Critical Incidents As Ptsd Risk Factors
Police officers are frequently exposed to traumatic stressors for example, they are expected to cope with many types of critical incidents such as situations of abuse, those involving victims of serious accidents and hostages, riot control, violent confrontations, faded resuscitation attempts, and assistance in disasters.
As a result, critical incidents have been examined by researchers as an important source of mental health symptoms among police officers. A critical incident is a potentially traumatic event which may cause a given individuals emotional resources to become overtaxed, resulting in a spectrum of reactions from exhaustion to increased and unrelenting mental health symptomatology.
Critical incidents often include a component of life threat and may range from being threatened to direct exposure and/or injury .
As examples, shooting incident has been high on the list of critical incidents for police officers, and situations such as being called to the scene of a battered or dead child is also ranked extremely stressful.
In a 1997 research report, researcher say they examined 100 police officers who were assigned to street patrol, and asked the officers to report critical incidents with questions such as “Have you ever had to discharge your weapon in the line of duty?”, and to rate the level of stress associated with the incident, e.g., “If yes, how stressful was the experience for you?”
What Are The Consequences Of Ptsd In First Responders
Did you know that nearly 37 percent of EMS personnel and firefighters in the US have contemplated suicide at some point in their lives? This is nearly 10 times the rate in average Americans.
The symptoms of PTSD can make it difficult for emergency workers to do their job properly. First responders with PTSD sometimes experience emotional numbing and avoidance, leading to strained relationships with friends and family.
Some of the other devastating consequences of PTSD in first responders include:
- Mental health problems like depression and anxiety
- Problematic alcohol use or substance abuse
- Suicidal ideation
The clinical picture can be further complicated by the presence of chronic pain and opioid dependence or chronic pain and depression. Many patients with PTSD suffer from chronic pain and weight gain. Also common is chronic pain and sleep problems among PTSD patients.
Studying Neural Basis Decision
Researchers will record electrophysiological activity while police officers and controls perform a go/no-go task.
Paradigms such as the go/no-go task have been used to study the neural basis rapid decision-making, which includes attention, cognitive control and responding or inhibiting a response.
During go/no-go tasks, participants have to maintain their attention over several minutes and respond to target stimuli but inhibit their response to other stimuli .
Psychological interviews and written tests will also be conducted to measure the presence and severity of PTSD symptoms. Other psychological tests of depression and anxiety also will be administered, Shucard says.
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The Call That Returned Eight Years Later
This event occurred in 1989 on Fathers Day. It was my first Fathers Day away from my daughter and I had plans to celebrate with my wife later in the evening.
I was acting as the patrol supervisor at a sheriffs office. Nearing the end of my shift, I received a call about a possible familial homicide in the nearby town.
After some time spent searching, we found the victims, a wife and young daughter, tragically murdered in a mobile home. Subconsciously, I noted the little girl and her resemblance to my own daughter at the time. I later found out that they were there to celebrate Fathers Day.
As I was standing in the horrific scene, dispatch advised me to call my wife, who was also a police officer. She asked when I would be home for our Fathers Day celebrations. I told her I wouldnt be able to make it as I was assisting on a homicide case, the details of which I didnt bother to elaborate on.
She was upset at my consistent unavailability to be home due to situations like this. Throughout the phone call where I was being thoroughly chewed out, I was acutely aware of the graphic and brutal scene surrounding me. Despite it all, this that day in itself was not traumatizing. I did not experience nightmares or horrible flashbacks. In fact, I quickly forgot about the case and it never came up in my thoughts after that.
Supporting First Responders With Cptsd
This mental health injury appears to be a growing issue for first responders. Valazquez and Herandez reviewed research on police mental health. Working as a first responder, they write, has been identified as one of the few occupations where individuals are repeatedly placed in high stress and high-risk situations. Typical coping strategies show a failure within organizations to recognize a developing issue like CPTSD. One of the most persistent barriers to seeking help is the stigma attached.
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Cambridge Researchers And A Policing Charity Are Calling For A National Mental Health Strategy In Law Enforcement
Close to one in five police officers and staff in the UK have symptoms consistent with either post-traumatic stress disorder or whats known as complex PTSD yet over two-thirds of those suffering are unaware.
This is according to early findings from the largest force-wide survey yet undertaken, which focused on police wellbeing and screened for clinical symptoms of both disorders. The research has been conducted by a team of sociologists at the University of Cambridge and funded by the charity Police Care UK.
Researchers analysed responses from 16,857 of the serving officers and operational staff who participated in The Job, The Life, a major survey carried out across England, Wales, Scotland and Northern Ireland during autumn last year.
The research team found that 90% of police workers who responded had been exposed to trauma. Of these, one in five reported experiencing either PTSD or Complex PTSD symptoms in the past four weeks.
PTSD is an anxiety disorder in which traumatic or life-threatening events cause disturbing memories to recur as well as intense states of hypervigilance.
