March 25th, 2022 
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 1
Family Assessment and Psychotherapeutic Approaches
Walden University
NRNP – 6645 Psychotherapy with Multiple Modalities
June 13, 2021
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 2
Family Assessment and Psychotherapeutic Approaches
Historian: Mother and daughter (Self)
Language: English
Name: Non- listed
Gender: Both female (mother and daughter)
Age: 40 years old and 23 years old.
Chief complaint — “I am in so much pain, nobody can help me and nothing is helping
me manage the pain. I want my mom to be more peaceful, I want her to lower her expectations
and accept a lot of things about life, I have a sense that my mom is holding me back from all I
could be doing”. I just want them to spend time with me, I am very lonely, and I get depressed
when I am lonely. I hate spending time with my mother, I hate her house, she has two dogs and I
do not like those at all, I do not like their hair on my body and I do not like touching them. Do
you believe I cannot even eat in her house, everything smells like dog, and it is very
uncomfortable for me”.
History of present illness (HPI) — This patient is a 40-year-old Iranian American
female. She is here today to be seen for complex family dynamic issues as it relates to her and
her five children. She was seen with her 23-year-old daughter who detailed the multiple issues as
it relates to her relationship with her mom and siblings. They are here for evaluation of trauma
related issues as it relates to abuse by her husband and their father. Mom is currently struggling
with trauma related issues from being married and also struggling with adjusting to the norms
and principles of America which can be called Adjustment disorder at this time
Per self report, one of her daughters was raped and abused by her biological father and
this has left a dent in the way the family relates with their dad. There has been difficulties
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 3
relating to one another, difficulties relating to their father, difficulties relating to the issues of
traditional Iranian family becoming “Americanized”, issues with spending time with their
mother, their lack of privacy and distrust overall. Overall, this is a complex family unit and there
are multiple conflicts active and ongoing at the same time. The biggest issue has to do with the
mother of the house becoming sick, and having multiple surgeries to fix her foot which has left
her almost dependent. The second issue is the rape allegation. One of the daughters alleged that
her biological father raped her., this has left the family traumatized and unforgiving.
Thirdly, there is the issue of the of a mother desperately trying to hold unto her traditional
Iranian beliefs and traditions. For example, in Africa and the Middle East, it is believed that
children are to stop their lives to care for their parents if they need that help. In America, the
tradition is to employ a capable nursing facility or a private nurse to do the caring. These are very
different standards. In this case, her children are urging her to do more for herself and for her
health, to not solely depend on them or wait on them. Overall, there are major unresolved
conflicts going on that are trauma related, depression, physical health etc.
Some physical signs noted during the assessments were fidgeting, excited. There are also
signs of hyperactivity, impulsivity, irritability, lack of restraint, and persistent repetition of words.
There is no notice of difficulty focusing, issues with paying attention or short attention span.
Past psychiatric history — In the scenario, mom mentioned depressive episodes, there
was however no mention of medically diagnosed psychiatric conditions like depression. They
denied suicidal ideations. They also denied the use of illicit drugs/ alcohol, prior serious mental
or psychiatric breakdown, or mania. No prior reports of psychiatric inpatient hospitalizations to
report either.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 4
Hospitalizations- No inpatient psychiatric hospitalizations reported nor are there any
reports for active Pyschotherapy medications listed for these patients.
Psychotherapy or previous psychiatric diagnosis — No current psychiatric diagnosis,
no Psychotherapy “therapy” is documented for this patient. Note however that the patient said
she “gets depressed when she is alone”. It was not reported that depression was medically
diagnosed or that it is currently being managed by any medication.
Pertinent substance use- Patients deny alcohol or abusing any substances at this time.
They also deny any chronic substance use/abuse.
Family psychiatric/substance use- Patients deny any family psychiatric/ substance use.
Psychosocial history/Developmental history — These patients are 40 and 23-year-old
Iranian immigrants that are currently struggling with adjusting their traditional beliefs with the
Americanized way of life. They are here today for mental assessment/ possible diagnosis of
trauma related issues including adjustment disorder. They were referred by their current
psychiatrist who has tried multiple dimensions to manage the patient and her children. Of note,
she was present for the assessment and answered pertinent questions as it relates to the patients,
their past and their overall issues.
