Associations between mindfulness, posttraumatic stress disorder symptoms, and posttraumatic growth in police academy cadets: An exploratory study.

Mindfulness-based treatments have been increasingly noted in the professional literature as a possible means to reduce posttraumatic stress disorder (PTSD) symptoms and promote well-being, especially among law enforcement officers. Scant research, however, has been conducted to study dispositional mindfulness and health outcomes in police cadets. The current exploratory study examined the association between the various facets of dispositional mindfulness (i.e., observing, describing, acting with awareness, nonjudging, and nonreactivity) and PTSD symptoms, posttraumatic growth (PTG), and other variables, including world assumptions, in police cadets (N = 379). Consistent with findings from previous studies of experienced officers, the results indicate that (a) mindful nonjudging is a salient trait in police cadets, which uniquely predicted lower PTSD symptoms, ß = -.31, p < .001, and was related to lower levels of PTG, r = -.12, p = .025, and (b) mindful observing was related to higher levels of PTSD symptoms, r = .14, p = .009 and higher levels of PTG, r = .26, p < .001, in the present sample. In addition, the findings demonstrate that nonjudging is an important trait in police cadets regarding world assumptions such that nonjudging was a significant, unique predictor of world assumption facets, including controllability of events, ß = .15, p = .025, and trustworthiness and goodness of people, ß = .18, p = .004. Clinical implications, including the importance of understanding the association between mindful nonjudging and the shattering and rebuilding of worldviews and following trauma reactions, are discussed.

Trauma-Related Sleep Problems and Associated Health Outcomes in Police Officers: A Path Analysis.

Police officers are frequently exposed to two different types of potentially traumatic events: one dealing with physical threats to self and the other involving the witnessing of harm to others. These different types of traumatic experiences are thought to produce various posttraumatic reactions. Furthermore, sleep problems are also reported as a hallmark of posttraumatic stress disorder. There is evidence, however, that sleep problems may mediate the relationship between posttraumatic stress disorder symptoms and health outcomes, especially physical health and depression. Previous research has shown this to be the case among officers from large urban agencies. The purpose of the present study was to test a model involving a pathway from trauma type and posttraumatic stress disorder symptoms to physical health and depression that is mediated by sleep quality in officers (N = 193) using data from small- to mid-size police agencies. Results revealed that sleep problems served as a mediator between posttraumatic stress disorder hyperarousal and avoidance symptoms and health outcomes, that the trauma types are related to different posttraumatic stress disorder symptoms, and that complicated relationships exist between the study variables. In addition, the results indicated that approximately 25% of our sample displayed probable partial posttraumatic stress disorder or probable full posttraumatic stress disorder, causing substantial functional impairment. Suggestions for improving officer health and performance in the field are provided. Specifically, it appears that interventions designed to address posttraumatic stress disorder hyperarousal symptoms related to personal life threat and the posttraumatic stress disorder avoidance symptoms related to the witnessing of human suffering may maximize officer sleep quality and ultimately overall wellness. In particular, mindfulness-based interventions are well suited for addressing these symptom clusters.

The Role of Moral Injury in PTSD Among Law Enforcement Officers: A Brief Report.

Exposure to critical incidents and hence potentially traumatic events is endemic in law enforcement. The study of law enforcement officers' experience of moral injury and their exposure to potentially morally injurious incidents, and research on moral injury's relationship with different forms of traumatization (e.g. compassion fatigue, post-traumatic stress disorder) are in their infancy. The present study aims to build on prior research and explores the role of moral injury in predicting post-traumatic stress disorder (PTSD) and its clusters thereof. To this end, a sample of law enforcement officers (N = 370) from the National Police of Finland was recruited to participate in the current study. Results showed that moral injury significantly predicted PTSD as well as its diagnostic clusters (i.e., avoidance, hyperarousal, re-experiencing). The aforementioned role of moral injury to significantly predict PTSD and its clusters were unequivocal even when compassion fatigue was incorporated into the path model. Clinical, research, and law enforcement practice implications are discussed.

Posttraumatic Growth in Relation to the Frequency and Severity of Traumatic Experiences Among Police Officers in Small to Midsize Departments.

The Critical Incident History Questionnaire (CIHQ) measures, through multiple measurement methods, the severity and frequency of traumatic events experienced by law enforcement officers. We, however, found no studies utilizing the CIHQ to examine posttraumatic growth (PTG) as measured by the Posttraumatic Growth Inventory. The purpose of this brief report was to assess the strength and direction of the relationships between PTG with trauma frequency, trauma severity, and health variables, including subjective traumatic stress, relationship stress, nontraumatic work stress, posttraumatic stress disorder (PTSD) symptoms, depression, and alcohol use among law enforcement officers (N = 193) from small and midsize agencies. In addition, we sought to explore differences between cognitive and behavioral PTG. Based on results from bivariate and multivariate analyses, we found that an idiosyncratic view of trauma severity shaped by personal experience demonstrated the strongest relationship with PTG among the frequency and severity variables and that increased PTG was not associated with reduced psychological distress. Alcohol use, a variable that is assessed primarily through behaviors compared with cognitions, was not significantly associated with PTG. Overall, the findings of this study demonstrate the importance for future research to consider both the frequency and severity of trauma exposure in the development of PTG and its impact on health outcomes.

