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Smaller hippocampal volume in Dutch police officers with posttraumatic stress disorder.

BACKGROUND: Previous magnetic resonance imaging studies of posttraumatic stress disorder (PTSD) have reported smaller hippocampal volume, especially in war and sexual abuse victims. Our aim was to assess hippocampal volume in traumatized police officers with and without PTSD in the absence of alcohol abuse and moderate to severe major depression. METHODS: In a case-matched control study, 14 police officers with current PTSD and 14 traumatized police officers without lifetime PTSD were examined using magnetic resonance imaging. Three temporal lobe areas were manually segmented: hippocampus, amygdala, and parahippocampal gyrus. Volumetric analysis was used to measure gray matter, white matter, and cerebrospinal fluid. RESULTS: After controlling for total brain volume, the hippocampal volume in the PTSD group was significantly smaller in comparison with the traumatized control group (total 10.6%; left 12.6%). Volumes of amygdala, parahippocampal gyrus, gray matter, white matter, and cerebrospinal fluid were not significantly altered. A significant negative correlation was found between reexperiencing symptoms and hippocampal volume in the PTSD group. CONCLUSIONS: We confirmed previous findings of smaller hippocampal volume in PTSD in a new population made up of police officers, excluding comorbidity as a confounder. The finding of smaller hippocampal volume was specific to PTSD.

Adult↗

Design of an algorithm to identify persons with mental illness in a police administrative database.

North American police maintain a database to track events and information related to their involvement with the public that contain a series of electronic caution/dependency flags attached to an individual's name for internal communication. To identify persons with mental illness in a police administrative database, an algorithm was developed that was composed of (a) caution/dependency flags, (b) addresses, and (c) key search words indicative of mental illness. Based on the level of confidence of the algorithm, persons with mental illness (PMI) were then assigned to one of three categories: Definite, Probable and Possible PMI. Results for 2000 include the sociodemographic characteristics of PMI and non-PMI in the database. The mean number of contacts, types of interactions, re-involvement with a year, charges and dispositions are described. The algorithm provides a cheap, quick method to identify PMI for North American police. It enables police to monitor the effectiveness of pre-arrest diversion programs and allows researchers to analyze questions of criminalization and mental illness.

Adult↗

Post-traumatic stress symptoms in an elite unit of Brazilian police officers: prevalence and impact on psychosocial functioning and on physical and mental health.

BACKGROUND: Frequent exposure to traumatic situations put police officers under an increased risk for developing post-traumatic stress disorder (PTSD). The goals of this study were to determine the current prevalence of post-traumatic stress symptoms (PTSS) in Brazilian police officers and to compare groups with and without PTSS in terms of associated morbidity. METHODS: Police officers from an elite unit (n=157) were asked to fill out a socio-demographic questionnaire, the 12-item General Health Questionnaire and the Post-Traumatic Stress Disorder Checklist-Civilian Version. The latter's scores were used to establish the diagnoses of "full PTSD" and of "partial PTSD". RESULTS: Prevalence rates of "full PTSD" and "partial PTSD" were 8.9% and 16%, respectively. Compared with the "no PTSD" group, police officers with "full PTSD" were five times more likely to be divorced (21.6% vs. 4.3%, p=0.008), felt that their physical health was poorer (64.3% vs. 6%, p<0.001), had more medical consultations during the last 12 months [2.00 (+/-1.62) vs. 1.09 (+/-1.42), p=0.03] and reported more often lifetime suicidal ideation (35.7% vs. 5.2%, p=0.002). LIMITATIONS: The sample was relatively small. A screening tool was employed instead of a semi-structured interview. The cross-sectional design is unsuitable for ascertaining cause-effect relations. CONCLUSIONS: PTSD prevalence in our sample was comparable to those reported for North American and Dutch policemen. The presence of "full PTSD" was associated with evidences of considerable morbidity. These findings may contribute to the development of effective policies aimed at the prevention and treatment of PTSD in law enforcement agents.

Adult↗

Effects of environmental benzene: micronucleus frequencies and haematological values in traffic police working in an urban area.

