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The prevalence of traumatic symptoms among police officers with different levels of service in the Vancouver… Ram, Jessbir L. 2001

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THE PREVALENCE OF TRAUMATIC SYMPTOMS AMONG POLICE OFFICERS WITH DIFFERENT LEVELS OF SERVICE IN THE VANCOUVER POLICE DEPARTMENT By JESSBIRL. RAM B.Comm. University of British Columbia, 1984 A THESIS SUBMITTEDIN PARTIAL FULFILMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF ARTS in THE FACULTY OF GRADUATE STUDIES Department of Educational and Counselling Psychology And Special Education We accept this thesis as conforming to the required standard THE UNIVERSITY OF BRITISH COLUMBIA April, 2001 © Jessbir L. Ram, 2001 In presenting this thesis in partial fulfilment of the requirements for an advanced degree at the University of British Columbia, I agree that the Library shall make it freely available for reference and' study. I further agree that permission for extensive copying of this thesis for scholarly purposes may be granted by the head of my department or by his or her representatives. It is understood that copying or publication of this thesis for financial gain shall not be allowed without my written permission. Department of &doc<^t\t>r\c\ aV\d C o U ' v S e l ) ^ \ ^ O ^ L P I O ^ 4 *> ^ f * C l « * . l c r Qtuc^n 0/\ The University of British Columbia Vancouver, Canada Date QMAI \g , ^PP l . DE-6 (2/88) Abstract 11 Police officers are subject to stressors from traumatic incidents, day to day policing duties as well as organizational sources. This quantitative study examined 195 serving police officers in the Vancouver Police Department to determine what if any relationship existed between any prevalence of traumatic symptoms and their years of experience as police officers. Trauma symptoms were measured through the use of the Trauma Symptom Inventory, which was administered to a randomly selected sample. The sample was divided into seven groups based on years of completed service; recruits, 0<2 years, 2<5 years, 5<10 years, 10<15 years, 15<20 years and 20+ years. While the recruit group showed a spike on the validity scale of Response Level and there were spikes in Anger/Irritability and Depression among the 2<5 years and 20+ groups respectively, most of the significant scores were among the group 10<15 years. This group showed significantly elevated scores in Atypical Responses, Anxious Arousal, Anger/Irritability, Depression, Intrusive Experience, Defensive Avoidance and Impaired Self Reference. In terms of support the respondents indicated through a demographic questionnaire that Family Support was the one most frequently endorsed at the high level, followed by Social Support and then by Peer Support. There was also low levels of endorsement of the Critical Item on the TSI that had to do with hurting others and problems due to alcohol consumption and sexual behaviour. Empirical support and personal experiences of the researcher are provided as explanations for the trends. The number of females in the latter groups was limited due to the demographics of the population. Several recommendations are made for future research as well as recommendations to the Vancouver Police Department to address the findings with their sworn members. i l l Table of Contents Abstract ii List of Tables vi List of Figures viii Acknowledgments ix Chapter One- Introduction 1 Autobiographical Situating 1 Nature of Police Stress. : 1 Purpose of the Study , 4 Limitations of the Study 4 Definition of Terms : 5 Chapter Two- Literature Review. 7 Introduction 7 PTSD Theoretical Underpinnings 8 Biological Explanation 8 Cognitive Appraisals of Stressful Events 11 Psychological Correlates of Stress Reactions 17 Personality Profiles of Police Officers .17 Implications for Police Susceptibility for Stress Reactions 21 Sources of Police Stress 28 Sources of Acute Stress l 29 Organizational and Administrative Sources of Stress .31 Stressors Inherent to Police Work 36 Stressors for Special Groups Within Policing 41 Policewomen. 41 Supervisors ..44 Police Managers 46 Traumatic Symptoms of Police Officers 47 General Symptoms 47 Police Shootings 51 IV Rescue Work ...60 Suicide 64 Police Family Difficulties 67 Alcohol Use 70 Relationship Between Stress and Experience 72 Rationale for Non-Linear Relationship 75 Research Question .78 Chapter Three-Method 80 Population 80 Instrument Description 82 Sample Selection ; 83 Test Administration 84 Data Analysis , 85 Chapter Four- Results 87 Demographic Data 87 ANOVA 90 Restatement of Question 93 Validity Scales 93 Clinical Scales Showing Significant Differences 95 Clinical Scales Showing No Significant Differences 99 Post Hoc Analysis of Support Measures ..101 Critical Item Analysis 103 Chapter Five- Discussion I l l Highlights of Results I l l Comparison to the Literature I l l Discussion of Results 114 Recruit Group 115 0<2 Years Group ; 116 2<5 Years Group 117 5<10 Years Group 118 10< 15 years Group 120 V 15<20 Years Group 124 20+Years Group , 126 Demographic Questionnaire Support Items 128 Critical Items 129 Comments by Respondents 130 Limitations 130 Future Research Implications 132 Recommendations 133 References. 135 Appendices 147 Appendix A: Informed Consent Form 147 Appendix B: Demographic Questionnaire 149 Appendix C: List of TSI Scales 150 Appendix D: List of TSI Critical Items 151 VI List of Tables Table 3.1- Population Available Listed by Group 81 Table 4.01- Demographic Data of Entire Sample T87 Table 4.02- Sample Age, Service and Patrol Time Means 88 Table 4.03- Sample Gender Demographics 88 Table 4.04-Distribution of Gender by Group of Sample as Compared to Population 89 Table 4.05-Educational Frequencies of the Sample 90 Table 4.06- Sample Test Score Means by Group and Gender 92 Table 4.07- Atypical Response Level Means 94 Table 4.08- Response Level Means. .94 Table 4.09- Anxious Arousal Means 96 Table 4.10-Depression Means 96 Table 4.11- Anger/Irritability Means : 97 Table 4.12- Intrusive Experience Means. 97 Table 4.13- Defensive Avoidance Means 98 Table 4.14- Impaired Self Reference Means 99 Table 4.15-Social Support Results 102 Table 4.16-Peer Support Results 102 Table 4.17- Family Support Results 103 Table 4.18- Critical Item 19-Thoughts or Fantasies About Hurting Someone 104 Table 4.19- Critical Item 58-Getting in Trouble Because of Your Drinking 104 Table 4.20- Critical Item 28- Getting Trouble Because of Sex 105 Table 4.21- Critical Item 50- Sexual Fantasies About Being Dominated or Over Powered 106 Table 4.22- Critical Item 99- Thinking That Someone was Reading Your Mind 106 Table 4.23-Critical Item 30-Wishing You Were Dead 107 Table 4.24- Critical Item 90-Feeling Like Life Wasn't Worth Living 107 Table 4.25- Critical Item 65- Hearing Someone Talk To You Who Wasn't Really There 108 Table 4.26- Critical Item 40- Using Drugs Other Than Marijuana 108 Vll Table 4.27- Critical Item 92- Seeing People From the Spirit World .. 109 Table 4.28- Critical Item 48-Intentionally Hurting Yourself ( For Example By Scratching, Cutting or Burning) Even Though You Weren't Trying to Commit Suicide 109 Vll l List of Figures Figure 4-1- Graphs of the means of the three validity scales 93 Figure 4-2- Graphs of Anxious Arousal, Depression, Anger/Irritability, Defensive Avoidance, and Impaired Self Reference Means 95 Figure 4-3-Graphs of Dissociation, Sexual Concerns, Dysfunctional Sexual Behaviour and Trauma Reduction Behaviour Means 100 V" IX Acknowledments I would like to thank the members of the Vancouver Police Department who agreed to participate in this study and share themselves, I feel honored to be a part of it with them. I would also like to express my appreciation to Chief Constable Terry Blythe for granting permission for this study to be carried out. I am forever in the debt of my family who have all persevered through this study and program beside me. To my wife Andrea, thanks to you not only for the encouragement but also keeping me grounded and helping me remember what is really important in this world, I love you. To my children Asha and Aaron, thank you for sharing with me your innocence and honesty, you will always bring smiles to my face and warmth to my heart. To my parents, Sohan and Sheela. Thank you for your confidence in my abilities and although only one of you is with us today, you will both be in my heart always. To the staff at the Justice Institute Library, thank you for all the help with the research. Christine, Lucy, Janice, April and Robert you are special group whom I will always remember. I would like to thank my committee. My original chair, Dr. Larry Cochran, thank you for the words of encouragement and support from the conception of this project. Dr. Bill Borgen, thanks for stepping in and providing the knowledge and feedback that made this project happen. Dr. Pamela Crammond-Malkin, your wisdom, compassion and thoughtfulness along with the support you have given me will be something that I will not forget. Dr. Norm Amundsen, thank you for your willingness to participate in the committee. I would also like to thank the many friends I have made during this journey. Shelley, Bill and Cheryl you have helped me discover different parts of myself than I was never aware of and I feel richer for having gotten to know you. 1 Chapter I Introduction Autobiographical Situating After working the last sixteen years as a police officer in the city of Vancouver, I have seen several trends emerge over that time. While some of these trends in policing have been quite positive, such as innovations in technology and police practices, many of these trends have been negative ones. Vancouver is becoming a more violent place to live, which may be a statement about society as a whole. Violent crimes as well as the prevalence of firearms have steadily increased. Attacks on officers by suspects have also increased. Unfortunately, these negative trends have served to influence the nature of police stress. Innovations have also taken place in the area concerning the mental health of police officers, exposed to a variety of psychological and emotional stressors on a daily basis. Peer counseling teams as well as Critical Incident Stress Teams are now a part of many police departments and their deployment is mandated as a part of any disaster or deployment plan. I have been involved with the Vancouver Police Department's Critical Incident Management Program since 1991. Nature of Police Stress To understand the nature of police stress it is important to understand the people who do this job. While police departments are traditionally para-military organizations, the trend over the past sixteen years has been a steady rnove away from this traditional organizational structure and the typical recruit, police departments are flattening their rank structures and delegating more decision making responsibilities to lower levels of 2 management. Today's police recruit is typically older than in previous years and has more formal education. While often compared to military personnel, police officers are distinct in that that they are also members of the community and are simply asked to perform the service of law enforcement. Police stress has a variety of sources. For ease of discussion these are divided into those which are acute and those that are more chronic in nature. The acute stressors include a number of situations in which police officers may find themselves on any given tour of duty. The following is a scenario that serving police officers could find themselves in on any given night. You are a police officer into your seventh hour of patrol and you are walking down a dark lane. There has been a report of a suspicious vehicle parked in the lane. The night is cold and there is a wet mist in the air. The alley is very poorly lit but you have a flashlight, which reveals a vehicle in the lane with the engine running. As you approach you are about to radio for assistance when you hear a door opening behind you. You swing around and see a figure come out of the door. The figure is carrying an armload of boxes. You tense up as the figure drops the boxes. At this point you see a shiny object in his hand as the figure begins to crouch. You draw your firearm and must make the decision to shoot or not to shoot. You have one second to decide if this person is-a threat to you and if that shiny object in his hand is a gun or not. Your time is up, what did you do? This vignette serves to illustrate the types of events that can be labeled as acute stressors for police. Criminals have become better armed and more sophisticated in their methods and their willingness to avoid capture. Organized criminals are often better funded and better armed than most police officers. Attacks on police officers seem to be occurring more frequently than they were in the past. It is not unheard of in domestic disputes to have the victim, often the female partner, to physically attack the same officers who have just moments before saved her from an attacking spouse. It has been my experience that the attack on the officers usually happens when the officers have handcuffed the offender and are leading him out of the premises. Police officers are also being exposed to individuals who are suicidal but do not possess the will to actually take their own life. As a result they will point a firearm at the police officer or threaten them with a knife. The perpetrators do this with the full knowledge that the police officers will likely use deadly force to defend themselves. Gerbeth (1993) calls this phenomenon "Suicide by Cop". The offender may use a toy or unloaded gun to taunt police. Acutely stressful incidents for police officers are not limited to those where their own bodily integrity is in jeopardy. Multi-car fatal accidents as well as violent crimes are increasing in both their frequency and their severity. In addition, multiple victim shootings in public places such as schools and work places are becoming a familiar news item. Murder suicides are also being reported with greater frequency. Left untreated exposure to various traumatic incidents has the potential to cause police officers to develop a host of different stress related problems. Police stress can also be chronic in nature. The police organization itself, with its bureaucratic policies and procedures can serve as a source of chronic stress for the police officer. Police officers may also experience frustrations with the judicial systems, where they feel offenders are being treated too lightly or with prosecutors who are not prosecuting offender due to what they perceive as a small likelihood of conviction. In 4 addition, the rights of the offender are often seen to supercede those of their victims. Police officers must also justify their actions and are open to public criticism and increased accountability. Moreover, police departments, like many other government agencies are experiencing the effects of fiscal restraint and poor budget management and as a result are being asked to perform at a higher level with fewer resources and manpower. Purpose of the Study The purpose of this research was to identify the prevalence of traumatic stress symptoms among sworn police members in the Vancouver Police Department. Specifically, the research question before the reader is; Was there a statistical difference in traumatic symptoms across different levels of experience? If there was a difference, what is the nature of this relationship? A secondary issue was to examine the data for gender differences. Lastly, the research looked to see what support indicators are related to traumatic symptoms. The importance of this research is threefold. It will allow police departments to gain insight into the prevalence of traumatic symptoms. It will then assist them in allocating limited mental health resources to police members when they can most benefit from them. And finally it may set the stage for further research in this area. Limitations of the Research There are several issues that this research did not attempt to cover. First, this research did not attempt to uncover the source or sources of the traumatic symptoms as reported by the participants in the study. A criticism of the psychometric tool used in this research, the Trauma Symptom Inventory (Briere, 1995), is that it is not specific in terms of identifying a particular stressful event in the subject's history. To this end, without the 5 use of a clinical interview, it would be difficult to determine whether or not the traumatic event that is producing the traumatic symptoms happened before or after the subject became a police officer. Given the sample size, the use of clinical interviews or other such structured assessment tools with all participants was impractical. Clinical interviews may also have served to reduce the subject anonymity and reduce any subject's willingness to participate in the study. Second, this research did not restrict itself to the cases of officers who fit the diagnostic criterion for Post Traumatic Stress Disorder. By restricting itself to those officers with this clinical diagnosis I felt that a large amount of rich data would be needlessly discarded. There may be a host of police officers who do not meet the DSM IV (APA, 1994) diagnostic criteria for PTSD but yet are still displaying some of the symptoms found in the three symptom constellations for this disease. Thus excluding them on the basis of them not meeting the full diagnostic criterion would have been at the very least irresponsible. Instead the research concerned itself with symptoms of stress, giving special attention to the traumatic symptoms. The reader must also remember that what constitutes a traumatic event depends upon the cognitive appraisal of the event by the police officer. Definition of Terms Stress and strain are two terms that should be defined early in this research. As defined in Pendleton et al (1989) strain is a negative result that comes from stress, while stress was defined as demands that over power a person's abilities to cope with a particular set of circumstances. Burnout and plateauing should also be defined so that a distinction can be made between the two terms. Childers (1991), in an article found in a police periodical, defines burnout is the long term effects of stress and what often leads police officers to becoming cynical, angry and frustrated. Plateaued officers are there because of what Childers calls the 99% rule, where there is only one Chief and because of traingular nature of police organizations. As police officers advance in their rank and service there are fewer and fewer positions available to them to compete for. The next chapter will review the literature on police stress as it relates to this research question. While much of the literature is from American and other international sources, this review assumes a degree of applicability across cultural borders. It is my belief that there are many parallels across policing in North America and Western Europe, Australia and South Africa. This is not to say that individual differences do not exist in specific regions but assumes that many of the experiences transcend geographical borders. 7 Chapter 2 Literature Review Introduction For ease of discussion this literature review is divided into five sections. Section one provides the reader with two complementary theoretical perspectives on the underpinnings of traumatic stress reactions. It sets the stage for understanding the myriad of different symptoms that are identified later in this review. Section two examines literature surrounding some of the psychological correlates that could influence stress reactions. This includes a review of the personality characteristics of police officers as well as some of the implications for police officer's susceptibility to stress reactions. Section three identifies the different sources of stress for police officers. This section is subdivided into subsections that cover the material around acute sources of stress, organizational and administrative sources of stress as well as sources of stress inherent to police work. This section also deals with stressors that apply to specific sub-populations within the police community. These groups included policewomen, supervisors and police managers. Section four concerns itself with the traumatic symptomology exhibited by police officers. This section reviews general traurnatic symptoms as well as those that accompany police shootings and rescue work. This section also briefly covers the literature having to do with some personal difficulties the police officer may encounter. These include suicide, family difficulties and alcohol use. Section five addresses the literature around the question of whether there is a relationship between stress and experience as well as some rationale for this documented relationship. This review 8 focuses on empirical research where possible and then reviews other occupational literature that is provided to police officers and those who treat them. PTSD Theoretical Underpinnings While there are there are a number of different theories underlying PTSD and the accompanying symptoms, the scope of this analysis will limit itself to two such theoretical perspectives which this author believes work in conjunction. Biological explanation. While there are a number of different biological theories of stress reactions it is not within the scope nor is it the intent of this review to assess the validity of all the various theories or to compare their merits and deficiencies. These biological theories are presented simply to provide a framework on which to base the ensuing discussion. The biological underpinnings of stress reactions are well documented by Selye (1978) and his General Adaptation Syndrome. Selye proposed that during the alarm phase there is an over production of adrenaline and corticoids. This intense high from these substances is followed by a depression. Everly (1989) in a Clinical Guide for those treating the stress response outlines a biological model of the stress response. The individual's cognitive appraisal of an event as being dangerous or traumatic is followed by an endocronological response. As Everly explains the stress response is initiated by the neocortical and limbic integration that occur when stimuli are interpreted as threatening to the organism. Neural impulses traverse to the posterior hypothalamus and anterior hypothalamus to the specific target organ which is attempting to deal with the threat. The flood of neurotransmitters such as norepinephrine, serotonin, acetycholine, gamma amino butryric acid (GABA) and 9 dopamine serve to either enlist, shutdown or accentuate activation of organ systems in the body. This biological component, while simplified may help to explain not only perceptual focusing during a traumatic event but may also be useful in understanding some of the somatic complaints that officers complain about during a traumatic event. With the understanding of this basic biological theory more complex biological explanations of traumatic stress reactions then become easier to understand. These include van der Kolk's (1987, 1997) information processing model and Everly's (1995) neurological hypersensitivity models. Van der Kolk's model has come from his work with trauma patients who have suffered sexual abuse. He has adopted a medical/information processing theory as one explanation for traumatic reactions. The limbic system is the system in the brain where information is processed. Information enters via the sensory organs, to the right side of the brain and proceeds to the thalamus, where information that is vital to the immediate survival of the organism is quickly selected from the mounds of sensory information that are received through the various sensory organs of the body. Information crucial to immediate survival, such as danger, will cause the amygdula to fire. Routine or information that does not have to do with threats to the organism then follows a path through the hippocampus and is sent via the bridge to the left side of the brain where it may be processed, have meaning attached to it, then stored in the appropriate location for later retrieval. During traumatic events the limbic system is subject to the release of specific neurotransmitters that cause the limbic system to operate in less than a perfect manner. Seratonin depletion in the brain during traumatic events causes the limbic system to label information as potentially threatening at a faster rate than normal. The ability of the organism to sit back and accurately assess 10 information is diminished. In addition, the limbic system becomes overly excited due to the endocrinological response of the organism. The flood of "excitatoxins", including epinephrine, dopamine and glutamine can cause a condition known as neural excitatory toxicity within the limbic system (Van der Kolk, 1987). The amygdula begins to fire very rapidly and as a result the bridge linking the two hemispheres of the brain is destroyed. Emotional memory registers on the right side of the brain but the corresponding cognitive memory cannot be encoded on the left side of the brain. The individual is left with emotional recollections of the event but is unable to make sense of it, which is usually done in the left hemisphere of the brain. Van der Kolk's model may help to explain police officers' flood of emotions and ruminations that they experience after a traumatic event such as a shooting. Everly(1995) in his two factor theory, explains that there is a biological and a psychological explanation that work simultaneously. The psychological hypersensitivity has to do with the person's world view and is similar to the one articulated later in this section. The biological or neurological hypersensitivity is again the result of the release of specific neurotransmitters in the brain and is somewhat similar to the previous model. Everly states that many of the symptoms that PTSD patients exhibit are the result of not only an over abundance of excitatory neurotransmitters but also a decrease in inhibitory neurochemicals which are required to counter act the excitatory activity in the brain. He goes on to hypothesize that the structure and function of the neuron actually changes. A state of neural toxicity may actually damage brain cells. Like the previous theory this condition will then affect the brain function. 11 The biological component of stress is supported in other research and literature. Roger et al (1995) claims that the victim's own rumination about events serves to perpetuate the stress response. The chemicals released by the pituitary gland help to maintain the arousal state. Cognitive appraisals of stressful events. The second perspective on the underpinnings of traumatic reactions involves how traumatic events serve to shatter existing assumptions. This perspective is documented in Janoff-Bulman's (1995) research with victims of violence and how trauma serves to shatter the victim's existing view of the world. Her concept of the individual's World View is central to this theory. An individual's world view is based on certain core assumptions. Anxiety and traumatic reactions result when events in the world do not fit the person's existing schema's or view of the world. These core assumptions include; a) the world is a benevolent place; b) events in the world are meaningful and; c) the self is worthy and competent (Janoff-Bulman, 1995). Traumatic events serve to shatter one, several or all of these assumptions. It is useful to examine exactly how traumatic events can serve to shatter these myths. The myth of the world being a benevolent or just place includes concepts or beliefs like good things happen to good people and bad things happen to bad people. A police officer will often see bad things happen to people whom he perceives as good, such as himself or innocent victims. Some of these traumatic events may even serve to cause the officers to consider, more deeply than they would like to, the issue of their own vulnerability or their own mortality. The myth of events in the world having meaning includes beliefs about the events in the world being predictable or making sense. This may include thoughts 12 about people getting what they deserve and there being justice in the world. When traumatic events do not make sense, officers may begin to feel that the victims in some way deserved what happened to them and even blame the victims, even if they themselves are the victims. Self blame, according to Janoff-Bulman serves two important functions. First, blaming helps the officer quickly assign meaning to a traumatic event, which may otherwise not have any immediate meaning. This will assist the officer in re-establishing the myth of control. During traumatic events the officer may feel out of control of the situation. By blaming themselves, they are now in a position to remedy this perceived shortcoming and have re-established the illusion of control. The event is reconciled by the belief by the officer that by improving themselves or bettering their skill set they can prevent themselves from being in a similar incident. Control issues have been borne out in empirical research. Hills and Norvell (1991) showed that a sense of control over a situation seemed counter physical symptoms of stress. Brown and Grover (1998) found that the officers who clung to their world beliefs during stressful events had more difficulty in dealing with these events. The issue of control and traumatic events is also illustrated in other research. Reiser and Geiger (1984) explain that police officers are traumatized when they loose the illusion of control and invulnerability. The purpose of this illusion is that it allows police officers to cope with their own fear and anxiety surrounding dangerous situations. The traumatic events may cause them to feel a loss of control over their environment and may also cause them to confront their own mortality which can lead to increased levels of anxiety. The second function of blaming is that by blaming themselves the police officers can protect their core assumptions that make up their world view (Janoff-Bulman, 1995). 