amygdala will become receptive to processed threats (Lanius et al., 2018). Therefore, patients with PTSD have hyperactivated amygdalae, which promotes hypervigilance, resulting in patients perceiving safe environments as very dangerous. Besides, traumatic events are closely associated with detrimental effects on the hippocampus. Patients with PTSD have a hypo-active hippocampus that can escalate the activities of the HPA axis (Dossi et al., 2020). In this view, chronic stress and traumatic events alter dendritic morphology in the hippocampus and hinder hippocampal neurogenesis. Consequently, it leads to re-experiencing and persistence of traumatic memories.

PTSD DSM-5 Diagnostic Criteria

Individuals can be diagnosed with PTSD if exposed to a serious injury, threatened death, or subjected to sexual violence. In this regard, the person may experience directly or witness the traumatic events. Secondly, the patient must have at least one intrusion symptom linked with traumatic events, such as recurrent distressing memories and dreams, dissociative reactions based on flashbacks, and intense psychological distress (Sakellariou & Stefanatou, 2017). Thirdly, the patient persistently avoids stimuli related to the experienced traumatic events, such as avoiding situations, conversations, people, and places that awaken distressing memories. The patients should also have cognitive alterations and negative moods linked to traumatic events. In this light, the patient cannot recall or remember due to dissociative amnesia (Sakellariou & Stefanatou, 2017). Moreover, the patient must have alterations in reactivity and arousal linked with traumatic events, such as angry outbursts and irritable behavior, especially when provoked slightly. In addition, the patient has difficulty staying awake or falling asleep.

Case Analysis

The video presented by Dr. Todd Grande provides sufficient information to diagnose Joe with PTSD illness. According to Dr. Todd Grande, Joe’s involvement in a minor vehicle accident with his father triggers distressing memories in him. Furthermore, Joe becomes anxious when shown anything that reminds him of the accident, including conversations and television stories about road accidents (Grande, 2019). According to Dr. Todd, Joe experienced sleep difficulties and had to accompany his father for him to sleep. Also, when asleep, Joe had several nightmares. While at school and home, Joe is physically aggressive. Moreover, he had outbursts in class; in one incident, he threw trash around the class and overturned tables. Also, when slightly provoked, Joe physically fights with his elder siblings (Grande, 2019). In this view, I do not agree with other diagnoses since the identified symptoms are more inclined to PTSD illness.

Other psychotherapy treatment

Another psychotherapy treatment for Joe’s case is prolonged exposure (PE) therapy, which helps the patient overcome fears associated with traumatic events. It is also an effective approach to lessen PTSD symptoms such as guilt, depression, anger, and negative self-perception (Rauch, Eftekhari & Ruzek, 2012). PE for PTSD patients is administered for at least three months, consisting of about 15 sessions. Each session is carried out within 120 minutes. In the initial session, therapists begin by having an overview of the client’s situation and creating a conducive environment to execute other sessions (Rauch, Eftekhari & Ruzek, 2012). PE is a gold-standard treatment because several clinical trials reaffirm an effective treatment for alleviating PTSD symptoms, especially among patients with complex comorbidity.

Supporting sources

 The supporting sources are scholarly because experts write them; each article has the author’s name and affiliated institution. The articles have a standard structure comprising an abstract, introduction, background, literature, method, findings, discussion, and conclusion. Also, the articles have highly specialized and technical language. The information is backed up with in-text citations and a list of bibliographies inserted at the end of the article. Lastly, the articles are published by professionals.

References

Dossi, G., Delvecchio, G., Prunas, C., Soares, J. C., & Brambilla, P. (2020). Neural Bases of Cognitive Impairments in Post-Traumatic Stress Disorders: A Mini-Review of Functional Magnetic Resonance Imaging Findings. Frontiers in psychiatry, 11, 176. https://doi.org/10.3389/fpsyt.2020.00176

Lanius, R. A., Boyd, J. E., McKinnon, M. C., Nicholson, A. A., Frewen, P., Vermetten, E., & Spiegel, D. (2018). A review of the neurobiological basis of trauma-related dissociation and its relation to cannabinoid-and opioid-mediated stress response: A transdiagnostic, translational approach. Current Psychiatry Reports, 20(12), 1-14. https://doi.org/10.1007/s11920-018-0983-y

Pant, U., Frishkopf, M., Park, T., Norris, C. M., & Papathanassoglou, E. (2022). A Neurobiological Framework for the Therapeutic Potential of Music and Sound Interventions for Post-Traumatic Stress Symptoms in Critical Illness Survivors. International Journal of Environmental Research and Public Health, 19(5), 3113. https://www.mdpi.com/1660-4601/19/5/3113#

Sakellariou, M. O., & Stefanatou, A. (2017). Neurobiology of PTSD and implications for treatment: An overview. Current Research: Integrative Medicine, 2(1), 263-278. https://www.pulsus.com/scholarly-articles/neurobiology-of-ptsd-and-implications-for-treatment-an-overview.html

Rauch, S. A., Eftekhari, A., & Ruzek, J. I. (2012). Review of exposure therapy: a gold standard for PTSD treatment. Journal of rehabilitation research and development, 49(5), 679-688.

Grande, T., (2019, August 22). Presentation Example: Posttraumatic Stress Disorder (PTSD). YouTube video. Retrieved from https://www.youtube.com/watch?v=RkSv_zPH-M4