Systematic review of posttraumatic stress disorder in police officers following routine work‐related critical incident exposure

• Published in: American journal of industrial medicine 2020-07, Vol.63 (7), p.600-615
• Main Authors: Wagner, Shannon L., White, Nicole, Fyfe, Trina, Matthews, Lynda R., Randall, Christine, Regehr, Cheryl, White, Marc, Alden, Lynn E., Buys, Nicholas, Carey, Mary G., Corneil, Wayne, Fraess‐Phillips, Alex, Krutop, Elyssa, Fleischmann, Matthew H.
• Format: Article
• Language: English
• Subjects: epidemiology; Evaluation; Exposure; Health promotion; Literature reviews; Mental disorders; Mental health; Occupational exposure; Organizational aspects; Police; police personnel; Post traumatic stress disorder; posttraumatic stress disorder; Risk; Systematic review; trauma; Variability; Working conditions
• ISSN: 0271-3586; 1097-0274
• DOI: 10.1002/ajim.23120

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.