Progress Report: Effects from Combat Stress Upon Reintegration for Citizen Soldiers and on Psychological Profiles of Police Recruits with Prior Military Experiences Stephen Curran, Ph.D., ABPP Atlantic OccuPsych
Objectives Participants will increase knowledge about effects from combat Participants will be energized to improve existing or start reintegration programs for returning citizen-soldiers in your agency Attendees will learn about the impact from combat stress on psychological profiles. Hypotheses about the psychological status of returning officers from deployments who are not assessed, medically or psychologically, due to prohibitions such as USERRA.
Introduction Scope of deployed ARNG Injuries/deaths Physical and Psychological Health Data PDHRA Police-Citizen Soldier specific research
Size of the Military
National Guard Data Over 487,000 soldier deployments of members of the National Guard have been deployed in support of combat operations in Iraq and Afghanistan 4,599 Law Enforcement* > 80% of ARNG joined after 9/11 > 50% of all ARNG are combat veterans 11% (494) of casualties have been National Guard CY 2011 80 NG and 34 Army Reserve Suicides
Physical and Psychological Impact 13 to 22 percent of all casualties between 2002 and 2010 have suffered eye injuries or trauma Of 32,233 wounded in Iraq, 20% serious brain or spinal injuries CY 2012 through July 30 200+ suicides of active duty personnel (38 during July, 2012) 17%-19% of OIF soldiers met screening criteria for depression, anxiety, or PTSD
Armed Forces Health Surveillance Data (through April 2012)
PDHRA Between May 2011 and April 2012 on postdeployment assessments (N=greater than 50,000) about 90 days after deployment 1. 42.9% were referred for medical follow-up 2. 21.6% referred for mental health follow-up 3. 31.4% reported health worse than before deployed 4. Alcohol misuse: combat exposure related to abuse
Police Officer-Citizen Soldier Data Two year follow-up study of 62 Connecticut National Guard from a medical and military police unit after Operation Desert Storm found Mississippi i i i PTSD symptoms of hyper-arousal were more severe at all time points than avoidance or re-experiencing type symptoms. A significant difference was found at two years dependent on level of combat exposure (Southwick et al.1995, Am J Psychiatry; y; 152:1150-1155).
Longitudinal RINGS study Negative emotionality and combat exposure were predictive of both chronic and vulnerable-risk trajectories. Chronic trajectory associated with high level of depression at pre-deployment and higher pre- deployment levels of concerns about life/family disruptions. Vulnerable-risk trajectory associated with low levels l of preparedness, high h levels l of perceived threat, post-deployment stressors and lower levels of post-deployment p support.
Current Reintegration Programs IACP Resources The Police Chief (Gupton et al. August 2011) Yellow Ribbon Reintegration Program The Center for Deployment Psychology (CDP) trains military and civilian behavioral health professionals to provide high-quality deployment-related behavioral health services to military personnel and their families.
Current Retrospective Study Current police officers for LE Agency N = 0 Police officers with prior deployment applying to Agency Applicants with no prior LE but with prior deployment
Demographics
Combat Exposure Rating None Light (Examples: under enemy fire less than once monthly, fewer than 25% of unit killed or wounded) Moderate to Heavy (Examples: 3 to 50+ times firing at enemy, 3 to 50+ times in danger of injury or killed, 26% to more than 76% of unit killed or wounded)
Psychological Tests MMPI-2 (A) MMPI-2-RF (B) IPI (C) 16PF (D)
Hypothesis 1 CES Rating correlated with an increase in psychological testing results. Sc cale Scores D C A B MMPI-2 (A) MMPI-2-RF (B) IPI (C) 16PF (D) Combat Exposure
Table 1. Combat Exposure and Psychological Tests
Table 2: Combat Exposure and p MMPI-2 PSY-5 Scales
Hypothesis 2 No differences between enlisted and A D officer ranks Sc cale Scores C B MMPI-2 (A) MMPI-2-RF (B) IPI (C) 16PF (D) Enlisted/Officer
Table 3: Officer versus Enlisted Differences
Hypothesis 3 No differences between current police officer- applicants and applicants in nonpolice officer positions at time of evaluation MMPI-2 (A) MMPI-2-RF (B) IPI (C) 16PF (D) Sc cale Scores B D C A Current Police Officer
Table 4: Differences Between Current LEO at Time of Assessment versus No Prior Police Employment
Discussion Implications Future Directions Prospective Study with Outcome Measures -Medical Complaints/Conditions, Sick leave use -Prescribed medication use, Other substance use/abuse, DUI/DWI -Excessive use of force sustained complaints, Other adverse performance factors -Suicides, Domestic Violence incidents Questions Contact Information StephenF F. Curran, PhD Ph.D., ABPP curran@atlanticoccupsych.com www.atlanticoccupsych.com (800)962-5763 Author acknowledges the research assistance of Timothy Wilkins and statistical analyses by Greg Marchetti, Ph.D. of Duquesne University in the preparation of this presentation.
Resources referred to in presentation PDHRA: http://www.dtic.mil/whs/directives/infomgt/forms/eforms/dd2900.pdf Combat Exposure Scale: http://www.ptsd.va.gov/professional/pages/assessments/assessment-pdf/ces.pdf IACP Reintegration Materials: http://www.theiacp.org/publicationsguides/contentbytopic/tabid/216/default.aspx?i d=1298&v=1 The Center for Deployment Psychology: http://deploymentpsych.org Yellow Ribbon Reintegration Program www.yellowribbon.mil Gupton, H.M., Axelrod, E., Cornell L. Curran, S.F., Hood, C.J., Kelly, J., and Moss, J. (August, 2011). Support and Sustain: Psychological Intervention for Law Enforcement Personnel. The Police Chief, pp 92-97 Petty v. Metropolitan Government of Nashville and Davidson County, #10-6013, 2012 U.S. App. Lexis 15181, 2012 FED App. 0226P (6th Cir.).