13 The final myth that makes up a person's world view is related to self image and how the police officer views their own level of skill and competency. Officers may often view themselves as more competent than they actually are and these myths are shattered when they do not perform as well as they believed they could during a traumatic event. Reiser and Geiger (1984) warn that police officers may be in the habit of viewing themselves as overly competent. When officers finds themselves on the loosing side of a physical confrontation their self-image will need to be re-evaluated. McMains (1990) states that the emotional arousal after a shooting can result from a shattering of the officers' myth of their safety and knowledge level. Violanti (1986) developed a hypothetical model to help to explain the police officer's vulnerability to traumatic symptoms. His model is based on the premise that the police officer's vulnerability originates from the shattering of some of their own myths about their invulnerability. He states police officers have been socialized from the beginning of their careers to depersonalize relationships and cling to a myth of indestructibility. While these myths help the police officer function on a daily basis they leave the officers to cope with traumatic reactions when, during an exposure to a trauma, their assumptions are shattered. Volanti (1986) goes on to explain that perception of vulnerability can originate from the degree the police officer identifies with the victim or the situation. Volanti also incorporates previously untreated vulnerability into his model. Thus reactions may not be associated with the present trauma, but relate to other traumas the police officer has experienced and is still carrying as psychological baggage. In my experience these previous traumas may originate from either the police officer's job or from their past before they became police officers. 14 Janoff-Bulman (1995) states that the intrusive symptoms will continue until either the event can be assimilated into the victim's assumptions about the world or the assumptions are modified in order to accommodate the traumatic event. Gentz (1990) supports the importance of an officer's view of the world and how they happen to organize existing information. His article appears to be consistent with other literature on the subject in its integration of the biological and physiological theories of traumatic symptoms. He agrees that the critical incident may serve to shatter some core assumptions about the world. He goes on to explain that the event may bother police officers because they have not yet developed the schemas in which to organize and fit this event. The development of new schemas or fitting an event into existing assumptions is what produces some of the traumatic symptoms such as rumination and feelings of isolation. Gentz (1990) goes on to theorize that officers who hold broader world views with more schemas, are likely to make a quicker and healthier adjustment to the event. Presumably this increase in the number of schemas available to any police officer would be a function of factors such as experience and exposure to previous events similar to the present traumatic event. There is other support for the use of schemas to deal with traumatic symptoms. Treating patients with PTSD may involve the assisting the person's natural attempts to reduce their level of arousal by fitting the latest information into existing schemas (Lawson, 1995). As Lawson refers in this article of conceptualizing and treating Vietnam Veterans, a person will attempt to reduce the level of unpleasant emotional intensity by either, avoiding the information, fitting it into present schemas or altering their schema so that it includes the present event. Ochberg (1990) also supports this view in a paper on posttraumatic therapy where he stresses the importance of the therapist's role of assisting the client in searching for the meaning of the traumatic event. There is ample support for the idea that the event itself is not inherently stressful but it is the cognitive appraisal of the event that gives it its emotional charge. Marmar et al (1996) examined the after effects of critical incident stress on rescue workers and reported that the importance of personal meaning was significant. Workers who felt a sense of personal meaning attached to the event were more likely to suffer long-term symptoms. Personal meaning had less of an impact for immediate distress than it did for long term symptoms. McCammon et al (1988) also found that seeking meaning was among the coping mechanisms used by traumatized rescue workers. Van der Kolk (1986) provides an intermediate step that may serve to link the biological and cognitive theories of traumatic stress reactions as provided by his theory on the psychological processing of traumatic events. He explains that immediately after one is exposed to a traumatic event, the individual may deny the event through either numbness or de-realizing. Following this the individual will flucuate between states of numbness and hyper-arousal. During the latter phase there is a conditioned release of opiods in the brain that can be addictive for the organism. Due to the fact that they are unable to verbalize the trauma, the victims are forced to constantly re-experience the event. This may be through excessive rumination or may progress to flashbacks, during which the victim is subject to the same type of physical reactions that they experienced during the original event. This re-experiencing is functional in that it is designed to protect the victim from further similar traumas, but it interferes with the person's ability to metabolize the traumatic event. They are unable to fit the event into existing schemas 16 or develop new schemas to attach meaning to the event When a traumatic experience cannot be pigeon holed into existing schemas the subject's coping skills become overwhelmed. Individuals who are exposed to a greater variety of different types of events are likely to have more schemas in which to fit an event and are thus protected from being overwhelmed. Thus a senior police officer who has had a variety of traumatic events will logically have more schemas in which to fit the event, as opposed to a new recruit. Finally van der Kolk (1986) explains that traumatic events can lead to regressive behavior once the victim becomes overwhelmed. These behaviors can include dependency, obsessive compulsive behavior and problems with affect regulation. Moreover, the victim is likely to experience depression, helplessness, and preoccupation with the traumatic event. Ostrov (1986) illustrates three case histories of traumatized police officers and illustrates exactly what van der Kolk (1986) asserts. He says that in all three cases the traumatic experience violated the victim's sense making abilities, their sense of the world and their concept of self. Along with anger, they exhibited affect control problems along with sleep disorders, self medication and suicidal ideation. The traumatic events served to violate the police officers' sense of invulnerability and competency, which had been very functional for them up to this point in their careers. In addition, the cumulative nature of trauma can lead to other types of psychological problems. Ostrov (1986) also states that the intensity of the reactions can be influenced by and is a function of the degree to which the officer identifies or takes ownership of the event. This special meaning can then serve to re-kindle previously unresolved experiences the police officer has been exposed to. 17 Psychological Correlates of Stress Reactions There are a host of factors and variables about the officer and the incident that can influence the degree of stress symptoms that the officer will realize after a traumatic or stressful incident. Personality profile of police officers Some of the research shows that police officers show high Type A personality scores (Kirkcaldy et al, 1995). This research revealed that they are impatient and assertive and in addition they often cope with stress with the aid of social support, which may explain why the lack of departmental support after a traumatic incident can be so harmful to the officer involved in the event. This research also showed that the police officers in the study had superior mental health scores. Kirkaldy (1993) negatively correlated Type A behavior to physical ill health and positively correlated it with coping. It appears that by this study the Type A behavior is actually beneficial to the police and went on to describe them as having high levels of job satisfaction and slightly superior mental health than compared to the general population. Evans et al (1993) also found that police officers have Type A personalities. In addition to a majority of police officers fitting the Type A personality profile, they found that they used direct coping techniques and they used common sense to solve problems. They described the police officers as practical, self confident, responsible, assertive, self-reliant and unsentimental. Police officers can also tend to under report symptoms. In a study of the Los Angeles police who were in the 1992 Rodney King Riots police officers were also believed to be under reporting the prevalence of PTSD symptomology (Harvey-Liritz & Tidwell, 1997). 18 The authors felt that the figure of 17% of officers reporting PTSD symptoms was an under report of the actual number that had symptoms. They theorized that this was largely due to the police culture's practice of promoting a certain image, that of staying in control. A police officer's career orientation can also reveal something about their personality as well as determine the degree of susceptibility to stress and stress tolerance. Burke and Kirchmeyer (1990) theorized that stress for a police officer is a function of the degree of fit between the officer's career orientation and his work setting. They divided career orientation in four categories. The four career orientations are the Self Investor, the Social Activist, the Careerist and, the Artisan. The Self Investor thinks policing is simply a job and a way of earning a living. The Social Activist wants to effect social change in society. The Careerist seeks traditional career success and advancement, as other people do in other walks of life. The Artisan is one who gains his satisfaction via intrinsic rewards. In this study of police officers, Social Activists were found to run the greatest risk of reporting stress symptoms even though they comprised only 13% of the sample. Because of the large difference between what they expected and what they actually found in the work place, they were most likely to find work a negative, place, feel increased stress, produce poor quality work and experience poor emotional and physical health. The Self Investors found themselves the most alienated and not surprisingly were the least satisfied and most likely to leave policing. There has been a considerable body of research around the cynicism exhibited by police officers. Violanti (1983) defines cynicism as a denial or disbelief of reality. He showed that cynicism was not effective as a coping strategy and actually served to 19 worsen stress levels, as did deviant behavior. Graf (1986) also found that cynicism contributed to stress unless it was expressed, in which it became stress reducer. O'Connell et al (1986) differentiated between organizational and work cynicism. They found a curvilinear relationship between length of service and organizational cynicism with the it being low until the tenth to the fourteenth years, when it went up, after which it returned to is previous lower level. Work cynicism showed a different pattern. It increased among police officers with ten to fourteen years of experience who had not yet been promoted. They also found that job complexity was negatively related to work cynicism. Work cynicism was higher among the senior officers who had not been promoted. There is conflicting research around the idea that negative or aversive mood states can influence self reports of stress. Ganster and Fox (1992) showed that trait negativity affectivity did not increase reports of stress. However, Mearns and Mauch (1998) defined Negative Mood Regulation (NMR) as the degree a person can control his own feelings of being in a bad mood. They found that while higher job stress levels were linked to more physical and emotional problems, officers with higher NMR abilities used more adaptive coping strategies and had lower anger and distress levels than those with lower NMR abilities. In addition, higher anger levels were correlated with higher levels of distress and emotional focused coping was a good predictor of anger. In a related study, Kop et al (1999) found that there was a positive relationship between use and the attitudes towards the use of violence and levels of burnout. Some of the changes in the police officer's personality may be predictable from the outset of their training. Stradling et al (1993) reported they saw some distinct changes in 20 several personality characteristics from when the subjects started their training. Feelings of isolations and apprehension rose during the training but fell after it was completed. Self worth actually fell during the training but also returned to the pre-training level once the training was complete. What was particularly interesting was the increased level of cynicism. High scores in commitment and empathy were significantly reduced once the training was complete. Finally the research around personality shows that the police personality is not unique to police officers. Rerning (1988) showed that the personality characteristics of habitual criminals and super cops were similar. Not only did habitual criminal and super cops not differ significantly from each other but these two groups differed from average police officers and average individuals. There were several dimensions that characterized both super cops and habitual criminals. Reming describes both groups as aggressive and control oriented, as well as vigilant and rebellious. He goes on to state that both groups are rebellious and frank in their expression. They both have friendship networks, elevated levels of self-esteem as well as feelings of uniqueness. While both groups are extroverts they are also very possessiveness of their sexual partners. They are also resistant to changing opinions and try to avoid blame. Stevens (1999b) also compared police officers, male convicts, female convicts and college students using the Myers Briggs Type Indicator test. He also found that while the police officers were more extroverted and the male inmates were more introverted, they were similar on sensing, thinking and feeling scores. 21 Implications for police susceptibility to stress reactions Police officers, as a result of the combination of their occupation and personality, are in some ways more susceptible to traumatic symptomology than non-police personnel. A example of this is the research finding of Machell (1993) who theorized, while profiling a police officer suffering from Combat Post Traumatic Stress Disorder (CPTSD) as well as alcoholism arid role immersion, that these three dimensions are all related. He states that the CPTSD attacks the officer's self esteem by drowning him in negative emotions that weed out and interfere with the a positive self concept. As a result the officer feels a sense of a loss of control. The officer uses alcohol in order to reduce painful emotions and suffers from blunted emotion and empathy abilities. The officers may also immerse themselves in their work. According to Machell role immersion addresses the officer's low self esteem, gives them back a sense of identity and succeeds in suppressing many of their emotions. Given the police officer's personality, police officers have a specific set of coping mechanisms that they typically employ. There has been considerable research on the coping styles. Alexander and Walker (1994) indicated that many officers were typical in how they coped with stressors. While on duty the majority, about 70%, chose to work harder in response to stress. Almost as many, 69%, chose to speak with colleagues, while 25%o vented feelings to the public or colleagues. The coping styles changed when the officers went off duty, with 79% choosing to keep to themselves and half increasing their alcohol intake. Professional help or assistance was not a popular choice, as the authors felt that officers may feel that seeking professional help may be seen as a sign of weakness by the police officers. Holaday et al (1995) stated that disaster workers used 22 any of five coping strategies. These included, task immersion as an avoidance strategy, distancing through denial or repression of emotions, denial through cognitive self-dialogue, maintaining altruistic motivation and social and/or peer assistance. While these may help officers with coping on the scene, the mechanisms themselves may lead to more problems for the officers in the long run when the cumulative effect of the incidents begins to add up, since most of these coping mechanisms rely on the officer shutting out or denying his own thoughts and feelings. Hart et al (1995) reported that emotional focused coping strategies were considered to be less effective as opposed to problem focused coping strategies that were thought of as more adaptive. The later helped the officers deal with the problem directly. The use of avoidance has been documented in other research. Kopel and Friedman (1997) felt that the macho image of South African Riot Police and the police culture advocated and encouraged the use of avoidance whereby officers could block traumatic images from the consciousness. Martin et al (1986) examined the prevalence of PTSD and details several important implications for police officers and PTSD symptomology. In addition to denial and repression strategies, they must distance themselves to avoid the constant reminders of previous traumatic events. There are implications for not having adequate coping skills. Googman (1990) found that the police officers with less than adequate coping skills were more prone to stress related difficulties and burnout. Martin at al (1986) also reports on the qualitative and quantitative aspects of the events that police officers must witness and how these can influence traumatic reactions. The differences in reactions to different stressors may be a result of the degree of identification with the victims, the frequency of exposures as well as their individual coping styles. The frequency of exposure and its effect on the duration of symptoms was also seen in volunteer emergency workers in New South Wales (Moran & Briton, 1994). Their study of emergency volunteers found that those who worked in busier stations were more likely to report longer lasting reactions in the form of traumatic symptoms. Stotland (1986) also found that call-load correlated positively with sick days, the number of disability episodes and automobile accidents. In Nielsen's (1990) paper looking at the factors that influence the nature of PTSD in police officers, he points to a number of factors that can affect the reaction a specific officer has to a traumatic event. The nature of the event will influence the reaction and if the event involves children as victims, the event is more likely to have more of an impact on the officer. In addition to the officers' own coping style, how they dealt with previous similar events will also influence the impact on the officers. Moreover, the degree of warning that officers have prior to the event as well as their physical and psychological proximity to it can also influence its impact on them. Finally the presence or absence of social support also played a part in the degree to which a critical incident affected the individual police officer. However, some research on social support indicates that social support is not always beneficial. Brown and Grover (1998) found that that during conditions of low stress social support was not as effective as when stress conditions were high. However, they also found that the police officers who were most distressed were the ones who reported low levels of social support and felt strongly about not expressing emotions. Coping with the assistance of caffeine, alcohol and tobacco has also been the topic of research. Burke (1994) researched ineffective coping techniques with police officers and found those who used alcohol and drugs as coping mechanisms reported higher rates of 24 psychosomatic symptoms and in turn not only drank more alcohol but smoked more cigarettes. In addition, withdrawal led to more negative feelings and greater use of medication and was correlated to greater coffee and alcohol consumption. This had a trickle down effect and the number of sick days taken was also related to age, tenure and the number of stressful events that officers had encountered. Older officers also drank more coffee and used more medication. Workers who are preoccupied with the job's adverse health effects were also less satisfied and more likely to leave policing. Follette et al (1994) also reported higher levels of coping through drugs and alcohol by police when compared to mental health professionals. Further literature on the use of alcohol by police officers will be reviewed later in this chapter. There is also research showing that police officers are reluctant to verbalize their thoughts and feelings, even if they choose not to deny them. Lowenstein (1999), in his review of police stressors also found that police officers were more likely to keep feelings to themselves. Violanti (1983) theorized that depersonalization, the shutting off or denial of emotions, was required in order for police officers to perform their duties amid the day to day tragedies. An authoritarian attitude was also required and it also had the effect of restricting the officer's range of emotional responses. This research found that as depersonalization increased so did the so did the levels of strain. Much of this emotional distancing is learned by police officers early in their training. Mitchell and Munro (1996) reported on how new police officers were taught to deal with sudden death investigations by their trainers. Their training stressed process and the investigation and its procedural steps. Thirty percent reported that they had received advice on how to deal with their own emotions and that was to detach and distance themselves. Lowenstein (1999) refers 25 to the police officers' usual practice of keeping feelings to themselves as the result of the officers' fear, real or imagined, that their expression will be held against them at a later date or that others may perceive them as weak. Officers have told me the same thing. Like most anyone else, the police officers' own life, current and past issues can also influence the police officer's reactions to stress. As Greene and Nowack (1995) showed greater levels of work and life hassles correlated to higher levels of absenteeism due to physical illness. A study comparing police officers and mental health professionals examined the question as to whether their own abuse histories influenced their specialization and how it affected their behavior towards abuse victims (Follette et al, 1994). Of those participating 19.6% reported some physical or sexual abuse as children. While the sample of police officers is relatively small in the total sample size, police officers who reported a history of abuse also reported significantly higher numbers of cases involving child sex abuse, as if they were attracted to these for some reason. In addition, the law enforcement contingent in this study showed significantly higher levels of distress than the mental health professionals showed. Only 15.6% of the police officers admitted to be involved in personal therapy as opposed to 59.1% of the mental health professionals. Nielsen (1990) states that one model of the stress reaction theorizes that the traumatic event may serve to activate the officer's latent intra-psychic conflicts. The officer's attitude can also influence the effects of stressful events. Rosse et al (1991) also showed that self esteem is negatively related to emotional burnout. They went on to say that low self esteem was not only linked to causing burnout but was a consequence of it. Stotland (1986) found that self esteem was negatively correlated to reports of stress and strain. Self esteem also related negatively to mental illness, physical 26 health, anxiety, violence to the spouse or children as well as drinking problems. Brown et al (1996) showed that there was a positive association between job satisfaction and physical and psychological well being. Burnout can be influenced by other factors. Burke (1993b) examined the predictors of burnout among police officers. Officers who were reported more social isolation and fatigue were also likely to report more emotional exhaustion. In addition, officers who were working in larger forces, had lower education levels or who were bored by their work were more likely to report depersonalization. There are other risk factors for police officers and the degree to which they are affected by stressors. Carrier et al (1997) reported a sample of police officers 7% of whom could be diagnosed with PTSD. Six percent had been diagnosed with the onset of PTSD within three months of their traumatic event while one percent had it diagnosed within the period of three months to one year after the incident. In addition, another 34% of the subjects had PTSD symptomology. There were several risk factors that seemed to correlate with those who were diagnosed with PTSD. The risk factors for those who were diagnosed with PTSD at three months included introversion, difficulty expressing emotion and emotional exhaustion. This group also felt that they had inadequate time to deal with their traumatic experiences, had little organizational support and an insecure job future. The group who were diagnosed with PTSD at three to twelve months had a different set of risk factors. This group seemed to share a lack of hobbies, subsequent traumas, dissatisfaction with the job including brooding over their work and finally lacked social interaction. There are some factors that have served to counter or mitigate stress levels among police officers. Graf (1986) found as the number of people who provided the officer 27 some type of support grew for officers their perceived level of stress decreased. He also stated that the expression of cynicism served to help officers vent and was a positive coping mechanism. Kaufmann and Beehr (1989) found that police officers who reported greater instrumental support, which was defined as direct assistance with tasks as opposed to emotional support, showed less effects of strain. However, those with high social support showed high levels of strains, which the researchers called Reverse Buffering. They hypothesized in some cases that some social support can actually serve to confirm the police officer's view as to how bad their life really is. Burke's (1994) research also uncovered certain attributes and practices by police officers that made them less or more likely to exhibit certain stress related symptoms. Education level, exercise and verbalizing thoughts and feelings were all inversely related to psychosomatic symptoms, smoking, alcohol consumption and negative feeling states. Hills and Norvell (1991) also showed that the presence of certain traits as well as the absence of other ones affected the prevalence of physical symptoms and illness. Those high in neuroticism were more likely to report more physical symptoms of stress and illness. These people were also more likely to report burnout symptoms. The authors reported that hardiness or a person's sense of control over the situation that they find themselves in seemed to protect them from the physical effects of stress. Solomon and Mastin (1999) report that Alcohol Tobacco and Firearms agents who were involved in the Waco Raid of the Branch Dividian Compound in 1993, which was the ATF's worst tragedy, are doing surprising well. They credit the agents' training, competence, group cohesiveness and dedication, along with the intervention they received after the incident. 