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PubMed2006

Predictors of posttraumatic stress in police and other first responders.

We provide an overview of previous research conducted by our group on risk and resilience factors for PTSD symptoms in police and other first responders. Based on our work, the findings of other investigators on individual differences in risk for PTSD, and drawing on preclinical studies fear conditioning and extinction, we propose a conceptual model for the development of PTSD symptoms emphasizing the role of vulnerability and resilience to peritraumatic panic reactions. We tested this conceptual model in a cross-sectional sample of police officers (n = 715). Utilizing an hierarchical linear regression model we were able to explain 39.7% of the variance in PTSD symptoms. Five variables remained significant in the final model; greater peritraumatic distress (beta = 0.240, P < .001), greater peritraumatic dissociation (beta = 0.174, P < .001), greater problem-solving coping (beta = 0.103, P < .01), greater routine work environment stress (beta = 0.182, P < .001), and lower levels of social support (beta = -0.246, P < .001). These results were largely consistent with the proposed conceptual model. Next steps in this line of research will be to test this model prospectively in a sample of 400 police academy recruits assessed during training and currently being followed for the first 2 years of police service.

Data Collection↗
PubMed2002

Abused patient's attitudes about mandatory reporting of intimate partner abuse injuries to police.

OBJECTIVES: This study examines abused women's preferences regarding medical clinician reporting of intimate partner abuse injuries to police. It also examines the influence of specific demographic factors on abused women's reporting preferences. METHODS: Telephone interviews were conducted with a random sample of women patients attending one of three public primary care clinics associated with the San Francisco Community Health Network. Participants reporting a history of abuse were asked to identify their preferences regarding the reporting of abuse by medical clinicians to police. RESULTS: Of the 358 abused women interviewed in this study, the majority of them (n = 243, 68%) did not prefer a domestic violence injury reporting system that was mandatory even if against patient wishes. However, almost all women (n = 329, 92%) favored some form of police reporting by medical clinicians. Women who had been abused within the past year were more likely to oppose mandatory reporting than women who had been abused more than one year ago. Younger women were more likely than older women to oppose mandatory reporting requirements, and women whose primary language was English were more likely to oppose mandatory reporting requirements than women whose primary language was Spanish. Current abuse was independently predictive of decreased likelihood to select mandatory reporting in all situations. There were no significant differences in reporting preferences by ethnicity, marital status, education, employment, or the presence of children at home. CONCLUSIONS: Despite broad support among abused women for medical clinician reporting of intimate partner abuse injuries to police, most women do not support mandatory reporting requirements that do not allow for consideration of the abused patients' wishes. More research is needed to ascertain whether the benefits of mandatory reporting outweigh the risks to those intended to benefit from the law.

Adolescent↗
PubMed2004

[Secondary prevention for police officers involved in job-related psychologically stressful or traumatic situations].

OBJECTIVES: Police officers are at high risk of being exposed to psychologically straining situations and potentially psychotraumatic experiences. In this article, such situations are exemplified and categorized, and the role and significance of secondary prevention following traumatic experiences is discussed. METHODS: From 1994 to 2003, 649 police officers received secondary prevention after being involved in a total of 250 potentially traumatic or psychologically stressful incidents. Psychological support was provided by teams of specially trained professionals in the acute phase after the incident following careful psychological evaluation. In a retrospective evaluation, the diagnoses obtained were analyzed with regard to sex and age and correlated with the severity of the incident. Three clusters of potentially traumatic situations were formed: (1) Employment of fire-arms with danger for the officer, (2) Standard situations including violence towards a third party, (3) Suicide or attempted suicide of a police officer. RESULTS: Police officers who experienced events assigned to cluster (1), comprising situations with considerable traumatic potential, had the highest incidence of posttraumatic stress disorder (PTSD) or other mental illness. Compared to male officers, females were more often diagnosed with other mental illness, whereas males had a higher incidence of PTSD. Cluster (2), which comprised situations of an officer's daily professional life, was not associated with an increased risk of mental illness. Officers were apparently capable of coping with situations considered psychologically straining for the general public without detectable evidence of a traumatic reaction. In cluster (3), which reflects the most dramatic interference with team relations, other forms of mental illness were diagnosed at a higher incidence.

