Training police trainees about ways to manage trauma and loss

For the second year we were invited to be trainers at a training seminar for senior police educators, held in the German Federal Police University and sponsored by the European Police College, hence, having the opportunity to build on their previous applications. We applied exercises (psychoeducation, mindfulness/awareness, journaling, processing in dyads) that introduced in this training and designed to teach officers how to handle exposure to adversities and minimize potential negative consequences. Police officers expect exposure to potentially traumatic incidents, yet, often suffer deeply because of unresolved trauma related to handling horrific events. Our work aimed to open discussion in order to formulate a standard component in training curricula related to teaching police trainees ways to effectively handle and process trauma.     

Adiposity in policing: mental health consequences

Previous research suggests that adiposity is a health problem among police officers. Stress is also a concern in police work and can lead to depression. Although previous studies have demonstrated an association between obesity and depression, this has not been adequately addressed in the police population. MAeasures of adiposity (Body Mass Index [BM1], abdominal height, waist circumference) and depressive symptoms (Center for Epidemiologic Studies Depression [CES-D] scale) were obtained from a random sample of 115 officers in an urban police department. Ninety nine officers (61 men and 38 women) who had complete data and were not on anti-depressive medication were used. Linear regression analysis was conducted separately for men and women. Covariate adjustments were made for age, alcohol use, smoking, pack-years of smoking, marital status, and physical activity. Statistically significant positive trends were observed in multivariate adjusted mean (+/- SE) depression symptom scores across increasing tertiles of BMI (7.0 +/- 1.3, 5.1 +/- 1.2, 8.8 +/- 1.3, p = 0.012) and abdominal height (6.0 +/- 1.4, 5.5 +/- 1.3, 9.2 +/- 1.4, p = 0.048) for men officers. No significant associations were found between CES-D score and adiposity in women officers (p = 0.075 for BMI, p = 0.317 for abdominal height, p = 0.114 for waist circumference). Additional factors that might influence this association should be examined prospectively in future work to help clarify causal direction.     

Homicide-suicide in police families: aggression full circle

Police officers are considered to be at increased risk for suicide, and such self-aggression may be extended to others. This paper describes antecedents of police family homicide-suicides in a sample of 29 cases. Police experiences with violence and aggression, domestic violence, and availability of lethal weaponry are possible correlates. Results from this sample suggested that police family homicide-suicides are increasing, as approximately twice as many cases were reported in 2006 as in the two previous years. The majority of homicide victims were women (N=24; 83%), however five of the victims were men killed by women police officers. The majority of incidents occurred in younger age groups (< 40 years of age). The primary weapon employed was the police service firearm (90%). Most incidents occurred on the local police departmental level (76%) as opposed to state and federal level departments. Similar to the majority of nationwide homicide-suicides, the homicide victim was primarily a spouse or female acquaintance. In three cases a child was also killed by the perpetrator While exposure to violence in police work cannot be changed, the establishment of a strict domestic violence policy by police agencies is discussed as one strategy to reduce the incidence of violence in the police family.     

Hardiness and psychological distress in a cohort of police officers

Since police officers are frequently exposed to high stress situations, individual differences in the response to stress and trauma are of interest. We examined the association of hardiness components (commitment, control and challenge) with depression, posttraumatic stress disorder (PTSD) symptoms, and symptoms of general psychological distress in police officers. The random sample included 105 officers (40 women and 65 men) from the Buffalo Cardio-Metabolic Police Stress (BCOPS) study baseline visit. Components of hardiness were measured using a 15-item hardiness scale. Depressive symptoms were measured using the Center for Epidemiological Studies Depression scale (CES-D), PTSD symptoms were measured using the impact of events scale (IES), and symptoms of general psychological distress were measured using the Brief Symptoms Inventory (BSI). Associations were assessed using linear regression analysis. Models were adjusted for age, education and marital status. Because of significant gender interactions, analyses were stratified by gender. The hardiness control dimension was significantly and negatively associated with CES-D for both genders but was not associated with IES. Hardiness commitment was significantly and negatively associated with both CES-D and IES in women. Men had negative but non-significant associations for commitment with CES-D and IES. Hardiness commitment was negatively associated with the overall BSI score for both men and women but the association was only significant for men, though the strength of the association was stronger for women. This is likely a result of the impact of the smaller sample size for women. The magnitude of gender differences in these associations shows that for depressive and PTSD symptoms, the commitment dimension of hardiness may be more protective in female police officers than in male officers.     