28 Specific things about a police officer's selection process and duties may assist in making them more resilient and serve to help minimize symptoms they may experience. Carlier et al(1998) found that police officers in the study showed a lower overall rate of PTSD symptoms after the critical incident than did other emergency health workers. The authors attributed this finding to the psychological pre-screening and selection processes of the police. Marmar et al (1996) also in a study of rescue workers, found police to be lower in symptoms after the incident. The researchers found that EMT/ Paramedics had higher reports of distress, than police or fire. They also cited differences in the police selection and recruiting practices as well as the police officers having the access to the co-ordination of efforts via radios that were likely responsible for the reduced feelings of isolation. Pendleton et al (1989) also showed when comparing police to other municipal workers, that although police admitted to experiencing the most stress, strain was highest among the municipal workers. The researchers also explained this by crediting the rigorous police selection process. They also presumed that police officers that had found themselves unsuited to the position would be astute enough to self-select and leave the service voluntarily, if they had found it overly stressful. There appear to be a number of factors that relate to the officer and the incidents or work that can serve to either exacerbate or mitigate the stress reactions that the police exhibit. Sources of Police Stress There is some research that claims that police officers do not experience excessive stress levels as a result of their occupation. McLaren et al (1998) claimed Australian police, ambulance officers and corrections officers all reported similar levels of stress, 29 which were lower than data reported in other studies and that no one group experienced more stress than the other. However, most of the research in this area and which is reviewed in this section, does acknowledge that police officers do exhibit considerable symptoms of stress from their jobs. Sigler and Wilson (1988) reported that police officers showed higher levels of perceived stress related to job stress and job dissatisfaction than did teachers. Not only do the sources of stress vary for a police officer, but there are a host of factors that may influence the stress experienced by a particular officer including the officer's coping ability, demographics and personality style of the officer, the degree of personal and organizational support as well as the nature of the stressor itself (Terry, 1983; Holaday et al, 1995). What is important to note is the system of classification of these symptoms, particularly when one is considering the specific treatment modalities for each individual. Martelli et al (1989) followed the leads of previous research and using the Police Stress Survey, divided the stress symptoms of 99 metropolitan and suburban police officers into two distinct categories, those which were administrative or organizational in nature versus those which were physical or psychological. Violanti and Aron (1994) also grouped the sources of stress according to an instrument's groupings, the Spielburg's Police Stress Survey. These groups included, acute sources of stress, organizational or administrative sources and sources inherent to police work itself. These groups provide a useful template to classify the literature. Sources of acute stress All of the literature on sources of acute stress seems to focus on the nature of the events that elicit these types of reactions and several types of events recur in this category 30 of stressor. It appears that events that are sources of acute stress are less frequent but more intense than daily stressors. Anshel et al (1997) gives several examples of acute stressors. They explained that these events often happen suddenly, are usually short in duration and are high in intensity. These events include child fatalities, duty related injuries to officers or their co-workers and dealing with victims of sexual assaults. The situations that showed the highest scores among police in these studies were those that involved unpredictable situations, such as domestic situations, those situations that involved risk of injury or those that involved dealing with armed people or arresting violent people. Evans and Coman (1993) divided work content stressors into those that occur often versus those which were infrequent. The infrequent content stressors included violent death of a partner, participating in police corruption, shooting someone, attending either an accidental or non-accident death of a child, facing an armed suspect or receiving a duty related injury. Alkus and Padesky (1983) label acute stressors as those the officer does not expect and are extreme in nature. These include having to deal with mutilated bodies, abused children and psychotic adults. These events can often elicit fear and anger in responding officers. Lowenstein (1999), in a review of police stress studies has also identified a number of sources of stress to police officers or stressors. These include assaults or physical injury as well as witnessing horrific events. Biggam et al (1997) found that some of the most important operational stressors included dealing with use of force issues, arresting violent offenders and testifying in court. Fifty-three police officers attending a Sensitive Crimes Seminar were questioned as to what types of events they felt were the most stressful (Martin et al, 1986). They included shooting someone or being shot, working with child abuse victims, dealing with rape cases, having to deal 31 with being threatened or having their families threatened, dealing with suicides, dealing with death of children and dealing with natural disasters. Holaday et al (1995) also reported in a study of disaster workers that the worse stressor for police was dead or abused children, which was also the case for fire personnel and emergency room workers. The themes that seem to be recurring in the literature are those incidents that involve death or injury to a child or those that involve a threat to the officer. Police officers have rated either killing someone or experiencing a fellow officer being killed as two of the most stressful events they could ever encounter (Violanti & Aron, 1994). Police officers involved in shootings have been a group of police officers that have been studied to a considerable degree. One of the reasons for this is that they are readily identifiable by an objective and verifiable event and the range of symptoms they can experience can easily be grouped into the three symptom clusters that are required for a diagnosis of either Acute Stress Disorder or Post Traumatic Stress Disorder. Stratton et al (1984) studied deputy sheriffs in the Los Angeles area who had been involved in shootings and found a host of both symptoms and also range of severity. These specific symptoms will be discussed in section four of this review. Organizational and administrative sources of stress Not all the sources of stress for police officers originate from those images that are conveyed in the popular media and entertainment programs. A consistent theme in this area is that the organization can be a greater source of stress than operational stressors. Violanti and Aron (1993) in their study used a definition of organizational stressors as those stressors that are created by the police administration. Some of these would include lack of recognition, little participation in decision-making, overly constraining 32 departmental regulations, excessive and inappropriate discipline, poor quality work assignments and constraining court decisions. They also found that organizational stressors not only significantly increased psychological distress but also were negatively correlated with positive attributes such as goal orientation and job satisfaction. Furthermore, organizational stressors also worked against any stress reducing potential of job satisfaction. This study went on to show that organizational stressors had a 6.3 times greater effect on distress levels than did those stressors which are considered the usual stressors associated to police work. Similar results were found in other research (Biggam et al, 1997). The authors reported that the organizational stressors were the most powerful stressors and they included shortage of staff and resources, time limitations and poor communication. Hart et al (1995) also supports the concept that organizational stressors are potentially more harmful than the operational stressors. Martelli et al (1989) found that administrative and organizational stressors had more of an affect on job attitude than did those that were considered more a regular component of policing. Kop et al (1999) also found that the stressors most endorsed were those that were concerned with the organization. Patterson (1999) found that the majority of the officers in this study picked an organizational event as the most important event that had happened to them in the last six months. Kirkcaldy (1993) also found police officers were more likely to be stressed in terms of organizational climate than the British norms. They were more stressed in terms of work/home relationships and relations with others. However, the generalizability of this data should be guarded since the participants were all attending the same course, which may already show a heightened sense level of interest in stress . and coping. 33 There are different sources of organizational stressors. However, the theme of the literature on organizational stress in police departments centers on poor leadership and supervision. Brandt (1993) found that frustration with police managers ranked as the most stressful item in the study. The complaints included non-supportive managers, lack of top management support and little control by the officers over the work they do. Violanti and Aron (1994) found that inadequate supervision and support along with the insufficient level of support from the department, insufficient personnel and excessive discipline were the highest ranking organizational or administrative stressors. Kirkcaldy et al (1995) also found that police officers they interviewed found more pressure from organizational factors than they did operational factors. These included poor guidance and back up from superiors as well as a lack of consultation and communication along with covert discrimination and favoritism. There is other research that supports the adverse effects of poor supervision. Burke (1993a) found that the stressors of poor supervision, social isolation and lack of participation in decision making were tied to work performance, including psychosomatic complaints, sick days taken and the likelihood of the use of medication. White and Marino (1983) found similar patterns related to the quality of supervision and role conflict as they related to levels of stress. This study found a strong negative correlation between the quality of supervision and levels of reported stress. In addition, as officers perceived themselves as having freedom to perform their work and control over it as well as trust in management, they were less likely to report high levels of stress. Role conflict and role ambiguity, along with increased levels of occupational stress were also related to higher risk of coronary disease (Kreitner et al, 1985). Evans and Coman (1993) found 34 that police officers are mainly stressed by organizational variables, with the largest one being the quality of the supervisor. Crank and Caldero (1991) also found that organizational stressors were endorsed by 68% of the respondents while task stressors were only endorsed by 16% of respondents. The two most common administrative stressors were superiors who could not manage people or operations and the shift-work rotation and/or the midnight shift. The potential danger of police-work was not endorsed very often in this study. Attitudes towards departmental initiatives can also be influenced by the officer's level of stress and frustration (Yates and Pillai, 1996). Interestingly, they had a return rate of only approximately 30%. They found some officers were less supportive of community policing initiatives. These were also the officers who reported high levels of frustration with not only their department's lack of support but also interference from defence lawyers. There are also other sources of organizational stress documented in the research. Organizational factors seemed to play a large role in accounting for dissatisfaction and emotional exhaustion (Gaines and Jerimer, 1983). One of the most powerful predictors of this exhaustion was the opportunity for promotion. In addition, there was a difference based upon work assignments. Patrol members were also more,exhausted than those with investigative postings. The difference was attributed to the higher status enjoyed by the latter group and the fact that those with jobs that are enriched enjoy lower levels of fatigue. The latter group also enjoyed the group cohesion of specialty units that can help to counter the harmful effects of stressors. However, these specialty work groups were more likely to become exhausted when faced with imminent danger as opposed to patrol 35 members who seemed to be able to accept higher levels of danger. Inequality in pay and inflexible rules were more of an issue for patrol offices. Alkus and Padesky (1983) also make reference to different organizational stressors. These include punitive policies, lack of participation in decision-making, workloads, career development opportunities and pay and benefits issues. They also cite problems due to mixed messages from superiors and like the previous studies cited the caliber of the supervision as potentially problematic. Finally, frustrations with the court system, either lack of support, lack of closure or lack of consideration in scheduling caused frustration with the judicial system. Brown and Fielding (1993) found that both sexes experienced organizational stressors. Doctor et al (1994), while examining the effects of brief psychotherapy in a British police force also reported that the police organization was in and of itself the major source of occupational stress among police officers. While this study had a poor return rate of 36 %, n= 61, the authors present an interesting theory as to why the theme of the organization as the major stressor is so common in the research. To them the organization acts as the focal point for the anxieties and negative experiences of police-work. Police officers can channel their experiences of frustration and persecution to the organization. While they may feel they are responding to the ill treatment by the organization they might unconsciously be dealing with the operational stressors that they have managed to shrug off as seemingly inconsequential or less important. A commentary by Hurrell (1995), from the National Institute for Occupational Safety and Health, reaffirms that the stress is caused by organizational factors. He recommends that organizations need to address this not through recruiting and stress management but by increasing the officer's sense of control, reducing workloads, increasing participation in decision making and being more flexible in scheduling work hours. Stressors inherent to police work The stressors that one would normally associate with police work have also been documented as causing stress reactions in police officers. Seyle (1978), in a dated but still relevant article on the stress of police work, outlined a variety of typical of stressors faced by police officers including long hours, shift work, constant fear and anticipating danger. He also stated police officers also have to deal with the risk of injury as well as the negative feelings of the public. Symonds (1970) through various anecdotal accounts of his work with the New York Police Department as a psychologist, describes some of the stressors that are inherent to police work. Police work in stressful settings and they must be flexible enough to adapt to different situations. Not only must they be able to apply various levels of force but they then must be able to later articulate why they employed that particular level of force. Evan and Coman (1993) found in that there were some stressors that had to do with actual police work, which occurred more frequently than others. These included, court testimony, shift work, command, and facing situations that carried the risk of physical injury and facing unpredictable situations. Violanti and Aron (1994) reported on those activities that police officers considered as part of police work and which caused them the most stress. These included physical attacks, battered children, high speed car chases, use of force, accidents in the patrol car, aggressive crowds, serious crimes in progress, plea bargaining and death notifications. Lowenstein (1999) also noted that marital problems, intra-organizational relationships, frustration 37 with young offenders were also stressors that police must contend with as a course of their employment. The perception of what is stressful as opposed to what is not may also be different for not only two different police officers but also for the two sexes. Jerimer et al (1989) found differences in the perception of dangerousness in the work, based on gender. Women reported they perceived police work as less dangerous than men. Street police officers rate their work as the most dangerous, clerical workers rated their work as least dangerous while investigators were somewhere in between. Jerimer also presents an interesting theory. He feels that the dangers of patrol work also provide excitement and exhilaration for those performing the work. Violanti and Aron (1993) also found that some of police work's inherent stressors directly increased job satisfaction and goal orientation while also decreasing psychological distress. This relationship between job satisfaction and job stress was also shown in Kirkcaldy's (1993) research. However, Jerimer warns that the dangerous work also has its down side which includes a reduced commitment to the department and increased dissatisfaction with pay. Anson and Bloom (1988) found that police officers were higher in episodic stress than probation officers and EMT's. Police officers and prison guards scored higher on work stress than all the other groups and showed similar levels of physical and emotional stress. Police officers also reported more boredom in their jobs than did the fire personnel surveyed. Burke (1993a) also made conclusions on the effects of tedium and found that police officers in this study were more likely to quit policing or experience low job satisfaction if they found the work boring. 38 Police relationships with the media and media accounts of police activities also serve as stressors for police. Lazin (1980) in his study found that ninety percent of the responses presumed the press were biased and had less than ethical motives and as a result would alter the truth to suit their purposes. Shift work is also a topic that is given considerable attention in the literature. Alkus and Padesky (1983) allude to a variety of stressors that are to inherent to police work. Routine stressors such as the effects of shift work on the police officers' ability to sleep and eat, as well as the effects on their families are important. Several other studies have looked at the effects of shift-work on police officers. Pierce and Dunham (1992) compared various measures for police officers who had made a switch from an eight to a ten hour shift. The participants reported that the job interfered less with their personal schedules and as a result they were better able to meet personal commitments. However, while the stress and fatigue levels decreased there was no direct effect to be realized in the effectiveness of the police department. Beerman and Nachreiner (1995) found that there were no gender differences for the effects of shift work. The authors felt that the women police officers used effective coping techniques to deal with the increased demands between work and home. Totterdell and Smith (1992) also found favorable results among those police officers who were working fewer night shift hours in terms of improving their social and personal lives. Depending upon the type of environment in which a police officer works, there can be different stressors. Police officers in rural or isolated areas often must contend with stressors that their counterparts in urban areas may not have to deal with. Walsh and Donavan (1984) in a study of game conservation, land manager and supervisors found 39 concerns specific to these peace officers. Some of the stressors were the same as those found among urban police officers such as paper work and having no voice in decisions that affected them. However this group was also faced with distinct stressors. First, they were not anonymous because they lived in the communities in which they served. These officers also felt isolated because it is difficult for them to build close personal relationships with people they must also police. Their family life was often disrupted because they were often away for long periods or they were constantly on call and it seemed like they could never escape the job. Certain police officers are subject to special stressors. Adler (1996) examined fear among probationary constables. This group was bothered by how the public treated them. Sewell (1994) outlines some of the major stressors that homicide investigators face. Death investigations carry a considerable amount of responsibility and pressure. There are often multiple interest groups who constantly pressure the investigators for immediate results. Homicide investigators are also under strict time pressure especially in the first fort-eight hours after the crime. Homicide investigators also walk a fine line between emotional involvement and emotional distancing in order to maintain their objectivity. Other stressors included inter-agency competition and lack of support from the courts. In addition, the long hours can lead to physical exhaustion as well as feelings of anger and frustration. Another group that may encounter high stress is hostage negotiators. Bohl (1992) points out in a stress management article for prospective negotiators that there are a variety of stress sources fors£hi§ group. This includes having to say things that they in fact may not believe, deal with interference from superviflpnf&taff, reassure hostages that they 40 will emerge unharmed and deal with their own fear of not being successful. If the situation is concluded with injury or death to either the suspect, hostages or other police officers the negotiators are also forced to deal with their own guilt and anger, emotions that may lead to among other things depressive symptoms. Zizzo (1985) reports interviewing police officers who have been involved in police shootings over a three year period. While he does not disclose the number of interviews or his methodology he does state that SWAT officers exhibit less conflict over the incidents than patrol officers. He attributes this difference to several factors that distinguish SWAT officers from regular patrol officers including selection, regular training and positive media attention that often surround their use of force. Workload also seems to influence the sources of stress for police officers. Stotland and Pendleton (1989) showed that those police officers who had high workloads were stressed by mainly by events on and off the job. Police officers with low workloads were more stressed by interpersonal relationships either with peers, supervisors and managers and members of the public Death exposure is also a stressor police officers must deal with as a normal course of their duties. Henry (1995), in an anecdotal article, addresses how police officers deal with death. He sees the exposure to death as a rite of passage, almost an initiation into the culture of policing. He states that many officers deal with death by disassociation, by separating the cognitive part of the event from its emotional portion. While this may be functional in the short term, at some point he believes the two parts will meet up again and Henry states that what results is guilt. This guilt may stem from either displaying no emotion or inappropriate emotion. The fact that officers are forced to confront their own 41 mortality may also play a part in this guilt and discomfort. The gallows humor that police officers are famous for may also serve to release much of the psychic tension they feel upon being exposed to death. Stressor for special groups within policing Certain sub-groups within policing have their own distinctive sources of stress. These groups include policewomen, supervisors and mangers. Policewomen Policewomen appear to have there own distinct sources of stress. Davis (1984) found that women officers are different in terms of personality characteristics and beliefs as compared to male officers. Policewomen in this study had more pessimistic and authoritarian attitudes as well as more cynical beliefs about a specific person's compliance with the law. They were also more bound by rules in that they were less likely to use discretion. While they did not experience greater stress than men, the stressor that resonates for them is danger to themselves, which Davis theorized as being related to their generally smaller size and physical vulnerability. The sources of stress for women police officers seemed to fall into two categories, job related stressors and stressors from being a women in a profession that has been traditionally occupied by men. Biggam et al (1997) found that the most stressful events for female police officers included court duty activities, violent arrests, work related injuries or changes in work location. In addition, women in this study found working with the victims of violence or sexual assault to be very stressful. Bartol et al (1992) found the performance ratings were the same for both sexes and both sexes listed organizational stressors as their main source of stress. However, women in this study 42 found the frequent exposure to tragedy as well as the constant danger to themselves more stressful than men did. In addition, women officers also found rumors about themselves and co-workers stressful along with male attitudes. The prevalent attitude expressed by men in this study was that women could only complete certain policing tasks, that they were overly sensitive and that they would soon be leaving to have children. Similar findings were found in other research. Wexler and Logan (1983) also found that the policewomen had specific sources of stress as a result of being female. Eighty percent stated that one source of stress was the poor attitudes of male police officers. These attitudes were often borne out in the frequent comments to the policewomen concerning their sexual orientation or anti-women comments. Another source of stress for women was training. Stress sources here ranged from anything as blatant as overt hostility to more subtle forms of inequality such as exercises that did not account for their physical limitations. As in the previous study, a third major source of stress for policewomen in this study was rumors. Ott (1989) also found that women police officers felt like they were on display, less accepted by co-workers and likely to respond to negative attitudes by taking time off. They also had to put up with more jokes and embarrassing questions about their personal lives. The problems of sexual harassment and discrimination was studied specifically in Brown et al (1995) found that policewomen were less likely to have access to training and overtime opportunities as well as promotion opportunities. As for sexual harassment, it appears that the policewomen were not as likely to be considered out of bounds as were the civilian female employees. The policewomen in this study reported that they were more likely than the civilians to have to endure explicit comments or comments about 43 themselves or other women. In addition, they were more likely to report that they had been touched or pinched. The researcher stated that this finding may be partially due to the fact that the typical civilian employee who works in a police station is older and is usually under the watchful and often protective eye of a senior officer. In addition, policewomen can be seen as a threat by some police male police officers whereas female civilian employees are not perceived as a threat. The reasons that male police officers have these feelings about police women is the focus and is explained in the research findings of Balkin (1988). Balkin theorizes that policemen may say that they feel that policewomen cannot handle violent situations but that this is not the true reason for their dislike of policewomen; He believes this dislike may arise from either sex role confusion on the part of male police officers along with pressure from their wives as a result of working with women officers. Besides the potential for infidelity, wives of police officers may believe that women partners do not offer their husbands the same degree of protection as a male partner presumably would. Balkin also theorizes, because some policewomen threaten the manner in which the male officer defines himself and his masculinity that they resent policewomen. If a male police officer defines his masculinity by the same dimensions that are required to perform the job and if a woman can do the same job, he then has to reconcile his definition of masculinity or sense of self. Warner and Steel (1989) predicted that most affirmative action programs would fail due to legal challenges as a result of law suits and promotion and hiring policies. Homosexual and lesbian police officers also have their own set of unique stressors. Burke (1994) found, in research involving interviews with gay and lesbian police 44 officers, distinct sources of stress. His research documents the strong anti-gay sentiment in the police service and even goes as far to distinguish the difference between male and female gays and how they are perceived. Straight male police officers may perceive homosexuality as a loss of masculinity. Lesbians are not as likely to be perceived as deviant and more likely to live up to their traditional sex-role expectations. However, lesbian officers are often denied their femininity by those who work with them. As a result many gay and lesbian police officers are forced to live double lives, one at work and a totally different one away from work. Burke cited that 53% of the officers interviewed were leading such double lives. The news for policewomen is not completely negative. Pendergrass and Ostrove (1984) found that while sworn female personnel reported higher levels of job stress than civilian employees they reported a lower level of stress consequences than these same civilian employees. One explanation for this is that the policewomen enjoy better status and higher income than civilian female members. Brown and Grover (1998) found that women and men sergeants did not differ in the stressors that they found. These authors believed that because the women sergeants were successfully able to integrate their dual roles of women and police officer, their stress levels were not as high as the women constable's stress level. However, sample size of women sergeants was quite small, with only seventeen female sergeants as compared to ninety-three males sergeants. Supervisors Police supervisors in Canadian police forces are made up of the ranks of Corporal, Sergeant and Staff Sergeant, also referred to as non-commissioned officers or NCO's. The American counterpart is the rank of Sergeant. Canadian police managers are made 45 up of the ranks of Inspector, Superintendent along with Deputy Chief and Chief. The American counterparts include the ranks of Lieutenant, Captain and Commander along with Assistant Chief and Chief. Perrott and Taylor (1995) showed that the Constables and their immediate supervisors did not differ on perceived stress but that the NCO's reported greater job satisfaction. The explanations offered for the differences relate to one of three different theories. The NCO's likely have greater contact with media, politicians and community groups and are likely to be more politically astute and more careful about expressing prejudicial and unpopular attitudes. They may have also a different personality make up than constables and while this may have existed prior to them ever joining the police force it may contribute to them having very different occupational experiences. This may also explain the higher rating of job satisfaction among supervisors, since they have had success in climbing the police hierarchy over the promotional hurdles placed in their career paths. Supervisors in this study also felt closer to mangers than did Constables. Biggam et al (1997) found the greatest amount of organizational stress was found among the sergeant's rank while the operational stress was highest among the constables. In a quantitative study of 121 police officers in the mid-western U.S. Kaufmann and Beerh (1989) also found that police supervisors showed weaker job stressors than patrol officers. Haward (1994) also outlines different sources of stress for the different ranks. However, he states that there is more variance among the first line officers stress sources as compared to supervisors. He feels that the promotional system may foster a certain homogeneity among supervisors. 