Resilience mediates the relationship between social support and post-traumatic stress symptoms in police officers

Authors

  • Erin C. McCanlies, PhD
  • Ja Kook Gu, MPH
  • Michael E. Andrew, PhD
  • Cecil M. Burchfiel, PhD
  • John M. Violanti, PhD

DOI:

https://doi.org/10.5055/jem.2017.0319

Keywords:

mediation, resilience, PTSD, gratitude, satisfaction with life, police officers

Abstract

Objective: Police officers in the New Orleans geographic area faced a number of challenges following Hurricane Katrina in 2005.

Design: This cross-sectional study examined gratitude, resilience, and satisfaction with life as mediators in the association between social support and post-traumatic stress disorder (PTSD) symptoms in 82 male and 31 female police officers. The Gratitude Questionnaire, Connor-Davidson Resilience Scale, Satisfaction with Life Scale, and the Interpersonal Support Evaluation List were used to measure gratitude, resilience, satisfaction with life, and social support, respectively. PTSD symptoms were measured using the PTSD Checklist-Civilian (PCL-C). Ordinary least square regression mediation analysis was used to estimate direct and indirect effects among gratitude, resilience, satisfaction with life, social support, and PTSD symptoms. All models were adjusted for age, alcohol, race, and previous military experience.

Results: Mean PCL-C symptoms were 29.1 (standard deviation [SD] = 14.4) for females and 27.9 (SD = 12.1) for males. There was no direct relationship between social support and PTSD symptoms (c9 = −0.041; 95% confidence interval [CI] = −0.199, 0.117) independent of the indirect effect through resilience (effect = −0.038; 95%CI = −0.099, −0.002). Neither gratitude (effect = −0.066; 95% CI = −0.203, 0.090) nor satisfaction with life (effect = −0.036, 95% CI = −0.131, 0.046) contribute to the indirect effect.

Conclusions: These results indicate that resilience mediates the relationship between social support and symptoms of PTSD. Targeting social support and resilience in officers may facilitate reduction of PTSD symptoms.

Author Biographies

Erin C. McCanlies, PhD

Epidemiologist, Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia

Ja Kook Gu, MPH

Statistician, Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia

Michael E. Andrew, PhD

Statistician, Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia

Cecil M. Burchfiel, PhD

Epidemiologist, Biostatistics and Epidemiology Branch, Health Effects Laboratory Division, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia

John M. Violanti, PhD

Full Research Professor, Principle Investigator, Department of Epidemiology and Environmental Health, School of Public Health and Health Professions, University at Buffalo, Buffalo, New York

References

Knabb RD, Rhome JR, Brown DP: Tropical Cyclone Report. Hurricane Katrina: August 23-30, 2005. 2011. Available at http://www.nhc.noaa.gov/data/tcr/AL122005_Katrina.pdf. Accessed February 9, 2016.

Baum D: Deluged: When Katrina hit, where were the police? The New Yorker. 2006: 50-63.

Bernard BP, Driscoll RJ, Kitt M, et al.: Health hazard evaluation of police officers and firefighters after hurricane Katrina—New Orle-ans, Louisana, October 17-28 and November 30-December 5, 2005. MMWR Morb Mortal Wkly Rep. 2006; 55(16): 456-458.

West C, Bernard B, Mueller C, et al.: Mental health outcomes in police personnel after Hurricane Katrina. J Occup Environ Med. 2008; 50(6): 689-695.

Adams T, Turner M: Professional responsibilities versus familial responsibilities: An examination of role conflict among first re-sponders during the Hurricane Katrina disaster. J Emerg Manag. 2014; 12(1): 45-54.

Marmar CR, McCaslin SE, Metzler TJ, et al.: Predictors of posttraumatic stress in police and other first responders. Ann N Y Acad Sci. 2006; 1071: 1-18.

Maia DB, Marmar CR, Metzler T, et al.: Post-traumatic stress symptoms in an elite unit of Brazilian police officers: Prevalence and im-pact on psychosocial functioning and on physical and mental health. J Affective Disorders. 2007; 97(1-3): 241-245.

Martin M, Marchand A, Boyer R: Traumatic events in the workplace: Impact on psychopathology and healthcare use of police offic-ers. Int J Emerg Mental Health. 2009; 11(3): 165-176.

Sareen J, Cox BJ, Stein MB, et al.: Physical and mental comorbidity, disability, and suicidal behavior associated with posttraumatic stress disorder in a large community sample. Psychosom Med. 2007; 69(3): 242-248.

Gupta MA: Review of somatic symptoms in post-traumatic stress disorder. Int Rev Psychiatry. 2013; 25(1): 86-99.

Cohen S, Hoberman HM: Positive events and social supports as buffers of life change stress. J Appl Soc Psychol. 1983; 13(2): 99-125.