Officer-involved shooting: reaction patterns, response protocols, and psychological intervention strategies

Psychologists who work with law enforcement agencies may be called upon to respond to an officer-involved shooting (OIS). These need not be the most traumatic critical incidents in policing, but when they are, the reasons usually involve a mix of incident characteristics, officer response styles, and departmental handling. This article describes some of the psychological reactions experienced by officers during and following an OIS and provides a model of administrative, legal, mental health, and peer support services for officers in need. Finally, the article discusses several key roles that the police psychologist can play in the process of managing an OIS.     

Association between childhood trauma and catecholamine response to psychological stress in police academy recruits.

BACKGROUND: Childhood trauma is a risk factor for anxiety disorders in adulthood. One possible mechanism for this association is an increased neuroendocrine response to stress in adults with a history of childhood trauma. METHODS: In a cross-sectional study, 76 police academy recruits (mean [+/-SD] age 28 +/- 5 years, 10 female) were exposed to a video depicting real-life officers exposed to highly stressful incidents. Salivary cortisol and 3-methoxy-4-hydroxy-phenylglycol (MHPG, the major metabolite of norepinephrine) were collected at baseline, immediately after the video, and 20 min after the video. Childhood trauma before age 14 was assessed with an interview (Life Stressor Checklist-Revised). RESULTS: Exposure to the video elicited significant MHPG and cortisol responses in both groups. Recruits with childhood trauma histories (n = 16) had a significantly greater MHPG response, as evidenced by a group effect (F = 8.0, p < .01), and a group x time interaction (F = 4.1, p < .05). The cortisol response did not differ between groups. CONCLUSIONS: Police academy recruits with childhood trauma histories have an increased catecholamine response to psychological stress. This might serve as a risk factor for anxiety disorders in recruits, and these findings might generalize to other groups with a history of childhood trauma.     

Association of sleep quality with depression in police officers

Poor sleep quality has been shown to adversely affect neurobehavior including an increase in depression symptoms. Police officers are at increased risk of poor sleep quality due to occupational factors. This study analyzed self-reported sleep and depression data from police officers; 391 police officers from Buffalo, New York reported on sleep and depression by completing the Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiological Studies Depression (CES-D) questionnaires. Mean CES-D scores were assessed across quintiles of PSQI. As PSQI scores increased, reflecting poorer sleep quality, CES-D scores also increased significantly indicating an increase in depression symptoms as sleep quality worsens. This trend held for both male and female officers. Mean CES-D scores across quintiles ranged from 4.72 to 12.65 in men and from 5.53 to 12.63 in women. Multivariate adjustment only very slightly attenuated the association in female officers. After adjustmnent, five of the seven PSQI components showed statistically significant associations with CES-D scores in male officers and two in female officers. Sleep quality was significantly and independently associated with depressive symnptoms as evidenced by a trend of increasing depressive symptom scores with decreasing sleep quality in both male and female officers.     

Dimensions de personnalité et facteurs de stress chez les policiers

ObjectivesPolice officers are exposed to chronic and cumulative potentially traumatic events in their careers. The personality influences the development of pathological stress. Literature highlights that positive valence personalities (conscientiousness, extraversion, and openness) are less susceptible to the development of pathological stress than neuroticism. The aim of this study is to assess the influence of personality dimensions on the development of acute stress disorder (ASD) and post-traumatic stress disorder (PTSD) among police officers.Patients or materials and methodsWe presented the research project to several police department heads and police officers in Belgium. We were contacted by volunteer police officers. Then, we organized interviews lasting nearly 2 hours. First, we conducted an anamnesis during which police officers identified the most traumatic events experienced in their career. Secondly, we administered diagnostic instruments evaluating ASD (SASRQ), PTSP (TraumaQ) and personality dimensions (BFI-fr). The population includes 83 police officers.ResultsMultiple linear regression analyzes show that neuroticism is the personality dimension influencing the development of acute stress disorder and post-traumatic stress disorder. It is positively associated with most of their symptoms. Moreover, extraversion appears as the most protective personality dimension against pathological stress symptoms.ConclusionsThe assessment of trauma and personality is therefore important in the selection process of police officers’ candidates and throughout the career. It can be useful in identifying signs of anxiety, or even acute or post-traumatic stress and risk factors related to their development.     