Mom is currently living on disability but her daughter that came with her for the
evaluation lives by herself. Of note, it was reported that she is currently in school, but her social
life was not discussed during assessment. It is always vital to know your patients, for this
evaluation., there was no concrete data collected or reported. For example, knowing what school
the daughter attends, her sexual orientation, understanding her full social life is important in
treatment plan. Questions like does she have a boyfriend and does she live with him? Is she
bisexual? What kind of friends does she have? How many drinks does she drink during nights
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 5
out? What kind of alcoholic beverages does she drink? Collecting, collating and analyzing these
informations can create a well-rounded scenario and can help in creating a full treatment plan for
targeted intervention.
Knowing our patient’s lifestyle and if they indulge in high risk behaviors can assist in
creating a plan of care that can address the specifics for high risk behaviors like testing
periodically for STDs, liver functions, and sometimes suicide. As we all know, alcohol and drug
use can contribute to unintentional injuries and sometimes violence. Tobacco use, unhealthy
dietary behaviors, physical inactivity and sexual behaviors can all contribute to unintended
pregnancy and sexually transmitted infections. It is therefore imperative to assess these functions
and tailor care to fit the assessment (Kelley, T., 2016)
For these patients and the family as a whole, there was no mention of past or current
medical history. From what I could deduce from the assessment, mom recently had surgery of
her bilateral foot. The reason for this surgery or what prompted it was not reported. To
understand this patients whole health history, it is imperative to ask some vital questions.
Considering her physical weight, I would want to know is she diabetic? Does she suffer from
hypertension? What medications does she take daily to manage these ailments? These are vital
information because we would know how to vigorously manage her wounds and how well she
may heal after surgery. (Kelley, T., 2016). Unmanaged diabetes can lead to necrotic wounds that
may not heal which can lead to sepsis. It is therefore vital to have a clear picture of your patient
during assessment (Kelley, T., 2016)
Work History — None on file/ assessed
Legal history — None on file/ assessed
Medical History- No head injuries to report, no seizures, no developmental concerns.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 6
Current Medications- None listed
Allergies — Unknown
Medical Diagnoses — none listed
Reproductive Hx — Post 6 children for mom, unknown for the children.Relationship
— Mom is separated from her husband and the father of her children, no relationship status
posted or reported for her children
Educational Level — None listed for everyone involved in this assessment
Occupation — None listed or reported
Hospitalizations — None reported or found in the chart.
Family Medical History —None reported or assessed from previous visits
Review of Systems (ROS)
General- mom reports fatigue and tiredness, denies night sweats, fevers, chills. Daughter
reports being fine but just overwhelmed by her moms demands and unaware of how to manage
the situation.
HEENT- No visible head injuries or trauma noticed on both patients, patients deny
change in vision, hearing, no ear pain, blurred or double vision, or yellow sclerae. Ears, Nose,
Throat: No hearing loss, sneezing, congestion, runny nose, or sore throat
Skin — No skin issues or concerns to report or noted.
Cardiovascular — No chest pain, heart palpitations, syncope, or edema noted on both
patients.
Respiratory — No cough, wheeze, or diminished breathe sounds noted, occasional
dyspnea with exertion noted, perhaps related to anxiety and depression.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 7
Gastrointestinal — No abdominal pain, constipation, diarrhea, nausea, constipation. No
anorexia noted.
Genitourinary — No flank pain, dysuria, burning on urination, hematuria etc.
Musculoskeletal — No myalgias, no joint pain.
Hematologic — No anemia. No easy bruising or bleeding.
Lymphatics — No lymph nodes issues to report. No enlarged nodes. No history of
splenectomy.
Endocrinology — No diabetes, no thyroid disorders. No polyuria, polyphagia, or
polydipsia, or polyphagia.
Neurological — No headaches, dizziness, syncope, paralysis, ataxia, numbness, or
tingling in the extremities. No change in bowel or bladder control.
