Shannon L Wagner1, Nicole White1, Trina Fyfe2, Lynda R Matthews3, Christine Randall4, Cheryl Regehr5, Marc White6, Lynn E Alden7, Nicholas Buys4, Mary G Carey8, Wayne Corneil9, Alex Fraess-Phillips1, Elyssa Krutop10, Matthew H Fleischmann11. 1. Department of Health Sciences, College of Arts, Social, and Health Sciences, University of Northern British Columbia, Prince George, Canada. 2. Northern Medical Program, University of Northern British Columbia, Prince George, Canada. 3. Faculty of Health Sciences, The University of Sydney, Sydney, Australia. 4. Menzies Health Institute of Queensland, Griffith University Gold Coast Campus, Southport, Australia. 5. Department of Social Work, University of Toronto, Toronto, Canada. 6. Department of Family Practice, University of British Columbia, Vancouver, Canada. 7. Department of Psychology, University of British Columbia, Vancouver, Canada. 8. School of Nursing, University of Rochester, New York, New York. 9. Telfer School of Management, University of Ottawa, Ottawa, Canada. 10. The Centre for Response-Based Practice, Kamloops, Canada. 11. Department of Educational & Counselling Psychology, McGill University, Montreal, Canada.
Abstract
BACKGROUND: The prevalence of PTSD in police officers has been the subject of a large and highly variable empirical literature. The present systematic review evaluates the extant literature on PTSD in police officers using an international dataset. METHODS: We employed best-evidence narrative synthesis to evaluate whether PTSD prevalence in police is elevated in comparison to the general population of Canada (8%), which itself has a higher lifetime PTSD prevalence than many other regions and thus serves as a conservative standard of comparison. RESULTS: PTSD prevalence in police varied considerably across studies from 0% - 44% (M = 14.87%, Median = 9.2%). Despite this variability, strong evidence exists to suggest PTSD prevalence is elevated in police officers. Examination of possible sources of variability in prevalence outcomes highlighted substantial variability in outcomes due to the selection of measurement tool for assessing PTSD (e.g., DSM vs. IES). Examination of commonly-assessed predictive factors for PTSD risk across the literature showed that individual-difference factors (e.g., age, years of service) bear weak-to-nonexistent relationships with PTSD risk, while incident-specific factors (e.g., severity of exposure) are more strongly and consistently associated with PTSD prevalence. Organizational factors (e.g., low support from supervisor) are at present understudied but important possible contributors to PTSD risk. CONCLUSIONS: PTSD prevalence is elevated in police officers and appears most strongly related to workplace exposure. Measurement variability remains a critical source of inconsistencies across the literature with drastic implications for accurate detection of officers in need of mental health intervention.
BACKGROUND: The prevalence of PTSD in police officers has been the subject of a large and highly variable empirical literature. The present systematic review evaluates the extant literature on PTSD in police officers using an international dataset. METHODS: We employed best-evidence narrative synthesis to evaluate whether PTSD prevalence in police is elevated in comparison to the general population of Canada (8%), which itself has a higher lifetime PTSD prevalence than many other regions and thus serves as a conservative standard of comparison. RESULTS:PTSD prevalence in police varied considerably across studies from 0% - 44% (M = 14.87%, Median = 9.2%). Despite this variability, strong evidence exists to suggest PTSD prevalence is elevated in police officers. Examination of possible sources of variability in prevalence outcomes highlighted substantial variability in outcomes due to the selection of measurement tool for assessing PTSD (e.g., DSM vs. IES). Examination of commonly-assessed predictive factors for PTSD risk across the literature showed that individual-difference factors (e.g., age, years of service) bear weak-to-nonexistent relationships with PTSD risk, while incident-specific factors (e.g., severity of exposure) are more strongly and consistently associated with PTSD prevalence. Organizational factors (e.g., low support from supervisor) are at present understudied but important possible contributors to PTSD risk. CONCLUSIONS:PTSD prevalence is elevated in police officers and appears most strongly related to workplace exposure. Measurement variability remains a critical source of inconsistencies across the literature with drastic implications for accurate detection of officers in need of mental health intervention.
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