Adult↗
PubMed2006

A study of the factors that influence how senior officers police crowd events: on SIDE outside the laboratory.

This paper fits into the SIDE perspective (Reicher, Spears, & Postmes, 1995; Postmes, Spears, Lea, & Reicher, 2000), which emphasises the importance of integrating the cognitive and strategic dimensions of group processes. Our study examines the decisions made by senior police officers during a simulation exercise of a crowd event. The analysis shows, firstly, that officers are deeply concerned about their accountability to a variety of audiences, both internal and external to the police force. Second, these different audiences pressure them to act in different, and sometimes contradictory, ways. What counts, then, is the overall balance between accountability concerns. Third, this balance - and, with it, police perceptions and decisions - alters in the course of an event. More specifically, with escalating conflict, the balance of accountability concerns moves increasingly in the direction of undifferentiated intervention against crowd members. In discussion, we consider both the theoretical implications of this analysis for research on group processes (in particular the importance of accountability issues once one moves beyond the laboratory and deals with groups that have a past and future and in which membership is more than simply an act of choice) and the practical implications in terms of crowd policing.

Adult↗
PubMed2001

A randomized controlled trial of community-oriented and hospital-oriented care for discharged psychiatric patients: influence of personality disorder on police contacts.

An important forensic psychiatric measure, contacts with police, was compared in a randomized, controlled trial of 155 patients with severe mental illness with a previous admission within the past two years. The patients, who also had their personality status addressed formally before randomization, were allocated to community multidisciplinary teams or to hospital-based care programs after discharge from in-patient care and were followed up for one year. A total of 138 patients (89%) had at least one post-baseline assessment and of these patients, 16 (12%) had at least one police contact in the year of the study, most of which were emergency assessments. The data showed significantly greater numbers of police contacts in patients with increasing severity of personality disturbance. Patients with such disturbance were six times more likely to have police contacts than those with no personality disorder. There were significantly more contacts in patients with borderline and antisocial (dissocial) personality disorder allocated to community-oriented care compared with hospital-oriented care. These findings have important implications for risk assessment in severe mental illness.

Adolescent↗
PubMed2003

Suicidal ideation and attempts in Norwegian police.

Studies on suicide among police show inconsistent results, thereby contributing to considerable speculation regarding why police officers commit suicide. The present paper is the first nationwide study on suicidal ideation and attempts among police. 3,272 Norwegian police completed Paykel's Suicidal Feelings in the General Population questionnaire. Lifetime prevalence of specific questionnaire items ranged from 24% for the feeling that life was not worth living, 6.4% for having seriously considered suicide, and 0.7% for attempted suicide. Independent predictors of serious suicidal ideation were marital status, subjective health complaints, reality weakness, anxiety, and depression. Serious suicidal ideation was mainly attributed to personal and family problems.

Adult↗
PubMed2004

Predictors of police suicide ideation.

Further inquiry into processes that lead to suicide in the police occupation is necessary. Suicide ideation in police officers and possible correlates associated with such ideation is explored in this paper. The focus was on psychologically traumatic police work experiences, the development of posttraumatic stress (PTSD) in officers, and the inordinate use of alcohol associated with this condition. The impact of these occupationally based factors and their association with suicide ideation has not yet been fully explored. Results suggest that certain traumatic police work exposures increase the risk of high level PTSD symptoms, which subsequently increase the risk of high alcohol use and suicide ideation. The combined impact of PTSD and increased alcohol use led to a ten-fold increase risk for suicide ideation.

Adult↗
PubMed2004

Maryland State Police Aviation Division. A model emergency medical system for our nation.