Physical Exam (Done by PCP)
T- 98.3 R 16 106/72 Ht 5’7 Wt 117lbs
Average build
Vital signs
RR:16 bpm,
BP: 106/72,
O2: 98%
Temp — 98.3 F,
P- 69
Weight — 117 lbs.
Height — 5’7, and 5’11 respectively
Head — atraumatic
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 8
Eyes — white sclera bilaterally, pink conjunctiva
Ears — patent, no discharge, grey pearl TM bilaterally.
Nose — pink mucosal membranes bilaterally, no congestion and intact turbinates
Throat — red mucosal membrane. No exudates.
Neck — no swelling and bruits. ROM is full.
Lungs — symmetrical chest, symmetry in expansion, and resonant sound in all areas.
Cardiovascular — S1, S2 clear, and no murmurs. Peripheral pulses 3+ and no edema.
Abdomen — flat and symmetrical, no tenderness, no masses, & normoactive sounds
Musculoskeletal — 5/5, no disuse/atrophy/hypertrophy.
Neuro — intact from CN I up to XII
Lymph/skin — no edema, no swelling.
Mental Status Examination
Mom is a 40-year-old Iranian female and her daughter is a 23 Americanized Iranian
female. Mom looks older than her stated age perhaps due to stress from being married young and
in an abusive marriage. Her daughter here today looks her stated age with no concerns. He is
cooperative with the examiner. They are both neatly groomed and clean, they are also dressed
appropriately for the weather and times. There is no evidence of any abnormal motor activity.,
They both however present with significant anxiety, restlessness and irritation.They deny any
visual or auditory hallucinations, delusions, tangentiality/mood. Their speeches are clear, stressed
and loud but coherent and normal in volume and tone. Thought process is goal driven and
logical.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 9
There is clear evidence of annoyance, excitability, fidgeting, hyperactivity, impulsivity,
irritability, medium restraint and persistent repetition of some words in a forced and aggressive
tone. They seemed present-minded when spoken to, there is no difficulty focusing, no lack of
memory recall/ forgetfulness, no issues paying attention, and no issues with short attention span.
Their moods are gloomy and affect is appropriate to presented moods (flat). They deny any
auditory or visual hallucinations. They also deny any current suicidal or homicidal ideations.
Cognitively, they are alert and oriented to themselves, the situation and recent and remote
memories are intact. Concentration is normal, insight is average, there is no difficulty in
memories recollection. Abstraction, attention, insight, and judgment are all reasonable and intact.
Eye contact- Good
Speech — Normal rate and volume.
Behavior — Anxious (for both patients)
Psychomotor — No involuntary movements.
Mood — gloomy
Affect — Flat.
Thought Process: logical, goal-directed and organized.
Thought Content: no delusions. — no suicidal ideations, — no homicidal, or self-harm
ideations noted.
Perception: Minimum reaction to external stimuli.
Attention/ Concentration: Sustained attention and concentration observed.
Cognition: Alert, and oriented X 4.
Memory: No issues with recall
Insight: Fair.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 10
Judgment: Average
Fund of Knowledge: Average.
Intelligence: Average
Post Traumatic Stress Disorder Diagnosis and Screening in Adults.
Previously, PTSD was simply called a “soldier's heart,” “shell shock,” or “combat
fatigue.” The terminology of post-traumatic stress disorder (PTSD) arose immediately after the
Vietnam War. It was observed that traumatic events lead to a complex psychobiological
presentation during and after the Civil War (Patra, B. N.,2018).
This disorder was first described by ABR Myers (1838–1921) in 1870, it was described
as a multifaceted disorder with complex factors and presentation combining acute fatigue,
dyspnea, a sighing respiration, palpitation, sweating, tremor, an aching sensation in the left
pericardium, utter fatigue, an exaggeration of symptoms upon efforts and in severe cases syncope
that can happen suddenly (Iribarren, J., 2015).
Differential Diagnoses
POST- TRAUMATIC STRESS DISORDER- PTSD; ICD-10 CODE: F.43
PTSD can occur after a traumatic event such as military combat, a violent physical
assault, or a natural disaster. While stress is usual after a trauma, people with PTSD often relive
traumatic events in their minds countless times. They may also begin to feel distant from friends
and family. They may also start to experience various emotions and experience anger that does
not go away over time, or perhaps even get worse.
