Abnormal externally guided movement preparation in recent-onset schizophrenia is associated with impaired selective attention to external input

Chronic stress can result in frequent or persistent challenges of the hypothalamic-pituitary-adrenal (HPA) axis resulting in abnormal cortisol patterns and increased risk for cardiovascular disease (CVD). Police work is an environment replete with stress. The present article describes associations between cortisol, a biomarker of stress, and brachial artery flow mediated dilation (FMD) in police officers. A random sample stratified on gender (n = 100, 33% women) was generated from officers in a mid-sized urban department. Four salivary cortisol parameters were derived: after awakening, following a standardized high protein meal challenge, during the entire day, and after a dexamethasone suppression test. Continuous scan B-Mode ultrasound was used to measure percent change in brachial artery FMD following occlusion and release. Elevated cortisol secretion after awakening was significantly associated with impaired FMD in women, reflected by an inverse trend. Adjustment for age, smoking, and alcohol consumption did not appreciably alter this trend. A similar result was not evident among male officers. Responses of other cortisol challenges to the HPA axis were not associated with FMD. In conclusion, increased cortisol secretion after awakening was independently associated with impaired FMD in female police officers only, indicating a possible link between HPA axis stress response and subclinical CVD. However, because associations were not found with other cortisol parameters and were not evident in male officers, replication of these findings with a prospective study design may be warranted.     

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.     

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.     

Associations between major life events, traumatic incidents, and depression among Buffalo police officers

Police officers are considered to be a highly stressed population due to the nature of the work they perform. Repeated exposures to work stress and stressful life events can affect one's psychological and physiological well-being. The objective of this study was to determine whether negative life events and traumatic police incidents are associated with depression in police officers. One hundred randomly selected urban officers completed a series of self-report measures as part of a cross-sectional pilot study. Using four negative life event categories (none, low, medium, and high) a J-shaped pattern was observed with mean depression scores (+/- SD) of 9.26 (+/- 7.41), 6.21 (+/- 5.94), 8.17 (+/- 7.42), and 14.64 (+/- 8.04), respectively (test for linear trend p = 0.0186). Adjustment for age (p = 0.0209), then age, gender and ethnicity together (p = 0.0184) did not alter this pattern appreciably. No association between traumatic police incidents and depression was observed. Results indicate that exposure to multiple negative life events is significantly associated with elevated depression scores among this sample. Police agencies should consider developing psychological assistance efforts to help affected officers cope with these events and deal with depression.     

Association of perceived stress with sleep duration and sleep quality in police officers

The objective was to investigate associations ofperceived stress with sleep duration and quality among 430 police officers. Perceived stress was assessed using the perceived stress scale. Sleep duration and quality were assessed using the Pittsburg sleep quality index questionnaire. Mean hours of sleep were determined across quartiles of perceived stress using ANOVA/ANCOVA. Logistic regression was used to obtain odds ratios and 95% confidence intervals for poor sleep quality across perceived stress quartiles. Mean age was 42.1 years. Perceived stress was inversely associated with sleep duration among certain groups: men (p = 0.004), higher-ranked officers (p = 0.002), those with higher depressive symptoms (p 0.097), no military experience (p = 0.006), and higher workload (p = 0.003). Gender, police rank, depressive symptoms, and workload each significantly modified the association between stress and sleep duration. Prevalence of poor sleep quality increased with higher levels of perceived stress; the trend was significant among men only (p < 0.0001), and gender significantly modified this association (interaction p = 0.015). Compared to those in the first quartile of perceived stress, women in the fourth quartile were almost four times and men almost six times more likely to have poor sleep quality. Perceived stress was inversely associated with sleep duration and positively associated with poor sleep quality.     

