The dimensionality of trauma: a multidimensional scaling comparison of police officers with and without posttraumatic stress disorder.

This study assesses the multidimensional structure of traumatic events as perceived by police officers and investigates individual differences in the scaling of such perceptions. Forty-two police officers with posttraumatic stress disorder (PTSD) and 40 officers without PTSD were given descriptions of critical incidents they were likely to encounter at work. They sorted these on the basis of similarity and rated them on 15 descriptive scales. The two groups were comparable in terms of relevant background characteristics. PTSD was diagnosed with the Structured Interview (SI-PTSD). The similarity data were subjected to individual differences multidimensional scaling analysis [Carroll and Chang, Psychometrika 35 (1970) 283]. The objective was, first, to identify the basic cognitive dimensions of psychological trauma that police officers use in discriminating between common critical incidents and, second, to test whether officers with and without PTSD apply such dimensions differently when interpreting critical incidents. The same three-dimensional solution was obtained for both groups: (1) emotional reactivity; (2) vulnerability and physical integrity; and (3) moral responsibility. Significant differences were found between the PTSD and non-PTSD groups in the salience of Dimension 2. Results are discussed with reference to other studies that address the meaning and interpretation of traumatic events. Implications for the conceptualization and assessment of trauma and PTSD are outlined.

Randomized clinical trial of brief eclectic psychotherapy for police officers with posttraumatic stress disorder.

The authors report on a randomized, controlled clinical trial on the treatment of posttraumatic stress disorder (PTSD), comparing manualized psychotherapy to wait-list control. This is the first study to evaluate Brief Eclectic Psychotherapy (BEP), which combines cognitive-behavioral and psychodynamic approaches within one treatment method. Forty-two police officers with the diagnosis of PTSD participated in the study; 22 were randomly assigned to the treatment group and 20 to the wait-list control group. Assessments of PTSD and comorbid conditions were made 1 week before treatment, after treatment session 4, upon termination of treatment (16 sessions), and at follow-up 3 months later. As expected, no significant differences between groups were observed at pretest or at session 4. At posttest and at follow-up, BEP had produced significant improvement in PTSD, in work resumption, and in some comorbid conditions.

Clinical utility of a brief diagnostic test for posttraumatic stress disorder.

OBJECTIVE: This study examines the psychometric properties and clinical utility of a brief diagnostic instrument known as the Self-Rating Scale for PTSD (SRS-PTSD). METHOD: The scale was applied to a sample of 136 survivors of a plane crash. We designed SRS-PTSD as an abridged version of the Structured Interview for PTSD (SI-PTSD), which measures the presence and severity of PTSD symptoms from both a current and a lifetime perspective. RESULTS: The results indicate that SRS-PTSD and SI-PTSD both show satisfactory internal consistency and interjudge reliability. Furthermore, SRS-PTSD was shown to have sufficient sensitivity and specificity and an adequate likelihood ratio. CONCLUSIONS: SRS-PTSD constitutes a good alternative for SI-PTSD, especially for sites with limited clinical resources.

Risk factors for posttraumatic stress symptomatology in police officers: a prospective analysis.

This study examines internal and external risk factors for posttraumatic stress symptoms in 262 traumatized police officers. Results show that 7% of the entire sample had PTSD, as established by means of a structured interview; 34% had posttraumatic stress symptoms or subthreshold PTSD. Trauma severity was the only predictor of posttraumatic stress symptoms identified at both 3 and 12 months posttrauma. At 3 months posttrauma, symptomatology was further predicted by introversion, difficulty in expressing feelings, emotional exhaustion at time of trauma, insufficient time allowed by employer for coming to terms with the trauma, dissatisfaction with organizational support, and insecure job future. At 12 months posttrauma, posttraumatic stress symptoms were further predicted by lack of hobbies, acute hyperarousal, subsequent traumatic events, job dissatisfaction, brooding over work, and lack of social interaction support in the private sphere. Implications of the findings regarding organizational risk factors are discussed in the light of possible occupational health interventions.

PTSD in relation to dissociation in traumatized police officers.

OBJECTIVE: The assumed relationship between dissociation and symptoms of posttraumatic stress disorder (PTSD) was examined. METHOD: From a group of police officers who had experienced a traumatic event, the authors assessed the chronic dissociative symptoms of 42 police officers with PTSD, 50 police officers with partial PTSD, and 50 police officers who experienced no PTSD symptoms after the trauma. RESULTS: Police officers with PTSD, as well as those with partial PTSD, exhibited significantly more dissociative symptoms than police officers without PTSD symptoms. CONCLUSIONS: The study shows that it is quite probable that PTSD and partial PTSD predict dissociation and not the other way around.