International Journal Of Emergency Mental Health[JOURNAL]
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200 papers
Crisis intervention and mental health services in the military.
Clark D
Int J Emerg Ment Health · 2010 · PMID 21473364
Abstract loading — click title to view on PubMed.
Cancer incidence among police officers in a U.S. northeast region: 1976-2006.
Gu JK, Charles LE, Burchfiel CM … +2 more , Andrew ME, Violanti JM
Int J Emerg Ment Health · 2011 · PMID 22900461
Police officers are exposed to occupational hazards which may put them at increased risk of cancer We examined the incidence of cancer in a cohort of 2234 white-male police officers in Buffalo, New York. The study popula...
Police officers are exposed to occupational hazards which may put them at increased risk of cancer We examined the incidence of cancer in a cohort of 2234 white-male police officers in Buffalo, New York. The study population was followed for 31 years (1976-2006). The incidence of cancer, ascertained using a population-based tumor registry, was compared with 9 US regions using the Surveillance Epidemiology and End Results (SEER) program data. Four hundred and six officers (18.2%) developed cancer between 1976 and 2006. The risk of overall cancer among police officers was found to be similar to the general white-male population (standardized incidence ratio [SIR] = 0.94, 95%, confidence interval [CI] = 0.85-1.03). An elevated risk of Hodgkin's lymphoma was observed relative to the general population (SIR = 3.34, 95%, CI = 1.22-7.26). The risk of brain cancer, although only slightly elevated relative to the general population (SIR = 1.61, 95%, CI = 0.73-3.05), was significantly increased with 30 years or more of service (SIR = 2.92, 95%, CI = 1.07-6.36). Incidence ratios were significantly lower than expected for skin and bladder cancer Police officers were at increased risk of Hodgkin's lymphoma overall and of brain cancer after 30 years of service.
Association of sleep quality with depression in police officers.
Slaven JE, Mnatsakanova A, Burchfiel CM … +7 more , Smith LM, Charles LE, Andrew ME, Gu JK, Ma C, Fekedulegn D, Violanti JM
Int J Emerg Ment Health · 2011 · PMID 22900460
Poor sleep quality has been shown to adversely affect neurobehavior including an increase in depression symptoms. Police officers are at increased risk of poor sleep quality due to occupational factors. This study analyz...
Poor sleep quality has been shown to adversely affect neurobehavior including an increase in depression symptoms. Police officers are at increased risk of poor sleep quality due to occupational factors. This study analyzed self-reported sleep and depression data from police officers; 391 police officers from Buffalo, New York reported on sleep and depression by completing the Pittsburgh Sleep Quality Index (PSQI) and the Center for Epidemiological Studies Depression (CES-D) questionnaires. Mean CES-D scores were assessed across quintiles of PSQI. As PSQI scores increased, reflecting poorer sleep quality, CES-D scores also increased significantly indicating an increase in depression symptoms as sleep quality worsens. This trend held for both male and female officers. Mean CES-D scores across quintiles ranged from 4.72 to 12.65 in men and from 5.53 to 12.63 in women. Multivariate adjustment only very slightly attenuated the association in female officers. After adjustmnent, five of the seven PSQI components showed statistically significant associations with CES-D scores in male officers and two in female officers. Sleep quality was significantly and independently associated with depressive symnptoms as evidenced by a trend of increasing depressive symptom scores with decreasing sleep quality in both male and female officers.
Adiposity in policing: mental health consequences.
Violanti JM, Fekedulegn D, Andrew ME … +3 more , Charles LE, Hartley TA, Burchfiel CM
Int J Emerg Ment Health · 2011 · PMID 22900459
Previous research suggests that adiposity is a health problem among police officers. Stress is also a concern in police work and can lead to depression. Although previous studies have demonstrated an association between...
Previous research suggests that adiposity is a health problem among police officers. Stress is also a concern in police work and can lead to depression. Although previous studies have demonstrated an association between obesity and depression, this has not been adequately addressed in the police population. MAeasures of adiposity (Body Mass Index [BM1], abdominal height, waist circumference) and depressive symptoms (Center for Epidemiologic Studies Depression [CES-D] scale) were obtained from a random sample of 115 officers in an urban police department. Ninety nine officers (61 men and 38 women) who had complete data and were not on anti-depressive medication were used. Linear regression analysis was conducted separately for men and women. Covariate adjustments were made for age, alcohol use, smoking, pack-years of smoking, marital status, and physical activity. Statistically significant positive trends were observed in multivariate adjusted mean (+/- SE) depression symptom scores across increasing tertiles of BMI (7.0 +/- 1.3, 5.1 +/- 1.2, 8.8 +/- 1.3, p = 0.012) and abdominal height (6.0 +/- 1.4, 5.5 +/- 1.3, 9.2 +/- 1.4, p = 0.048) for men officers. No significant associations were found between CES-D score and adiposity in women officers (p = 0.075 for BMI, p = 0.317 for abdominal height, p = 0.114 for waist circumference). Additional factors that might influence this association should be examined prospectively in future work to help clarify causal direction.