Among the toxic chemicals present in the ambient air of urban centres, benzene raises particular concern due to its haematoxicity and leukaemogenic hazards, probably related to clastogenic factors. However, little is known about the health risks associated with environmental--rather than industrial--exposure to benzene. We analysed micronucleus (MN) frequencies in peripheral lymphocytes by use of the cytokinesis-block technique, and haematological parameters among 49 traffic police and 36 indoor workers (controls) in the city of Bologna. The analysis of urban air provided by a municipal air-quality monitoring station indicated that the levels of environmental benzene were often above the recommended threshold level (10 microg/m3) whereas other pollutants--nitrogen oxides, polycyclic aromatic hydrocarbon compounds, total suspended particulate matter, carbon monoxide, sulfur dioxide--did not exceed the maximum atmospheric concentration established for air-quality standards. Mean levels of individual airborne benzene exposure--as measured by personal devices worn during 4-h morning work-shifts--were six-fold higher in the traffic police than in controls (P=0.001). While no significant difference in haematological parameters was found between the two groups, MN frequency was significantly higher among the traffic police than in indoor workers (P=0.001). Among the study population, MN frequency was found to increase with age, but no influence was observed for gender or smoking. Although it cannot be excluded that the increase of MN frequency observed in traffic police could also depend, apart from benzene, on the complex mixture of pollutants encountered in urban air, our data indicate that elevated personal benzene exposure could represent a genetic risk. The analysis of biomarkers of genetic damage in subjects particularly exposed to environmental benzene deserves careful study.

Adult↗

The effect of traffic policing on road safety in Israel.

We use panel data on road sections to investigate the effect of traffic policing on non-urban road accidents in Israel. Traffic policing is measured indirectly by the number of police reports issued for driving offences. Our main findings are: (1) only large-scale enforcement has any measurable effect on road accidents while small-scale enforcement has no apparent effect. (2) The enforcement effect is slightly larger in the long run than it is in the short-run. (3) The effect of enforcement tends to dissipate rapidly after the dosage of enforcement is reduced. (4) Enforcement has no effect on fatal road accidents. (5) The evidence that the effect of policing in one road section spills over onto other road sections is weak.

Accidents, Traffic↗

Front-line police officers' practices, perceptions and attitudes about the enforcement of impaired driving laws in Canada.

A survey of front line police officers' practices, perceptions and attitudes regarding detection of impaired driving, processing of driving while impaired (DWI) charges, criminal court proceedings and DWI sanctions was conducted across Canada. A sample of 1545 officers of all jurisdictions across the country, representative of different types of police services (i.e. national, provincial, municipal) and types of policing (i.e. traffic, general duty) were surveyed by mail. The results, based on a 71% response rate, indicate that: an average of 7.5 charges/year are laid by officers resulting mainly from erratic driving; videotaping and mobile breath testing could improve efficiency of DWI enforcement; it takes an average of 2 h 48 min to process each DWI charge; about 2/3 of officers say plea bargaining occurs at least sometimes; the average length of DWI trial is over 4 h; less than half of officers think Crown Attorneys are adequately prepared for DWI cases; about 3/4 of officers think the accused escapes conviction on a legal technicality at least sometimes; about 30% of officers say short-term licence suspensions and other forms of discretion are used at least sometimes; DWI places fifth in priority among 15 offences, up from eighth in a 1981 survey; DWI is a priority for most police management but human resources are not adequate; and there is greater support for administrative than for Criminal Code changes. Multiple regressions indicated that the number of DWI charges laid by officers depended mainly on the officers' personal priority regarding DWI enforcement. The results suggest that many officers want to enforce DWI laws but that the numerous procedural and legal barriers that they confront often force them to exercise discretion in the laying of DWI charges.

Accidents, Traffic↗

Impact of police-reported intimate partner violence during pregnancy on birth outcomes.

