Identifying law enforcement stress reactions early.

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The collapse of the World Trade Center and the partial destruction of the Pentagon starkly and vividly showed the whole world the damage inflicted upon America by the Al Qaeda Terrorist Organization. These horrific acts harmed all Americans, including thousands of law enforcement officers. Clearly, large-scale critical incidents are stressful, but so are the numerous smaller scale events that so many law enforcement officers encounter on the job. Who can accurately measure the stress caused by being wounded in the line of duty, having a partner killed or injured, shooting another person, seeing abused or deceased children, and witnessing severe motor vehicle accidents? Who can calculate the effects of continued exposure to murders, suicides, kidnappings, hijackings, rapes, and other violent acts that assault the sensibilities of law enforcement officers? Too often, assistance is delayed until officers display maladaptive behaviors, such as excessive drinking, domestic violence, or even suicide. Predictably, adverse events take their toll, but, as yet, the extent of the stress reactions has not been fully assessed. The time has come to identify stress reactions early so that officers can receive meaningful help before problems emerge. (1)

Reviewing Causes

Critical incidents, both large and small, are not the only events that negatively impact law enforcement officers. Other more subtle, but no less devastating, factors interfere with the psychological equilibrium so necessary for the emotional welfare of law enforcement officers. For example, organizational stressors, such as inadequate training, poor supervision, lack of recognition for superior job performance, perceived nepotism in awarding promotions and financial incentives, inadequate pay, and insensitivity to family or personal needs, often cause discord. (2) Job stressors, such as long hours, "on-call" status, and extended periods outside the home, can have adverse effects. Varied work schedules caused by rotating shifts, irregular days off, and court time frequently interfere with sleep patterns and family activities. Public scrutiny, media focus, and civil litigation can make inherently difficult situations even more stressful. Specialized duties, such as undercover assignments, (3) evidence recovery, crisis negotiation, and hostage rescue, also increase stress levels.

Moreover, law enforcement officers have personal problems just like everyone else. The normal physical changes associated with aging can be quite stressful for officers who rely on their ability to physically control situations. Natural changes to all of the body's systems (muscle, bone, cardiovascular, respiratory, nervous, immune, and neuroendocrine) have strong consequences. (4) Eventually, fading visual acuity, failing hearing, diminishing muscle mass, waning stamina, dwindling dexterity, and attenuating balance impose limitations on officers whose years of experience alone cannot always offset. Injuries and illness also play a part in this dynamic. Psychological factors, such as unfulfilled personal relationships, lack of spiritual meaning, loss of control over an important aspect of their lives, unrealized career goals, and interpersonal conflict, can prove incredibly stressful.

Summarizing Reactions

Critical incidents alone do not cause most law enforcement officers undue stress; neither do cumulative stressors, such as organizational and job factors, nor personal stressors, such as physical and psychological elements. Instead, the confluence of all of these different factors does. Proof of this exists everywhere. Cumulative stress contributes to high rates of gastrointestinal disorders, high blood pressure, and coronary heart disease in the law enforcement community. Alcohol and prescription drug abuse often occurs. High levels of domestic violence in law enforcement families have been related to stress on the job. (5) Critical incidents leave some officers with acute stress disorder (ASD) or post-traumatic stress disorder (PTSD) and many more with transitory symptoms, such as intrusive thoughts, sleeping difficulties, changed eating patterns, and muted emotional responses.

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Since 1980, when the American Psychiatric Association introduced PTSD as a diagnosable condition, several developments have occurred. In 1994, the short-term pattern of some severe psychological reactions was acknowledged with the inclusion of ASD. Most discussions of these extreme reactions to stress revolve around core symptoms experienced after a life-threatening event and include--

* reexperiencing the trauma in the form of nightmares and intrusive thoughts;

* avoiding reminders of the event; and

* experiencing numbing to the point of not having loving feelings, increased arousal in the form of exaggerated startle response, hypervigilantism, and sleeping difficulties.

Many factors influence whether or not a particular incident results in ASD, PTSD, or its symptoms. Recent research (6) suggested that certain factors predict the like-lihood of someone experiencing PTSD and its symptoms. Most predictive was a dissociative experience during or in the immediate aftermath of the traumatic event and high levels of emotion during or shortly after the traumatic event. Perceived life threat during the traumatic event and perceived social support following the event are helpful predictors. Other less strong predictors include prior trauma, psychological adjustment before the trauma, and a family history of mental illness. Prior exposure to a similar event probably is the most difficult to understand because it is counterintuitive. In most other aspects of life, experience helps. Unfortunately, many law enforcement officers discover that repeated exposure to certain events can have seriously detrimental effects. The frequency, duration, and intensity of stressors represent determining factors as well. Stress reactions vary among individuals because perceptions of situations differ and reactions are subjective.