Associations between police officer stress and the metabolic syndrome.
Hartley TA, Burchfiel CM, Fekedulegn D … +3 more , Andrew ME, Knox SS, Violanti JM
Int J Emerg Ment Health · 2011 · PMID 22900458
The purpose of this study was to examine the association of police officer stress with metabolic syndrome (MetSyn) and its individual components. Participants included 288 men and 102 women from the Buffalo Cardio-Metabo...
The purpose of this study was to examine the association of police officer stress with metabolic syndrome (MetSyn) and its individual components. Participants included 288 men and 102 women from the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study. Police stress was measured using the Spielberger police stress survey. MetSyn was defined using 2005 guidelines. Results were stratified by gender ANCOVA was used to describe differences in number of MetSyn components across police stress categories after adjusting for age and smoking status. Logistic regression was used to calculate odds ratios for having each MetSyn component by increased police stress levels. The multivariate-adjusted number of MetSyn components increased significantly in women across tertiles of the three perceived stress subscales, and administrative and organizational pressure and lack of support indices for the previous month. No association was found among male officers. Abdominal obesity and reduced high density lipoprotein cholesterol (HDL-C) were consistently associated with police stress in women. Police stress, particularly organizational pressure and lack of support, was associated with MetSyn among female but not male police officers. Given the stress of policing and the adverse cardiovascular disease (CVD) risk factors prevalent among police officers, exploring the association between specific types of police stress and subclinical CVD is important.
Association of perceived stress with sleep duration and sleep quality in police officers.
Charles LE, Slaven JE, Mnatsakanova A … +6 more , Ma C, Violanti JM, Fekedulegn D, Andrew ME, Vila BJ, Burchfiel CM
Int J Emerg Ment Health · 2011 · PMID 22900457
The objective was to investigate associations ofperceived stress with sleep duration and quality among 430 police officers. Perceived stress was assessed using the perceived stress scale. Sleep duration and quality were...
The objective was to investigate associations ofperceived stress with sleep duration and quality among 430 police officers. Perceived stress was assessed using the perceived stress scale. Sleep duration and quality were assessed using the Pittsburg sleep quality index questionnaire. Mean hours of sleep were determined across quartiles of perceived stress using ANOVA/ANCOVA. Logistic regression was used to obtain odds ratios and 95% confidence intervals for poor sleep quality across perceived stress quartiles. Mean age was 42.1 years. Perceived stress was inversely associated with sleep duration among certain groups: men (p = 0.004), higher-ranked officers (p = 0.002), those with higher depressive symptoms (p 0.097), no military experience (p = 0.006), and higher workload (p = 0.003). Gender, police rank, depressive symptoms, and workload each significantly modified the association between stress and sleep duration. Prevalence of poor sleep quality increased with higher levels of perceived stress; the trend was significant among men only (p < 0.0001), and gender significantly modified this association (interaction p = 0.015). Compared to those in the first quartile of perceived stress, women in the fourth quartile were almost four times and men almost six times more likely to have poor sleep quality. Perceived stress was inversely associated with sleep duration and positively associated with poor sleep quality.
Is suicide higher among separated/retired police officers? an epidemiological investigation.
Violanti JM, Gu JK, Charles LE … +3 more , Fekedulegn D, Andrew ME, Burchfiel CM
Int J Emerg Ment Health · 2011 · PMID 22900456
It is often assumed that separated or retired officers are at increased risk for suicide. The goal of this study was to compare police suicide rates between currently working and separated/retired officers. A 55-year ret...
