Progress Report: Effects from
p
Combat Stress Upon
Reintegration for Citizen
y
g
Soldiers and on Psychological
Profiles of Police Recruits with
y Experiences
p
Prior Military
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
t i officers
ffi
ffrom d
deployments
l
t who
h are
not assessed, medically or psychologically, due
prohibitions such as USERRA.
to p
Introduction
•
•
•
•
•
Scope of deployed ARNG
Injuries/deaths
Physical
y
and Psychological
y
g
Health Data
PDHRA
Police-Citizen Soldier specific research
Size of the Military
National Guard Data
• Over 487
487,000
000 soldier deployments of members
of the National Guard have been deployed in
support of combat operations in Iraq and
Af h i t
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
y
and Psychological
y
g
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 post
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%
3.
31 4% reported health worse than before
deployed
4. Alcohol misuse: combat exposure
p
related to
abuse
Police Officer-Citizen Soldier
Data
• Two year follow-up
follow up study of 62 Connecticut
National Guard from a medical and military
police unit after Operation Desert Storm found
Mi i i i PTSD symptoms
Mississippi
t
off hyper-arousal
h
l
were more severe at all time points than
g type symptoms.
avoidance or re-experiencing
A significant difference was found at two years
dependent on level of combat exposure
((Southwick et al.1995,, Am J Psychiatry;
y
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 predeployment levels of concerns about
life/family disruptions.
• Vulnerable-risk trajectory associated with low
l
levels
l off preparedness,
d
high
hi h levels
l
l off
perceived threat, post-deployment stressors
post-deployment
p y
support.
pp
and lower levels of p
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
pp
with no prior
p
LE but with prior
p
deployment
p y
Demographics
Combat Exposure
p
Rating
g
• 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
MMPI-2-RF (B)
IPI (C)
( )
16PF (D)
Hypothesis 1
C
Sccale Scores
• CES Rating
correlated with
an increase in
psychological
testing results.
D
A
MMPI-2 (A)
MMPI-2-RF (B)
IPI (C)
16PF (D)
B
Combat Exposure
Table 1. Combat Exposure and
Psychological Tests
Table 2: Combat Exposure
p
and
MMPI-2 PSY-5 Scales
Hypothesis 2
A
Sccale Scores
• No differences
between
enlisted and
officer ranks
C
MMPI-2 (A)
MMPI-2-RF (B)
IPI (C)
16PF (D)
B
Enlisted/Officer
D
Table 3: Officer versus Enlisted
Differences
ff
• No differences
between current
police officer
officerapplicants and
applicants
pp
in nonpolice officer
positions at time of
evaluation
l ti
MMPI-2 (A)
MMPI-2-RF (B)
IPI (C)
16PF (D)
Sccale Scores
Hypothesis 3
B
D
A
C
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
Medical Complaints/Conditions
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,
Suicides Domestic Violence incidents
• Questions
Contact Information
Stephen F
F. Curran
Curran, Ph
Ph.D.,
D ABPP
[email protected]
www.AtlanticOccuPsych.com
(800)962 5763
(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
p
•
•
•
•
•
•
•
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
p y
Psychology:
y
gy
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
Pettyy v. Metropolitan
p
Government of Nashville and Davidson County,
y, #10-6013,,
2012 U.S. App. Lexis 15181, 2012 FED App. 0226P (6th Cir.).