These debilitating symptoms are not the worst things that can happen. Sadly, among law enforcement officers, job-related stress frequently contributes to the ultimate maladaptive response to stress: suicide. (7)

Making Critical Distinctions

Discussing this topic requires making some distinctions. According to Dr. Han Selye, the generally acknowledged founding pioneer of stress research, stress is the nonspecific response of the body to any demand placed upon it. (8) A stressor is an external, environmental event that has the potential to cause a reaction. A stress reaction is an internal sequence of events that occurs as a result of a real or imagined threat. A negative stress reaction is called distress. However, not all law enforcement officers exposed to stressors become distressed.

On a positive note, stress management appears to help, and sound reasons for this exist. Because stressors are external events, individual law enforcement officers and their organizations cannot always control them. Sometimes, unfortunate events happen in spite of everyone's best efforts. Stress management focuses on the reactions that are internal and more subject to individual control. The reasoning for this states that officers cannot always control what somebody else does to them, but, at some point, they can choose to control their own reactions to the event.

Stress management, as practiced by the FBI, (9) involves three distinct steps: understanding, recognizing, and coping. The understanding and recognizing steps occur preincident, wherein administrators take great care to ensure personnel understand the nature of the stress response and learn to recognize the common symptoms experienced by those responding to stressful events. Coping constitutes the FBI's third stress management step that transpires after events happen and where administrators make every effort to support personnel through a variety of programs, such as employee assistance, chaplain support, critical incident seminars, and peer support. Although not all law enforcement agencies in the United States may have such a comprehensive program, the underlying principles are useful in moving effective law enforcement stress management forward.

Identifying the Pressing Issue

All of this information has been thoroughly studied, documented, and discussed. The potential ill effects of job-related stressors clearly are established for law enforcement officers. Researchers no longer need to focus on the stressors officers experience or all of their negative reactions. Now, the critical task is to identify, at the earliest stage possible, when particular law enforcement officers incur an excessive stress reaction to the numerous pressures confronting them. To this end, the authors present the Law Enforcement Officer Stress Survey (LEOSS) as a potential tool for agencies to employ in their efforts to help their officers cope with job-related stress.

Developing the Context

For 5 years (1995-1999), Special Agent Sheehan taught Stress Management in Law Enforcement (SMILE) at the FBI Academy. The purpose of the course was to reduce drinking, prescription drug abuse, domestic violence, divorce, suicide, and other maladaptive responses to stress among members of the FBI National Academy. These individuals, comprised of command-level law enforcement officers, attended a 10-week training program involving various criminal justice subjects. Chosen from local, state, and federal agencies throughout the United States and from several foreign countries, these veteran officers provided invaluable insight into job-related stress.

As part of the course, which had 50 officers per session, Special Agent Sheehan asked these highly successful officers what bothered them. The lists he compiled revealed a staggering assortment of human suffering. The problems--personal and professional, traumatic and cumulative, and large and small--all appeared. Class after class replicated the results. These observations buttressed what Special Agent Sheehan had observed year after year while working with the spouses, children, parents, siblings, and partners of slain officers during National Police Week under the auspices of Concerns of Police Survivors, Inc. (10) He realized that something was missing between stress management training and treatment for severe stress reactions.

Finding the Missing Link

Stress management training makes law enforcement officers more stress resistant, and various treatment modalities by mental health practioners can help those who have extreme reactions. To date, what has been missing is an assessment tool that provides early detection of stress-related problems among law enforcement officers. To be useful, a law enforcement stress evaluation tool has to have several characteristics. It specifically must address the unique challenges and stressors that officers face. It also has to be brief in format to facilitate its use by a population that historically has resisted interaction with the mental health system.

Formulating the Answer

Special Agent Sheehan discussed the problem with Dr. Van Hasselt, who suggested using a behavioral analytic model (11) to construct a screening device. This is a sophisticated and highly effective means of identifying distress in law enforcement officers. It involved five basic steps: situational analysis, item development, response enumeration, response evaluation, and construction of the instrument. Simply put, the authors asked officers to identify major areas of stress. Then, based on these responses, the authors formulated the situations into scenarios. (12) They asked other officers to rate each scenario on two different scales. One scale evaluated the likelihood that a law enforcement officer would encounter the situation described. The second scale rated how difficult each situation would be for the officer experiencing it. Thus, the resulting instrument became the Law Enforcement Officer Stress Survey. (13)

Taking the Next Step

The authors have completed the first phase of the development of LEOSS. (14) The next step will involve determining scoring strategies and developing norms. The objective is to develop a tool that can help all law enforcement officers. To this end, individual law enforcement officers exhibiting distress reactions can receive timely assistance. In addition, law enforcement managers can design training programs to show their officers effective strategies for dealing with stressful situations.

Conclusion

Granted, the law enforcement profession is inherently stressful for many reasons, and numerous officers experience distress in a variety of forms. But, officers are not destined to suffer as much as they have in the past. A valid and reliable early screening tool that effectively and efficiently measures stress reactions by officers can assist mental health practioners in making timely, focused interventions and law enforcement supervisors in formulating useful training programs. The authors will continue to explore the possibilities of the Law Enforcement Stress Survey becoming that tool.