It is often assumed that separated or retired officers are at increased risk for suicide. The goal of this study was to compare police suicide rates between currently working and separated/retired officers. A 55-year retrospective mortality police cohort was utilized consisting of 3228 officers who worked between January 1, 1950 and December 31, 2005. Poisson regression and survival analysis were used for comparisons. Adjusted for age and years of service, suicide rates were 8.4 (95% CI = 3.8-18.7) times higher in working officers vs. separated/retired officers (110.5 vs. 13.1 per 100,000 person-years respectively). Survival time to suicide was significantly lower (p < 0.0001) for current working officers, suggesting suicide in a significantly shorter time span. Previous research indicates that the majority of suicides in working officers occur in the five years just prior to retirement eligibility, suggesting a period of decision anxiety. Results suggest a higher risk of suicide among working compared to separated/retired officers. However, the need for suicide prevention efforts remains important among both active and retired police officers.
Health disparities in police officers: comparisons to the U.S. general population.
Hartley TA, Burchfiel CM, Fekedulegn D … +2 more , Andrew ME, Violanti JM
Int J Emerg Ment Health · 2011 · PMID 22900455
Police officers have one of the poorest cardiovascular disease (C'D) health profiles of any occupation. The goal of this study was to determine if police officers in the Buffalo Cardio-Metabolic Occupational Police Stres...
Police officers have one of the poorest cardiovascular disease (C'D) health profiles of any occupation. The goal of this study was to determine if police officers in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) Study (between 2004 and 2009) had a more adverse CV profile than the general US. employed population. Nearly one-half (46.9%) of the officers worked a non-day shift compared to 9% of U.S. workers. The percent of officers with depression was nearly double (12.0% vs. 6.8%) and officers were nearly four times more likely to sleep less than six hours in a 24-hour period than the general population (33.0% vs. 8.0%). A higher percentage of officers were obese (40.5% vs. 32.1%), had the metabolic syndrome (26.7% vs. 18.7%), and had higher mean serum total cholesterol levels (200.8 mg/dL vs. 193.2 mg/dL) than the comparison employed populations. In addition to having higher levels of traditional CVD risk factors, police officers had higher levels of non-traditional CVD risk factors. These findings highlight the need for expanding the definition of a health disparity to include occupation. Future studies should expand this comparison to additional traditional and non-traditional CVD risk factors and to other occupational groups.
Introduction to special issue: Stress and health in law enforcement.
Violanti JM
Int J Emerg Ment Health · 2011 · PMID 22900454
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Longitudinal Stroop Score changes in adolescent females with PTSD.
Salazar J, Motta R
Int J Emerg Ment Health · 2011 · PMID 22708147
This study is a preliminary investigation that analyzed whether or not the Emotional Stroop procedure would be able to detect the changes in PTSD levels of individuals as they undergo treatment for that disorder. This re...
This study is a preliminary investigation that analyzed whether or not the Emotional Stroop procedure would be able to detect the changes in PTSD levels of individuals as they undergo treatment for that disorder. This repeated measures, small n study utilized 8 in-patient adolescent females with a history of sexual abuse and an Axis I diagnosis of PTSD. Individuals were given the Emotional Stroop procedure and two standardized, self-report measures of PTSD every two weeks over the course offive months. In addition, daily point sheets of adaptive behavior were also collected. The individual's change on the standardized measures was compared against their change in reaction time on the Emotional Stroop procedure, and changes in the percentage of time the individual earned privileges based on the behavioral management system. The results provided some promising information that suggests that these measures do co-vary and that the Emotional Stroop does indeed reflect variations in levels of PTSD. This is the first study to show that therapeutic changes in PTSD are reflected in changing reaction times on the Emotional Stroop.
Brief trauma intervention with Rwandan genocide-survivors using thought field therapy.
Connolly S, Sakai C
Int J Emerg Ment Health · 2011 · PMID 22708146
This randomized waitlist control study examined the efficacy of Thought Field Therapy (TFT) in reducing Posttraumatic Stress Disorder symptoms in survivors of the 1994 genocide in Rwanda. Participants included 145 adult...
This randomized waitlist control study examined the efficacy of Thought Field Therapy (TFT) in reducing Posttraumatic Stress Disorder symptoms in survivors of the 1994 genocide in Rwanda. Participants included 145 adult genocide survivors randomly assigned to an immediate TFT treatment group or a waitlist control group. Group differences adjusted for pretest scores and repeated measures anovas were statistically significant at p < .001 for 9 of 10 TSI trauma subscales and for both severity and frequency on the MPSS, with moderate to large effect sizes. Reduced trauma symptoms for the group receiving TFT were found for all scales. Reductions in trauma symptoms were sustained at a 2-year follow-up assessment. Limitations, clinical implications, and future research are discussed.