Police trauma and cardiovascular disease: association between PTSD symptoms and metabolic syndrome

Although prior evidence exists concerning the association between posttraumatic stress disorder (PTSD) and cardiovascular disease, few studies have examined associations of PTSD symptomatology and the metabolic syndrome in the high stress occupation of police work. The metabolic syndrome is a clustering of cardiovascular disease risk factors that have also been independently associated with psychological conditions. The aim of this study was to examine associations between the PTSD symptoms and metabolic syndrome in police officers. A stratified sample of 115 police officers was randomly selected from the Buffalo, NY Police Department. PTSD symptoms were measured with the Impact of Event scale (IES), divided into categories of subclinical, mild, moderate and severe symptom levels. The metabolic syndrome was considered present if three or more of its component parameters (obesity, elevated blood pressure, reduced high density lipoprotein (HDL) cholesterol, elevated triglycerides, and abnormal glucose levels) were present in each officer. Results indicated a significantly increased prevalence of the metabolic syndrome among those officers in the severe PTSD symptom category compared with the lowest PTSD severity category (prevalence ratio (PR) = 3.31, 95% C.I. = 1.19 - 9.22). Adjustment for age did not alter the association appreciably (PR = 3.12, 95% C.I. = 1.15 - 8.50). Adjustment for several demographic and lifestyle factors (age, education, smoking, alcohol intake) reduced the magnitude of the prevalence ratio slightly for the severe versus subclinical PTSD category (PR = 2.69, 95% C.I. = 0. 79 - 9.13), with adjustment for age and education accounting for most of the attenuation (PR = 2.71, 95% C.I. = 0.99 - 7.37). Thus, officers with severe PTSD symptoms were approximately three times more likely to have the metabolic syndrome and education may account for some of this association.     

抑郁症伴焦虑症状的影响因素分析

目的探讨抑郁症患者伴焦虑症状的发生情况,并从社会心理因素方面分析抑郁症伴焦虑症状的影响因素。方法采用汉密尔顿抑郁量表(Hamilton depression rating scale,HAMD)、汉密尔顿焦虑量表(Hamilton anxiety rating scale,HAMA)、艾森克人格问卷(Eysenck personality questionnaire,EPQ)、生活事件量表(life event scale,LES)、特质应对方式问卷(trait coping style questionnaire,TCSQ)、社会支持问卷(social support scale,SSS)对729例抑郁症患者进行评估,根据HAMA得分将患者分为不伴焦虑症状组(HAMA7分)和伴焦虑症状组(HAMA14分),比较两组社会心理因素,并分析抑郁症伴焦虑症状的影响因素。结果抑郁症患者中焦虑症状(HAMA14分)的发生率为58.85%(429/729),16.32%(119/729)肯定不伴焦虑症状(HAMA7分)。伴焦虑症状组神经质、精神质、负性生活事件、消极应对方式的得分高于不伴焦虑症状组(P0.001);外倾性的得分低于不伴焦虑症状组(P=0.010)。抑郁程度(OR=9.255,95%CI:4.726~18.127)、神经质(OR=1.595,95%CI:1.197~2.125)、负性生活事件(OR=1.009,95%CI:1.001~1.017)、消极应对方式(OR=1.046,95%CI:1.013~1.080)均是抑郁症患者伴焦虑症状的危险因素(P0.05)。结论抑郁症患者焦虑症状的发生率高。抑郁症状严重、高神经质水平、经历更多负性生活事件、倾向于采用消极应对方式的抑郁症患者更有可能伴焦虑症状。     

The impact of posttraumatic sress on Iraqi police

This paper explores the psychological impact of posttraumatic stress on a sample of the Iraqi Police Service (IPS). Four separate surveys of lPS members were administered utilizing a 17-item National Center for PTSD checklist. In total, 231 of the 520 IPS (44%) achieved scores indicating that they had met the criteria for the diagnosis of PTSD. As a result, a two-hour lecture dealing with critical incidents, stress, cumulative stress, vicarious traumatization, posttraumatic stress disorder reactions to terrorism, compassion fatigue, burnout, and acute traumatic stress management (ATSM--which helps manage individual responses during traumatic events) was developed. This intervention was translated and conducted in Arabic for the IPS. It was noted that the majority of IPS surveyed never had been given information regarding traumatic stress symptoms or reactions, nor were they aware that they themselves might have traumatic stress. In addition, there is very little access to appropriate psychological assistance, either on the job or in the community.     