46 Police managers The research around stress and police officers has also included research on police managers and police department leaders. Crank et al (1995) identified four institutional and organizational characteristics that were potential sources of stress for police department executives. These were manager selection, legitimacy issues (which included media relations, relationships with other parts of the Criminal Justice System, other police officers and departmental issues.), control over hiring procedures and the complex nature of the organization. Chiefs with post graduate degrees showed lower levels of role stress, work alienation and anomie. The research also showed that the leader stress, work alienation and anomie lower among African American executives as well as those who believed in public service. In addition, Chiefs with greater experience were less likely to feel alienated. Interestingly enough, just as with the police constables some of the organizational and institutional stressors tended to counter the beneficial effects of some of the individual's personal characteristics. Loo (1994) reports the rates of burnout among Canadian police managers as being very low. This study of Sergeants and Staff Sergeants reported that only 3.7% fell into the classification of the burned out. The generalizability of this finding is limited due to the fact that the subjects were all attending a management program at the Canadian Police College. Given that various police agencies had paid for these police officers to attend this course, one would think that a police agency would be certain to send its best and brightest members to this course and not someone who they consider close to burning out. 47 Other research supports the different sources of stress for police managers and the causes. Joseph (1989) found that while some stressors were the same across ranks, others were particular to different ranks. Inspectors and sub Inspectors, or managers, scored higher in the stress that was related to the responsibility for others. Cooper et al (1994) in a study of police holding the rank of Superintendent found that Type A behavior was negatively correlated to job satisfaction, positively correlated to job stress along with inferior mental and physical health. They also found that those officers with an external locus of control were more likely to experience job stress and exhibit Type A behavior. In addition, the authors felt that Type A behavior directly affected somatic complaints and indirectly affected job stress and job satisfaction. Traumatic Symptoms of Police Officers General symptoms There is ample evidence to show police officers who have been exposed to traumatic events will show symptoms from all three symptom clusters that are associated to a diagnosis of PTSD, re-experiencing, avoidance and increased arousal (APA, 1994). Kuch et al (1995) in an analysis of the clinical charts of 11 police officers who were being examined for PTSD symptomology found they had all met the diagnostic criteria for PTSD, according to the DSM-III-R criterion. The symptoms included those from all three symptom clusters including re-experiencing, avoidance and increased arousal. In a study of the April 29, 1992 civil unrest and riot in Los Angeles the prevalence of PTSD symptomology was also clearly laid out (Harvey-Lintz & Tidwell, 1997). The results of this study showed that 17% of the officers had PSTD symptomology, as defined by the Mississippi Scale for Combat Related PTSD, nineteen months after the incident. The 48 17% used avoidance twice as often as the rest of the sample, which was presumably used by the individuals to protect themselves from arousal and intrusive symptomology. These officers were also more likely to avoid social contact and avoid the emotions that they were feeling by not expressing them. On the other hand people who had lower PTSD levels were also the ones who coped by seeking out social support and alternative validation sources. Finally, this study did show a difference between male and female officers. Women supported more symptoms associated with intrusive experiences while men supported more symptoms associated with the arousal. Literature has tracked the prevalence of PTSD symptoms, without necessarily f confining research to those whose symptom constellations fit the DSMIV criteria for PTSD. Robinson et al (1997) examined the effects of duty-related stress on police officers. In this study the best predictor of intrusive memories, avoidance and hyperarousal was exposure to death. Symptoms of hypervigilance were also tied to injury or loss of life. Wilson et al (1997), in study of Irish police officers showed specific types of trauma symptoms as well as PTSD. Of the officers who claimed low to moderate symptom frequency, intrusive thoughts were the most common symptom and were reported by 57.9% of the subjects, while 53.7 % reported hyper alertness and 42.1% reported flashbacks. As for those officers who reported low to moderate symptom severity of PTSD symptoms, the most frequently reported symptom was again intrusive thoughts at 53.7%, followed by 37.9% reporting flashbacks and 33.8% reporting an exaggerated startle response. There was a strong correlation between the frequency and severity of PTSD symptoms and depression scores. Finally, depression scores were lower for those receiving intervention immediately post incident. Martin et al (1986) 49 found that of their subjects 26% met criteria for the clinical diagnosis for PTSD, due to either their own traumas or as the result of secondary traumatization from working with victims of crime. Officers who had been threatened or whose families had been threatened seemed to exhibit stronger symptoms. The most common symptoms were recurrent and intrusive recollections of the trauma, which was reported by 47% of the participants. Forty percent also reported sleep disturbances along with 32% reporting hyper-alertness or an exaggerated startle response. In addition, 28% reported feelings of detachment. Kopel and Friedman's study of Riot Police officers in South Africa he examined what types of trauma exposure lead to either intrusive or avoidance symptomology. Witnessing or being exposed to violence versus life threatening incidents was more likely to lead to intrusive but not avoidance symptoms. In addition, the length of service and number of symptoms were positively correlated. He interpreted avoidance as a defence mechanism that protected the officer from the effects of being exposed to the traumatic event. Other literature also supports the assertion that traumatic symptoms are often the result of police officers being exposed to critical incidents (Horn, 1990). Horn outlines several types of traumatic reactions and symptoms, following exposure to a critical incident. Physical symptoms may include muscle tremors, nausea, headaches, hyperventilating and fainting. Vulcano et al (1984) reported higher frequencies of headaches, hypertension, indigestion, constipation, nervous stomach and diarrhea among police officers. Conversely they reported no significant difference between this population and the general population for stomach aches, asthma and colitis. Interestingly, the authors theorized that either the stress of policing contributes to this 50 higher incidence rate and/or persons who are predisposed to these conditions are for some reason drawn into the policing profession. Behavioural symptoms may include sleep disturbances, crying, nightmares, withdrawing, dulled affect and perceptual distortions. Smith and de Chesnay (1994) found that common symptoms included anger, empathy for victims, guilt, self blame, sleep disturbances, increased alcohol consumption, as well as an exacerbation of pre-existing medical conditions. Flashbacks and gastrointestinal disturbances were also prevalent. Fear or being afraid is a symptom that may occur on a daily basis or in response to a critical incident or traumatic event. Adler (1996), in a study of probationary constables examined the prevalence of fear and reported that 66% of these officers, who had up to two years of experience, reported some type and degree of fear and most reported it was specific rather than general in nature. They were generally fearful of their safety and general violence. Along with fear of general violence, 96% of the responses involved fear of the unknown and sudden death. Female officers were more likely to report feeling more scared but those officers who had regular problems with the members of the public reported lower levels of fear. The researcher states that this latter group acted almost as though they had learned to adapt to the fear and that it did not bring about the same reaction that it once did. In addition, fear of the unknown, of the uncontrollable, of discipline and of the legal system were all mentioned in this study. There is other literature which infers the effects of stress and the reactions from other behavior. Tang and Hammontree (1992) showed a positive relationship between police stress and the effects upon both illness and absenteeism. Hardy officers with high levels of stress showed higher absenteeism than hardy officers with low levels of stress. 51 Some literature bases it conclusions on less than empirical methods. McCafferty and McCafferty (1998), in a journal article, based their assertions on thirty years of treating police officers. They linked stress in policing to different psychological conditions. These included borderline personality disorder, narcissistic and antisocial personalities as well as passive, dependent or inadequate personalities. They claimed that these disorders were the result of the police officer's attempt to cope with stress. As stated earlier, the article has no empirical research to support these findings, which causes the reader to be wary of any correlation much less causation relationship that is asserted. There is also literature that attempts to explain more exotic and rare phenomenon. Divasto and Saxton (1992) attempt to explain the occurrence of Munchausen's Syndrome in police officers. They explain, again in a non-research based journal article, that there are two types of the syndrome found among police officers. Type A Munchausen's Syndrome has to do with a police officer's inability to obtain professional assistance with interpersonal problems because they are afraid of appearing incompetent in front of others. The officer engages in self-mutilation so they can create the situation where they can gain access to assistance, the proverbial cry for help. Type B Munchausen's Syndrome is more a compensation on the part of officer who has for some reason either avoided or not experienced exposure to danger. Exposure to dangerous situations is seen as a normative transitional stage in policing and is a component part of an officer's credibility, that in turn leads to the officer's acceptance among his peers. Police shootings Police shootings have received much of the attention in the research in the area of police and stress since they provide a specific life-threatening event that is relatively easy 52 to quantify for research purposes. The police shooting incident clearly provides a myriad of life threatening stimuli. The Criminal Code of Canada (1997) clear outlines that in order for police officers to be justified in the use of lethal force they must be engaged in the immediate protection of themselves or someone else from death or grievous bodily harm. Thus, even prior to making the conscious decision to employ a lethal force option, the officer has already been confronted with a life-threatening situation. The application of the lethal force then adds a second life-threatening situation. Whether the suspect dies as a result of being shot may be a secondary consideration regarding severity of the officer's reactions. Jones (1989) identifies officers who are at risk for post shooting reactions as those who shoot someone, are shot or are in the company of another officer who either shoots someone or is shot. Reiser and Geiger (1984) discuss the various reactions of police officers during traumatic situations. This article provides an excellent overview of this section on police shootings. They describe the officer's initial experience of perceptual changes such as tunnel vision, auditory and visual distortions. Once the event has passed officers may report symptoms such as feelings of shock and denial. They may also experience fatigue, depression and guilt. Officers are also very y likely to ruminate about an incident and second guess their own actions. These feelings likely progress into self doubt and anxiety about future events. While second-guessing oneself is the most common symptom, ruminations may be accompanied by nightmares. Officers who have been involved in shootings have reported experiencing flashbacks and may begin to experience disassociation. Other symptoms include depressive symptomology, decreased sexual interest, withdrawal and feelings of alienation. Lastly, some officers may report a delayed onset of the symptoms. 53 Studies on police officers involved in shootings seem to document both the variety of symptoms as well as different degrees of reactions. Stratton et al (1984) in a study of police shootings, reflected the varying degrees of reactions in the study's finding that found 30.5% of the officers were severely effected, 33.8% were moderately affected and 35.5 % were minimally effected. The most common reactions were flashbacks or recurring thoughts, sleep disturbances and fear of legal repercussions. This study also documented the fact that a large percentage of the study group experienced a variety of emotional reactions including anger, elation, crying or depression. Gersons (1989), in a study of 37 police officers who had been involved in serious shooting incidents also found that three were symptom free, seventeen suffered from post traumatic stress symptoms and the other seventeen met the criteria for a diagnosis of PTSD. This continuum of different traumatic symptoms is also documented in van der Kolk's (1987) research that is based on work his with victims of trauma. He supports the idea of individual differences in traumatic stress reactions and concludes that characteristics about the traumatic event, as well as other factors, will influence the severity of the reactions. Turco (1986) in a discussion paper of various case studies of police shootings also supports the concept of a host of reactions. The reactions include feelings of persecution, confusion, indecision and guilt. Turco goes on to theorize that shootings are powerful enough to reactivate earlier conflicts in the officer's life and that this trigger can account for the delayed onset of symptoms. The question of why this range of symptoms occurs in different individuals is itself an important question and while there are a number of factors that may influence this phenomenon, this is a question whose answer is too complex to be dealt with inside the scope of this review. 54 Solomon (1988) in an industry periodical, developed a four stage model which he uses to categorize the various post shooting reactions officers may encounter. While linear in nature, it does provide a convenient framework in which to prevent the myriad of symptoms that have been documented among police officers involved in shootings. The stages are; Pre-shooting Perceptual Focusing; Shock Disruption; Impact; Coping and Acceptance/Resolution. The focus of this literature review is on the first three stages, which in no way is meant to discount the importance of the latter two stages. Solomon's (1988) first stage of post shooting trauma is what he refers to as intense perceptual focusing that occurs immediately prior to the shooting. The perceptual focusing is a natural defence mechanism of the body designed to assist the individual in dealing with the threat. Solomon (1990) stresses the functional component and purpose of fear. He stresses that fear is an automatic emotional reaction, that addresses the perception of danger and which helps the person prepare to deal with the threat. He points out that during the alarm phase the body is experiencing certain chemical changes such as increased level of adrenaline flow and as a result certain perceptual distortions may occur. The officer may experience auditory, time and visual distortions. Solomon explains that these distortions all help the officer focus on the details of the threat. Carson (1987) also describes the intense perceptual focusing and distortions. He reports that officers had experienced the event in slow motion. One police officer could describe the cylinder of the suspect's gun revolve as he fired at the officer, while others described the gun fire as sounding like a cap gun or not even hearing the sounds of the bullets being discharged. In addition, some officers reported their peripheral vision had disappeared. In another study of police officers who had shot a suspect, Solomon and Horn (1986) 55 revealed similar findings about perceptual distortions. While the sample in this study was admittedly less than random and the researchers admitted there was room for interpretation in the self-reports, they found that 83% of the respondents suffered from time distortions, 67% suffered from auditory distortions and 56% suffered from visual distortions. The next stage of post shooting trauma as described by Solomon (1988) is known as the shock disruption phase, which begins immediately after the shooting incident. It may last from several minutes to several days. Jones (1989), in his book based on officers involved in shooting incidents, reports that some officers reported symptoms such as numbness to pain, shaking or feeling cold, while other officers experienced nausea, vomiting or incontinence. Officers may experience specific emotions at this stage. Lippert and Ferrara (1981) state that police officers at this stage may encounter shock and disbelief that the incident has just occurred. Officers may begin to regret what has happened and begin to ruminate about the host of possible reprisals and paperwork that need to be completed. Carson's (1987) also supports this stage when he reports that the officers' initial disbelief is followed by an unexplainable fixation with administrative matters. Solomon (1988) also explains that police officers may begin to experience some blunting of their emotions, something that Solomon explains is a defense mechanism initiated to protect the officers from a cascade of very powerful emotions. Denial and dulled affect are functional in protecting the officers from further psychological harm. Once the officers are sent home they transition to stage three of the post shooting reaction (Solomon, 1988). This stage is known as the impact phase and is distinguished from the previous stage by a noticeable reduction in acute somatic complaints but at the 56 same time there is an increase in the number of psychological complaints and behavioral changes. Solomon (1988) reports that this stage can last as long as six months to one year after the incident, but it typically begins within three days of the shooting. Loo (1986), his interviews with RCMP members who were involved in shootings, concluded that the most intense reactions occurred within the first forty-eight hours after the shooting. It is useful to organize the symptoms during the impact stage in the same three symptom clusters used to diagnose Post Traumatic Stress Disorder, re-experiencing, avoidance and arousal (APA, 1994). There are several symptoms that can be classified as re-experiencing. Loo (1986) states that rumination is one of the longest lasting symptoms along with the re-experiencing through nightmares and dreams. Carson (1987) also states that the rumination and second guessing serves a useful purpose when an officer is working through his trauma. Solomon and Horn (1986) also found that re-experiencing through dreams was common as were feelings of anger. Several emotions seem to be common during this stage. Stratton et al (1984) indicates that a large percentage of the officers experienced anger, which may come from a variety of sources including the suspect. Loo (1986) found that long court cases and unjustified questioning of the officer's integrity or competence also fed their feelings of anger. Other emotions that the officer may feel include guilt (Geberth, 1993), which is pointed out in an article in which Geberth reports a phenomenon known as Suicide by Cop. Suicidal individuals will often point unloaded weapons or knives at police officers, knowing full well that the officers will be forced to fire on the suspect to protect themselves. The intent of the suspect is to have the officer carry out the suspect's 57 execution. This phenomenon has been documented in other research (Parent and Verdun-Jones, 1999) that reported that 30% of the incidents they studied were classified as precipitated by the victim. Lord (2000) also examined victim precipitated police shootings and found some weak relationships between the behaviour and factors such as mental health issues, substance abuse and critical life events. Feelings may originate not only from the incident but also how the police officers are treated by their own departments. Depending on how the officers are treated after the shooting by their families and the police department they may also have feelings of abandonment (Solomon and Horn, 1986). Leonard and Alison (1999) compared two groups of officers post shooting, one who had received Critical Incident Stress Intervention versus the other group who were not offered such intervention. The latter group exhibited more anger than the former group and used more maladaptive coping techniques. The authors admit they could not tell whether the resulting symptoms were as a result of the second group not actually receiving the same intervention or because of the inference they drew when they were not even offered the service. Police officers are also likely to experience reactions and symptoms that can be classified as those from the second DSM IV symptom cluster, which is an increased state of arousal. The most common symptom of increased arousal is the exaggerated sense of guarding or hypervigilance. Carson (1987) documents this increased fixation on one's own safety by documenting officers carrying back-up weapons and wearing the soft body armor everywhere they went, after being involved in a shooting. Some officers went as far as protecting their families by removing the house numbers from the front of their houses and ensuring that mail was sent to post office boxes to keep their home addresses 58 secret. Gersons(1989) documented that the hyper-alertness or exaggerated startle response was the second most frequently occurring symptom. Loo (1986) also reported increased arousal symptoms in the form of sleep disturbances. Solomon and Horn (1986) as well as Carson (1987) also reported sleep disturbances in their studies. Another symptom of increased arousal is the general increase in anxiety and fear. Martin et al (1986) stated that fear in this study was thought to originate from the fact that an officer could conceivably be faced with the same set of facts and concerns in close proximity to the last incident. Thus because the officers must answer their calls for service, they could see the same type of incident in the same week if not the same shift. In addition, the fear may also come from legal and administrative hurdles that the officer faces after a shooting. Stratton (1984) reported that the fear of legal problems were the most common fears for up to one month after the shooting. The final cluster of PTSD symptoms found at this stage, are those that can be characterized as avoidance symptoms. Officers will avoid things that remind them of the shooting. Stratton (1984) reported that some officers felt anxiety when they returned to work since environmental triggers in the station caused them to be reminded of the shooting. They may wish to avoid things at work that remind them of the shooting. Loo (1986) reports that officers tended to withdraw from family and friends after a shooting. Solomon and Horn (1986) theorize that officers who withdraw do so because of the belief of uniqueness and the self-imposed isolation is in response to a myth that no one else can understand their plight. Marital discord may also result after a shooting. Carsons (1987) explained this as the brush with death provided by the shooting may serve to accelerate any decision the officer had been contemplating prior to the shooting. If this happens to 59 be to end a relationship the shooting can be mistakenly seen as the cause rather than a catalyst. The last two stages of Solomon's model are outside the scope of this review but should be at least mentioned for the sake of completeness. After the Impact phase the officer enters the coping phase. Once the officers are able to work through the emotional turmoil and impact of the event they then progress to the Acceptance phase, where they understand and accept what has happened. More recent research on police shootings reinforces what has been found in previous studies. Parent and Verdun-Jones (2000) found similar results as have been described in previous studies. They found reports of time, perceptual and auditory distortions during the incident as well as the loss of fine motor skills after the incident. They also reported the same host of symptoms among the police officers including problems eating and sleeping, rumination, reliving the incident through flashbacks, decreased interest in sex, hypervigilence, fear of being alone and increased use of alcohol. The media and peers also served as sources of stress to these officers. The event did affect the officer's family, but not always adversely. It did act as a catalyst to end some relationships, however it made others stronger, depending on the situation pre-incident. Officers involved in these incidents would rely on substances to deal with the pain or they would immerse themselves in their work. The authors felt that this may be an attempt by the officers to surround themselves with others who would perpetuate their methods of coping, including the use of alcohol. 