This disorder usually affect individuals who have experienced a wide range of life-
threatening occurrences. According to research, approximately 8% of the American population
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 11
will experience PTSD at some point in their lives. In Veterans, PTSD is commonly associated
with combat trauma. According to the National Center for PTSD, the prevalence of PTSD is not
fixed on race, sexual orientation or physical features, it can happen to both men and women in
various capacities.
The stress that results from traumatic events bring about a spectrum of psycho-emotional
and physiopathological consequences. Post-traumatic stress disorder (PTSD) is a psychiatric
disorder that expresses itself as a result of an experience or of a witnessing of really traumatic or
a life-threatening episode. Post Traumatic Stress Disorder has a profound psychological
correlation with generalised physical impairments. These symptoms can profoundly impair an
individual’s daily life functions and can be life and mind-altering. This disorder is common in
extended combat, terrorism, exposure to certain environmental toxins etc. Overall, per recent
research, there is expected to be a rise in individuals with Post Traumatic Stress Disorder
diagnosis is expected in upcoming decades
Overall post-traumatic stress disorder (PTSD) is a disorder that develops in certain
individuals who have experienced a shocking, scary, and or a dangerous experience that has left
scars too fearful to forget. As we all know, fear triggers many split-second changes in the body to
help defend against danger scenarios and propel certain actions that it deems fit would cause
rescue from the situation. This episode known simply as “fight-or-flight” response is a typical
reaction meant to shield an individual from harm in frightful circumstances
Of note., 95% of individuals will experience a variety of reactions after a life- altering
trauma episode, but most people will recover fully from initial symptoms without any external
help or re-direction. The individuals who keep experiencing trauma as a result of an experience.,
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 12
will be diagnosed with PTSD. People who have this disorder usually feel stressed or frightened,
even when there is no danger lucking around.
All criteria met : Some signs of PTSD are persistent thoughts about a past event,
persistent negative emotional thoughts, extreme thoughts of fear, fear, horror, anger, guilt, or
shame. “Markedly diminished interest or participation in significant activities” (Adler et al.,
2006; Glind et al., 2013). These patients are currently experiencing chronic signs of PTSD, from
being married to an abusive man and from having a sister that was sexually abused by their
father.
Another significant factor of PTSD verbal aggression, unsanitary home, and
economically depressed lifestyle. These factors are current in “moms” behaviour. Her verbal
aggression has also contributed significantly to her estrangement from her children.
ADJUSTMENT DISORDER — ICD-10-CM Code F31
Adjustment disorder refers to an unexpected strong behavioral or emotional reaction that
occurs as a result of an identifiable stressful life change or that occurred within the past three
months. It can present in multiple forms and behaviors, these can include the feeling of
hopelessness, sadness or persistent stress. This can also include physical symptoms occurring
after one undergoes through a stressful event in life. Overall, adjustment disorder primarily deals
with mood, while acute stress disorder deals with environmental stimulation (Harvard Medical
School, 2017). Psychological symptoms such as anxiety, low mood, irritability, emotional ups
and downs, poor sleep, poor concentration, wanting to be alone etc are some symptoms.
Fundamental issues coping with daily activities, mental abilities and general day-to-day activities
are some challenges of having this disorder.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 13
As at the time of this assignment, there is no known cause of this disorder.(Brüne, 2015).
However, the disorder is thought to be as a result of life’s stressors and experiences, interaction
of genetics, temperament and altered levels of some chemicals in the brain. Over the years,
research has revealed that certain events can increase the chances of developing this disorder.
These events can range from daily challenges to school functions. In the psychiatry community,
there is a belief that genetics is again believed to play a significant role in the formation, while
the environment is assumed to play an aggravating factor in its activation and symmetry. Overall,
a combination of genetics, the environment, and sometimes a “modified” brain structure and
chemistry may play a significant role.