Trauma postvention response in Manitoba: coping with trauma and disasters.
Favelle GK
Int J Emerg Ment Health · 2011 · PMID 22708145
Manitoba utilises three different trauma "postvention" services and approaches to assist responders (including emergency services, government and non-governmental organisations) and communities affected by trauma and dis...
Manitoba utilises three different trauma "postvention" services and approaches to assist responders (including emergency services, government and non-governmental organisations) and communities affected by trauma and disaster. A coordinated response is required to assist those affected utilising: Community Trauma Postvention and Critical Incident Stress Management services and a multifaceted psychosocial support approach. It is important to recognise the role and place of each service and approach to ensure all those affected have an opportunity to have their needs met in a comprehensive and efficient manner. This paper briefly describes the concept of "postvention" and the situations in which these "postvention" services and approaches were developed and/or utilised in Manitoba and internationally.
Testing the warning signs of suicidal behavior among suicide ideators using the 2009 National survey on drug abuse and health.
Gunn JF, Lester D, McSwain S
Int J Emerg Ment Health · 2011 · PMID 22708144
In order to help crisis counselors assess clients for their suicidal risk, in 2003 the American Association of Suicidology proposed ten warning signs, memorized through the acronym IS PATH WARM However, little research h...
In order to help crisis counselors assess clients for their suicidal risk, in 2003 the American Association of Suicidology proposed ten warning signs, memorized through the acronym IS PATH WARM However, little research has been done investigating their effectiveness for predicting suicidal behavior The present study compared (1) suicide ideators with non-suicide ideator controls and (2) suicide ideators with suicide attempters on six of the IS PATH WARM warning signs, along with depression in the past year, marital status, and gender With regards to the comparison between suicide ideators and non-ideators, all variables but gender; abuse of alcohol in the past year, and anxiety in the past year were predictive of suicide ideation. However, when comparing suicide ideators who had not made a suicide attempt with those who had, only anger/aggression, depression in the past year, and marital status were predictive of a suicide attempt.
Critical decision points in crisis support: using checklists and flow charts in psychological crises.
Mitchell JT
Int J Emerg Ment Health · 2011 · PMID 22708143
The field of crisis intervention has grown dramatically during the last hundred years. Many new procedures and techniques have been added to the crisis intervention repertoire. Periodically, providers of crisis intervent...
The field of crisis intervention has grown dramatically during the last hundred years. Many new procedures and techniques have been added to the crisis intervention repertoire. Periodically, providers of crisis intervention, psychological first aid, critical incident stress management, or Peer Support overlook important elements of crisis intervention or make inadvertent mistakes as they attempt to intervene. The use of checklists and flow charts, similar to those used in aviation and medicine, may assist crisis intervention personnel in properly assessing a traumatic event and its impact on the people involved. Simple checklists and flow charts may significantly decrease the potential for mistakes in crisis intervention. This article provides background on the development of flip charts in aviation and medicine and suggests how these tools may be utilized within the field of crisis intervention. Examples of checklists and flow charts that are relevant to crisis intervention are provided. The article also provides guidelines for developing additional checklists and flow charts for use in crisis intervention services.
Crisis and trauma intervention efforts.
Miller L
Int J Emerg Ment Health · 2011 · PMID 22708142
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Resilience training for functioning adults: program description and preliminary findings from a pilot investigation.
Schiraldi GR, Jackson TK, Brown SL … +1 more , Jordan JB
Int J Emerg Ment Health · 2010 · PMID 21138155
It has previously been asserted that the construct of resilience holds great promise for diverse high-risk populations and that resilience may be an attribute that can be acquired through training. A rich body of literat...
It has previously been asserted that the construct of resilience holds great promise for diverse high-risk populations and that resilience may be an attribute that can be acquired through training. A rich body of literature suggests the strengths that comprise resilience. This paper describes a resilience training program based upon the identified strengths of resilience and provides additional preliminary data from a pilot investigation which lend support to the idea that resilience can be acquired through training. Suggestions for future research are provided.
New York City social workers after 9/11: their attachment, resiliency, and compassion fatigue.
Tosone C, Bettmann JE, Minami T … +1 more , Jasperson RA
Int J Emerg Ment Health · 2010 · PMID 21138154
This study examines the relationship between attachment classification, resiliency, and compassion fatigue in New York social workers following 9/11. We used single occasion, quasi-random sampling, surveying 481 social w...