OBJECTIVE: To examine the relationship of police-reported intimate partner violence during pregnancy and adverse birth outcomes. METHODS: We conducted a population-based, retrospective, cohort study in Seattle, Washington, using Seattle police data and Washington State birth certificate files from January 1995 through September 1999. Exposed subjects were women with an intimate partner violence incident reported to police during pregnancy and who subsequently had a singleton live birth or fetal death registered in the state of Washington. Unexposed subjects were randomly selected Seattle residents with a singleton live birth or fetal death in the same time period and who did not report an incident. The main outcome measures were low birth weight (LBW less than 2500 g), very LBW (VLBW less than 1500 g), preterm birth (20-36 weeks' gestation), very preterm birth (20-31 weeks), and neonatal death (before discharge). RESULTS: Women reporting any partner violence during pregnancy were significantly more likely to have a LBW infant (adjusted odds ratio [aOR] 1.70; 95% confidence interval [CI] 1.20, 2.40), a VLBW infant (aOR 2.54; 95% CI 1.32, 4.91), a preterm birth (aOR 1.61; 95% CI 1.14, 2.28), a very preterm birth (aOR 3.71; 95% CI 1.80, 7.63), and a neonatal death (aOR 3.49; 95% CI 1.43, 8.50). CONCLUSION: Police-reported partner violence during pregnancy is significantly associated with an increased risk of adverse birth outcomes. There is a critical need to identify pregnancy among women with reported incidents and to provide women health and social service information and referrals, particularly referrals to high-risk pregnancy programs.

Adolescent↗

The impaired driver: hospital and police detection of alcohol and other drugs of abuse in motor vehicle crashes.

STUDY OBJECTIVES: To determine the incidence of drugs of abuse and alcohol use in admitted drivers involved in motor vehicle crashes (MVCs) and to determine the rate of police detection of alcohol and drug use in these motorists. DESIGN: Retrospective chart review of hospitalized drivers involved in MVCs and review of corresponding police reports. SETTING: Two Level I trauma centers in a large metropolitan region. PARTICIPANTS: All MVC drivers/motorcycle operators admitted to the trauma service from January 1, 1990, to December 31, 1990. MEASUREMENTS AND MAIN RESULTS: The records of 634 injured motorists were reviewed; 200 (32% of the 625 patients with serum alcohol levels) were legally drunk (serum alcohol of 100 mg/dL or more), and 132 (22.6% of the 585 urine drug screens) had positive urine drug screens. Cocaine was the most prevalent drug of abuse, present in 51 patients (8.7%). Two hundred eighty-five patients (45.0%) were considered impaired (alcohol of 100 mg/dL or more and/or positive drug screen), representing almost half of all motorists admitted. The impaired motorists were younger, more often male, less likely to use a seat belt or helmet, and had higher Injury Severity Scores than their unimpaired counterparts. Police reports were available for 446 patients, 139 (31.2%) of whom were legally drunk and 67 (15%) of whom had positive drug screens, yielding an overall impairment rate of 46.2%. Only 34 (16.5%) patients were cited for driving under the influence. CONCLUSION: An exceedingly high rate of impairment existed in this population of seriously injured motorists in a metropolitan region, the majority of whom were not charged by the police. Although alcohol is the most prevalent source of driver impairment, other drugs of abuse are also important contributors to this problem.

Accidents, Traffic↗

The treatment of drug misusers in police custody.

Large numbers of drug users appear in police stations, either as a result of drug offences or as offenders who also misuse drugs. Invariably such offenders are dealt with by police surgeons or forensic medical examiners as they are now called. In this paper a review is made of the guidelines for drug users to access medical help, and the nature of the medical service provided. Supporting material is also provided by the use of some case histories taken from one UK police station. An assessment is made of the obligations and requirements of police surgeons to notify selected drug users under the Notification Regulations and the authors also suggest a more detailed research programme which could be developed.

Forensic Medicine↗

Bridging healthcare, police, and court responses to intimate partner violence perpetrated by individuals with severe and persistent mental illness.