Mindfulness-Based Psychotherapy Approaches for First Responders: From Research to Clinical Practice.

First responders are psychosocially burdened with work-related stressors that occur frequently during required duties. Related mental health difficulties, such as direct and vicarious trauma, depression, and interpersonal problems often affect first responders' ability to perform effectively, and their personal lives may be disrupted. Mindfulness-based interventions have been shown to directly promote first responders' mental and physical health while providing increased resilience when facing work-related stressors. This article summarizes mindfulness-based benefits and empirical research related to first responders, using law enforcement officers as one specific example. Two specific mindfulness-based psychotherapies are introduced, as are generalizable mindfulness techniques useful for first responders. Psychotherapists can use these empirically supported treatment approaches to help first responders understand and incorporate awareness-based, nonjudgmental, and present-centered mindfulness techniques during critical incidents and while off duty as resilience-building mechanisms.

Relationships among traumatic experiences, PTSD, and posttraumatic growth for police officers: A path analysis.

OBJECTIVE: Law enforcement officers tend to be exposed to a high frequency of potentially traumatic incidents. A dichotomous distinction among these events involves the witnessing of threat or harm to others and the experiencing of threat or harm directly to oneself. Past research suggests that different types of trauma exposure produce varying levels of negative posttraumatic responses including posttraumatic stress disorder (PTSD) symptoms and positive outcomes such as posttraumatic growth (PTG). With the goal of better assisting officers experiencing posttraumatic stress, enhanced knowledge regarding this psychological response to the development of PTG is necessary. METHOD: The purpose of this study was to test a proposed model involving a pathway from type of trauma exposure to PTG that is mediated by PTSD symptoms among law enforcement officers (N = 193). Differences among cognitive PTG and behavioral PTG as our dependent variables, with age, marital status, and relationship stress as control variables, were assessed. RESULTS: Findings indicate that events involving threat to self are more closely related to PTG, via an indirect pathway through PTSD symptoms. Additionally, personal relationship stress was directly associated with PTSD symptoms and behavioral PTG, but not cognitive PTG. CONCLUSION: Overall, the results of this study provide initial evidence that trauma exposure type (i.e., direct vs. indirect) plays a significant role in the level of PTG. Lastly, the results allow for the possibility of positive changes in behaviors facilitated by cognitive avoidance, in contrast to the common notion that deliberate cognitive engagement is required for growth to occur. (PsycINFO Database Record

Critical incident history questionnaire replication: frequency and severity of trauma exposure among officers from small and midsize police agencies.

Frequency and severity of trauma exposure are thought to influence posttraumatic reactions. Weiss et al.'s Critical Incident History Questionnaire (CIHQ; 2010) measures these variables among law enforcement officers; they reported findings using a sample of officers from large urban departments. We noted the need for replication studies utilizing samples from smaller and rural police agencies. The purpose of this study was to replicate the CIHQ findings from Weiss et al. using a sample (N = 193) of officers from small and midsize police departments and officers whose duties include policing rural and isolated jurisdictions. Frequency and severity findings were similar to those reported by Weiss et al. (). Regarding frequency, the present study found the critical incident exposure mean score was 188.5, compared to 168.5 from Weiss et al. (). Making a mistake that kills or injures a colleague had the highest mean nomothetic severity rating in both studies. Among the various variables examined in this study, PTSD symptoms demonstrated the strongest association with the exposure indices, based on Spearman rank correlations (r = .26-.46).

Posttraumatic distress and growth: an empirical study of police officers.

Few studies have examined the experience of posttraumatic growth, among police officers following traumatic incidents. Additionally, research examining the relationship between posttraumatic distress (e.g., posttraumatic symptoms) and posttraumatic growth among various populations has been inconsistent. Consistent with the need to gain enhanced understanding in the area of posttraumatic growth, this study investigated the relation between posttraumatic distress (using the Impact of Events Scale-Revised) and posttraumatic growth (using the Posttraumatic Growth Inventory) among 183 police officers. Results of Pearson Correlations showed that posttraumatic distress was significantly and positively related to the Posttraumatic Growth Inventory full-scale and all sub-scale scores. Multiple regression analyses revealed that being involved in a duty-related shooting was the most significant predictor of posttraumatic growth. Implications for mental health providers are discussed.

Psychotherapists' countertransference reactions toward clients with antisocial personality disorder and schizophrenia: an empirical test of theory.

Contemporary theoretical and clinical literature asserts that countertransference reactions are common and may be specific to clients' presenting concerns and interpersonal styles. Although this phenomenon has broad implications for psychotherapy training and practice, little empirical research is available to support these claims. This study investigated the phenomenon of client-induced countertransference toward two client populations that may evoke strong reactions in psychotherapists--persons with Antisocial Personality Disorder and Schizophrenia. Results of a MANOVA and follow-up ANOVAs indicate that psychotherapists displayed significantly stronger feelings of being dominated (i.e., exploited, manipulated, talked down to) by clients with Antisocial Personality Disorders. Counselors manifested significantly stronger positive feelings (i.e., being liked and welcomed and being in charge, that is, being put in a decision-making role) when working with clients having Schizophrenia. We discuss research and clinical implications of these findings.