60 Rescue work Rescue work in disaster situations also elicits a specific constellation of trauma symptoms. While many of the workers share common symptoms there are some symptoms that are particular to specific work forces or disasters. Police officers are often within the group of rescuers who are called upon to respond to such incidents. In a frequently cited article Ursano and McCarroll (1990) outline some of the major stressors for body handlers. One of the major stressors among these workers was viewing the bodies of children. Not only were badly injured bodies bothersome to the rescue personnel but so were those that carried no obvious cause of death. Workers commented on the different sensory impressions they experienced. Identifying with the victim in some way or viewing their effects also made it more difficult for the worker to create emotional distance which helped them continue to performing their duties. There are a few studies that document the specific symptoms that rescue workers exhibit. Foreman (1990), in a study of police officers who responded to a light airplane crash into a shopping mall, reported that most prevalent symptoms included an exaggerated startle response and the avoidance of social and sexual activities. Participants also reported survivor guilt and problems with concentration ability. Approximately 71% of the participants in this small sample reported symptoms at a level sufficient to warrant a diagnosis of PTSD. Marmar et al (1996) reported on emergency workers who responded to a freeway collapse. This study showed that workers exhibited disassociation, an altered sense of time and body image as well as memory disturbances. They also found that workers who had higher levels of exposure had more disassociative symptoms. In addition, workers who felt less prepared going into the incident felt greater 61 levels of grief, helplessness, guilt and other negative emotions. They were also more likely to exhibit symptoms in the long term. Wilkinson (1983) presented a study of rescuers involved in hotel skywalk collapse. The symptoms included many of those one would expect in such a set of circumstances and included; repeated recollections, sadness, anxiety, depression, recurrent dreams, nightmares, depressive patterns, loss of appetite and enthusiasm, concentrations problems, exaggerated startle response, and avoidance of the site or similar structures. Some of those involved in the rescue efforts experienced feelings of guilt, believing that they had not done enough to ease the suffering of the victims. Anger by victims was based on the absence of control over the situation and was often projected onto the rescuers. Finally, rescuers who were similar in age to the victims tended to identify with them more than rescuers who were not similar in age to the victims. Carlier et al (1998), in a study of police officers near Amsterdam who had worked at the site of a plane crash, found that after 18 months the officers who had received debriefing exhibited significantly more symptoms of hyperarousal than did the officers who had not received any post incident debriefing. The authors wer,e guarded about drawing any conclusions about the effectiveness of debriefing interventions and did admit that data collection did not begin until eight months after the incident. Jones (1985) showed various different symptoms among military rescue personnel after the People's Temple body recovery mission in Jonestown, depending on their age and racial origin. Black rescue workers in this study showed more short-term dysphoria than other workers. Enlisted personnel were more likely to show symptoms, especially if they were subject to high levels of exposure to the victims. Jones believes that younger rescue workers were affected because of their lack of experience, while black rescuers were 62 likely to identify with the victims, who were predominantly of Afro-American origin. Taylor and Frazer (1982) found similar results among police body handlers, after the 1979 Mt. Erebus air crash. The younger rescue workers reported higher stress levels, specifically twenty months after the incident. The authors theorized that factors such as experience, age and familiarity all served to mitigate and minimize stress reactions. The authors also reported that 18% of the sample were symptom free. Of the 35% who reported symptoms at the start of the study, 15% of these individuals experienced total symptom metabolization within three months. Common symptoms included dreams, flashbacks, sleep and eating disturbances, interruption socializing, emotional problems, difficulty expressing emotions including anger and cessation of sexual activity. Finally, it is interesting to note that 30% of the participants in this study used an adaptive and functional form of dissociation in order to complete their work. They would view the bodies as objects, frozen meat or scientific specimens. Alexander (1993) and Alexander and Wells (1991) paint a much more optimistic picture in a research study of workers who were involved in the body recovery operation following the 1988 Piper Alpha Oil Platform disaster. Most had managed to shift their perspective of the event from a negative to a positive one. While anxiety levels never returned exactly to baseline levels they did reduce to levels slightly above original levels. The author credited the reduction of symptomology to four factors. First, the high profile rescue was made highly public and for those involved in the rescue it may have served to increase self-image. Second, rescuers were successful and which lead to more positive feelings. Third, the very nature of the rescue reinforced the team's cohesiveness. Fourth, the rescuers likely adapted by learning new coping techniques. 63 Few documented rescue events have coupled the exposure to death with the direct danger to police from assailants as in the following study. In a study of police officers that were present at the Hillsborough Football Stadium disaster in 1989, Sims and Sims (1998) reported the prevalence of distinct traumatic symptomology. While the sample size was only 70 out of a possible 700 police officers, 44% of the sample showed severe PTSD symptoms, 41% had moderate PTSD symptoms and 10% did not meet the PTSD threshold criteria. These officers had not only been under attack themselves but had witnessed the crushing of innocent victims. The length of exposure seemed to worsen the symptoms. Common complaints included feeling numb or severe distress after the event, second guessing their own efforts and feeling as if the job they were doing was thankless. There was also anger directed by involved police officers at fellow officers who were not involved in the event and at the police officers that were at the scene but not living up to the expectations of other police officers. There was also anger directed at senior police officers and their lack of leadership. Intrusive recollections were a common complaint. Olfactory triggers seemed to trigger recollections of the incident among some of the officers, while others were reminded of previous traumatic events by this event. In terms of depressive symptoms, common complaints among the officers included anhedonia, the loss of the expectations of future, sleep disturbances, low mood, guilt and low self worth. In terms of anxiety and avoidance the officers stated that they were very aware of danger, depersonalizing, phobic and showing obsessive symptoms. In addition, 65% of the officers stated their marriages were affected and 48 % reported their sexual relationships were affected. Many also reported a reduction in social activity as well as increased use of alcohol and tobacco. Finally Sims and Sims (1998) explained that the absence of the 64 exaggerated startle response may indicate that horror was more prevalent than the component of terror. Suicide While suicide is not a traumatic symptom in and of itself, a successful argument could be made that it is an act that could be precipitated by or at least influenced by reactions to a severely traumatic event. This topic does demand some coverage in this section. The research seems to be divided as to whether or not stress alone is a cause of suicide. There are arguments from two camps around police suicide. Some studies report increased suicide rates for police (Violanti, 1995) while others state there is no increased rate of suicide among police in the Los Angeles Police Department (Dash & Reiser, 1978) as well as the RCMP (Loo, 1986). Loo's study of suicides in the RCMP was based on data compiled over 23 years from January 1960 to March 1983 and says that the rate in the RCMP over this time was half the Canadian rate. He goes on to state that the most frequent contributing factors were depression along with anxiety. A large percentage of police officers, 77%, died by gunshots from their own revolvers. However, it should be noted that Loo's study is fourteen years old. Lester and Fricke (1999), in a quantitative study, indicated that there was no difference in the rate of suicide when comparing the rate for German Police officers to general age adjusted rates for the male population of the same age group. This research, which collected data among German Police forces through the use of surveys for 1996, is also useful in illustrating two of the problems around conducting research on police suicide. First, the reliability and validity of death records becomes an issue. Some deaths may be reported as accidents, although a more thorough investigation may uncover that 65 the accidental death was in fact a suicide. Some of this irregular reporting may stem from the police departments attempt to hide the actual suicide rate (Lester & Fricke, 1999). A second problem with this type of research is the varied reporting procedures among different police agencies, as was the case among the different German Police agencies who participated in this research. However, this research did confirm the fact that a majority of police officers, 66% to 87%, of police offices committed suicide with firearms, which is also supported in Loo (1986), who reported a rate of 77% using firearms. The authors also encapsulate the relationship between stress and police suicide succinctly by acknowledging that there may be an interaction between a host of factors including work stress, job satisfaction and other personal factors. The complex nature of police suicide and the interaction among different variables is evident in Janik and Kravitz's (1994) study with police officers who had been sent for fitness for duty evaluations. They concluded after surveying these officers that officers who reported marital problems were 4.8 times as likely to attempt suicide while those who had been suspended were 6.7 times as likely to attempt suicide. Interestingly, complaints of being harassed by ones administration were associated with a lower likelihood of suicide. It is as if the department becomes a focal point for frustrated officers to focus and they are able to vent their feelings at a tangible target instead of having them turned inwards. Again as in previous studies, the authors were candid about the limited access they had to data around why officers had been suspended, probably due to active litigation. The authors also admitted that their findings predicted attempts and that another set of variables may better predict completions. 66 In an anecdotal report of six hostage takings or incidents where the barricaded suspect was a police officer, Russell et al (1986) stated that in these situations there is a high potential for the officer to commit suicide. They felt that the officers would likely perceive that there was no way out of the situation or way to retain their jobs once a hostage taking or barricaded suspect scenario had been initiated. The profile of the officers involved in these scenarios as the suspect included older officers, with at least five years of police experience. These officers likely had other problems such as histories of alcohol problems, abuse and violent behavior. These officers are also typically dealing with marital problems and may be in the process of separating from spouses or partners. These officers love police work so much that they would rather commit suicide than loose a job that is so much a part of them and their identity. The authors feel that these drastic actions were likely the cumulative effect of a variety of stressors. Baker and Baker (1996) in a journal article designed to illustrate the warning signs of suicide in police officers state there are several factors that may contribute to the difficulty in predicting or identifying a police officer's decision to commit suicide. Those around the suicidal officer may deny the in fact they are "really suicidal". In addition, the suicidal police officer may fear asking for assistance due to the long-term ramifications on their jobs, ranks and positions within the community. The complexities around police suicide are also illustrated in a paper (Allen, 1986). He states that suicidal thoughts develop over time and that they may manifest in Indirect Self Destructive Behaviour. This involves the officer taking risks, the opportunity for which present themselves very frequently in police work. He states that risk taking becomes detrimental when instead of leading to growth and development for the person these risks lead to depression and 67 result in the officer making poor decisions. This latter behaviour can put the officers and their co-workers at unnecessary risks. The problems around measurement and identification of police suicide make it a phenomenon that may be not only difficult to identify and quantify but also to treat. Police family difficulties Police officers do not react in a vacuum. Their families must often share in not only their triumphs but also in their bitter moments. Some research indicates that the idea of the police being the victims of a higher divorce rate is a belief based on suppositions and not fact (Stratton & Stratton, 1982). This article does not cite the research, but the authors claim the literature they reviewed does not support the assertion that the police divorce rate is higher than the divorce rate in many other occupations. The article does shed light on two sources of conflict in police officers' relationships. First, by the very nature of their job police officers are required to assume an autocratic role in their job. They are expected to restore order amid chaos. However, once the officer returns home, problems may arise when they continue to tell others what they should do and when. The second situation that this article identifies is compared to the officer's daily activities, the daily activities of their spouses and family members may be comparatively boring and mundane. The police officer may communicate this belief either overtly or through subtle but equally damaging actions. Hartsough (1990) provides a list of stressors that may produce both marriage and family difficulties for the police officer. He states that besides the long shifts and having to miss i m p o r t s holidays and family occasions, when other family members are present and expecting\wt officer to be in attendance, police families must often have to deal with 68 the police officer working a second job. It has been my experience that this may be more of an American phenomenon, due to the problem of poorer wages among smaller police forces. In addition, the police officer is constantly associating and among the undesirable people in society in surroundings that may be described as scary. Moreover, when the officer returns home the police family is often bombarded with the officer's need to vent and the family must deal with the officer's fixation with police work rather than the family awaiting them. The police spouses must be seen as supportive but may feel abandoned when it comes time to deal with their own issues. Coping styles can also be an area of misunderstanding among spouses. Alkus and Padesky (1983) state that in order to cope with the day's activities more experienced police officers are more apt to employ emotional withdrawal and distancing techniques. This can easily be misinterpreted as a sign of marital difficulty by the spouse. Police officers may seem even more isolated when they spend a greater deal of their off duty with their co-workers. In addition, the officers do not seem bothered by the limited time they have to cultivate and maintain relationships with non-police people, since they can compensate through their close relationships in the workplace. The spouses either stay at home or attend the non-police events by themselves. As stated earlier, police officers are often required to work holidays and may miss routine family activities such as dinner and family functions. Children of police officers may also miss their parent at crucial times. Lowenstein (1999) explains that the police officer's reactions to their spouses or neglect of their children may be predominantly the result of emotional exhaustion. Empirical research supports these findings. Alexander et al (1996) in a study of police spouses found that about two thirds of the subjects in this study stated that their spouses' stress at work had impacted family relationships, while one quarter felt this same stress had impacted relationships with people outside the nuclear family unit. Spouses of the police officers reported that big stressors for them included the police officer's long hours, shift work, cancelled leaves and house moves. The study did not support either claim, that the dangerous nature of police work or that police officers work with the opposite sex, were major stressors for police spouses. While a high number of police officers turned to their families for support, problems seemed to arise from the coping styles that the police officers used. Officers who kept their feelings to themselves served to distance their spouses, emotionally. Other officers often used displacement of their emotions in order to cope with stress. One other source of stress for spouses was the police officer that was preoccupied with work at home and could not leave the work at the station. Finally, alcohol and tobacco are popular coping tools and were seen as partially validated by the police culture and preserved the image of a police officer. These methods of coping were seen as maladaptive as well as ineffective and self-defeating. Alexander and Walker (1994) also found that 40% of police officers admitted to taking things out on their families. Beehr et al (1995) studied the coping styles of police officers and their spouses. They studied the effects of four different coping styles and the resulting strain the officers and their spouses experienced. Those officers who coped through a problem focus orientation were more likely to report somatic complaints, emotional exhaustion, detachment and suicidal ideation and thoughts. Religion was effective for the police spouses and was related to reduced levels of drinking alcohol and experiencing stress symptoms. The macho police image or rugged individualism was positively correlated to drinking among police officers, since alcohol is an important component of this image. This macho coping style was also positively related to burnout. Jackson and Maslach (1982) studied police couples where the wives of policemen reported that their husbands, when they were exhausted, were more likely to come home in upset or angry moods and this anger would often manifest itself in complaining and difficulty sleeping. In addition, officers who were experiencing stress were more likely to try to find ways to escape which included getting away, drinking or thinking about other things. The police wives were instead more likely to talk with their spouse, friends or a support group. Moreover, women married to officers who were emotionally exhausted were less satisfied with their husband's jobs and also reported having fewer friends. This was because the husband seemed to cope with the stress by withdrawing from social contact. This officer also tends to spend less time with his own family and will likely spend a greater portion of his off-time away from home, as compared to the officer who is not emotionally exhausted. Stevens (1999) in a study police officers reported that officers attributed a number of behaviours to the effects of stress. Some of these had to do with family relationships and included abusing or neglecting to give their own children parental affection along with difficulties in the marriages as well as alcohol abuse. Alcohol use As mentioned in the previous section, alcohol use in relation to dealing with the effects of stress seems to be culturally acceptable. The recurring theme about alcohol use among the police is that it is a systemic problem that is perpetuated and endorsed by the sub-culture. Violanti (1985) found the effect of stress on alcohol use was twenty times as 71 great as that of the effects of stress on cynicism or emotional dissonance. He also points out that coping through alcohol use is convenient and socially acceptable. Richmond et al (1999) in a study of Australian police officers also found that alcohol was a tool of stress relief and socializing within the police culture. While seeking professional assistance was seen as a sign of weakness, alcohol was viewed as an acceptable coping device. There was a positive relationship in this study between alcohol consumption and reported time off taken for sick leave. They also reported that female officers drank less than males. Pendergrass and Ostrove (1986) found that not only did police consume more alcohol than the general public but that male police officers drank more than female police officers. However, the female police officers seemed to be attempting to catch up to the same consumption patterns of the male officers. Furthermore, consumption did not decline with age or seniority. The authors of this study explained that alcohol is seen as a component of social interaction among police officers. These social interactions may take the form of after-shift drinking parties. Patrol officers seem to be more susceptible to these practices in order to live up to social obligations. Burke (1993a) found alcohol consumption to be more likely among lower police ranks and among those officers who were single. Alexander and Walker (1994) in a study of coping styles of Scottish police officers found that few of the police officers actually drank at work. However, outside of work hours the consumption of alcohol went up to over half of the sample, in order to deal with stress. The authors also theorized that alcohol is an easy outlet since it does not require the officers to admit they have problems. Masking the problem with alcohol is much 72 easier than admitting to a mental health professional that they have a problem. This may be due to the fact that alcohol is still seen as a legitimate part of the police culture. The consumption of alcohol also affects the family unit. Jackson and Maslach (1982) in a quantitative study of police couples in California looked at the effects of police work on the family. They reported that couples that used alcohol as a coping device were less happily married. However, an interesting finding related to this was that those officers who used alcohol to a greater extent also reported more satisfaction with police work. There may be a variety of explanations for this finding, however being that this sample was non-random, one should be cautious to attempt to quickly attempt to explain such an enigma. It does again point to the culturally accepted role of alcohol within the police culture. Violanti (1985) showed that cynicism and alcohol were related. In this study he showed that alcohol and cynicism are often used at different stages of an officer's career. As cynicism becomes increasingly ineffective and fails the officer is more likely to turn to alcohol. The data certainly supports the theory that alcohol consumption is a systemic problem that is used by many officers as a means of coping with stress. The Relationship Between Stress and Experience The notion of a non-linear relationship between police officers' experience and the level of strain that they exhibit is one that has received support in empirical research. Patterson (1992) in a study of almost 4500 police, correctional, probation and parole officers showed a curvilinear relationship between time on the job and perceived stress. The highest stress scores were received from police officers in two groups, those with 73 between four to seven years of experience and those with eight to eleven years of experience. However, Patterson went on to discuss that when only line or patrol police officers are examined the curvilinear relationship tended to dissipate. One reason that he offered was that shift work affects senior line police officers in a disproportionately hard manner than it does younger officers. Thus when senior officers leave the patrol function, their stress levels appears to be reduced. Burke (1989) also showed support for the idea of a curvilinear relationship between stress levels and experience. He found that constables in the range of six to fifteen years reported they disliked their work settings, felt more effects of stress, felt burned out, felt alienated and had more family problems than officers in the different years of experience. This group also took more sick days and consumed more tobacco, alcohol and coffee. The only criticism of this research is that only 10% of the total sample for this study had over sixteen years of service. Robinson et al (1997) also found that officers with less than eleven years of experience reported more PTSD and somatic complaint symptoms. In this study of 105 suburban police officers, the second highest predictor of PTSD symptoms behind death exposure was age. Logan (1995) found that in a quantitative research study involving 101 RCMP officers and 72 spouses found that the highest levels of stress were experienced by patrol members with between nine and twelve years of experience. He believes that as officers aged and gained experience their stressors changed more to family sources and away from job related stressors. Violanti (1983) in a quantitative study of 500 police officers looked at the relationship between stress and whether it was constant or whether it fluctuated depending upon 74 where the police officer was in terms of his career stage, as defined by previous literature. Violanti called that the first stage of the police officer's career the Alarm Phase and it includes the first five years of his service. The second stage is called the Disenchantment stage and extends from the sixth to thirteenth years of a police officer's career. During this time the gap between their ideals and reality widens and they tend to become disenchanted and they become more cynical. The third stage is the Personalization stage, which extends from year fourteen to year twenty of the police officer's service. The officer now switches their focus to personal instead of work related goals and policing become less of a priority. The fourth and final stage is the Introspection stage, which extends past the twenty-year mark when officers are secure in their jobs and they have the opportunity to reflect. Violanti showed that there exists a curvilinear relationship between stress and years of service. He found that during the first thirteen years that there was a positive relationship between the two variables. After this point the two variables showed a negative relationship. Gaines and van Tubergen (1989) also uncovered different pattern of stressors for officers, depending on their level of experience. The purpose of their quantitative study of fifty police officers was to identify the different causes of stress among police officers and determine if any type of pattern existed. Younger patrol officers, those with limited experience as well as those who were non-operational were more stressed by criticism and organizational stressors. On the other hand, officers with medium levels of experience and female officers experienced more stress from job specific events and less from the actions of their bosses or the organization. Finally, more experienced officers 75 experienced more stress over problems that they saw co-workers having rather than their own problems. This curvilinear relationship was also found in a study of military personnel. Jones (1985), in quantitative study of military rescue personnel found that experience of the rescuers determined the prevalence of symptomology. Younger workers, those under twenty-five years of age reported significantly more short term dysphoria. Jones attributed this to the lack of experience these younger rescuers would have had with this type of work. Supervisors were also subject to similar correlations between age and experience. Stotland (1986) in a quantitative study of 227 Portland police officers found that experience or time on the job was negatively correlated to stress and strain for supervisors. Rationale for a non-linear relationship The next question becomes why does such a curvilinear relationship exist for police officers. There are several plausible theories that attempt to account for this curvilinear relationship. It would be prudent to examine each part of curve as it relates to experience. One theory for the inclining portion of the curve is that new officers may not have been on the job long enough for stressors to bother them or their symptoms may be minimized by the excitement of the new job, they are in the proverbial "honeymoon" stage (Patterson, 1992). Patterson also proposed that the new officers may also model themselves after veterans who they see as less stressed by the demands of policing. Thus the cumulative effect has not had time in which to manifest in newer officers. There is 76 some research to indicate that younger officers show higher PTSD scores. Robinson et al (1997) offer a logical explanation for the higher scores of PTSD symptoms among less experienced police officers. This research asserts that younger officers are new to the occupation and may not have developed effective coping mechanisms. The implied message is that this over statement of symptoms is a temporary condition. There is also another set of explanations for the declining backside of the curve where senior officer's scores are lower than the scores of intermediate officers. These officers may have developed adequate coping techniques over the years and they are more secure in their jobs and less worried about work demands and have shifted their focus to their futures (Patterson, 1992). Patterson also suggests that those police officers that found the levels of stress unbearable may also have dropped out of policing. Through this form of attrition or self selection, the officers who have remained on the job may be the ones who do not find the work as stressful as those who have left policing or may be the ones who • have better coping skills and abilities. The quality of coping ability in older police officers was also supported in other empirical research. Gaines and van Tubergen (1989) in a quantitative study of the patterns of stressors over the different level of experience, also theorize that the older officers experience less stress because they have successfully learned to cope. They argued that in their particular study that police officers had hit what Violanti had called the introspection stage at 12 instead of 20 years. They went on to state that more experienced officers may also learn to adjust to the requirements of the job. There is also support that older police officers have found more job satisfaction. In a quantitative study of the effects of aging as a moderating variable on employee stress, Mayes et al (1991) found that there are certain stressors that effect older employees in a 77 positive manner. In a study of 692 police, fire and electrical contracting employees, the researchers found that leader production emphasis and having responsibility for others seemed to benefit older workers and as a result they experienced less depression, more life satisfaction and fewer health symptoms that younger employees. This may be due to the fact that they are feeling like their skills are being utilized and that the employees over which they have responsibility are likely all younger than them. The police officer's years of experience also seems to effect the officers perception of control over events which in turn effects the cognitive appraisal they give the event. In a study of Australian police officers and their appraisal of stressors, years of experience among police officers was shown to influence the appraisal of acute stressors (Anshel et al, 1997). Experienced officers were more familiar and experienced with stress inducing events and were more likely to use problem focused coping strategies to deal with the event. On the other hand younger officers who lacked the same level of experience reacted with emotionally focused coping strategies including emotional distancing and avoidance strategies. The third set of theories deals with why the officers in the intermediate years of experience have higher scores on stress perception tests than the groups on either side of them, or why they make up the peak of the curve. There appears to be a fair number of different stressors for this group. This group may be finding their jobs are more demanding either in terms of volume of work or scope of responsibility thereby demanding more from them (Patterson, 1992). Burke (1989) suggested that the officers in the intermediate level of experience were feeling trapped in policing since they could not transfer their skills sets to many occupations outside the Criminal Justice system. Burke also suggests that the self-concept of many officers is tied to promotion. 