This study examines the relationship between attachment classification, resiliency, and compassion fatigue in New York social workers following 9/11. We used single occasion, quasi-random sampling, surveying 481 social workers living in Manhattan. Hierarchical regression analyses revealed that secure attachment is predictive of the ability to cope with secondary traumatic stress as well as capacity for resilience, explaining approximately 7% of the variance in both compassion fatigue and resiliency. These findings suggest that secure attachment may serve as a source of resilience for social workers, immunizing them from significant compassion fatigue. Such findings have significant implications for clinicians working with traumatized populations.
The Badge of Life Psychological Survival for Police Officers Program.
Levenson RL, O'Hara AF, Clark R
Int J Emerg Ment Health · 2010 · PMID 21138153
Worldwide, there is no more consistently stressful job than that of the police officer. In the United States, police officers are more likely to die by suicide than by any type of criminal or criminal activity. This arti...
Worldwide, there is no more consistently stressful job than that of the police officer. In the United States, police officers are more likely to die by suicide than by any type of criminal or criminal activity. This article discusses the Badge of Life Psychological Survival for Police Officers Program (BOL), founded in 2008, with the goal of developing an effective police officer suicide primary and secondary prevention program. Such a program is not a regular entity within the majority of accredited law enforcement agencies. Along with standard suicide prevention protocols typically used in other programs, an Emotional Self-Care Program (ESC) was designed to focus on the officer's ability and responsibility to care for his own emotional well-being. The model relies on teaching the factor of resilience as a significant component of stress-resistance (Everly, Welzant, & Jacobson, 2008). Selected for their credibility and trust level, peer support officers conduct the actual annual training workshops, set the example, and encourage involvement at all levels. A "cradle-to-the-grave" program (i.e., rookies to retirees), ESC calls upon departments to begin teaching their personnel about the effects of job-related stress and trauma while they are still in the academy, emphasizing the importance of voluntary, confidential "annual mental health checks." Representatives of BOL now lecture regularly across the United States and Canada. All consultations, lectures, educational and training workshops, services, and referrals are free, as are original training materials developed and approved by the BOL Board of Directors.
Suicide or undetermined? A national assessment of police suicide death classification.
Violanti JM
Int J Emerg Ment Health · 2010 · PMID 21138152
The validity of police suicide rates is questionable. The objective of this paper is to compare national police suicide rates with "undetermined" death rates and compare across occupations similar in exposure. An additio...
The validity of police suicide rates is questionable. The objective of this paper is to compare national police suicide rates with "undetermined" death rates and compare across occupations similar in exposure. An additional objective is to compare police suicide and undetermined rates in female and minority officers. Results indicated that male police officer deaths had a 17% increased risk of being misclassified as undetermined (Proportionate Mortality Ratio (PMR) = 117, 95% CI = 110,123, significant at p < 0.01). The risk was higher than both firefighter and military occupations (PMR = 101 (1% risk), 95% CI = 89, 114; PMR = 108 (8% risk), 95% CI = 104,113 respectively). A high risk of misclassification was also seen in female and African American officer deaths (PMR = 198 (98% risk), 95% CI = 151-255, sig. p < 0.01 and PMR = 344 (344% risk), 95% CI = 178-601, sig. p < 0.01 respectively). The significantly higher ratio of police deaths classified as undetermined is interesting, given the high profile of law enforcement in society and the generally thorough investigations of police officer deaths. Also of interest is the suggestion that police misclassification risk is higher for police than other similar occupations. Future research should suggest possible ways to increase the validity of police suicide rates through methods such as post-suicide psychological autopsies.
Critical incident stress management in a school setting following police shooting of an adolescent.
Miller RL, Grueninger CE
Int J Emerg Ment Health · 2010 · PMID 21138151
Cincinnati Public Schools Critical Incident Stress Management Team responded when a teenager who was in possession of a pellet gun was killed by police. The themes that emerged had more to do with rage than typical berea...
Cincinnati Public Schools Critical Incident Stress Management Team responded when a teenager who was in possession of a pellet gun was killed by police. The themes that emerged had more to do with rage than typical bereavement or trauma responses. The primary objective was the prevention of school and community violence. Strategic planning was critical in preventing violence and responding to the changing needs of students, staff and families during the weeks following this tragedy. Team members had to consider cultural differences related to interpretation of events, grieving rituals, and expectations for appropriate behavior when planning and providing interventions.
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