Health disparities in police officers: comparisons to the U.S. general population

Police officers have one of the poorest cardiovascular disease (C'D) health profiles of any occupation. The goal of this study was to determine if police officers in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (between 2004 and 2009) had a more adverse CV profile than the general US. employed population. Nearly one-half (46.9%) of the officers worked a non-day shift compared to 9% of U.S. workers. The percent of officers with depression was nearly double (12.0% vs. 6.8%) and officers were nearly four times more likely to sleep less than six hours in a 24-hour period than the general population (33.0% vs. 8.0%). A higher percentage of officers were obese (40.5% vs. 32.1%), had the metabolic syndrome (26.7% vs. 18.7%), and had higher mean serum total cholesterol levels (200.8 mg/dL vs. 193.2 mg/dL) than the comparison employed populations. In addition to having higher levels of traditional CVD risk factors, police officers had higher levels of non-traditional CVD risk factors. These findings highlight the need for expanding the definition of a health disparity to include occupation. Future studies should expand this comparison to additional traditional and non-traditional CVD risk factors and to other occupational groups.     

Development and Validation of the Mental Health Attitude Survey for Police

Police officers often lack sufficient mental health training and knowledge of mental illness to manage the risks associated with emotionally disturbed person (EDP) encounters. Still, it is not clear how much mental health training police officers actually need and, to date, there are no measures for police departments to use to determine officer attitudes toward dealing with EDPs. This led to the development of the Mental Health Attitude Survey for Police (MHASP), a modification and compilation of previously developed and newly developed items, which can be used to measure the effectiveness of mental health crisis training curricula in improving police attitudes toward persons with mental illnesses. A sample of 412 police officers from a major city police department in the northeast anonymously completed the MHASP. The results provide good evidence that the MHASP is a reliable and initially validated measure of police attitudes toward persons with mental illnesses.     

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.     

The prevalence of psychosomatic disorders among a sample of police officers

Summary The present study examined the prevalence of psychosomatic disorders among a sample of 571 police officers. Psychosomatic disorders for the purposes of this study included the following symptoms (headaches, indigestion, constipation, nervous stomach, stomach aches, and diarrhea) and conditions (high blood pressure, asthma, ulcers, and colitis). Police officers reported a greater frequency of psychosomatic symptoms and conditions than previously tested general population samples. The high prevalence rates for psychosomatic symptoms and conditions found in this sample suggest that the occupational stress of police work could be a contributory factor in these elevated rates.This research was supported in part by the National Health Research and Development Program through a National Health Fellowship to Brent A. Vulcano.During the completion of this project Dr. Barnes was supported by a National Health Research Scholar Award (No. 6607-1155-48).     

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.     

Suicide among New York City police officers, 1977-1996

OBJECTIVE: The authors assessed the suicide rates of New York City police officers during a recent period. METHOD: The authors reviewed death certificates of active New York City police officers who died from 1977 through 1996 (N=668); age-, gender-, and race-specific suicide rates among New York City police officers and the city's residents were determined. RESULTS: The police suicide rate was 14.9 per 100,000 person-years, compared with a demographically adjusted suicide rate of New York City residents of 18.3 per 100,000 person-years. Suicide rates among male police officers were comparable to their reference population. Female police officers had a higher risk of suicide than female residents of New York, but the number of suicides of female police officers was small. CONCLUSIONS: The rate of suicide among New York City police officers is equal to, or even lower than, the suicide rate of the city's resident population.     

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.     

Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use

van Reedt Dortland AKB, Giltay EJ, van Veen T, Zitman FG, Penninx BWJH. Metabolic syndrome abnormalities are associated with severity of anxiety and depression and with tricyclic antidepressant use. Objective: The metabolic syndrome (MetSyn) predisposes to cardiovascular disease and diabetes mellitus. There might also be an association between the MetSyn and anxiety and depression, but its nature is unclear. We aimed to investigate whether diagnosis, symptom severity and antidepressant use are associated with the MetSyn. Method: We addressed the odds for the MetSyn and its components among 1217 depressed and/or anxious subjects and 629 controls, and their associations with symptom severity and antidepressant use. Results: Symptom severity was positively associated with prevalence of the MetSyn, [adjusted odds ratio (OR) 2.21 for very severe depression: 95% confidence interval (CI): 1.06–4.64, P = 0.04], which could be attributed to abdominal obesity and dyslipidemia. Tricyclic antidepressant (TCA) use also increased odds for the MetSyn (OR 2.30, 95% CI: 1.21–4.36, P = 0.01), independent of depression severity. Conclusion: The most severely depressed people and TCA users more often have the MetSyn, which is driven by abdominal adiposity and dyslipidemia.