Cancer incidence among police officers in a U.S. northeast region: 1976-2006

Police officers are exposed to occupational hazards which may put them at increased risk of cancer We examined the incidence of cancer in a cohort of 2234 white-male police officers in Buffalo, New York. The study population was followed for 31 years (1976-2006). The incidence of cancer, ascertained using a population-based tumor registry, was compared with 9 US regions using the Surveillance Epidemiology and End Results (SEER) program data. Four hundred and six officers (18.2%) developed cancer between 1976 and 2006. The risk of overall cancer among police officers was found to be similar to the general white-male population (standardized incidence ratio [SIR] = 0.94, 95%, confidence interval [CI] = 0.85-1.03). An elevated risk of Hodgkin's lymphoma was observed relative to the general population (SIR = 3.34, 95%, CI = 1.22-7.26). The risk of brain cancer, although only slightly elevated relative to the general population (SIR = 1.61, 95%, CI = 0.73-3.05), was significantly increased with 30 years or more of service (SIR = 2.92, 95%, CI = 1.07-6.36). Incidence ratios were significantly lower than expected for skin and bladder cancer Police officers were at increased risk of Hodgkin's lymphoma overall and of brain cancer after 30 years of service.     

Comparing psychological distress, traumatic stress reactions, and experiences of unaccompanied refugee minors with experiences of adolescents accompanied by parents

The objective of this study is to make comparisons of the severity of the psychological distress, behavioral problems and traumatic stress reactions, and experiences of unaccompanied refugee minors (URMs) with immigrant/refugee (I/R) and Dutch (native) adolescents with parental caregivers (N = 3273). Self-report questionnaires were administered. Most assessments took place at school. URMs consistently reported significantly higher scores for internalizing problems, traumatic stress reactions, and stressful life events than all other groups. Gender appears to play an important role in the native and I/R samples in reporting psychological distress, behavioral problems, and traumatic stress reactions. Older age was significantly related to higher scores only in the URM group. Natives scored higher on externalizing problems than the other groups. URMs reported to have experienced twice as many stressful life events than I/Rs and natives. URMs appear to be at significantly higher risk for the development of psychopathology than refugee adolescents living with a family member, immigrants, or Dutch adolescents.     

Life events and psychopathology in a group of suicide attempters

Researchers examined the incidence of negative life events and associated these events with psychological scales (depression, hopelessness, self-esteem and state-trait anger) in a group of suicide attempters (n = 101) within the framework of the WHO/EURO Multicenter Study on Suicidal Behavior. Certain negative life events (especially relationship problems and physical/mental abuse in childhood) turned out to be the main indicators of severe mental problems in the family of the attempters (e.g. addiction, self-destructive behavior or psychiatric hospitalization). Significant positive correlations were found between the number of events and some psychopathological symptoms like depression, hopelessness, anger and lack of self-esteem. The role of stressful life events in suicidal behavior is emphasized. Particularly traumatic events (e.g. abuse in childhood) may be involved in the development of psychological and/or biological vulnerability (stress-diathesis model) and cognitive dysfunction. Therefore, in the psychotherapy of suicide attempters, it is essential to explore and discuss negative life events.     

A pilot study exploring mental health consumers’ experiences with the police

Police encounters with people experiencing mental illness are both common and problematic. While there is an international body of literature on police officers’ perceptions of mental-health-related incidents, few studies have sought to understand these encounters from the perspectives of people experiencing mental illness. This pilot study recruited 26 people through a state-wide Consumer Advisory Group who completed an online survey regarding their encounters with police. Results indicated that when people perceived procedurally just treatment from police they were more likely to co-operate with them and to evaluate the encounter positively. The nature of police involvement and levels of internalised stigma moderated the association between perceived procedural justice and their evaluation. Prior contacts were also important in shaping participants’ overall attitudes towards police. Findings highlight the importance of officers treating people experiencing mental illness fairly and respectfully to facilitate peaceful encounters and help foster more positive perceptions of the police.     

Associations between police officer stress and the metabolic syndrome

The purpose of this study was to examine the association of police officer stress with metabolic syndrome (MetSyn) and its individual components. Participants included 288 men and 102 women from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. Police stress was measured using the Spielberger police stress survey. MetSyn was defined using 2005 guidelines. Results were stratified by gender ANCOVA was used to describe differences in number of MetSyn components across police stress categories after adjusting for age and smoking status. Logistic regression was used to calculate odds ratios for having each MetSyn component by increased police stress levels. The multivariate-adjusted number of MetSyn components increased significantly in women across tertiles of the three perceived stress subscales, and administrative and organizational pressure and lack of support indices for the previous month. No association was found among male officers. Abdominal obesity and reduced high density lipoprotein cholesterol (HDL-C) were consistently associated with police stress in women. Police stress, particularly organizational pressure and lack of support, was associated with MetSyn among female but not male police officers. Given the stress of policing and the adverse cardiovascular disease (CVD) risk factors prevalent among police officers, exploring the association between specific types of police stress and subclinical CVD is important.