78 A deeper psychological explanation for the changes in stress levels is offered by Winter (1993). He, like Remming, theorized that police officers are drawn to policing because it them allows them to destroy the idea that they are similar to the very people that they arrest. However, in order to do this the police officer needs to develop a professional construct subsystem, which helps them impose structure on the work that they do. Until such time as that happens the ambiguity of the role causes them anxiety. Once this professional construct sub-system is in place, anxiety diminishes. Research Question The purpose of this research is to measure traumatic symptoms among police officers in the Vancouver Police Department and to determine if there is a significant difference between groups of officers based on years of experience. It is different from other research in several ways. Rather than targeting a specific group or subset of officers who have been involved in specific incidents, such as a shooting or other traumatic incident, this research chose a random sample of police officers. The logic behind this decision is that the random selection will control for a host of different phenomenon that may affect the scores. As a result, the findings in this research will be able to be more applicable and relevant to more members of at least this department. In addition, the occurrence of, highly publicized traumatic incidents such as shootings or fatal police pursuits is not an everyday occurrence among this population. As a result if this research were to focus solely on the participants in such events, the identity of the subjects would likely be difficult to conceal. This researcher has then decided that the protection of the identity of the participants is paramount and that the methodology employed will keep this as a high 79 priority. In addition, this research uses an instrument that measures symptoms of traumatic stress with the intent on examining the cumulative nature of traumatic events. p. 80 Chapter 3 Method Population The sample was drawn from a population of 1177 serving police officers with the city of Vancouver. The criterion for selection were sworn police officers who were presently serving on the force and were not retired or on long term sick leave. The Vancouver Police Department consists of three Divisions. The Operations Divisions is the largest of the three and houses the patrol and traffic sections. The second division is the Investigations Division, which houses the various specialized investigation teams and the Support Services Division, which is made up of the various staff functions. The categories or grouping of the subjects was done on the basis of years of completed policing service. There were seven groups. Group one consisted of police recruits who had completed their first three months of academy training and were about to embark on their training practicum in the company of a qualified and trained field trainer. Group two was made up of serving members who had up to two years of police service. Group three consisted of serving police members who had two to up to five years of police service. Group four consisted of police members who had five up to ten years of experience. Group five consisted of those police members who had from ten up to fifteen years of experience. Group six consisted of police officers with fifteen up to twenty years of police service. Finally Group seven consisted of those officers with over twenty years of police experience. 81 The total number available in each group as of February 17, 2000 is listed below in table 3.1. Table 3.1- Population Available Listed by Group Group Size 1 32 ~ 2 107 3 113 4 188 5 180 6 184 7 373 Total 1177 As is apparent group seven is considerably larger than the other groups, which is to be expected as this group combines serving police members with service levels from 21 to over 30 years of experience. Group number one is considerably smaller as its size is dependent upon the number of recruits that have been selected for a specific academy class. This figure is dynamic and is dependent on a variety of external factors such as municipal budgets, attrition and retirements. Non-sworn or civilian personnel were not included in this research. Written permission to conduct the research was obtained from the Chief Constable Terry Blythe prior to beginning any data collection. 82 Instrument Description This research study employed the Trauma Symptom Inventory to measure trauma symptoms among the subjects (Briere, 1995). The Trauma Symptom Inventory (TSI) is a 100 item self-report test. The test booklet contains the 100 test items and the subject scores the answers on a separate carbonless answer sheet. Each item is rated on a scale of 0 to 3 according to how often the subject has experienced the symptom within the last six months. A score of zero on an item signifies that the subject has never experienced the symptom while a three signifies that the subject has experienced the symptom often. Each test requires about twenty minutes to complete and can be scored in about 10 to 15 minutes. It is designed to measure traumatic symptomology. There are ten clinical scales to measure various effects of trauma (see Appendix 3) as well as three validity scales. The ten clinical scales include: Anxious Arousal; Dissociation; Depression; Sexual Concerns; Anger/Irritability; Dysfunctional Sexual Behavior; Intrusive Experience; Defensive Avoidance; Impaired Self Reference; and Tension Reduction Behavior. These ten clinical scales are internally consistent with mean alpha coefficients of .86, .87, .84 and .85 in standardization (n^ 836), clinical (n= 370), university (n= 279) and a military samples (n=3,659) respectively. The TSI also has reasonable predictive value and in a standardized sample predicted PTSD in over 90% of the cases with an n= 449. In addition, in a sample of psychiatric inpatients the TSI was successful in identifying 89% of people with Borderline Personality Disorder, who had already been diagnosed by other means. In addition, as shown in the TSI (Briere, 1995) boasts not only good construct 83 validity, but also convergent and discriminant validity along with good incremental and criterion validity. The three validity scales, Response Level, Atypical Response and Inconsistent Responses allow the detection of a variety of different problem subjects. They allow the test to identify those subjects who deny even the most commonly endorsed symptoms, the identification of people who report an unusually high number of responses or responses that are bizarre in nature. In addition, these validity scales also help to identify subjects whose responses seem inconsistent or random in nature (Briere, 1995). The TSI also contains twelve Critical Items which identify serious problems such as suicidal ideation or behavior, substance abuse, psychosis, and self mutilation behavior. These are designed to indicate subject who require immediate intervention, which is indicated by an endorsement of even a one (see Appendix 4). Sample Selection The test subjects were chosen by a random non-replacement method. A number was assigned to each subject in each group. Each number was then written on small plastic chip, which was then placed in a container. Thirty chips were selected for each group as well as twenty additional ones. The twenty addition selections served as additional subjects if the first ones for some reason could not participate, declined to participate or could not be contacted. This eliminated the problem of having to return and reselect more participants in the same manner at a later date. The only group for which this procedure was not followed was group one, which were sampled as a whole during their orientation, prior to their embarking on their on practicum. Two members of this group 84 were unavailable due to training commitments. Those members who had retired in group seven were excluded from the samples. Test Administration All potential subjects in the study were approached for their voluntary participation. They were first advised of the nature of the research project and advised that participation was completely voluntary and anonymous. If they agreed in principle then they were provided with the Informed Consent Form (Appendix A), which outlined not only the purpose of the study but also reinforced the fact that participation was voluntary and also anonymous. The subjects were then asked again if they wished to participate. Those who agreed to participate where provided with the TSI question booklet, answer sheet and a demographic questionnaire for capturing specific demographic data (Appendix B). Due to the fact that the instrument is a psychometric tool, the researcher awaited the completion of the material in a nearby location, as opposed to mailing the test out to subjects. Many of the subjects were approached during briefing periods at the beginning of their shifts. Due to the deployment and location of various subjects, some were approached during a duty shift and a small number were asked to complete the tests during off duty hours, in order to facilitate the completion of the tests. Tests answer sheets and matching demographic questionnaires were each numbered and subjects were informed that if they desired to have a follow up interview during whichthey could discuss their results that they needed to retain this number. The identity of the subjects was safeguarded in several ways. The researcher did not record the subjects name on any form. In addition, the researcher did not record the 85 number of each form to match the subject's name. There is no way in which to match the number on the test answer sheet and demographic questionnaire to any test subject. This was an important issue, since anonymity had to be assured. While demographic data collected attempted to identify which patrol areas the subjects had worked, when the data was analyzed this data was further sanitized by simply totaling the various years worked in patrol, so as not to inadvertently identify any participant. This method provided a simple number of patrol years for each subject and took another step towards protecting the identity of the subjects. Tests were collected over approximately an eight-month period from February 2000 to September 2000, with most of the data being collected within a two-month period. The years of police service was measured as of February 17, 2000. However, due to the length of time that was taken to collect the data, some subjects may have moved from one category into the next. This partially accounts for the different numbers of subjects found in some of the groups. The fact that the researcher was working full time during the duration of the study also helps to account for the period over which the data was collected. Data Analysis The data analysis was done with the assistance of the SPSS statistical computer program. At the project's conception the analysis was to be completed with the assistance of the primary researcher, Dr. Larry Cochran. However, due to Dr. Cochran's retirement and subsequent relocation the assistance of a former Statistics Graduate student was employed as a statistical consultant who oversaw the data analysis portion of 86 this research study. This former graduate student had provided a written submission to the researcher early in the research's formative stage as part of his own graduate level course requirements, thus he was familiar with the study. Data was also sanitized, as outlined above, prior to his involvement. The data analysis took three major avenues. The first involved the analysis of basic statistical information. The second stage examined the means between the seven groups and an examination for statistical differences between the means. The final stage examined descriptive measures on the remaining data that was collected. 87 Chapter 4 Results Demographic Data There were a total of 202 subjects approached to participate in the study. Of these 5 declined to participate. Of the 197 who participated, one subject's test was not completed. It appears that the last page of the question booklet was not turned over so that 30 items were left unanswered. One additional test was disqualified due to the high score on one of the validity scales. As a result 195 usable tests were available to be analyzed. The demographics of the sample are laid out in table 4.1. Table 4.01- Demographic Data of Entire Sample Age Year of Patrol Time Service 10.21 7T07 8.69 5.87 75.58 34.41 31 25 0 0 31 25 As shown in Table 4.01 the mean age of the sample is just over thirty-six years and the mean years of service is just over ten years. The subjects ranged in age from twenty-one to fifty-four years of age, while service duration ranged from zero years of service to thirty-one years of service. Time is patrol also ranged from zero years to twenty-five years. Mean 36.26 Standard Deviation 7.99 Variance 63.82 Range 33 Minimum 21 Maximum 54 88 Table 4.02 shows the mean ages, years of service and years of patrol experience across the seven groups. Table 4.02 Sample Age, Service and Patrol Time Means Age (sd) Service (sd) Patrol Time (sd) Group 1 Group 2 Group 3 Group 4 Group 5 Group 6 Group 7 27.55 (4.52) 28.74 (2.54) 31.79(3.77) 35.35 (4.06) 37.86(2.81) 43.46 (4.07) 48.36 (3.50) 0.06 (.258)* 1.30(0.44) 3.78 (0.90) 9.08 (0.99) 12.79(1.54) 18.46(1.23) 24.88(3.10) 0(0) 1.28(0.47) 3.52(1.08) 7.45(1.58) 9.62 (3.32) 12.61(4.14) 14.30 (4.85) * A few of the recruits had been employed as pre-recruits working in a non-operational position until such time as they were sent to the police academy. Table 4.03 shows the gender demographic of the sample. As table 4.03 shows, a large percentage of the sample is male. Table 4.03- Sample Gender Demographics Frequency Percentage Female 43 221 Male 152 77.9 Total 195 100 89 Table 4.04 Distribution of Gender by Group of Sample as Compared to Population Sample Population Group 1-Recruits Group 2- 0<2 yrs Group3-2<5 yrs Group 4-5< 10 yrs Group 5- 10<15 yrs Group 6- 15<20 yrs Group 7- 20+ yrs. Total Male(%) 19 (66) 14 (50) 13 (56) 24 (77) 26 (90) 28 (100) • 28.(100) 152 Female(%) 10(34) . 14 (50) 10 (44) 7(23) 3(10) 0 0 43 Total 29 28 23 31 29 28 28 195 Male (%) -70(65)* 73 (64)* 144(77)* 156(87)* 173(94)* 346(93)* Female(%) -37(35)* 40 (35)* 44 (23)* 24 (13)* 11 (6)* 27_(7)* Total 32 107 113 188 180 184 373 1177 *Approx. Table 4.04 shows the actual breakdown by group in both the sample and the population from which it was drawn. The numbers for the entire populations are only approximate as they include persons who had retired but are still listed on the departmental strength and have not yet been officially retired. In addition, for the breakdown of the population I determined gender by recognizing the subject's name and most of the people were known to me, which aided in the determination of gender. However, the list of police officers was obtained from the Human Resources Section and may have been missing some members who had recently been hired as exemption candidates from other departments. Furthermore, three police nurses were in group seven of the population and none of them were included in the sample. The break down for the recruit group was purposely left out so that the identity of those who did not participate 90 could remain unknown and thereby the anonymity of the sample could be maintained. Suffice to say that 90% of this population was surveyed. The proportion of females in the sample drops off remarkably between groups 3 and 4 and diminishes to zero in the last two groups. This is actually reflective of the change in the recruiting and hiring practices of the Vancouver Police Department over the last ten years, when they have been aggressively pursuing female as well as minority applicants in order to better reflect the demographics of the community which they serve. Table 4.05 Education Frequencies of Sample Frequency Percent Cumulative % 18 56 40 71 10 195 9.2 28.7 20.5 36.4 5.1 100 9.2 37.9 58.5 94.9 100 Table 4.05 shows the educational background of the sample and it is apparent that most of the sample are somewhere between two years of college, which is now the minimum requirement to be considered for employment with the Vancouver Police Department and an undergraduate degree. There are small percentages at the polar extremes, those having high school degrees and those having graduate degrees, which only account for 14.3% of the sample. ANOVA Table 4.06 shows all the sample means for the three validity scales as well as the ten clinical scales of the Trauma Symptom Inventory. The means are shown for both the males and females in each group along with the total group mean. A One Way ANOVA was conducted and showed that there were significant differences at the .05 level in the means between groups for the several scales. The data was analyzed using the High School Up to 2 Yrs. College Diploma Undergrad Degree Graduate Degree Total 91 Bonferroni test. What follows is a description of each scale, the possible meanings of the nature of extreme scores on each scale (Briere, 1995) and the various results found. Table 4.06 Sample Test Score Means by Group and Gender 92 AR Recruits M(19) 45.42 s.d. 1.26 F(10) 45.90 s.d. 2.02 10131(29) 45.59 s.d 1.55 0<2Yrs M(13) 46.64 s.d. 3.75 F(13) 46.08 s.d 1.61 Total(26) 46.37 s.d 2.88 2<5 Yrs M(13) 48.77 s.d 8.00 F(10) 47.80 s.d 5.07 Total(23) 48.35 s.d 6.76 5<10vrs M(24) 46.00 s.d 2.43 F(7) 47.71 s.d 7.18 Total(31") 46.39 s.d 3.92 10<15vrs M(26) 49.15 s.d 5.97 F(3) 48.00 s.d 3.00 Total(29) 49.03 s.d 5.71 15<20yrs M(28) 46.61 s.d 3.08 Total(28) 46.61 s.d 3.08 20+yrs M(28) 46.71 s.d 2.97 Total(28) 46.71 s.d 2.97 RL IR 50.21 48.05 7.08 6.23 47.70 46.30 7.10 8.68 49.34 47.45 7.07 7.06 48.00 51.86 6.86 11.42 46.15 49.08 7.13 7.76 47.11 50.52 6.92 9.75 44.69 49.08 4.75 6.74 44.60 48.30 5.02 4.95 44.65 48.74 4.75 5.91 46.21 48.63 6.21 6.55 42.43 45.71 2.44 5.25 45.35 47.97 5.77 6.32 44.73 51.69 5.18 8.50 47.33 43.00 10.97 8.00 45.00 50.79 5.76 8.74 44.57 47.96 4.53 6.27 44.57 47.96 4.53 6.27 44.39 46.54 4.37 5.97 44.39 46.54 4.37 5.97 AA D 48.16 44.32 5.19 3.11 47.20 44.10 4.47 1.79 47.83 44.24 4.89 2.69 48.29 45.21 5.48 3.77 48.38 41.69 7!56 2.75 48.33 43.52 6.43 3.71 51.77 46.31 7.32 5.89 • 51.70 44.10 7.48 2.28 51.74 45.35 7.22 4.73 48.17 45.42 5.66 3.30 44.43 44.00 2.51 3.11 47.32 45.10 5.33 3.26 53.00 48.46 7.78 8.51 47.67 45.67 5.77 5.13 52.45 48.17 7.69 8.21 48.64 45.25 4.70 3.45 48.64 45.25 4.70 3.45 49.50 48.43 7.06 7.01 49.50 48.43 7.06 7.01 A/I IE 47.11 47.32 7.08 3.83 44.30 45.60 3.02 3.75 46.14 46.72 6.08 3.83 51.00 51.50 9.27 6.94 47.23 46.00 5.80 6.16 49.19 48.85 7.89 7.03 55.85 52.38 9.27 10.14 50.50 51.40 6.38 7.99 53.52 51.96 8.42 9.08 48.67 50.17 8.20 8.19 48.14 45.57 5.58 5.65 48.55 49.13 7.61 7.85 53.38 57.08 9.06 12.45 46.67 47.00. 9.02 7.00 52.69 56.03 9.13 12.32 46.43 49.14 5.65 6.82 46.43 49.14 5.65 6.82 51.61 49.54 8.63 5.51 51.61 49.54 8.63 5.51 DA DIS 47.53 50.95 7.48 6.94 46.40 47.60 5.54 4.33 47.14 49.79 6.79 6.29 50.43 51.00 5.97 7.72 44.46 45.00 6.31 3.56 47.56 48.11 6.74 6.70 49.31 52.77 4.96 . 6.38 48.10 50.00 6.52 5.35 48.78 51.57 5.58 5.99 47.92 49.67 7.21 7.31 45.57 48.43 7.23 5.00 47.39 49.39 7.16 6.80 54.96 54.50 11.32. 12.14 48.67 46.33 10.07 4.16 54.31 53.66 11.20 11.80 47.04 48.61 5.99 5.75 47.04 48.61 5.99 5.75 49.75 51.46 7.28 7.51 49.75 51.46 7.28 7.51 SC DSB 47.74 49.63 7.68 5.00 47.30 47.40 3.59 4.03 47.59 48.86 6.49 4.74 50.50 55.29 8.54 15.83 45.77 47.38 4.13 7.25 48.22 51.48 7.08 12.88 50.62 53.54 6.96 7.39 46.40 48.00 5.15 5.48 48.78 51.13 6.47 7.07 48.04 51.04 7.38 7.12 45.14 47.00 2.54 4.83 47.39 50.13 6.68 6.82 48.35 48.85 6.18 5.88 43.33 44.00 2.31 0 47.83 48.34 6.08 5.75 46.39 47.25 3.99 5.59 46.39 47.25 3.99 5.59 46.68 49.54 5.36 7.71 46.68 49.54 5.36 , 7.71 ISR TRB 46.68 49.05 2.98 5.33 44.40 44.40 3.60 2.37 45.90 47.45 3.33 5.01 49.43 52.00 7.47 11.53 47.31 46.00 6.40 4.58 48.41 49.11 6.92 9.25 50.85 52.85 6.14 7.93 47.40 50.20 5.06 6.81 49.35 51.70 5.84 7.42 46.83 48.63 6.02 6.27 46.00 44.57 5.26 3.64 46.65 47.71 5.78 5.98 50.62 49.23 9.17 7.30 44.67 44.00 5.13 1.73 50.00 48.69 8.96 7.10 45.04 46.00 3.78 4.83 45.04 46.00 3.78 4.83 47.57 48.71 5.36 6.77 47.57 48.71 5.36 6.77 93 Restatement of Question At this point it is useful to restate the question this research is addressing, whether statistically significant differences exist on the clinical scales of the TSI that measure trauma symptoms across groups that are based on years of service. Validity Scales The first three scales that are displayed in table 4.06 are the three validity scales of the instrument. The graphic display of the means on all three validity scales is shown in figure 4-1 Figure 4-1 Graphs of the means of the three validity scales. * A* J? <* sr A* F Only the Atypical Response Level and the Response Level showed any statistically significant differences. 94 Table 4.07 Atypical Response Level Means Recruits 0<2yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs "Mean 45.59 46.37 48.35 46.39 49.03 46.61 46.71 s.d. 1.55 2.88 6.76 3.92 5.71 3.08 . 2.97 The Atypical Response level is one of the three validity scales and it provides a measure of the degree that the test subjects endorse unusual items. According to Briere (1995) high scores on this scale may indicate that an individual has a tendency to present symptoms at a higher rate that that at which they actually exist. High scores may also be an indication of psychotic process. Another explanation for high scores may be long-term substance abuse. The lowest mean score was among the recruits. The two highest scores were the 10<15 years group and the 2<5 year group. The difference between the recruit group and the 10<15 year group was the only one that was statistically significant at the .05 level. Table 4.08 Response Level Means Recruit 0<2yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs Mean 49.34 47.11 44.65 45.35 45.00 44.57 44.39 s.d 7.07 6.92 4.75 5.77 5.76 4.53 4.37 Response Level is the second validity scale and according to Briere (1995) is designed to identify respondents who non-systematically endorse zeros for the various items that are least likely to receive zeros in a normative sampling. According to the test manual subjects who score high on this scale may be highly guarded and defensive and are avoiding endorsing commonly endorsed items. There were two significant differences. The difference between the recruit group's mean and the 15<20 year group mean was 95 4.77, which was significant to the .05 level. The recruit group's mean also differed significantly from the mean for the group of 20 + years of experience. Inconsistent Response Level is the third validity scale and is designed to measure the rate of inconsistent responses among test subjects. While this inconsistency may be due to randomness it can also be caused by dissociative symptoms and, inability to concentrate or poor attention abilities (Briere, 1995). There were no statistically significant differences on this scale. Clinical Scales Showing Significant Differences The next set of scales are those on the test that are designed to measure specific symptoms of trauma and all showed at least one statistically significant difference between at least two groups. Figure 4-2 graphically illustrates the means for these six clinical scales. Each scale is then described and the specific results are highlighted. Figure 4-2 Graphs of Anxious Arousal, Depression, Anger/Irritability, Defensive Avoidance, Impaired Self Reference Means - • - D A/I - * - l / E - * - D A - • - I S R 96 Table 4.09 Anxious Arousal Means Recruit 0<2 yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs Mean 47.83 48.33 51.74 47.32 52.45 48.64 49.50 • s.d 4.89 6.43 7.22 5.33 7.69 4.70 . 7.06 According to Briere (1995) Anxious Arousal is a measure of the effects of anxiety and hyperarousal. High scores on this scale may be linked to conditions such as PTSD, ASD or other anxiety driven conditions. These individuals are likely to also report symptoms of excessive alertness and hypervigilance. These individuals may be more prone to anxiety and panic attacks. There is only one statistically significant difference. The mean for the group 5<10 years is significantly lower than the mean for the group from 10<15 years with a rise in the latter mean of 5.13. The difference between the 10<15 years group and the recruit level group is almost as great but is just outside the statistically significant bounds. This difference may have been statistically significant if the sample size had been larger. Table 4.10 Depression Means Recruit 0<2 yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs ' 20+yrs Mean 44.24 43.52 45.35 45.10 48.17 45.25 48.43 s.d 2.69 3.71 4.73 3.26 8.21 3.45 7.01 The depression scale is designed to capture the extent that test subjects are encountering depressed affect and thoughts (Briere, 1995). High scores in this scale are also linked to poor self-concept and hopeless thoughts about the future as well as focusing on death and the act of dying. The individuals with high scores may also report seclusion or isolation and ruminate about suicide. There were several groups whose means were statistically significant in their differences. The mean for the recruit group is 97 significantly lower than the mean for the mean for the group with 20+ years of service with a difference in the means of 4.19. In addition the mean for the group 0<2 years of service is also significantly lower than the mean for the group 20+ years of service with a difference in the means of 4.91. Finally the mean for the group 0<2 years is also significantly lower than the mean for the group 10<15 years with a difference in the means of 4.65. Table 4.11 Anger/ Irritability Means Recruit 0<2yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs Mean 46.14 49.19 53.52 48.55 52.69 46.43 51.61 s.d 6.08 7.89 8.42 7.61 9.13 5.65 8.63 This scale measures the prevalence of anger and irritability among the test subjects (Briere, 1995). This could be from PTSD or other sources and it attempts to measure internal feelings of anger but also behavioral correlates of angry behaviour. There were several means that were significant in their differences. The mean for the recruit group was significantly lower than the mean for the 2<5 years group with a difference of 7.38. The recruit group's mean was also significantly lower than the mean for the group 10<15 years with a difference of 6.55. Finally, the mean for the group 2<5 was significantly lower than the mean for the group 15<20 with a difference of 7.09. There appears to be two statistically significant spikes on his scale. Table 4.12 Intrusive Experience Means Recruit 0<2 yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs Mean 46.72 48.85 51.96 49.13 56.03 49.14 49.54 s.d 3.83 7.03 9.08 7.85 12.32 6.82 5.51 98 The Intrusive Experience scale measures intrusive recollections associated to post traumatic reactions, as they relate to PTSD and ASD in the DSMIV. These include nightmares, recollections, unpleasant memories and are not only unwanted but appear without warning (Briere, 1995). From a statistically significant point of view this seems to be one of the most obviously curvilinear relationship of all the reported scales as this scale had the most significant differences at the .05 level. The recruit group was significantly lower than the group 10<15 in their means with a difference of 9.31. The group 0<2 was also significantly lower than the 10<15 group with a significant difference in the means of 7.18. The group mean for the group 5<10 years was also significantly lower than the group mean for the group 10<15 years with a difference of 6.91. The mean for the group 15<20 was also lower than the mean for the group 10<15 with a difference of 6.89. Finally the mean for the group with 20+ years of experience also had a significantly lower mean than the mean for the group 10<15 with a difference in the mean of 6.50 Table 4.13 Defensive Avoidance Means Recruit 0<2 yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs Mean 47.14 47.56 48.78 47.39 54.31 47.04 ' 49.75 s.d 6.79 6.74 5.58 7.16 11.20 5.99 7.28 This scale measures the symptoms of avoidance as they relate to PTSD and ASD according to the DSM IV. High scores on this scale are seeking to avoid unpleasant internal experiences as well as external triggers that may trigger such memories (Briere, 1995). There were many statistically significant differences. The recruit group's mean is significantly lower than the mean for the 10<15 group with a difference in the means of 99 7.17. The mean for the group 0<2 is also significantly lower than the mean for the group 10<15 with a difference of 6.75. The mean for the group 5<10 is also significantly lower than the mean for the group 10<15 with a difference of 6.92. Finally the mean for the group 15<20 is significantly lower than the mean for the group 10<15 with a difference in the means of 7.27. Table 4.13 Impaired Self Reference Means • Recruit 0<2 yrs 2<5 yrs 5<10yrs 10<15yrs 15<20yrs 20+yrs Mean 45.90 48.41 49.35 46.65 50.00 45.04 47.57 s.d 3.33 6.92 5.84 5.78 8.96 3.78 5.36 This scale measures the subject's problems with sense of self and identity. Subject's with high scores on this scale are often less self aware and due to low levels of self confidence are easily persuaded by others and are not only more easily excited but also are less functional under stressful conditions. The mean for the group 10<15 is significantly larger than the mean for the group 15<20 with a difference of 4.96. None of the other means is significantly different at the .05 level. Clinical Scales With No Significant Differences The last set of clinical scales are those among which no statistically significant differences were shown among the means across any of the seven groups. This can be seen in figure 4-3. 