This collective review has the following purposes. First we will describe each of the components of the Maryland State Police Aviation Division. We will then provide detailed information about the Atlas and Database of Air Medical Services (ADAMS) compiled by the center for transportation and injury research (Buffalo, New York) in alliance with the Association of Air Medical Services (Alexandria, Virginia) that provides a unique opportunity for each state to evaluate the comprehensive nature of their air medical services. The concept "the golden hour" has been molded into the world's premier public service aviation unit, which has proudly served the citizens of Maryland for over 24 years. This effort was initially made possible through a cooperative effort between the Maryland State Police Aviation Division and Dr. R Adams Cowley at the University of Maryland Hospital as a public service to the citizens of the state. This arrangement added a unique, economical, and life-saving component to the regionalized Emergency Medical Services and Critical Care system coordinated by the Maryland Institute for Emergency Medical Services Systems (MIESS). The Maryland State Police Aviation Division has four components: (1) aircraft, (2) state troopers, (3) system communications (SYSCOM) center, and (4) level I adult and pediatric trauma centers, as well as a regional burn center. ADAMS is a compilation of information of Air Medical Services in the United States to respond to traumas and other emergencies. Specifically, ADAMS provides descriptive and geographic information on Air Medical Service base locations, communication centers, rotor wing (RW) assets, and the major hospitals and transports that receive scene transports. The database includes all types of provider organizations including nonprofit, commercial, and public service (fire, police) air medical service providers, as well as several military units that routinely provide transport in remote areas. ADAMS provides national and statewide maps indicating air transport systems, trauma centers, and geographic population density. To provide a greater perspective on emergency medical care in individual states using the carefully tabulated ADAMS data, we compared the air emergency medical systems in Maryland to those of Oregon. Regardless of population density, Maryland provides air medical transport throughout the entire state, with the exception of only three small geographic areas. Maryland's 15 helicopter bases provide quick access for the seriously injured patient to either a Level I or pediatric trauma center within the "golden hour." In contrast, the air medical transportation system in Oregon is restricted to only three small geographic regions, making it an invitation to death for many seriously injured patients. It should be a federal mandate that the injured patient should gain access either by air transport or ambulance service to a Level I trauma center within that "golden hour." This federal legislation should include new criteria to initiate the dispatch of a helicopter to the scene of an accident or injury.

Air Ambulances↗
PubMed2002

Fear and expectations: differences among female victims of domestic violence who come to the attention of the police.

This study investigated a broad range of female victims of domestic partner abuse who came to the attention of the police. Ninety-five consecutive victims were interviewed by officers in a police department's domestic violence unit. Twenty-two percent of the victims matched expectations of women who were both afraid of their abusers and expected future abuse. Surprisingly, 46% of the victims were unafraid of their offenders and believed that future abuse was unlikely. A consistent pattern of findings supports the conclusion that a much broader range of victims than expected comes to the attention of the police. These results suggest exploring alternative police responses for different types of victims.

Crime Victims↗
PubMed1994

Ranking police stressors.

Police stressors were measured using Spielberger's Police Stress Survey with a sample of 103 police officers. Rankings of police stressors are discussed.

Data Collection↗
PubMed2000

Demographic factors as predictors of coping strategies among police officers.

This study examined the effects of demographic factors on coping responses among police officers. A sample of 233 police officers completed the Ways of Coping Questionnaire (Folkman & Lazarus, 1988). The regression analysis showed that the higher the reported educational attainment, the more police officers reported coping which was emotion-focused and seeking social support. The rank of the officer was directly related to reported emotion-focused coping. These results are discussed relative to research on the relations of demographic factors and coping responses among police officers.

Adaptation, Psychological↗
PubMed1999

Blood lead in Swedish police officers.