Sleep disturbance, irregular heartbeats and sweats are common and can lead individuals to self-medicate with drugs and alcohol. The research found 8% of those workers exposed to trauma had clinical symptoms of PTSD.
Biometric Telehealth: A Holistic Approach To Ptsd Treatment
At Institutes of Health, we use a state-of-the-art Biometric Telehealth platform to recreate what we do in our brick and mortar clinic. Our treatment approach to PTSD is based on an evidence-based, interdisciplinary biopsychosocial model. This model addresses the underlying mechanisms that produce the symptoms of PTSD. It is a multi-pronged approach that gives first responders with PTSD the best chance of recovery, stay-at-work and/or return to work.
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Five Most Likely Causes Of Post
A combination of genetic and emotional differences may lead to post-traumatic stress 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 , and certain genetic differences, including some known to influence a persons 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.
Ptsd Treatment That Works
Organizational and cultural changes are beginning to break down some of these barriers, and, with increased awareness, many officers now voluntarily seek help for PTSD symptoms. Evidence-based treatment options are, by definition, the most effective means of confronting PTSD. Researchers and mental health professionals have studied these methods showing demonstrated and, importantly, repeatable patterns of efficacy in proactively addressing PTSD and offering viable treatment options that serve the unique needs of law enforcement officers. The American Psychological Association strongly recommends four specific PTSD treatments:
Cognitive Behavioral Therapy
CBT examines relationships between thoughts, feelings, and behavior. For instance, by exploring ones patterns of thoughts and better understanding them, a patient can see improvements in emotions and behaviors.
Cognitive Processing Therapy
This therapy seeks to help a person challenge and modify unhelpful beliefs about the trauma they experienced. By creating a new understanding of the trauma itself, CPT can reduce its ongoing negative impact.
Cognitive Therapy
An offshoot of CBT, this treatment involves modifying the pessimistic evaluations and memories of trauma, with the goal of interrupting the disturbing behavioral and/or thought patterns that have been interfering in the persons daily life.
Prolonged Exposure
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Ptsd In First Responders
- PTSD in First Responders
Biometric Telehealth: An Innovative Solution for First Responders with PTSD
Paramedics, EMTs, police officers, firefighters, and rescue workers are the first to respond to emergencies. The scene of critical incidents often involves exposure to life- threatening situations, frightening events, and stressful experiences. These experiences can lead to post-traumatic stress disorder among first responders.
The most common symptoms of PTSD are nightmares and flashbacks of distressing events. PTSD can also cause physical symptoms such as chronic pain, sweating, jitteriness, headaches, dizziness, and chest pain. Other PTSD symptoms include irritability, angry outbursts, sleep problems, and difficulty concentrating. 1
Because PTSD can cause such a wide range of symptoms, the treatment for this condition needs to be multi-pronged.
The biopsychosocial model practiced at the Institutes of Health is an evidence-based interdisciplinary program that helps first responders receive comprehensive treatment for PTSD. An alternative to on-site clinic care at IOH is our Biometric Telehealth platform, an advanced remote treatment solution that allows first responders to receive effective PTSD treatment in the comfort of their homes or elsewhere as needed. In this article, we will talk about the prevalence and consequences of PTSD in first responders and how biometric telehealth can help.
Could A Ptsd Diagnosis Be Cte
To better understand the potential link between CTE and PTSD affecting LEOs, a survey was constructed utilizing past research conducted on athletes and service members to include sports participation and exposure to blasts and low-level blasts.
The occurrence of CTE in both athletes and service members causes concern for LEOs due to their potential participation in contact sports and exposure to blasts and low-level blasts throughout a 30-year career. A confidential and anonymous survey was sent to 4,458 Florida LEOs, which asked them about their history of sports participation, and years of police experience, SWAT and military experience.
Of the 589 LEOs who completed the survey, the results illustrate that LEOs share similarities with athletes and service members. LEOs participated in contact sports and have been exposed to blasts and low-level blasts. It is alarming that more than 84% of the LEOs reported sub-concussive hits to the head, with 20% suffering from a range of 6 to 20 and 19% suffering from 21 or more.
More alarming is that 79% reported suffering concussive hits to the head with more than 430 LEOs identifying between 1 to 5 concussive hits. It should be concerning that LEOs who reported suffering from sub-concussive hits and concussive hits were largely self-reporting with a small number being clinically diagnosed with concussions. Only 32% reported being diagnosed with at least one concussion.
1. Medical interventions
3. Training and education
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The Challenges And The Solutions
There are challenges specific to addressing trauma in the police and first responders, such as the stigma, and the tough men/women mentality. By nature, this job requires authority and control, and some officers, or their superiors, see vulnerability or seeking help as weakness.
The truth, however, is that all humans are vulnerable. We are not made to have such horrific experiences on a regular basis. Based on our unique biology and the severity and repetition of trauma, many of us will feel an impact this is just how the human body and brain react to trauma and stress.
