The effects of occupational exposure to traumatic events were examined in two studies of Queensland (Australia) Police Officers. A cross-sectional pilot study of 237 experienced police officers was conducted to develop three survey instruments and to provide preliminary tests of research hypothesis. A prospective study of 100 inexperienced officers examined participants as police recruits, before they were exposed to occupational trauma, and assessed them at two subsequent occasions over a one year period following commencement of police work. Five research questions were addressed by the prospective study: a) What is the nature and extent of occupational trauma exposure in police officers? b) What is the nature and extent of trauma-specific and non-specific morbidity in police officers? c) What is the relationship between police work-related trauma exposure and morbidity? D) What are the determinants and concomitants of sequelae associated with occupational trauma exposures? and e) What characterises the phenomenology of response to police work-related trauma?
The pilot study measured participants' sociodemographic characteristics, Post Traumatic Stress Disorder (PTSD) symptoms, characteristics of exposure to a participant nominated work-related traumatic event, peritraumatic dissociative phenomena, and attendance at a Critical Incident Stress Debriefing using self-report questionnaires. Instruments were developed to assess the frequency and impact of exposure to police work-related traumatic incidents, to measure peritraumatic phenomena, and to examine work-place hassles and climate.
Results of the pilot study indicated that work-related traumatic events were ubiquitous. Ninety-five percent of participants reported experiencing a work-related traumatic event some time in their career. Eight percent of participants reported clinically significant PTSD symptomatology associated with a work-related event. Other significant predictors of symptomatology were the cumulative impact of work-related trauma exposure, participants' rank, work-place characteristics, and peritraumatic-phenomena. Participation in a Critical Incident Stress Debriefing (CISD) was not related to reported symptomatology.
In the prospective study, data were obtained on the nature and extent of occupational trauma exposure (characteristics of exposure to a participant nominated most-traumatic work-related event, and the frequency and impact of concurrent occupational trauma exposure), the nature and extent of trauma-specific and non-specific morbidity (PTSD, anxiety, depression and somatic symptoms, general psychological distress, and alcohol consumption and smoking behaviour), and characteristics of putative determinants of morbidity (sociodemographic characteristics, personality constructs, parental relationship characteristics, cognitive constructs, significant life events, coping processes. Social support, work-environment characteristics, CISD participation and peritraumatic phenomena).
Consistent with the results of the pilot study, 95% of participants in the prospective study reported clinically significant PTSD symptomatology. Non-specific morbidity rates indicated a general trend of deterioration of participants' health and well-being over the three assessment periods. Of event characteristics, only participants' ratings of the subjective severity (impact) of an event emerged as a significant predictor of symptom measures, with greater severity ratings being associated with higher symptom scores. Similarly, cumulative subject severity ratings of concurrent event exposure were correlates of morbidity measures, whereas frequency ratings of those same events were not. Important determinants of morbidity were found to be greater peritraumatic reactivity and dissociation, greater neuroticism, greater use of coping strategies overall, less reported social support, poorer self-worth, greater number of significant life events, and poorer work-place climate characteristics. As with the result of the pilot study, CISD attendance was not related to reported symptoms.
Further examination of the role of peritraumatic phenomena indicated evidence of mediational relationships between peritraumatic phenomena and the morbidity determinants; neuroticism, self-worth, significant life events, coping strategies, social support, work-place climate and comorbidity. A significant interaction between the cumulative impact of concurrent occupational trauma exposure and peritraumatic phenomena indicated that participants who reported greater overall impact of concurrent event exposure and greater peritraumatic phenomena also reported greater Symptomatology associated with a particular event.
The findings of this research provide the basis for strategies to more effectively manage the effects of occupational trauma exposure. The modulation of peritraumatic phenomena may prove central to the mitigation of the effects of work-related traumatic event exposure. The cumulative effects of long term exposure to occupational trauma may account for the discrepancy in PTSD morbidity rates between the two studies, and may point to a second promising area of future research. Prospective multi-method research using large samples assessed over several years is required to further develop the construct of peritraumatic phenomena and to examine the chronic effects of occupational trauma exposure.