BACKGROUND: Shooting with lead-containing ammunition in firing ranges is a well-known source of lead exposure in adults, and police officers may be at risk of lead intoxication. More stringent national lead regulations stimulated a survey of blood lead (PbB) in Swedish police officers with regular shooting habits. METHODS: Police officers considered as the most active shooters on and/or off duty responded to a questionnaire about health, lifestyle, shooting habits, and potential lead exposure. Blood samples were collected and analyzed for PbB and a multivariate regression analysis was performed. RESULTS: The mean PbB in male officers (n = 75) was 0.24 mumol/L (5.0 micrograms/dL); range 0.05-0.88 mumol/L (1.0-18.2 micrograms/dL), and in female officers (n = 3) it was even lower (0.18 mumol/L; 3.7 micrograms/dL). For both sexes combined, a positive correlation (r = 0.55; P < 0.001) of PbB with the number of bullets annually fired both on and off duty was observed, and this finding remained in a multiple regression analysis including age, smoking habits, and latency from last shooting exercise. DISCUSSION: In conclusion, occupational and recreational lead exposure from firing ranges still seems to be a source of lead exposure in Swedish police officers, but it no longer appears to be a health risk. Lead-free communication and well-ventilated indoor firing ranges may have been decisive for this encouraging finding.

Adult↗
PubMed1999

[Greater success by cooperation between claim review experts and the police].

The examination of claims settlement in life assurance usually begins when police investigation is finished. During the acute phase of police investigation there is very rarely contact between the police and the life insurance company concerned. The advantages of early cooperation are demonstrated by two case reports. Immediate communication during the first four days after death initially helps the police investigators; later the life insurance company profits from the accelerated examination of the insured event.

Adult↗
PubMedDate not supplied

Police and corrections.

The author summarizes important occupational hazards of police and corrections work. Included in this chapter are morbidity and mortality data of police officers that describes increased risks of suicide, homicide, and ischemic heart disease. Information on tuberculosis exposure in correctional workers and of bloodborne pathogen exposure in police and corrections work is presented. The discussion concludes with strategies for the prevention of illness and injury among police officers and corrections workers based on these data.

Accidents, Occupational↗
PubMed2002

Musculoskeletal disabilities among police force personnel of the Islamic Republic of Iran.

Musculoskeletal disorders are among the most common causes of disability in the military population. The objectives of this study were to assess the frequency of musculoskeletal disabilities in police force personnel and to determine the association between disabilities and age, rank, and different job types. The population studied were 2600 Islamic Republic of Iran police force disability cases from March 1997 to March 1998. Ninth revision of International Classification of Diseases was used to indicate diagnoses. The frequency of disabilities related to musculoskeletal disorders was 25.7%. Back disabilities were the most common musculoskeletal problems. Patients with back disabilities were older on average than patients with other musculoskeletal disorders (p < 0.001). Back disabilities were more common in commissioned officers (third lieutenant to colonel) than other police force personnel (p < 0.0001). On the contrary, fractures and dislocations were more common in noncommissioned officers (sergeant to warrant officer) (p < 0.001). There were associations between specific jobs and musculoskeletal disabilities. According to present data, musculoskeletal disorders account for one-quarter of disability cases in police force personnel. Prevention programs, especially in high-risk groups, should be considered.

Adult↗
PubMed1999

Governing police practice: limits of the new accountability.

The advent of public-sector managerialism has brought with it a new principle of police accountability in Western democracies such as Australia and Britain. The new accountability gives emphasis to managerial rather than legal or public-interest standards, favours external oversight combined with self-regulation rather than centralized control, and promotes risk management rather than rule enforcement. This article makes use of the experience of an Australian police force to show that the new accountability has not been successful in holding police accountable, while elements of the old accountability have re-emerged to dominate public debates. It is argued that in the area of police governance, the neo-liberal state does not necessarily pursue a coherent strategy of 'acting at a distance' (cf. Miller and Rose 1990), partly because of the inability of accountability technologies to deliver substantially the promised policy outcomes and partly because of the sensitivity of its political arm to the public's moral outrage against corruption (cf. Garland 1996).

Australia↗
PubMed2004

Urine phenol levels among Thai police, implications for occupational health.

In this study, we study an at-risk occupation, the police. Forty-five urine samples were obtained from 45 Thai police working close to traffic in an urban area, for analysis of urine phenol levels. The average (mean +/- SD) urine phenol level in these police was 16.94 +/- 11.72 mg/g-Cr. Significantly higher urine phenol levels were found among police who had worked for longer durations (p < 0.05).

Adult↗
PubMed2006

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.

Adult↗