Systematic review of posttraumatic stress disorder in police officers following routine work‐related critical incident exposure

Abstract

Background: The prevalence of PTSD in police officers has been the subject of a large and highly variable empirical literature. The present systematic review evaluates the extant literature on PTSD in police officers using an international dataset. Methods:We employed best-evidence narrative synthesis to evaluate whether PTSD prevalence in police is elevated in comparison to the general population of Canada (8%), which itself has a higher lifetime PTSD prevalence than many other regions and thus serves as a conservative standard of comparison.Results: PTSD prevalence in police varied considerably across studies from 0% -44% (M = 14.87%, Median = 9.2%). Despite this variability, strong evidence exists to suggest PTSD prevalence is elevated in police officers. Examination of possible sources of variability in prevalence outcomes highlighted substantial variability in outcomes due to the selection of measurement tool for assessing PTSD (e.g., DSM vs. IES). Examination of commonly-assessed predictive factors for PTSD risk across the literature showed that individual-difference factors (e.g., age, years of service) bear weak-to-nonexistent relationships with PTSD risk, while incidentspecific factors (e.g., severity of exposure) are more strongly and consistently associated with PTSD prevalence. Organizational factors (e.g., low support from supervisor) are at present understudied but important possible contributors to PTSD risk. Conclusions: PTSD prevalence is elevated in police officers and appears most strongly related to workplace exposure. Measurement variability remains a critical source of inconsistencies across the literature with drastic implications for accurate detection of officers in need of mental health intervention. K E Y W O R D S epidemiology, occupational exposure, police personnel, posttraumatic stress disorder, trauma Institution at which the work was performed: University of Northern British Columbia

Probable PTSD, depression and anxiety in 40,299 UK police officers and staff: Prevalence, risk factors and associations with blood pressure

“…Across England, Wales and Scotland, the number of police officers amounts to over 140,000 individuals [1]. It is commonly assumed that policing is a particularly stressful occupation with elevated rates of mental disorders, and that this is largely due to the high rates of exposure to traumatic events [2][3][4]. A study published in 2003 investigating the mental health of UK police officers identified that 41% reported symptoms of common mental disorders (CMDs) such as depression and anxiety [5].…”

Traditional Male Role Norms, Social Support, and Symptoms of Post-traumatic Stress Disorder Among Male Polish Police Officers

“…The risk of the development of PTSD is higher among women (Creamer et al 2001;Kamijo et al 2020;Syed et al 2020), young people (at the age of 15-24) (Bromet et al 1998), those who are married (Creamer et al 2001), those who have longer time in policing (Dudek 2003;Syed et al 2020;Wagner et al 2020), and those who have problems with talking about their emotions or experience emotional exhaustion (Carlier et al 1997;Meffert et al 2008;Wagner et al 2020). The factors that accelerate the development of PTSD are experiencing shame and anger as a response to other people's reaction to one's participation in a traumatic event (Dudek 2003;Papazoglu et al 2020), a number of traumatic experiences in the young age (Buchanan et al 2001), the intensity of the experienced trauma, multiple participation in traumatic events, and a lack of support/insufficient support (Carlier et al 1997;Ma et al 2015;Marmar et al 2006;Mona et al 2019;Violanti et al 2018;Wagner et al 2020). PTSD develops more frequently in persons that have got injured during a traumatic event-including perceived moral injury (Papazoglu et al 2020); the persons also more often abuse medicines and suffer from depression and adjustment disorders (Koren et al 2005;Wagner et al 2020).…”

“…The factors that accelerate the development of PTSD are experiencing shame and anger as a response to other people's reaction to one's participation in a traumatic event (Dudek 2003;Papazoglu et al 2020), a number of traumatic experiences in the young age (Buchanan et al 2001), the intensity of the experienced trauma, multiple participation in traumatic events, and a lack of support/insufficient support (Carlier et al 1997;Ma et al 2015;Marmar et al 2006;Mona et al 2019;Violanti et al 2018;Wagner et al 2020). PTSD develops more frequently in persons that have got injured during a traumatic event-including perceived moral injury (Papazoglu et al 2020); the persons also more often abuse medicines and suffer from depression and adjustment disorders (Koren et al 2005;Wagner et al 2020). A positive attitude toward expressing emotions (Stephens et al 1997), self-resiliency (Lee et al 2016b;van der Meulen et al 2018), having a hobby, job satisfaction (Carlier et al 1997), an internal locus of control, a sense of coherence (Schäfer et al 2020), and co-worker support (Martin et al 2009;Syed et al 2020;Wagner et al 2020) constitute protective factors.…”

“…PTSD develops more frequently in persons that have got injured during a traumatic event-including perceived moral injury (Papazoglu et al 2020); the persons also more often abuse medicines and suffer from depression and adjustment disorders (Koren et al 2005;Wagner et al 2020). A positive attitude toward expressing emotions (Stephens et al 1997), self-resiliency (Lee et al 2016b;van der Meulen et al 2018), having a hobby, job satisfaction (Carlier et al 1997), an internal locus of control, a sense of coherence (Schäfer et al 2020), and co-worker support (Martin et al 2009;Syed et al 2020;Wagner et al 2020) constitute protective factors.…”

Trauma and Mental Health Awareness in Emergency Service Workers: A Qualitative Evaluation of the Behind the Seen Education Workshops

“…The repeated exposure places them at high risk of poor mental health, including posttraumatic stress disorder (PTSD) [ 1 ]. There is increasing recognition of the impact of emergency service work [ 2 , 3 ], with poor social support, high occupational stress and maladaptive coping strategies associated with an increased prevalence of mental health problems [ 2 , 4 , 5 ]. ESWs are also twice as likely to experience suicidal thoughts [ 6 ], and one ESW dies by suicide in Australia every four weeks [ 7 ].…”