Posttraumatic stress disorder diagnostic criteria and suicidal ideation in a South African Police sample

Abstract

Objective: Exposure to traumatic events may precipitate suicidal ideation. Once an individual is diagnosed with PTSD, a suicide risk assessment often follows. This study explores how PTSD symptom criteria correlate with suicidal ideation in a sample of police officers. While the psychometric measures of PTSD often mirror the DSM-IV-TR criteria, focusing on exposure, symptom, and duration criteria, suicidal ideation measures often focus on concepts quite different from that. In this report the focus was on investigating how PTSD symptom criteria correlate with the suicidal ideation. Method: A group of South African police officers (N = 217) were assessed by means of the Posttraumatic Diagnostic Scale and a short version of the Adult Suicide Ideation Questionnaire. Linear and hierarchical regressions were used to determine which PTSD symptom criteria best predict suicidal ideation. Results: Hyperarousal was the primary predictor of suicidal ideation (R 2 [adjusted] = 0.249). Intrusive thoughts added only marginally to the model, contributing a further 2.5% to the declared variance. The contributions of the other two symptom types were negligible. Conclusion: In this study hyperarousal correlated significantly with suicidal ideation. It is suggested that practitioners be alert to these symptoms as possible indicators of suicidal ideation. Implications for suicide risk assessment and prevention measures are discussed.

Neurophysiological correlates of suicidal ideation in major depressive disorder: Hyperarousal during sleep

“…The potential role of hyperarousal during sleep as a contributor to suicide risk is also supported by recent work that examined sleep EEG macroarchitecture and reported more awakenings, greater NREM Stage 1 sleep, and lower sleep efficiency for individuals with suicidal ideation (Ballard et al, 2016; Bernert et al, 2016). Although there is substantial evidence demonstrating the link between waking cortical and behavioral hyperarousal and suicide (Graae et al, 1996; Iosifescu et al, 2008; Perlis et al, 2015; Steyn et al, 2013), this is one of the first studies to demonstrate that cortical hyperarousal during sleep may be associated with increased suicidal ideation in MDD. Prospective or experimental studies will be necessary to confirm that hyperarousal is related to suicidal ideation in MDD, particularly given weak evidence for increased beta activity.…”

A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics

“…PTSD is emphasized since, surprisingly, few studies have empirically examined PTSD as a risk correlate for suicide among first responders (Panagioti, Gooding, & Tarrier, 2009). Among police, our review yielded just five studies examining this conjecture, with two utilizing a U.S. sample, and all finding a statistically significant relationship between PTSD and suicidality (Chopko et al, 2014;Maia et al, 2007;Steyn, Vawda, Wyatt, Williams, & Madu, 2013;Violanti, 2004;Violanti et al, 2008). For example, one study of 157 Brazilian police officers who were part of an elite unit found that, of the 8.9% who met criteria for PTSD, 35.7% reported lifetime suicidal ideation (Maia et al, 2007).…”

An Intervention Framework to Facilitate Psychological Trauma Management in High-Risk Occupations

“…According to Mostert and Rothmann (2006), policing is identified as one of the most dangerous occupations in the world. Steyn et al (2013) report that hyper-arousal, as a result from exposure to traumatic events is the main predictor of suicide ideation in the South African Police Service (SAPS).…”

“…High-risk occupational settings considered globally as some of the most dangerous are the mining, policing and emergency medical services (EMS), which often result in traumatic incidents (Adriaenssens et al, 2012;Kowalski-Trakofler and Vaught, 2012;Ménard and Arter, 2013). In South Africa, these work environments are experienced as particularly hazardous and traumatic (Wilson, 2011;Steyn et al, 2013). Employees are left with psychological trauma that hinders their productivity and threatens their well-being (Ward et al, 2006;Zungu, 2013).…”