Significantly, management for this disorder can be lifelong and treatment revolves around
intricate combination of medications, psychotherapy and other kinds of therapies. Psychiatric
Mental Health Nurse Practitioners diagnose Adjustment disorders after reviewing the patient’s
symptoms, overall history, life experiences plus family history etc. As we all understand in
Mental illnesses, it is vital to diagnose adjustment disorders early enough for a targeted
intervention and expected outcome to occur promptly.
“The Outcome of Depression International Network (ODIN) project shows adjustment
disorder in less than 1% of population. Another recent study of the general population found the
prevalence of adjustment disorder to be about 0.9%. Note that when the criterion of clinically
significant impairment was considered. A further 1.4% of the sample was diagnosed with
adjustment disorder without fulfilling the impairment criterion” (Patra, B. N., 2018).
All criteria not met: The diagnostic criteria is not met due to the time frame for the
diagnosis which ranges between 0-3 months. Some symptoms of adjustment disorder are feeling
sad, hopelessness or lack of enjoyment. Adjustment disorders do share some symptoms with
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 14
depression and some Practitioners have diagnosed depression in place if this disorder. Frequent
crying, worrying or feeling anxious, nervous, jittery or stressed out, trouble sleeping, lack of
appetite, difficulty concentrating, feeling overwhelmed, and lastly difficulty functioning overall
(Ustun, B., 2017)
ACUTE STRESS DISORDER— 2021 Acute Stress Disorder DSM-5 308.3 (F43.0)
Acute Stress Disorder (ASD), unlike Adjustment disorder, develops within the first
month after an individual develops/ witnesses an event that involves a threat or actual death.
Overall, these patients respond to these events with excessive feelings of helplessness, dread and
horror. ASD was introduced as a diagnostic procedure to help in identifying persons that would
ultimately develop post-traumatic stress disorder (PTSD). However, PTSD and ASD differ in
two major ways (Brüne, 2015).
The obvious difference between ASD and PTSD is the onset and duration of symptoms.
The effects of ASD present immediately and last up to a month, while PTSD symptoms present
slower and last longer, up to several years if not treated. Psychological symptoms such as
anxiety, low mood, irritability, emotional ups and downs, poor sleep, poor concentration, wanting
to be alone are all signs and symptoms that point to ASD.
All Criterias not meet;- Based on the accepted time frame for diagnosing this ailment, it
is highly impossible for these patients to be suffering from acute stress disorder. This is a
possibility but not a diagnosis at this time. PTSD as a result of a traumatic marriage and abuse is
the more possible choice at this time.
Case Formulation and Treatment Plan
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 15
The main treatments for people with PTSD are medications, psychotherapy, or both.
Everyone is different, and PTSD affects people differently, so a treatment that works for one
person may be ineffective for another. It is important for patients with PTSD to be managed by a
licensed mental health provider that is experienced and knowledgeable with this disorder. Some
people with PTSD may need to try different treatments to find what works for their symptoms.
This is where an experienced practitioner comes in.
The complicating factor in mental heath is the factor of co-occuring mental illnesses. It is
vital to treat illnesses from their root course. For example, if my patient is going through PTSD
as a result of an abusive and physical relationship, it is important to stop that trigger and that may
usually mean ending the relationship and charting a new course of rehabilitation. Like I pointed
out prior, if depression is related to the root cause of a patients PTSD presentation, that
depression has to be treated with first class SSRI and psychotherapy, or possibly group therapy
depending on the trigger and aggravating factor. Other ongoing problems that can co-occur are
panic disorder, depression, substance abuse, and suicidal ideation.
Mom in this scenario is exhibiting signs and symptoms of socialization skills and has
noticed an increase in her depressive issues. Linkage to community resources, assistance with
medical appointments, psychotherapy, and problem-solving with issues related to activities of
daily living.
Treatment Plan
Prozac 20mg daily
Buspar 15mg BID
Seroquel 50mg po QHS
Psychotherapy with Cognitive Behaviour Therapy to be followed up in four weeks.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 16
Stress management
Diet and Nutrition specialist
Medications side effects and overall expectations.