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Endnotes

1 For a complete examination of the authors' work on the Law Enforcement Stress Survey, see V.B. Van Hasselt, D.C. Sheehan, A.H. Sellers, M.T. Baker, and C. Feiner, "A Behavioral-Analytic Model for Assessing Stress in Police Officers: Phase I, Development of the Law Enforcement Officer Stress Survey (LEOSS)," International Journal of Emergency Mental Health 5, no. 2 (Spring 2003): 77-84.

2 J.M. Brown and E.A. Campbell, Stress and Policing: Sources and Strategies (New York, NY: Wiley, 1994).

3 S.R. Band and D.C. Sheehan, "Managing Undercover Stress: The Supervisor's Role," FBI Law Enforcement Bulletin, February 1999, 1-6.

4 H.L. Bee, The Journey of Adulthood (Upper Saddle River, NJ: Prentice Hall, 2000).

5 D.C. Sheehan, ed., U.S. Department of Justice, Federal Bureau of Investigation, Domestic Violence by Police Officers (Washington, DC, 2000).

6 E.J. Ozer, S.R. Best, T.L. Lipsey, and D.S. Weiss, "Predictors of Post-traumatic Stress Disorder and Symptoms in Adults: A Meta-Analysis," Psychological Bulletin 129, no. 1 (2003): 52-73.

7 D.C. Sheehan and J.I. Warren, eds., U.S. Department of Justice, Federal Bureau of Investigation, Suicide and Law Enforcement (Washington, DC, 2001).

8 H. Seyle, Stress Without Distress (New York, NY: Signet, 1975).

9 D.C. Sheehan, "Stress Management in the Federal Bureau of Investigation: Principles for Program Development," International Journal of Emergency Mental Health 1 (1999): 39-42.

10 For information, access the organization's Web site, http://www.nationalcops.org.

11 V.B. Van Hasselt, A.E. Kazdin, M. Hersen, J. Simon, and A.K. Mastantuono, "A Behavioral-Analytic Model for Assessing Social Skills in Blind Adolescents," Behavior Research and Therapy 23 (1985): 395-405.

12 The authors used the officers' own words in the scenarios to better describe how law enforcement officers refer to situations that they encounter in the performance of their duties.

13 Supra note 1.

14 The authors gratefully acknowledge the cooperation and support of the FBI National Academy and Nova Southeastern University in gathering data for this project, but do not release any rights to the Law Enforcement Officer Stress Survey. The authors developed the LEOSS external to any institution and retain its sole intellectual property.

Law Enforcement Officer Stress Survey

First Rating Scale

For each scenario, please circle a number from 1 (Not Common) to 7 (Common) that best reflects how common the situation is for you. For example, a 1 would mean you have not experienced the situation, whereas a 7 would mean the situation is extremely common.

      1    2    3    4    5    6    7
  Not Commoon                      Commo

Second Rating Scale

For each scenario, please circle a number from 1 (Not Difficult) to 7 (Extremely Difficult) that best reflects how difficult or problematic that situation is or has been for you. For example, a 1 would mean that the situation is not difficult or problematic for you at all, whereas a 7 would mean that the situation is extremely difficult or problematic for you.

      1        2      3      4      5      6          7
  Not Difficult                              Extremely Difficult

Scenarios

1. You are called to a burglary in progress. The assailant may be armed.

2. You are called to respond to a silent alarm from a bank.

3. You respond to a shooting in progress between two gangs.

4. You are executing an arrest and search warrant for a violent criminal and are unsure of his location.

5. You are executing an arrest warrant when the suspect barricades himself. There may be other people with him.

6. You respond to a major motor vehicle accident with multiple injuries and possible fatalities.

7. You are engaged in the promotional process.

8. You have been brought up on civil rights violations that are untrue.

9. You have plans with your family, but work demands interfere and you are unable to participate.

10. You are on a high-pursuit chase in icy conditions.

11. You are investigating an officer's death in which suicide is suspected.

12. You are responsible to notify the parents of a child killed by a hit-and-run driver.

13. You are called to contain a public rally that is becoming agitated.

14. You have been recruited to investigate a fellow officer.

15. You have been injured during an assault, and your backup is late responding.

16. You find that your subordinates did not complete the assignment you gave, for which you are responsible.

17. You must rely on employees you feel are not trustworthy or competent.

18. You are trying to solve a high-profile case while the public pressures' for immediate results but continues to be uncooperative.

19. You have spent hours putting data into your computer, only to have it go down and lose your data.

20. You are making progress on a case when you are reassigned for political reasons.

21. You find that work is taking up more time and energy, leaving you with little left for family and recreation.

22. You are unable to complete a project because your supervisor keeps changing the direction or priorities.

23. You are on your way to a high-emergency call when the radio has interference and you are unable to get all of the information you need.

24. Changing shifts has interfered with your sleep patterns, causing you to experience increased fatigue.

25. You frequently argue with your spouse, but are unable to resolve anything because of scheduling conflicts.

Note: The authors invite law enforcement officers to use this survey as an early screening device.