NRNP 6635 – Week 4: Anxiety Disorders, PTSD, and OCD Case History Reports
1. Introduction
Focus of Week 4: Anxiety disorders, Post‑Traumatic Stress Disorder (PTSD), and Obsessive‑Compulsive Disorder (OCD).
Clinical Importance: These conditions are among the most prevalent psychiatric disorders, often comorbid, and significantly impair functioning.
Case Studies: Symptom Media training titles provide realistic patient scenarios to practice assessment, diagnosis, and treatment planning.
2. Anxiety Disorders
Definition
Excessive fear, worry, or apprehension that is difficult to control and causes impairment.
Includes Generalized Anxiety Disorder (GAD), Panic Disorder, Social Anxiety Disorder, and specific phobias.
Clinical Features
Physical: Palpitations, sweating, trembling, shortness of breath, GI upset.
Cognitive: Excessive worry, difficulty concentrating, intrusive thoughts.
Behavioral: Avoidance, restlessness, irritability.
Risk Factors
Genetic predisposition.
Family history of anxiety or mood disorders.
Stressful life events.
Personality traits (neuroticism).
Assessment Tools
GAD‑7: Screens for generalized anxiety.
HAM‑A: Hamilton Anxiety Rating Scale.
PHQ‑9: Screens for comorbid depression.
Treatment
Pharmacological: SSRIs (sertraline, escitalopram), SNRIs (venlafaxine, duloxetine), buspirone.
Psychotherapy: Cognitive Behavioral Therapy (CBT), relaxation training, exposure therapy.
Lifestyle: Sleep hygiene, exercise, mindfulness.
3. Post‑Traumatic Stress Disorder (PTSD)
Definition
Psychiatric disorder following exposure to actual or threatened death, serious injury, or sexual violence.
DSM‑5 Criteria
Exposure to trauma.
Intrusive symptoms (memories, nightmares, flashbacks).
Avoidance of reminders.
Negative alterations in cognition/mood.
Hyperarousal (sleep disturbance, irritability, hypervigilance).
Duration >1 month.
Clinical Features
Re‑experiencing trauma.
Emotional numbing.
Hypervigilance.
Functional impairment.
Risk Factors
Combat exposure, sexual assault, disasters.
Childhood trauma.
Family history of psychiatric illness.
Lack of social support.
Assessment Tools
PCL‑5: PTSD Checklist.
CAPS‑5: Clinician‑Administered PTSD Scale.
C‑SSRS: Suicide risk assessment.
Treatment
Pharmacological: SSRIs (sertraline, paroxetine), SNRIs, prazosin for nightmares.
Psychotherapy: Trauma‑focused CBT, EMDR (Eye Movement Desensitization and Reprocessing), prolonged exposure therapy.
Supportive: Family involvement, veteran support groups.
4. Obsessive‑Compulsive Disorder (OCD)
Definition
Presence of obsessions (intrusive, unwanted thoughts) and/or compulsions (repetitive behaviors) that cause distress and impairment.
Clinical Features
Obsessions: Contamination fears, symmetry, aggressive or sexual thoughts.
Compulsions: Washing, checking, counting, repeating.
Insight: Patients often recognize irrationality but feel compelled to act.
Risk Factors
Genetic predisposition.
Family history of OCD or anxiety.
Childhood onset common.
Stressful events may exacerbate symptoms.
Assessment Tools
Y‑BOCS (Yale‑Brown Obsessive Compulsive Scale).
OCI (Obsessive‑Compulsive Inventory).
Treatment
Pharmacological: SSRIs (fluoxetine, fluvoxamine, sertraline), clomipramine.
Psychotherapy: Exposure and Response Prevention (ERP), CBT.
Supportive: Family education, stress management.
5. Case History Integration
Sergeant Berry Sullivan (Training Title 21):
27‑year‑old veteran, combat exposure, hypervigilance, nightmares.
Likely PTSD with comorbid anxiety.
Treatment: SSRIs, trauma‑focused CBT, prazosin for nightmares.
Mr. Luca Esposito (Training Title 37):
21‑year‑old student, tachycardia, restlessness, academic stress.
Likely GAD or Adjustment Disorder with Anxiety.