Part of the blame is on us medical and mental health experts because we sometimes might create a perception that a condition such as PTSD is a label the person has to live with forever. Denial is often a response to believing the illness is ones new identity.
Steve once told me that what he found most empowering in our first visit was when I said We can fix this. I was being honest with him we can help a lot. One does not have to forever suffer the impact of trauma on their mental health, body , career and family life.
Steve and I worked together for some time. Steve is now enjoying work and family life again, and we just catch up once in a while. He now leads a peer-to-peer team that provides support and education to other officers after critical incidents, and mental health referral when needed.
The Link Between Brain Injuries And Cte
Currently, the only avenue to diagnose CTE is through a post-mortem exam when the brain can be dissected to determine the presence of the tau protein.
CTE has been diagnosed in athletes and service members who experienced repetitive traumatic brain injuries and mild traumatic brain injuries that can be caused by sub-concussive and/or concussive hits to the head. These injuries result in symptoms such as loss of consciousness, headaches, nausea, vision impairments, dizziness and sleep problems. Long-term consequences of suffering from mTBIs and TBIs can result in a diagnosis of CTE.
It has been determined that veterans and service members with a history of playing contact sports had an increased risk of developing CTE. It was further concluded that CTE was found in veterans and service members who were exposed to blasts and low-level blasts with no history of sports participation.
LEOs are a diverse group of people with a history of sports participation and/or military service who have suffered blast and low-level blast injuries. LEOs with no prior military service are exposed to low-level blasts in the form of repeated exposure to various types of gunshots as part of training. SWAT operators are routinely exposed to more low-level blasts from distraction devices, commonly referred to as flashbangs. Police snipers are routinely exposed to large caliber gunfire such as .308 and .50 caliber rifle rounds. Entry members are exposed to flashbangs and explosive entry techniques.
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Why Does Public Safety Use The Term Post
While consulting with public safety officers, PS heard about the impact of mental health stigma in the public safety community, and how terms like disorder can have a negative connotation, which can deter public safety officers from seeking help or treatment for occupation-related mental health issues. As such PS and federal partners have adopted the term post-traumatic stress injuries to better characterize occupation-related mental health issues as injuries resulting from their daily work, and to help increase awareness that the mental health impacts of exposure to traumatic events extend beyond clinically diagnosed PTSD and include other issues, such as drug and alcohol abuse, anxiety, depression and others. The intent is that this language will help to reduce the stigma associated with mental health issues and build an environment of acceptance and inclusion.
I Have Lost Count Of The Number Of Traumatic Incidents I Have Investigated
The research encompassed serving officers across all ranks throughout the UK, and operational staff such as emergency call operators and digital image specialists.
Two-thirds of all respondents to The Job, The Life said they had a mental health issue directly resulting from police work. Yet almost all the surveys respondents some 93% said they would go to work as usual if suffering from psychological issues such as stress or depression.
Repeated trauma exposure may also increase risks of long-term physical illness in the policing workforce. The survey results showed those with Complex PTSD symptoms reported three times the rate of cardiovascular disease as those without, and twice the levels of both gastrointestinal issues and immune disorders such as IBS and arthritis.
Even in the 80% without clinical levels of PTSD or Complex PTSD, half reported overall fatigue, half reported anxiety, and half reported trouble sleeping all over the last 12 months.
Police Care UK, a charity supporting the police and their families, is today calling for a national policing mental health strategy. With more than fifty UK policing employers, all with a different approach, they say there is a postcode lottery when it comes to attitudes and access to trauma management.
There is no comprehensive strategy to tackle the issue of mental health in policing, and that has to change, said Gill Scott-Moore, Chief Executive of Police Care UK.
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Ptsd Can Manifest In Unusual Ways
At the time, there was not as much awareness about PTSD, especially relating to law enforcement, as there is now. Today, the symptoms of PTSD are widely talked about. These being emotional distress, physiological reactions, recurrent nightmares or memories, flashbacks, irritability, bursts of anger, insomnia and depression. But, PTSD is not black and white. While I did not experience flashbacks or insomnia relating to that event, it still manifested in unusual ways. And the trauma became linked to that specific phone call with my wife as it acted as a bridge between the two events. Also, my symptoms didnt appear until years after that initial event.
I no longer dismiss the threat of PTSD. Between seven and 19% of police officers exhibit symptoms of PTSD, compared to 3.5% of the general public and around 125 to 300 officers commit suicide every year. As much as officers dont like to believe it, we are susceptible to stress and mental disorders. And while you may think its easier to just deal with it yourself, I urge you to take action before symptoms start taking a hold of you.
Dont bottle up your emotions as I did but make sure to talk to someone a friend, a family member, or a professional. And for those who are experiencing unusual events, know that you are not going crazy. But perhaps its resulting from an old incident you are still subconsciously carrying. This is why its important to familiarize yourself with the symptoms of PTSD.