Reflections /Legal and Ethical Implications
As I began to study the scenario and the topics for this assignment, I was intrigued by the
spectrum and the many factors that set each mental illness factor apart. PTSD is a complex
disorder that most folks incorrectly relate to veterans. Many neurotransmitters are associated in
the formation and sustainability of PTSD. So far Glutamate and Dopamine are said to be the
largest contributor in this class. The prefrontal cortex is also implicated in the roles in attention
and regulation of impulse control in impulse control. EEG studies found elevated beta activity in
their electroencephalography studies (Sadock, B. J., 2015).
Considering that patients with PTSD have a predisposition to obesity, it is imperative that
these patients understand the detriments of having excess body weight as it predisposes them to
acute and chronic illnesses like diabetes mellitus, hyperlipidemia, obstructive sleep apnea,
cardiovascular disease, chronic obstruction pulmonary disease, rheumatoid arthritis etc. “Post
Traumatic Stress Disorder is associated with an increased risk of type II diabetes mellitus,”
(Brüne, 2015). Across the lifespan, there is a correlation between PTSD and complex
health complications. Including behaviors that can trigger high risk behaviour regardless of their
consequences. Some high risk behaviors that can be activated as a result of PTSD are substance
abuse, binge-eating, obesity, and improper/unsafe sexual behavior etc. It is therefore imperative
to educate these patients on the importance of safe sex practices, healthy food options and
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 17
exercises. Practitioners and their patients may discuss healthy habits, healthy meals and exercises
with this patient to promote good health and prevent diseases and complications (Sadock, B. J.,
2015).
In ethical implications, confidentiality in practice has always been the strongest
contender. Mental illness has continued to be a source of stigmatization and mockery in our
communities today. It is therefore important to maintain HIPPA laws to the full extent the law
permits. Lastly, the principle of autonomy, justice, beneficence, and nonmaleficence must be
maintained throughout the interaction with the patient and thereafter. Legal and ethical
implications have to be considered during every patient/ provider encounter. Patients and their
families must be given accurate and up to date information, and given the options to either seek
care or decline.
References
“Mother and Daughter: A Cultural Tale.” , directed by Anonymous., Masterswork
Productions, 2003. Alexander Street, https://video.alexanderstreet.com/watch/mother-and-
daughter-a-cultural-tale.
Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of
psychiatry (11th ed.). Wolters Kluwer.
FAMILY ASSESSMENT AND PSYCHOTHERAPEUTIC APPROACHES 18
American Psychiatric Association. (2013). In Diagnostic and statistical manual of mental
disorders (5th ed.). https://doi.org/10.1176/appi.books.9780890425596.dsm05
Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition
Rajan P. (2017). Community physiotherapy or community-based physiotherapy. Health
promotion perspectives, 7(2), 50–51. https://doi.org/10.15171/hpp.2017.10
Patra, B. N., & Sarkar, S. (2018). Adjustment disorder: current diagnostic status. Indian
journal of psychological medicine, 35(1), 4–9. https://doi.org/10.4103/0253-7176.112193
Brüne, M. (2015) Textbook of Evolutionary Psychiatry and Psychosomatic Medicine:
The Origins of Psychopathology. OUP Oxford.
http://www.ptsd.va.gov/professional/treatment/early/acute-stress-disorder.asp
Iribarren, J., Prolo, P., Neagos, N., & Chiappelli, F. (2015). Post-traumatic stress disorder:
evidence-based research for the third millennium. Evidence-based complementary and
alternative medicine : eCAM, 2(4), 503–512. https://doi.org/10.1093/ecam/neh127
Kelley, T., Docherty, S., & Brandon, D. (2016). Information needed to support knowing
the patient. ANS. Advances in nursing science, 36(4), 351–363.
https://doi.org/10.1097/ANS.0000000000000006
International meta-analysis of PTSD genome-wide association studies identifies sex- and
ancestry-specific genetic risk loci. Nievergelt CM, et al. Between 5% and 20% of PTSD risk can
be identified to inherited genes, with heritability higher in women than men. In addition, a gene
previously linked to Parkinson’s disease is also associated with PTSD. Nat Commun. 2019 Oct
8;10(1):4558.
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