A subgroup of individuals with severe and presistent mental illness (SPMI) commit acts of intimate partner violence (IPV). State and federal legislators have enacted statutes altering police response to IPV. Proarrest laws have curbed police discretion to a degree, and resulted in more IPV arrests. Unaware of alternative options, such as family court, mental health professionals may refer families with IPV to the police. However, perpetrators with SPMI may be inappropriate for adjudication in the criminal justice system. A singular legal response to IPV may miss the opportunity for detection and assertive treatment of SPMI, that could promote safety and reduce the likelihood of violence. Offenders with SPMI may also have difficulty comprehending court procedures. This article discusses the potential for a more flexible approach to IPV through interdisciplinary coordination and training of police, judges, attorneys, legal advocates, mental health professionals and substance abuse providers.

Criminal Law↗

Police referral to victim support: the predictive and diagnostic value of the RISK (10) screening instrument.

One of the basic rights of crime victims granted under victim-orientated legislation introduced during the last 20 years in more than 100 countries worldwide is the right to be referred to victim support by the police. The under-utilization of psychological services by crime victims who are objectively in need of external support is substantial. Current legal procedures tend to perpetuate this unwanted condition. Programs aimed at the early detection and prevention of persistent postvictimization distress are more in line with the ideals of therapeutic jurisprudence. The RISK (10) screening instrument, which was specifically developed to be administered by police officers, may provide a basis for early detection. RISK (10) consists of a selection of 10 Risk factors with prior empirical evidence and theoretical significance. The focus of the present study was to examine the predictive and diagnostic power of RISK (10) components to detect persistent future psychological distress, among other things, in terms of Adjustment Disorder. Analyses were based on a sample of 93 crime victims who participated in the police and (3 months) follow-up parts of the study. Findings provided initial validation for the predictive accuracy of most RISK (10) components, and confirm the diagnostic value (in terms of specificity, sensitivity, positive and negative predictive power) of risk factors, such as engaging in character attributions, upward comparison processes, fatalistic appraisals of the episode, and the initial reporting of expected deficiencies in social support. The clinical utility of RISK (10) for early detection in police stations is confirmed.

Adolescent↗

Reactions to penalties for offenses committed by the police and public citizens: testing a social-cognitive process model of retributive justice.

This research investigated situations involving the police and public citizens in which both committed offenses and were punished. Participants responded to either a scenario describing police violence against a "green" protester (n = 177) or one describing dangerous driving by detectives leading to injury of juveniles in a car chase (n = 149). Results showed that information about following orders mitigated participants' reactions to offenses committed by authority figures. The perceived seriousness of the offenses committed by police authorities was negatively related to participants' level of right-wing authoritarianism and positively related to the importance participants assigned to universalism values. These relations were opposite in direction for the public offenders who refused to obey a police order. Other relations supported a social-cognitive process model in which values, responsibility, seriousness, and deservingness are key variables.

Adult↗

Quality of treatment following police detention of mentally disordered offenders.

There is a growing interest in patients' perspectives in relation to the treatment and management of mentally disordered offenders at all levels of service delivery. This paper reports on a group of mentally ill individuals who were admitted to a place of safety following detention by the police. The principal purpose of the study was to determine the quality of care that the patient experienced under section 136 of the Mental Health Act (1983) from police detention to hospital admission. The major focus concerned the anticipated disparity between the non-professional police interactions and those of the mental health professional. The method employed was a grounded theory analysis of audio-taped interviews utilizing a three-level coding of data. The results indicated a general dissatisfaction with the quality of care and treatment from both police and professionals, but with the former being viewed as acceptable whilst the latter was considered unacceptable. The patients made a series of recommendations for detention in places of safety.

Adolescent↗

Quantitative and qualitative evaluations of brief interventions to change excessive drinking, smoking and stress in the police force.

