Anxiety Disorders and Stress Q 4
Nurse Vicky is assessing a newly admitted client for symptoms of post-traumatic stress disorder (PTSD). Which symptoms are typically seen with this diagnosis? Select all that apply.
A. Anger with numbing of other emotions.
B. Exaggerated startle response.
C. Feeling that one is having a heart attack.
D. Frequent thoughts about contamination.
E. Frequent nightmares.
F. Survivor's guilt.
Correct Answers: A, B, E, F
These are common symptoms of PTSD. Option C is common in panic disorder, and option D is characteristic of obsessive-compulsive disorder. Posttraumatic stress disorder (PTSD) is a syndrome that results from exposure to real or threatened death, serious injury, or sexual assault. Following the traumatic event, PTSD is common and is one of the serious health concerns that is associated with comorbidity, functional impairment, and increased mortality with suicidal ideations and attempts. The Diagnostic and Statistical Manual of Mental Disorders(DSM-5) has included PTSD in the new category of Trauma- and Stress-related Disorders.
Option A: On the mental status examination, the patient would likely mention poor sleep and concentration, frequent nightmares and flashbacks related to the event, guilt or negative emotions associated with the reminder, avoidance, and increased vigilance. There is a persistent inability to experience a positive emotion such as happiness, satisfaction, or love.
Option B: Furthermore, problems with sleep and concentration, irritability, increased reactivity, increased startle response, hypervigilance, avoidance of traumatic triggers also occur. There is a significant impairment in social, occupational, and other areas of functioning. However, the symptoms of PTSD overlap with acute stress disorder. For a patient to be diagnosed as PTSD, the duration of the symptoms must be more than one month.
Option C: In order to make an accurate diagnosis of panic disorder, it is important to differentiate the two entities from each other. According to DSM V, panic disorder can be diagnosed if recurrent unexpected panic attacks are happening followed by one month or more of persistent concern over having more attacks, along with a change in the behavior of the individual to avoid a situation in which they attribute the attack to.
Option D: Obsessive-compulsive disorder (OCD) is often a disabling condition consisting of bothersome intrusive thoughts that elicit a feeling of discomfort. To reduce the anxiety and distress associated with these thoughts, the patient may employ compulsions or rituals. These rituals may be personal and private, or they may involve others to participate; the rituals are to compensate for the ego-dystonic feelings of the obsessional thoughts and can cause a significant decline in function.
Option E: The symptoms of PTSD include persistently re-experiencing the traumatic event, intrusive thoughts, nightmares, flashbacks, dissociation(detachment from oneself or reality), and intense negative emotional (sadness, guilt) and physiological reaction on being exposed to the traumatic reminder.
Option F: Negative alterations in mood and cognition that began or worsened after the traumatic event, as evidenced by persistent negative emotional state, including fear, guilt, anger, or shame; persistent distorted cognition that leads the individual to blame self or others for causing the traumatic event.