Treatment: CBT, SSRIs, lifestyle interventions.
Ms. Connie Weidre (Training Title 40):
53‑year‑old female, family history of anxiety, somatic complaints, hypersomnia.
Likely GAD with somatic symptom disorder.
Treatment: SSRIs, CBT, medical management.
Matilda Johnson (Training Title 55):
8‑year‑old child, picky eater, possible separation anxiety.
Likely Separation Anxiety Disorder or GAD.
Treatment: CBT, family therapy, school support.
Mrs. Isla Flanagan (Training Title 85):
47‑year‑old female, acute stress after school shooting.
Likely Acute Stress Disorder, risk of PTSD.
Treatment: Trauma‑focused CBT, SSRIs, sleep hygiene.
Ms. Serenity Jackson (Training Title 95):
24‑year‑old female, diabetes, family conflict, concealed sexual orientation.
Likely GAD or Adjustment Disorder with Anxiety.
Treatment: CBT, SSRIs, family support.
6. Nursing and Clinical Implications
Assessment: Comprehensive history, collateral information, standardized tools.
Intervention: Tailored to disorder type, age, severity.
Family Support: Education, counseling, involvement in therapy.
Ethical Issues: Confidentiality, informed consent, stigma reduction.
Cultural Considerations: Respect cultural beliefs about trauma and mental illness.
7. Summary
Anxiety disorders, PTSD, and OCD are highly prevalent and impair functioning.
Case histories illustrate diverse presentations across age groups and contexts.
Effective management requires pharmacological, psychotherapeutic, lifestyle, and supportive interventions.
Early recognition and intervention improve outcomes and quality of life.
📝 Quiz (15 Questions)
Multiple Choice – Select the best answer.
Which disorder involves excessive worry for ≥6 months? a) PTSD b) GAD c) OCD d) Adjustment Disorder
Which symptom is characteristic of PTSD? a) Compulsions b) Intrusive memories c) Excessive worry d) Somatic complaints
Which therapy is gold standard for OCD? a) Psychoanalysis b) Exposure and Response Prevention c) EMDR d) Dialysis
Which medication is FDA‑approved for PTSD? a) Sertraline b) Lithium c) Clozapine d) Haloperidol
Which tool screens for generalized anxiety? a) GAD‑7 b) Y‑BOCS c) PCL‑5 d) CAPS‑5
Which disorder involves obsessions and compulsions? a) OCD b) PTSD c) GAD d) Depression
Which therapy is trauma‑focused? a) CBT b) EMDR c) Prolonged Exposure d) All of the above
Which lifestyle intervention is appropriate for anxiety? a) Sleep hygiene b) Smoking cessation c) Alcohol detox d) Dialysis
Which family history increases risk for anxiety? a) Depression b) Substance abuse c) Anxiety disorders d) All of the above
Which child disorder involves fear of separation lasting ≥4 weeks? a) Separation Anxiety Disorder b) GAD c) OCD d) Adjustment Disorder
Which medication is first‑line for OCD? a) SSRIs b) Benzodiazepines c) Antipsychotics d) Lithium
Which patient case involved combat trauma? a) Luca Esposito b) Berry Sullivan c) Connie Weidre d) Isla Flanagan
Which patient case involved acute stress after a school shooting? a) Serenity Jackson b) Isla Flanagan c) Matilda Johnson d) Connie Weidre
Which patient case involved somatic complaints and hypersomnia? a) Connie Weidre b) Luca Esposito c) Berry Sullivan d) Matilda Johnson
Collepals.com Plagiarism Free Papers
Are you looking for custom essay writing service or even dissertation writing services? Just request for our write my paper service, and we'll match you with the best essay writer in your subject! With an exceptional team of professional academic experts in a wide range of subjects, we can guarantee you an unrivaled quality of custom-written papers.
Get ZERO PLAGIARISM, HUMAN WRITTEN ESSAYS
Why Hire Collepals.com writers to do your paper?
Quality- We are experienced and have access to ample research materials.
We write plagiarism Free Content
Confidential- We never share or sell your personal information to third parties.
Support-Chat with us today! We are always waiting to answer all your questions.