100 Figure 4-3 Graphs of Dissociation, Sexual Concerns, Dysfunctional Sexual Behaviour and Trauma Reduction Behaviour Means - • - D I S - • - S C DSB -H-TRB / *A * <P / f * The Dissociation scale measures the degree of dissociation, which can be an avoidance tactic often below the level of conscious awareness (Briere, 1995). While there were no statistically significant differences among the means, there were spikes in the means scores in three groups, the 2<5 years, 10<15 years and the 20+ years group with the largest spike being in the 10<15 year group. These differences may have been statistically significant with a larger sample size. The Sexual Concerns scale measures sexual anxiousness and negative cognitions and behaviours during sexual activity. It does not measure sexual orientation or unwelcomed sexual contact (Briere, 1995). High scores on this scale may indicate that the subject either sexual dissatisfaction, problems or disorders. There were certainly no statistically significant relationships that would lead one to believe that there was any discernable pattern. 101 Dysfunctional Sexual Behaviour is a scale that is designed to measure sexual behaviour that in some way has become or is inherently dysfunctional or may cause the individual problems or concerns. High scores on this scale can be associated to childhood sexual assaults and may also be linked to high-risk sexual practices (Briere, 1995). There are no statistically significant differences between the group means on this scale. Incidentally the last three groups have significantly fewer women than the first four groups. The final scale is Trauma Reduction Behaviours, which measures a subject's abilities to self regulate negative internal feelings. It focuses on acting out behaviour and high scores can indicate a tendency to engage in potentially self-injurious behaviour. High scores can also be associated with diagnosis of Borderline or Histrionic Disorders (Briere, 1995). There were no statistically significant differences across the various group means. Again there may have been statistically significant differences if the sample size had been larger. Post Hoc Analysis of Support Measures During the data collection each respondent was also asked to complete a demographic questionnaire. While this was not intended to be a measure taken by a reliable and validate psychometric instrument is was designed to be an indicator for future research as to where the subjects felt their support originated. While it was not a part of the main question these results would certainly have implications for policy suggestions and coping strategies. 102 Tables 4.15, 4.16 and 4.17 show the responses to the support questions on the demographic questionnaire. Each table shows the breakdown by response for the entire population and also by sex. Table 4.15 Social Support Results Total(% of group) Male (%of group) Female(% of group) Low 8(4.1%) 7 (4.6%) 1 (2.3%) Medium 59 (30.4) 51 (33.8%) 8(18.6) High Total 127(65.5) 194 (100%) 93 (61.6) 151.(100%) 34(79.1) 43 (100%) Women appear to endorse high social support more often then men in this sample, while a larger percentage of men endorsed medium levels of social support. Social support was defined as support from friends. Table 4.16 Peer Support Results Total(% of group) Male (%of group) Female(% of group) Low 4(2.1%) 4(2.6%) 0 (0%) Medium 66 (34) 54(35.8) 12(27.9) High Total 124 (63.9) 194 (100%) 93(61.6) 151 (100%) 31(72.1) 43 (100%) 103 The rating for high peer support appears to be slightly higher on the part of the females. Table 4.17 Family Support Results Total(% of group) Male (%of group) Female(% of group) Low 7 (3.6%) 4(2.6%) 3 (7%) Medium 26(13.3) 22(14.5) 4(9.3) High Total 162(83.1) 195 (100%) 126(82.9) 152 (100%) 36(83.7) 43 (100%) Of all three areas of support, family support seems to be the one out that has the strongest endorsement in the high category among both genders. A Chi Squared analysis was considered however while there appears to be a difference between genders due to the considerable cells with small numbers or zeros there is little confidence in the p value of this statistical test. Critical Item Analysis The TSI also contains twelve Critical items within the one hundred test items that respondents answer. These items are important for diagnostic purposes Briere (1995) urges those who are interpreting these Critical Items that any non-zero response to these items has a potential to be a clinical issue. He therefore suggests that the clinician follow up these items. Thus without a qualitative interview to follow up non-zero responses, any conclusions about the responses must be very guarded as there is ample room for 104 interpretation in the questions from the respondents point of view. They are presented simply for the sake of interest. The three most commonly endorsed items were questions are presented first. Tables 4.18 through to 4.28 show the distribution of the responses on eleven of the twelve critical items. The critical item number 25, Threatening or attempting suicide was excluded as all of the responses from all useable tests were marked with zero. Table 4.18 Critical Item Number 19-Thought or fantasies about hurting someone Item Score Total (%) Male(%) Female(%) 6" 140 (71.%) 105(69.1%) 35 (81.4) 1 37(19.0) 30(19.7) 7(16.3) 2 13(6.7) 12(7.9) 1(2.3) 3 5(2.6) 5(3.3) 0 Total 195(100%) 152(100%) 43(100%) For the entire sample over 28% of the subjects endorsed this question with at least a response of a 1. For males it was over 29% while for females it was 18.3%. Table 4.19 Critical Item Number 58-Getting in trouble because of your drinking Item Score Total (%) Male(%) Female(%) 0 165 (84.6%) 126 (82.9%) 39 (90.7%) 1 26(13.3) 23(15.1) 3(7.0) 2 2(1.0) 2(1.3) 0 3 2(1.0) 1 (0.7) 1 (2.3) Total 195(100%) 152(100%) 43(100%) 105 For this item the percentage that endorsed this item with more than a 0 in the entire population was 15.3%. Males endorsed this item with at least a 1 in 17.1% of the cases while women endorsed this item with at least a 1 in 9.3% of the cases. Table 4.20 Critical Item Number 28-Getting in trouble because of sex Item Score Total (%) Male(%) Female(%) 0 175 (89.7%) 133(87.5%) 42 (97.7%) 1 15(7.7) 14(9.2) 1(2.3%) 2 3(1.5) 3(2.0) 0 3 2(1.0) 2(1.3) 0 Total 195(100%) 152(100) 43(100%) For this item just over 10% of the entire sample endorsed the question with at least a response of 1. While 12.5% of the males sampled endorsed this item in some way only 2.3% of the women endorsed it at all and all the women who endorsed it went only as high as 1, while men's responses ranged from 1 to 3. 106 Table 4.21 Critical Item Number 50-Sexual fantasies about being dominated or over powered Item Score Total (%) Male(%) Female(%) 0 176 (90.3%) 143 (94.1%) 33(76.7%) 1 17(8.7) 9(5.9) 8(18.6) 2 2(1.0) 0 2(4.7) 3 0 0 0 Total 195(100%) 152(100%) 43(100%) The total sample included 9.7% who endorsed this item with at least a response of 1. While for the men the percentage who endorsed the item with more than a 0 was 5.9% while for the women the percentage was 23.3%. Table 4.22 Critical Item Number 99-Thinking that someone was reading your mind Item Score Total (%) Male(%) Female(%) 0 180 (92.3%) 142 (93.4%) 38 (88.4%) 1 13(6.7) 9(5.9) 4(9.3) 2 2 (1.0) 1 (0.7) 1 (2.3) 3 0 0 0 Total 195(100%) 152(100%) 43(100%) On this item of the total sample 7.7% endorsed the item with a 1 response or higher. The male sample endorsed the item with a 1 or 2 response 6.6% of the time while the female sample endorsed the item with a 1 or 2 response 11.6% of the time. 107 Table 4.23 Critical Item Number 30-Wishing you were dead Item Score 0 1 2 3 Total Total (%) 187(95.9%) 6(3.1) 2(1.0) 0 195 (100%) Male(%) 145(95.4%) 5(3.3) 2(1.3) 0 152 (100%) Female(%) 42 (97.7%) 1 (2.3) 0 0 43 (100%) Only 4.3% of the entire population endorsed this item, an none of them responded with anything higher than a 2. For the men in the sample 4.6 % responded with a 1 or a 2, while the women only responded with a 1 and this accounted for only 2.3% of the women subjects. Table 4.24 Critical Item Number 90-Feeling like life wasn't worth living Item Score Total (%) Male(%) Female(%) 0 188(96.4%) 145(95.4%) 43(100%) 1 6(3.1) . 6(3.9) 0 2 0 . 0 0 3 1 (0.5) 1 (0.7) . 0 Total 195(100%) 152(100%) 43(100%) This item was also only endorsed at a higher than 0 level by men. When the entire sample was taken into account 3.6% endorsed the item with a 1 or higher. However, 108 when only the male subject's responses were examined, 4.6% actually endorsed the item with a 1 of higher. Table 4.25 Critical Item Number 65-Hearing someone talk to you who wasn't really there Item Score 0 1 2 3 Total Total (%) 190 (97.4%) 4(2.1) 0 1 (0.5) 195 (100%) Male(%) 147 (96.7%) 4(2.6) 0 1 (0.7) 152 (100%) Female(%) 43 (100%) 0 0 0 43 (100%) This critical item was endorsed at higher than the 0 mark only by men. When the entire sample was accounted for endorsement of 1 or higher occurred in 2.6% of the cases. However, when men alone were examined, 3.3% of the subset were seen as endorsing the item with higher than 0 scores. Table 4.26 Critical Item Number 40-Using drugs other than marijuana Item Score Total (%) Male(%) Female(%) 0 192(98.5%) 149(98%) 43(100%) 1 2(1.0) 2(1.3) 0 2 0 0 0 3 1(0.5) 1 (0.7) 0 Total 195(100%) 152(100%) 43(100%) 109 The total endorsement to this critical item with at least a 1 was 1.5% for the entire population. For the men, 2% answered with at least a while there were no women endorsing this item with anything other than a 0. Table 4.27 Critical Item Number 92-Seeing people from the spirit world Item Score Total (%) Male(%) Female(%) 0 192 (98.5%) 149 (98%) 43 (100%) 1 2(1.0) 2(1.3) 0 2 0 0 0 3 1 (0.5) 1 (0.7) 0 Total 195 152 43 (100%) This item was also responded to with a 1 or higher only by the male subjects. When the entire sample was examined 1.5% of the respondents responded with a 1 or higher. However, when just the male subjects were examined, 2% endorsed this item with at least a l . Table 4.28 Critical Item Number 48-Intentionally hurting yourself (for example by scratching, cutting, or burning) even though you weren't trying to commit suicide Item Score Total (%) Male(%) Female(%) 0 193 (99%) 151 (99.3%) 42 (97.7%) 1 1 (0.5) 0 1 (2.3) 2 1(0.5) 1(0.7) 0 3 0 0 0 Total 195(100%) 153(100%) 43(100%) no Only 1% of the total population endorsed this item with anything other than a 0. For the men the percentage endorsing it with higher than a 0 was 0.7 % while for women the same number was 2.3%, but the absolute numbers were very small, one in each subgroup. The analysis of the differences between males and females was considered by way of a Chi Squared test, however although there appears to be a difference due to the low frequencies and considerable cells with small numbers or zeros, there is little confidence in the resulting p values. Cells in the critical items could not be collapsed for the purposes of this statistical test for fear of blurring the interpretation misrepresenting the answers given by the respondents. I l l Chapter 5 Discussion Highlights of Results There are several aspects of the results that should be highlighted. There were statistically significant differences found between at least two groups in two of the validity scales, Atypical Response Level and Response Level. In addition there were statistically significant differences found between at least two groups on six of the clinical scales including, Anxious Arousal, Depression, Anger/Irritability, Defensive Avoidance, Intrusive Experience and Impaired Self Reference. In all six of these clinical scales the group with 10<15 years of experience had a mean that was statistically different from at least one other group in the sample. Of the three types of support that were questioned on the demographic questionnaire the largest total response percentage for high level of support came from Family Support, which was followed by Social Support and then by Peer Support. As for the Critical Item endorsement, while the absolute endorsement level was quite low, the highest non-zero endorsement was for the item concerned with having thoughts or fantasies about hurting others. The second most endorsed item was the one which concerned itself with getting into trouble because of alcohol while the third most frequently endorsed critical item had to do with getting into trouble due to sex. Comparison to the Literature^, There is a great deal of support in the literature for the findings in this study. The idea of a curvilinear relationship between^experience and stress symptoms is documented in several researcfearticles. Patterson (1992) Explained that officers in the intermediate 112 years had the highest stress scores because they had not yet formed adequate coping skills and that their job demands and responsibilities were taking more of a toll on them than officers with either less or more experience. In addition, he also stated that in the intermediate years the excitement and novelty of police work, which may have earlier served to counter stress symptoms, were now gone. Burke (1989) also found that officers between the range of six to fifteen years exhibited more stress related difficulties and he explained it by stating that the officers in the intermediate years of service may be feeling trapped due to limited skill sets and may also be defining self worth through the promotional competitions. Logan (1995) also found that the officers who were showing the highest levels of stress symptoms were the patrol members with between nine and twelve years of service. Volanti (1983) also labeled the sixth to thirteenth years of service as the Disenchanted stage of the officer's service. During these years they find that due to the widening traverse between what they idealize and what they realize the officer's disenchantment level grows and it fuels cynicism. He found that during this stage there was a positive relationship between stress symptoms and years of service. However, after this point he found that the symptoms became negatively related. Gaines and van Tubergen (1989) also showed that officers with intermediate levels of experience showed more stress symptoms from job specific events. There is also ample empirical support for the specific symptoms that were found in this study. Symptoms of anxious arousal were documented in traumatized officers (Reiser & Geiger, 1984; Ostrov, 1986). They were also documented in police officers diagnosed with PTSD (Kuch et al, 1995; Harvey-Lintz & Tidwell, 1997; Wilson, 1997). This finding was also documented in research that did not limit itself to police officers 113 with a diagnosis of PTSD but who showed similar symptom constellations (Robinson et al, 1997; Martin et al,1986;) Anxious arousal symptoms were also documented in officers who had been involved in shootings (Carson, 1987; Gersons, 1989, Loo, 1986;) as well as in rescue work (Foreman, 1990; Carlier, 1998; Alexander, 1993). Symptoms of depression were also documented among police officers in general (Wilson et al, 1997; Vulcano et al, 1984) as well as those who had faced life threatening situations (Sims and Sims, 1998) and among those who were self destructive (Allen, 1986) Anger and irritability were also symptoms that were well documented in the literature. These were seen in case studies with traumatized police officers (Ostrov, 1986) as well as with police officers and their ability to regulate their moods ( Mearns and Mauch, 1998) as well as when studies examined their views on the use of violence (Kop et al, 1999). Anger and irritable feelings were found among police officers involved in violent incidents (Smith and de Chesnay, 1994) as well as shootings (Solomon and Horn, 1986; Stratton et al, 1984; Loo, 1986; Leonard and Alison, 1999) and in rescue work (Wilkinson, 1983; Taylor and Frazer, 1982; Sims and Sims, 1998). Intrusive experience symptoms were frequently supported in the literature. The support for these types of symptoms included literature from that on the shattering of the police officer's assumptive world (Gentz, 1990) to the literature on police officers with PTSD diagnosis (Kuch et al, 1995; Harvey-Lintz & Tidwell, 1997; Wilson et al, 1997) as well as those with PTSD symptoms (Robinson, 1997; Martin et al, 1986). These symptoms were also found in the officers who had been involved in violent incidents (Sims and Sims, 1998) as well as those officers that had been involved in shootings 114 (Solomon and Horn, 1986; Carson, 1987; Loo, 1986; Parent & Verdun-Jones, 2000). Police officers involved in rescue work also showed these types of symptoms ( Taylor andFrazer, 1982). The symptoms of defensive avoidance were also documented in the same studies that have been referenced already. Defensive avoidance has been theorized in some literature (Van der Kolk, 1986) and documented with PTSD patients, police involved in shootings and rescue work as referenced with the same authors listed above. There is other documentation that is relevant and consistent with the findings in this literature. The use of alcohol as a coping mechanism (Burke, 1994) was referenced as well as its increased use after an incident (Sims and Sims, 1998; Smith and de Chesany, 1994). The use of alcohol by the police was also documented as it related to stress (Violanti, 1985) as well as its acceptance in the police culture (Richmond et al, 1999; Alexander and Walker, 1994; Pedergrass and Ostrove, 1986; Jackson and Maslach, 1982). In addition, there was academic support for the concept of support systems for the officer ( Graf, 1986) and that support from specific individuals helps to reduce the negative effects of stressful events. Discussion of Results The discussion of the specific results of this study is organized by specific group. Symptoms that were statistically significant are highlighted, followed by empirical support, from the literature if any has been found. Finally I will add my own intuitive and experiential perspectives, from a police officer's point of view. 115 Recruit group The Recruit Level group consistently had the lowest scores in most of the scales. The only scale in which their mean was significantly higher was Response Level, where they had the highest score of all the groups. It was statistically higher than the means for the groups 15<20 and 20+ years of experience. This group's mean for Depression, Anger/Irritability, Intrusive Experience and Defensive Avoidance were all statistically lower than at least one other group. These findings are consistent with the literature. Paterson (1992) had stated that these are new officers who have not yet been in policing long enough for stressors to bother them. In addition, he stated that any symptoms of stress may be over shadowed by the excitement of starting this new career. As Kopel (1997) demonstrated there is a positive relationship between length of service and the number of stress symptoms that were demonstrated by police officers. This group was sample of new recruits on the verge of beginning their practicum, having just completed their first eleven weeks of training at the police academy. While the low means on the various traumatic symptoms scores are consistent with the existing literature, the high score on the Response Level validity scale is something on which there appears to be a paucity of research. From my own experiences as a police officer, having been one of these recruits approximately seventeen years ago, the mean for the Response Level scale is reasonable. Recruits are most often guarded in their responses to other senior officers for fear of standing out as problematic. Most have worked a number of years to obtain not only the academic requirements but also the volunteer experience and other requirements that are 116 necessary to successfully navigate the selection process. They are socialized to understand that their every action will be scrutinized. At any point during their 18 month probation period they may be dismissed. As a result, they may be very conscious of creating a less than favourable impression among the senior members of the police department. These impressions can often follow an officer through their entire career. Thus one explanation for this high Response Level mean could be in an attempt to appear overly normal, the recruits may have been reluctant to endorse any item and as a result drove up their Response Level scores by not endorsing items that the majority of test subjects should endorse with more than a zero. 0<2 years group The mean scores for the group 0<2 years shows that some changes take place in the first two years of police service. While approximately the first eight months are spent at the recruit training level, this group has had up to a sixteen months of actual street experience. Many of the score on the various scales have gone up, but none significantly from the recruit group. This may be attributed to the first exposure for many of these police officers to the various traumatic events. The reason that this pattern is inclining may be accounted for by the research of Patterson (1992) who states that the negative emotions have not yet had time to amass and that the excitement of the new experiences serves to wash out or at least delay the effects of exposure to traumatic incidents. Everything is new and exciting for this group. Some of these officers may have only been exposed to minor events and may have not yet had to experience traumatic events. Many of the means were still lower than the means for other groups. The mean score on 117 the Depression scale was statistically lower in this group as compared to the 10<15 and the 20+ groups. The means for Intrusive Experience and Defensive Avoidance were also significantly lower in this group as compared to the 10<15 years group. This group is very distinctive. From my own experience the picture painted by Patterson (1992) is a conservative one. The work for these officers itself becomes all engrossing and some young police officers seem to appear to be consumed with all things that are related to police work. This may involve everything from buying police paraphernalia in order to better look the part, to staying at work late to complete paperwork, to associating with only other police officers, to neglecting anything that does not directly affect their roles as police officers. This level of enthusiasm does eventually subside but it may certainly be powerful enough to counter any adverse effects of stressful events. 2<5 years group. For the group 2<5 years mean scores on scales rose and actually peaked for the first time. The mean for the Anger/Irritability scale was significantly higher in this group as compared to the recruit group. Scores on other means also rose but not to a statistically significant level. The research suggests that there are several things that may drive this degree of anger and irritability up. Exposure to traumatic events may account for some of the anger (Leonard and Alison, 1999; Ostrov, 1986; Solomon and Horn, 1986) as well as ineffective coping strategies ( Lowenstein, 1999; Mearns and Mauch, 1998, Kopel and Friedman, 1997; Burke, 1994). Anger could also originate from involvement in rescue 118 work (Wilkinson, 1983, Taylor and Frazer, 1982) and exposure to danger while involved in crowd control (Sims and Sims, 1998). Moreover, as suggested by Gaines and van Tubergen (1989) younger officers may be bothered more than more experienced officers by the host of organizational stressors that were referred to in the literature review. From my own experience, at this point these police officers have been on the road for as much as four years and four months and have likely experienced a number of different traumatic events and have been exposed to a number of stress inducing events that are inherent to police work. They may have also begun to feel the internal pressures of administrative stressors from within the police department. This group has also now had enough time to be frustrated with aspects of the organization and with the court system (Alkus and Padesky, 1983). By this time they have likely been to give testimony in court and had to deal with prosecutors, defense lawyers, judges and court schedulers, all of which have the potential to" anger these young officers. They could also be angry at the lack of appreciation and lack of departmental resources (Volanti and Aron, 1994). Their excitement and enthusiasm, that had previously served to dissipate the harmful effects of stressors, may now start to wane. The proverbial "Honeymoon" seems to be over. The beneficial effects of the novelty of the work have likely worn off and these officers are likely beginning to experience the cumulative effects of multiple stressors, which may be both operational and administrative in nature. 5<10 years group In the group 5<10 years of experience several of the scores on the scales seem to be decreasing. The significant differences for this group are that the mean score on the 119 Anxious Arousal scale is significantly lower when compared to the group 10<15 years. The means scores on the Intrusive Experience and Defensive Avoidance scales we're also significantly lower for this group when compared to the 10<15 year group. Little empirical evidence was found to explain the profile of this group. However, again based on my own experiences this group is now maturing in their role as police officers. The group 5<10 years may be developing and successfully using coping mechanisms that were alluded to in previous research such as Robinson et al (1997). They have discovered, possibly through trial and error, what techniques are better suited to them individually than others, not to say they are not necessarily adaptive. These techniques may serve them well for several years or possibly for the remainder of their career. While the scores are not significantly lower than the previous group they are lower than in the 10<15 years group. Another explanation for this difference may be a phenomenon that is particular to the Vancouver Police Department. Around the five-year mark patrol officers may begin to recognize or develop expertise in specific areas such as Traffic Enforcement, Surveillance or Drug Enforcement. These interests are often cultivated and the officers may apply for and are often successful in obtaining transfers to specialty squads that offer not only new challenges but are not as service call dependent as the Patrol positions. This movement can be seen in table 4.04 where in Group 4 (5<10) begin to show a difference in their total experience versus patrol experience. These specialized assignments can seen to be more prestigious than patrol assignments with better working conditions and shifting hours (Patterson, 1992). Officers who choose to stay in Patrol may also develop niches within the Patrol function and become quite competent. They may be feeling a greater level of comfort and confidence with their 120 ability to perform the Patrol function and may be seen as experienced Patrol officers by newer officers. This may also to affect lower scores on the different scales. Other transfers also become available at the 5<10 year mark including those in Support positions such as Recruiting, Investigations Division and Administrative Support. These positions are often less stressful than Patrol positions in the type of work that is required and the hours during which it performed. Patrol officers who do transfer into higher stress positions such as Emergency Response Teams, Forensic Identification Unit or Collision Investigation for example also have the benefit of the comradery of small, specially trained and highly cohesive units. The beneficial effect of such tight knit groups is documented in Solomon & Mastin (1999) and Zizzo (1985). 