AIMS: To evaluate the effects of a brief intervention to reduce excessive drinking, smoking and stress among police. DESIGN: (1) Controlled intervention trial with pre and post-intervention assessment approximately 8 months apart; (2) focus group identification of relevant factors). SETTING, PARTICIPANTS: Assessment was carried out of 954 NSW (Australia) police at 19 stations within two matched districts in the Sydney metropolitan area. Five focus groups were carried out with 43 randomly selected police from the matched districts. MEASUREMENTS: Weekly alcohol consumption and binge drinking, smoking and symptoms of stress were measured by a self-administered Health and Fitness Questionnaire. Recorded responses to set questions provided qualitative data. RESULTS: Participation was high (89%) at both quantitative assessments. Alcohol consumptions, particularly among men, was high at both baseline and follow-up assessments, although comparisons between groups across occasions showed no significant intervention effects. Excessive drinkers and those reporting moderate to severe stress levels reported more sick leave days (p < 0.05, p < 0.05). A significant increase in awareness of alcohol policies in the work-place showed in both experimental and control groups over time (p < 0.01). The percentage of smokers declined significantly in both intervention and control groups. Overall, women had significantly more symptoms of stress than men. Only 20% of police thought they would seek advice from work-place staff about alcohol consumption, 14% for smoking and 61% for stress. In the qualitative study, employees generally distrusted their organization's involvement in health unless work performance was affected. Seeking professional assistance for life-style issues was viewed as a sign of weakness. Alcohol use was seen as a way of obtaining information or group membership, self-medication and socializing. CONCLUSIONS: The brief interventions did not produce significant improvements in three life-style factors beyond positive trends in alcohol consumption among women and general reductions in smoking among both study groups. Combining quantitative and qualitative approaches helped identify interactive individual and organizational factors which influence behavioural and cultural norms.

Adolescent↗

[Psychosocial stress at work and musculoskeletal pain among police officers in special forces].

This study investigates associations of an adverse psychosocial work environment with musculoskeletal pain among German police officers in special forces. Analyses are based on a survey of 480 officers in special police forces (mainly special assignments and mobile units). An adverse psychosocial work environment is measured by the effort-reward imbalance model that identifies "high effort/low reward" working conditions. Musculoskeletal pain is assessed by means of a validated questionnaire (12 months and 7 days prevalence). Analyses confirm that police work is a stressful occupation. Multivariate logistic regression analysis indicates a twofold risk for neck, back and hip pain among police officers defined by an imbalance of high effort and low reward at work after adjustment for age, gender, socio-economic status, and physical work load.

Adult↗

An investigation of the effectiveness of police cruiser doors as protection from handgun attack.

The objective of this research was to investigate the degree to which automobile doors (especially police cruiser doors) may be used as protection by police officers when under handgun attack. This is a vital question, since the cruiser door is often the only defense a police officer has when encountering gunfire. Data were collected on door penetration capabilities of 3 calibers of handguns (selected based on FBI data on police officer assaults) at 2 different angles of fire. Results indicated that caliber has a significant effect, with the likelihood of penetration increasing with caliber. The oblique angle of fire (45 degrees) was somewhat less likely to penetrate than an orthogonal angle, although the difference was not significant. Overall, 68% of the rounds penetrated the door regardless of angle of fire or caliber.

Accident Prevention↗

Managing psychological trauma in the police service: from the Bradford fire to the Hillsborough crush disaster.

Particularly since the Bradford football stadium fire of May 1985, the UK Police Service has been developing increasingly sophisticated procedures for managing post-traumatic stress reactions in its officers. Coupled with the growth of dedicated occupational health units within the Police Service, this suggests that physicians working within police forces will have an increasingly important role to play in the management of such problems. A brief account is given of the confidential screening and counselling service for police officers that was instituted after the Bradford fire, and a corresponding description is given of the more elaborate procedures implemented after the Hillsborough football stadium crush disaster of April 1989. In conclusion, the possible scope for preventive management of Post-traumatic stress disorder (PTSD) is highlighted.

Crowding↗

Musculoskeletal problems and driving in police officers.

The Occupational Health Department of a rural police force in the UK had concerns regarding sickness absence levels due to musculoskeletal problems, particularly in officers who drove as part of their job. It was decided to conduct an interview survey comparing two groups of police officers with differing levels of exposure to driving, recording sickness absence and prevalence data related due to musculoskeletal troubles. The results indicate that exposure to car driving, both in terms of distance and hours driven, had a significant effect on self-reported low back trouble. Officers whose job mainly involved driving also experienced more low back trouble over the last 12 months than those whose job primarily involved sitting (not driving), standing and lifting tasks. Police motorcyclists had significantly higher prevalence figures for reported shoulder trouble than police car drivers.

Adult↗