Police officers face multifaceted, compounding stressors that can lead to adverse events

August 18, 2020

Science Daily/University of Texas Health Science Center at Houston

Repeated exposure to high-stress calls for service and ongoing exposure to stress without relief were two of the contributing factors that could lead law enforcement officers to become susceptible to adverse events while performing their duties, according to a new study published in BMC Public Health by researchers at The University of Texas Health Science Center at Houston (UTHealth).

The study team aims to use this research to develop intervention models that can address and help prevent these multifaceted stressors from affecting an officer's ability to respond to high-stress calls confidently.

"If we can develop innovative interventions for law enforcement officers that address their unique occupational demands, we can help mitigate compounding stress factors that affect their overall mental health," said Katelyn Jetelina, PhD, MPH, the study's lead author and an assistant professor at UTHealth School of Public Health in Dallas.

The research team collected data from three law enforcement agencies in the Dallas-Ft. Worth metroplex: a large urban department, a suburban department, and a rural department. The researchers met with officers in focus group settings to identify stressors and to gain insight on how to prevent future adverse effects such as use of force, officer or civilian injury, civilian complaints, or discharge of a weapon.

The study participants were 86% male and 14% female with an average tenure of 12 years. Five themes emerged that influenced an officer's perception of the stress level of a call -- officer characteristics such as former military experience or gender, civilian behavior, supervisor factors such as the tendency to micromanage, environmental factors, and situational factors.

The data revealed several factors that contributed to officer stress accumulation, including not "resetting" stress levels after a high-stress call, burnout from answering numerous back-to-back calls, and feeling pressure to move on to the next call quickly. Experience from a previous adverse event was also a contributing factor to cumulative stress. However, according to the focus group responses, behaviors such as taking a break between calls, practicing breathing exercises, and addressing one's mental health over time can help lower levels of chronic stress.

The researchers noted that the combination of the perceived stress level of a call and other cumulative stress factors increase the likelihood for adverse events between police and the public. If the cycle of chronic stress is addressed and limitations placed on the number of high-stress calls an officer responds to during a shift, adverse events may be limited as well. Previous studies have shown that for other occupations, reduced levels of stress increase productivity and job satisfaction.

Irving Police Chief Jeff Spivey, whose officers participated in the study, said the results will help them find additional ways to assist their officers with mental health needs.

"Providing multiple resources for our officers to support and focus on their mental health needs, like our internal peer support groups, is a cause I am very proud to champion," Spivey said. "Peer support services have proven to be effective in helping police officers appropriately manage their mental health; that's why we have teamed up with the Caruth Police Institute and other departments across the state to create a peer network for first responders throughout Texas."

Jetelina and her team are currently testing the feasibility of using smart watches to break cumulative, real-time stress for officers. Additional research on the prevalence of undiagnosed mental health disorders among law enforcement officers is necessary to assess the effectiveness of current mental health resources and to ensure that new resources are developed.

https://www.sciencedaily.com/releases/2020/08/200818142143.htm

Study pinpoints five most likely causes of post-traumatic stress in police officers

August 11, 2020

NYU Langone Health / NYU School of Medicine

A combination of genetic and emotional differences may lead to post-traumatic stress (PTS) in police officers, a new study finds.

Based on biological studies of officers in major cities, the study showed that the most significant PTS predictors are the tendency to startle at sudden sounds, early career displays of mental health symptoms (e.g., anxiety and depression), and certain genetic differences, including some known to influence a person's immune system.

"If we can identify major risk factors that cause PTS and treat them before they have the chance to develop into full-blown post-traumatic stress disorder, or PTSD, we can improve the quality of life for police officers and perhaps other emergency responders, and better help them deal with the stressors of their work," says senior study author Charles Marmar, MD, the Lucius N. Littauer Professor of Psychiatry at NYU Grossman School of Medicine.

Publishing online Aug. 10 in the journal Translational Psychiatry, the study authors employed a mathematical computer program developed by scientists at NYU Langone Health and the University of Minnesota. They used a combination of statistical analyses to test which of a large number of features linked by past studies to PTSD were the best at predicting its occurrence in police officers.

Some of this winnowing that determined the best predictors was accomplished using machine learning, mathematical models trained with data to find patterns. These algorithms enabled researchers to track how experiences, situations, and characteristics may have interacted over time to lead to PTS symptoms, and represent the first use of such techniques in PTS research in police officers, the authors say.

"Based on these techniques, our study identified specific causes of PTS, rather than possible links," says Marmar, also chair of the Department of Psychiatry at NYU Langone.

He adds that the need for better information is urgent. An estimated eight out of every 100 people experience PTS in their lifetimes, according to the National Institute of Mental Health. Police officers are particularly vulnerable, he says, facing an average of three traumatic experiences for every sixth months of service. Common symptoms include nightmares, aggression, and distressing flashbacks of the traumatic event, which can lead to poor sleep, anxiety, depression, and increased risk of suicide.

In the new study, the investigators analyzed data collected on 207 police officers from departments in New York City, San Francisco, Oakland, and San Jose who had PTS. All officers had experienced at least one life-threatening event during their first year on the job.

Using the computer program, the investigators searched for patterns in 148 different characteristics previously thought to be involved in PTS. They mapped out 83 different possible combinations of factors, or pathways, which could have influenced the officers as they developed the condition.

Then, they identified factors which appeared most frequently, and found that every pathway to PTS shared one of five causes. Besides the tendency to startle easily, severe distress following a traumatic experience, and a set of emotional health problems, such as anxiety and depression, played a key role in PTS. Genetic causes included mutations in the HDC gene, which is linked to problems in the immune system and mutations in the MR gene, which is involved in the body's immediate reaction to threats, known as the fight-or-flight response. If all five factors were eliminated, researchers say, the officers would not be expected to develop PTS.

"Because the factors we identified are causal, they should be actionable as well," says lead study investigator Glenn Saxe, MD, a professor in NYU Langone's Department of Child and Adolescent Psychiatry. "Several of the causal factors we identified -- the HDC gene, the MR gene, and the startle response -- point to well-mapped nerve circuits, which should allow us to find drugs and behavioral therapies that might help. Down the road, we see the possibility of using information collected from patients about causal factors to select the interventions that would provide the most benefit to them."

Saxe says other future interventions might target factors that may not cause PTS on their own, but frequently contribute to its development. For example, the study found that difficulty adjusting to work contributed to PTS development in 60 percent of the causal pathways. Therefore, a straightforward solution, like giving more support to new police officers who are having difficulty adjusting to police work, may reduce their risk of getting PTS, according to Saxe.

Moving forward, the researchers plan to apply the same algorithm technique in a much larger group of traumatized adults and children, focusing on a more extensive set of characteristics and experience

https://www.sciencedaily.com/releases/2020/08/200810213211.htm