10<15 year group In the group 10<15 many of the scales peak and many of the mean scores show statistically significant differences when compared to the mean scores of other groups. Of any of the groups this is likely the group that has the most concerns in terms of trauma symptoms. The mean Atypical Response score in this group is the highest of any group. It is significantly different from the mean of the recruit group. While this could be indicative of an attempt by the 10<15 year group to over-endorse certain items, another possible explanation for this high score could be an extreme distress level. The mean score for Anxious Arousal is also the highest in this group and it is statistically larger than the mean for the 5<10 year group. These are items that indicate endorsement of hyperarousal items. The mean score for Anger/Irritability for this group is significantly higher than the mean for the recruit group. The mean score on the Depression scale was 121 also significantly higher than the mean for the group 0<2 years. The means score on the Intrusive Experience scale were significantly higher than the means for the recruit group, 0<2 years group, 5<10 years group, 15<20 years group and the 20+ years group. The means for Defensive Avoidance for this group was significantly higher than the recruit group, the 0<2 years group, 5<10 years group and the 15<20 years group. On the scale Impaired Self Reference this group also showed a significantly higher mean than the group 15<20 years. This group encompasses several groups that have been identified in previous research as having elevated stress scores including; Patterson (1992) who highlighted officers with eight to eleven years of service, Burke (1989) who high lighted officers with six to fifteen years of service, Logan (1995) who highlighted patrol officers with nine to twelve years of service, Robinson et al (1997) who highlighted officers with less than eleven years of service, and Volanti (1983) who highlighted officers in six to thirteen years of service, who he referred to this as being the Disenchanted Phase. Moreover, officers who have this level of service have a higher probability of having been involved in either traumatic incidents, shootings or rescue work as laid out in the literature review. This group appears to be experiencing the most distress of any group. They are exhibiting high levels of Atypical Responses, Anxious Arousal, Anger/Irritability, Depression, Intrusive Experience, Defensive Avoidance and Impaired Self Reference. Based on my experience as a police officer who has until just recently been in this group, there are several explanations that could account for these spiked scores. First, some members of this group may still be working in the Patrol function and the cumulative effects of repeated exposures may now becoming apparent. They may have had several 122 incidents that have similar themes and these events and their effects are becoming cumulative for the individual officer. Second, the individuals in this group may have also returned to the Patrol division after a tour of duty or several tours in specialty squads. In the specialty squads they likely enjoyed greater freedom and flexibility in assignments and hours than is available to them in a Patrol function. Upon returning to a Patrol function, nick-named the "harness bull" position within police circles, police officers are not only regimented to a strict shift schedule they are often directed as to what duties they can and cannot perform and where they must perform them. In addition, previously unresolved incidents that they experienced while in patrol for the first rotation may also have the potential to be reactivated when they return to a similar function. Furthermore, officers finding themselves back in Patrol may also find it does not carry the glamour or prestige that some specialty squad positions carry, by virtue of their high profile assignments. Regardless of where their service has been performed the members of this group have had at most almost fifteen years of police service during which they have been exposed to a host of daily stressors and possibly several traumatic incidents along with a host of administrative and institutional stressors. The data does seem to support at least the proposition that traumatic events are cumulative in nature. Third the members of this group may also be feeling the pressure to compete for their first promotion. In the Vancouver Police Department this is the period of time when an individual seeking promotion should realistically be pursuing it. The push to compete for the Sergeant's level promotion may be coming from well meaning supervisors or co-workers as well as marital partners. The increased pressure from a spouse or partners can partially be due to the spouse comparing their police partner to non-police friends who ' 123 may have already achieved several promotions by similar points in their own civilian careers. Promotional competition involves the officer having to take more academic courses, participating in interviews, assessment centers and putting in extra time and effort, all with the hope that superiors will recognized the overt displays of initiative. As Burke (1989) accurately states that not only is the officer likely to tie promotion into self worth but they are likely to feel discouraged when they realize that the job they have come to believe is the ultimate vocation, has very few transferable skills outside the Criminal Justice System. If one were to transfer to a different part of the Criminal Justice System it could be seen as a demotion, since many people who had unsuccessfully tried to be police officers have had to settle for other positions within the Criminal Justice System. Fourth, there are likely many normative pressures that occur for many people at this age. These may include marital discord, concerns with raising children and child minding when both parents are working or for the single parent family, economic concerns or pressures. Furthermore, the health of the officer's parents and the health of the police officers themselves may start to become a concern at this point in the officer's career. Thus this group has a huge potential to be exposed to a variety of stressors that may very well interact with each other. As seen by the elevated Impaired Self Reference score this group may also be in the midst of now redefining their previously defined sense of self and their place in the world. Fifth, police officers who have been problem performers may finally be encountering challenges to their previously unchallenged methods and behaviours. In speaking with other police officers, the practice of transferring problem performers was agreed to be a 124 frequent practice in the past. With new systems of increased officer accountability and progressive discipline, these problem performers may be now encountering attempts at corrective actions and coaching from supervisors that should have been addressed earlier in their career. While all of these theories are based on my own experience, they should have to be confirmed through qualitative research. 15<20 years group For the group 15<20 years many of the scores came down from the scores found in the previous group. The mean score on the Response Level for this group is significantly lower than the recruit group. This group may feel significantly less guarded than the recruit group and feel as if they are free to answer the test items honestly without fear of reprisal. Another explanation for this lower score is that this is the group in which I fit into and thus this group may trust me more since they represent my own peers in terms of similar years of service. The mean for this group on the Anger/Irritability was significantly lower than the 2<5 years group. The mean score on Intrusive Experience was also significantly lower in this group when compared to the 10<15 years group as are the mean scores for Defensive Avoidance and Impaired Self Reference. The research supports the concept that officers in this stage of their career are apt to feel fewer stress symptoms. Patterson (1992) showed that stress symptoms were reported with less frequency after eleven years of service, while Burke (1989) stated that police officers with more than fifteen years of service had less of a tendency to report stress related difficulties. Robinson et al (1997) also found that officers with less than eleven years of service exhibited greater symptomology while Logan expressed that after twelve 125 years the stress levels of police officers in his study dropped. Violanti (1983) calls this the Personalization Stage, where officers now shift their focus and energy inwards away from the demands of police work. Based on my own experience there may be several reasons as to why the scores on some of the scales have fallen. It may indicate that this group has achieved some level of resolve with some of the issues that were plaguing them when they were in the previous group, assuming they are similar to the research group with 10<15 years of experience. They may have been successful in promotional endeavors, feel better prepared for future competitions or may have decided that they would rather not pursue promotional opportunities. This last option has become more of a possibility within the last six to seven years in the Vancouver Police Department with the advent of the Detective/Constable position, where Constables are now allowed to compete for Investigative positions that had been traditionally only available to Corporal/Detectives. In addition, there has been the implementation of incremental pay levels, where Constables, by taking a required number of post secondary courses and writing standardized departmental exams, can achieve the same pay grades as the Detective/Corporal. This has removed the solely financial motivation to be promoted to the Corporal/Detective level. With the increased flattening of the organization the Corporal/Detective Rank is being grand-fathered out and the first promotion sends the Constable directly to the Sergeant level. This promotion can also serve to limit the range of possible assignments within the organization. Therefore, Constables are more likely to stay at the Constable level, be paid what the Detective/Corporal rank once earned and have a larger range of desirable work assignments to choose from. They may also have 126 now found themselves an assignment in which they are happy and that is congruent for their coping style and resources as well as it demands and their personal lives. They may better know who they are and be more at peace with this concept of self. Volanti (1983) refers to this as the Personalization stage. Their focus has turned away from the police department and turned towards themselves and their families. If they have children, these children may be getting older and are now demanding more of the officer's off duty time, which also facilitates the shift away from police work. As a result he states that their stress level is lowered. Logan (1995) also documented that as RCMP officers progressed through the ranks their focus and subsequent stressors were more related to their families. -Those who may have been experiencing high levels of distress and found themselves unable to cope may have left policing. As a result the remaining officers were those who could cope effectively. Patterson (1992) proposed this explanation of self selection in his research. 20+ years group Finally for the group 20+ years many of the scales remain relatively unchanged. The mean score for the Response Level in this group is significantly lower in this group than the recruit group. Again, as in the previous group this group may feel more comfortable with answering the questions and with me as the researcher. On the Depression scale this group's mean is significantly higher than the mean for the recruit and 0<2 years groups. In addition, this group's score on Depression was the highest of all the groups. In terms of Intrusive Experience this group is significantly lower than the score for the group 10<15 years. 127 As referenced in the previous section, the empirical research shows that this group should have fewer stress symptoms. Violanti (1983) calls this stage the introspection stage. Gaines and van Tubergen (1989) proposed that this stage occurs earlier in the officer's career, around the twelfth year, but this data does not support that conclusion. Mayes et al (1991) found that depression in older employees decreased once they had more responsibility for others and a leader production emphasis. Older officers were also more likely than younger officers to used problem focused coping strategies and appraise events as within their own control (Anshel et al, 1997). Based on my experience there may be several explanations for the scores for this group. On the positive side these officers know their job and they know the system, in terms of what can and cannot happen to them. They are likely comfortable in their jobs. As suggested by Violanti (1983) they have turned their focus inwards and reflect back on their career. Some look forward to retiring and have begun to work towards setting themselves up for post retirement activities, be they vocational or recreational. Many have also secured themselves dayshift positions and no longer have to contend with the perils of working shift work. They may also have learned to cope with past traumatic events, not to say that these are necessarily resolved and may be subject to reactivation given the right set of circumstances. The factors responsible for the Depression score may be different from those within other groups. First, this group may be harboring some residual symptoms. While they are no longer in stressful assignments, they may still have unresolved issues that are starting to regenerate symtomology that was picked up by this instrument. These symptoms may be the result of specific traumatic incidents, cumulative effects of day to day stress, 128 traumatic stressors or administrative injustices. Second, this stage in their career may carry its own worries and stressors. Volanti (1983) referred to this stage as the Introspection stage, where police officers look back on their own careers. Possibly the officers in this stage may have regrets as to things they wished they would have done over the course of their careers and were prevented from doing by specific individuals or administrators. Third, the officers in this stage may also be realizing that they have come as far as they are going to and attempts at further promotions have been unsuccessful. Fourth, the officer's health, the health of the officer's spouse and health of the officer's parents along with the welfare and demands of any children may also have become issues of concern. In addition, the concerns around retirement and leaving the police department may also be wearing on this officer. For so many years they have defined themselves by what they do and now this is coming to an end. The officer may begin a pre-retirement mourning. This may again cause the officers to redefine their sense of self. Demographic Questionnaire Support Items The support indicators from the demographic questionnaire indicate that the largest group to which the sample attributed high support were members of their own family. The important implication of this finding is that when the officer loses the support of this family, usually through marital discord three options are available. Have the other two support systems compensate, those being peers and social networks, find a new surrogate family or cope by themselves without any additional assistance. All three options present their own sets of unique challenges and difficulties. 129 . Critical Items As for the endorsement of the Critical Test items there are several interesting findings. The most endorsed item had to do with having thoughts about hurting other people. While on the face this could cause one concern, the emphasis should be noted that the question asks only about actually having the cognitions and does not actually ask if the person has acted upon them. With the police officers often being asked to deal with, arrest and question suspects who have committed horrible acts, this thought processes would be quite normal. The problem of stifling these emotions may cause problems for the police officer in the long term. The police officer can be left with anger and frustration, which they must address or else these emotions are left to fester. This build up may lead to some of the symptoms that have been outlined in this study. Kop et al (1999) found that there was a positive attitude towards the use and feelings about the use of violence and burnout levels. Thus the attitude that was found in the study may be an indicator of burnout. The second most endorsed item was trouble the officer had become involved in due to drinking followed by trouble because of sexual practices. The endorsement of the item concerned with the officer getting into trouble because of drinking does support the idea of the use of alcohol by police as a coping mechanism. However, it may understate the actual number of officers who have used alcohol to cope since it only deals with officers who have gotten into difficulties as a result and does not deal with more general users of alcohol. Sexual activity may be seen as acting out behaviour or a behaviour endorsed in the cultural bounds of policing, as is the use of alcohol. The predominant endorsement of these items was by male officers. There was some minor endorsement of Critical items that dealt with auditory and visual hallucinations, that could support some prevalence of psychotic process, but any such conclusions are difficult to make without following up with the specific individuals and exploring the actual reason for their endorsement. Comments by Respondents It is useful to highlight several impromptu comments made by subjects after they had returned their tests. The researcher obtained oral permission to use the flavour of these comments in this section to add to the richness of the findings. Several indicated that there should be questions for police officers to deal with coping strategies such as alcohol and prescription drugs. Several made reference to the cumulative nature of events they had encountered and how these events were affecting them today as compared to several years ago. There was also an indication by senior police officers that if the test had been given to them earlier in their career that their scale scores would be much higher. A general mistrust of the police department and testing was communicated to me and that had this instrument not been presented personally by this researcher that it would likely have never been completed had they not had trust in me as the researcher. Limitations There are a number of limitations with this study that should be noted, besides those normally associated with using a self report measure. First, the number of women subjects was not constant across the seven groups. There was solid representation of females in the first three groups, it fell drastically in the fourth and fifth groups and there 131 were no females in the last two groups. While this is the result of smaller numbers of females available to draw on in the last four groups, it prevented the comparison of how males and females responded, across the seven groups. While it would have been possible to purposely load the last four groups with more females by picking them specifically this would have compromised the randomness of the selection process and the generalizabilty of the results. This problem will eventually correct itself as the larger number of females works it way through the department ranks. A related problem was also the number of subjects in each group. While most groups ranged in number from 28 to 31 subjects, the group 2<5 only contained 23 subjects and the group 0<2 years only contained 26 subjects. Ideally future research would have larger numbers in all groups. Second, the recruit group had already attended approximately twelve weeks of training and thus their socialization process had begun. A truer reading of their levels may have been obtained if they had been tested prior to them attending any training. Third, the sample could not be divided into patrol and non-patrol sub-groups for fear of the loss of their anonymous status with the researcher. A more accurate picture of the implications of patrol versus non-patrol on traumatic symptoms could have been ascertained if the subjects had provided their actual service records. However, this would have jeopardized their anonymity since the researcher may have been able to deduce who some of the subjects were based on the present and pattern of past service. Fourth, the study was done only with members of the Vancouver Police Department. The generalizability of all the findings may be limited to Canadian police departments that are similar to the Vancouver Police Department in their demographics, 132 organizational structure and workload. Smaller police departments may find some similar results if the study was replicated in their departments. Fifth, the support measures that were captured on the demographic questionnaire were not recognized and reliable instruments that had been normed and validated. They were only included to provide an indication of sources of support. Sixth, there were no structured interviews conducted with the test subjects. The TSI does not indicate from what traumas or events the specific symptoms originate. Interviews could have yielded such rich information such as the sources of stress for the different groups and whether it came from within the department or from external sources, the nature of the endorsement of the Critical Items and coping strategies for the different groups. Interviews were prohibitive due to the large sample size and the initial polling of several officers, who did not participate in the study, but indicated that given the researcher's position as a supervisor within the Vancouver Police Department, the subject's anonymity could be comprised in an interview. In addition, the researcher and subject may be placed in a conflict position if the two were ever found to be in an employee/supervisor role in the future. Future Research Implications There are several areas in which future research should concentrate as a result of the findings in this study. First, it would be fruitful to conduct structured interviews with members of each group. Qualitative research among these groups would help to identify the sources of stress for the members of the different groups. It would also allow the exploration of the Critical Item endorsement and coping strategies. Second they would be useful in helping to distinguish between the symptom patterns of patrol based officers 133 versus non-patrol based officers. It would also be important to find out where in the city officers have done their patrol time and during what stage of their career. Third, it would also be beneficial to compare Constables against Sergeants as previous research does indicate there is a difference in the stress level experienced by the two groups (Beerh, 1989; Haward, 1994). Fourth, the prevalence of alcohol use and prescription medication as coping devices was not adequately measured by this study. These would be useful item to co-vary with the various clinical measures of stress symptoms. Fifth, this study could be replicated with not only larger numbers of subjects within each group but also with an additional group, retired police officers. It would be useful to examine how retirement has affected different officers and how it has affected their symptom constellations. Finally, it would be very useful to measure the clinical levels of individuals in high stress specialty squads and compare their results to patrol members who would be matched for demographic and service characteristics. It would be important to know how the high stress placements actually affect the police officers and what mediating variables, if any, are at work to counter the effects of the position's stressors. Recommendations The results of this research study indicate that three groups, 2<5 years, 10<15 years and 20+ years showed elevated trauma symptom levels. It is this researcher's position that the Vancouver Police's psychological resources and funding should include these three target groups. There are several ways in which this could be done. First the Vancouver Police Department should consider stress inoculation training. New police members should receive mandatory stress inoculation training against there own previous 134 stressful events, designed to aid in the prevention of their own stressful events being re-activated by job related traumas. In addition, experienced police members should receive stress inoculation training at specific periods over their career, but at least at the two year mark and definitely before the ten year mark. This could address any traumas that have been activated by incidents they have been involved with. Providers of such training should determine the major sources of stressors for each of these individuals and groups and then provide them with the tools necessary to combat the effect of these stressors. Second, the Vancouver Police Department should consider providing regular training and information sessions to spouses, partners and family members of the police members. This service may be provided in conjunction or as an addition to the services provided for the police members. As with the police members, these groups should be canvassed as to the sources of their stress and provided with tools and a forum to learn about how best to deal with these stressors and their effects. Third, the Vancouver Police Department should consider the promotion of the psychological wellness of its members through the use of a Coordinator of Psychological Services. This individual could oversee the various psychological wellness programs that could be initiated and maintained. 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Psychological intervention and specialized law enforcement groups. Emotional First Aid 2(1). 25-27. 147 Appendix A: Informed Consent Form A Masters Thesis research study on the prevalence of trauma symptoms in police officers in the Vancouver Police Department. Description of the Research: The purpose of this study is to measure the prevalence and severity of trauma symptoms among sworn members of the Vancouver Police Department. The study will compare the results of members with different levels of experience to determine if a statistically significant difference exists between police officers with different levels of experience. The study will also examine if there is a difference between genders and attempt to determine when in a Vancouver Police Officer's career these symptoms peak. This research will be helpful in determining when a police officer can benefit most from mental health resources. You have been chosen to complete a test called the Trauma Symptom Inventory, along with a short demographic questionnaire. The demographic questionnaire is designed not to identify the subject but to assist in the research by providing a number of variables that could help to account for an individual's score. As you can see the only identification on the two forms is a number. Please do. not put your name on either form. No attempt will be made to identify the member filling out each form and to help assure complete confidentiality no list will be kept to identify the number of the form completed by each member. The data will be available to me, Jessbir Ram, the co-investigator in the study and to my faculty supervisor and principal investigator Dr. Larry Cochran. The data will be secured in my personal computer with a password. In addition, upon completion of the research the data will be destroyed. Dr Cochran may be reached at the department of Counselling Psychology at the University of British Columbia at 822-5259. Please realize that participation in this research is completely voluntary and it will take approximately thirty minutes to complete the two forms. Completion of the test and demographic survey implies consent to participate in the research. 149 Appendix B; Demographic Questionnaire Please complete all items and do not place your name on either form 1. My age is years. 2. Sex (circle one) M F 3. Years of completed police service years. 4. Years of service in each division Operations Division years Operational Support Division years Administrative Support Division years 5.Of your years of patrol service please indicate the number of years spent in each patrol district. District One years District Two years District Three years District Four years 6. Indicate the number of times, if any you have received intervention from the Post Critical Incident Trauma Team (PCIT Team). Times 7. Please indicate the level of education you have completed by circling the one that applies to you a. High School b. Up to 2 years College c. Diploma d. Undergraduate Degree e. Graduate Degree 8. Please indicate which best applies to you by circling the best response. I would rate my level of family support as: High Medium Low I would rate my level of peer support as: High Medium Low I would rate my level of social support as: High Medium Low (friends) 150 Appendix C: List of TSI Scales (Briere. 1995) Validity Scales Response Level Consists of number of zeros for those items least likely to be endorsed with a zero response in a standardized sample. Atypical Response Consists of least commonly endorsed or bizarre items. Inconsistent Response Consists of absolute difference between 10 pairs of items that are likely to be endorsed in a similar fashion. Clinical Scales Anxious Arousal Records Symptoms of anxiety especially hyperarousal. Depression Records depressive symptoms. Anger/Irritability Records anger and irritability affect, thoughts and behaviours. Intrusive Experience Records intrusive PTS symptoms. Defensive Avoidance Records PTS avoidance in cognitive and behavioural aspects. Dissociation Records dissociative symptoms Sexual Concerns Records sexual distress Dysfunctional Sexual Behaviour Records sexual behaviour that is in some manner dysfunctional Impaired Self Reference Records problems with sense of self Tension Reduction Behaviour Records maladaptive methods of reducing internal tension Appendix D: TSI Critical Items (Briere, 1995) Item Number Item Text 19 Thoughts or fantasies about hurting someone 25 Threatening or attempting suicide 28 Getting into trouble because of sex 30 Wishing you were dead 40 Using drugs other than marijuana 48 Intentionally hurting yourself (for example by scratching, cutting or burning) even though you weren't trying to commit suicide 50 Sexual fantasies about being dominated or overpowered 58 Getting in trouble because of your drinking 65 Hearing someone talk who wasn't really there 90 Feeling like life wasn't worth living 92 Seeing people from the spirit world 99 Thinking someone was reading your mind 

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