Dinenberg RE, McCaslin SE, Bates MN, et al.: Social support may protect against development of posttraumatic stress disorder: Findings from the Heart and Soul Study. Am J Health Promotion. 2014; 28(5): 294-297.

Platt J, Keyes KM, Koenen KC: Size of the social network versus quality of social support: Which is more protective against PTSD? Soc Psychiatry Psychiat Epidemiol. 2014; 49(8): 1279-1286.

Berkman LF, Glass T, Brissette I, et al.: From social integration to health: Durkheim in the new millennium?. Soc Sci Med. 2000; 51(6): 843-857.

Yuan C, Wang Z, Inslicht SS, et al.: Protective factors for posttraumatic stress disorder symptoms in a prospective study of police officers. Psychiatry Res. 2011; 188(1): 45-50.

Iacoviello BM, Charney DS: Psychosocial facets of resilience: Implications for preventing posttrauma psychopathology, treating trauma survivors, and enhancing community resilience. Eur J Psychotraumatol. 2014; 5(23970): 10.

McCanlies EC, Mnatsakanova A, Andrew ME, et al.: Positive psychological factors are associated with lower PTSD symptoms among police officers: Post Hurricane Katrina. Stress Health. 2014; 30(5): 405-415.

Southwick SM, Bonanno GA, Masten AS, et al.: Resilience definitions, theory, and challenges: Interdisciplinary perspectives. Eur J Psychotraumatol. 2014; 5(25338): 14.

Bonanno GA: Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? Am Psychol. 2004; 59(1): 20-28.

Hoge EA, Austin ED, Pollack MH: Resilience: Research evidence and conceptual considerations for posttraumatic stress disorder. Depress Anxiety. 2007; 24(2): 139-152.

Smith-Osborne A, Bolton KW: Assessing resilience: A review of measures across the life course. J Evid Based Soc Work. 2013; 10(2): 111-126.

Connor KM, Davidson JR: Development of a new resilience scale: The Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003; 18(2): 76-82.

Diener E, Emmons RA, Larsen RJ, et al.: The satisfaction with life scale. J Pers Assess. 1985; 49(1): 71-75.

Feller S, Teucher B, Kaaks R, et al.: Life satisfaction and risk of chronic diseases in the European Prospective Investigation into Cancer and Nutrition (EPIC)-Germany study. PloS one. 2013; 8(8): e73462.

McCullough ME, Emmons RA, Tsang JA: The grateful disposition: A conceptual and empirical topography. J Pers Soc Psychol. 2002; 82(1): 112-127.

American Psychiatric Association [APA] (ed.): Diagnostic and Statistical Manual Of Mental Disorders. IV-TR ed. Arlington: American Psychiatric Association, 2007.

Weathers F: PTSD Checklist (PCL). 1993. Available at http://www.ptsd.va.gov/. Accessed September 26, 2013.

Hayes AF: Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. New York: The Guil-ford Press, 2013.

Brewin CR, Andrews B, Valentine JD: Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults. J Consult Clin Psychol. 2000; 68(5): 748-766.

Cherry KE, Sampson L, Nezat PF, et al.: Long-term psychological outcomes in older adults after disaster: Relationships to religios-ity and social support. Aging Mental Health. 2015; 19(5): 430-443.

Thompson DJ, Weissbecker I, Cash E, et al.: Stress and cortisol in disaster evacuees: An exploratory study on associations with social protective factors. Appl Psychophysiol Biofeedback. 2015; 40(1): 33-44.

Bonanno GA, Galea S, Bucciarelli A, et al.: What predicts psychological resilience after disaster?. The role of demographics, re-sources, and life stress. J Consult Clin Psychol. 2007; 75(5): 671-682.

de Terte I, Stephens C: Psychological resilience of workers in high-risk occupations. Stress Health. 2014; 30(5): 353-355.

Turner RJ, Marino F: Social support and social structure: A descriptive epidemiology. J Health Soc Behav. 1994; 35(3): 193-212.

Tsai J, Harpaz-Rotem I, Pietrzak RH, et al.: The role of coping, resilience, and social support in mediating the relation between PTSD and social functioning in veterans returning from Iraq and Afghanistan. Psychiatry. 2012; 75(2): 135-149.

Fredrickson BL, Tugade MM, Waugh CE, et al.: What good are positive emotions in crises?. A prospective study of resilience and emotions following the terrorist attacks on the United States on September 11th, 2001. J Pers Soc Psychol. 2003; 84(2): 365-376.

de Terte I, Stephens C, Huddleston L: The development of a three part model of psychological resilience. Stress Health. 2014; 30(5): 416-424.

Kashdan TB, Uswatte G, Julian T: Gratitude and hedonic and eudaimonic well-being in Vietnam war veterans. Behav Res Therapy. 2006; 44(2): 177-199.

Samaranayake CB, Fernando AT: Satisfaction with life and depression among medical students in Auckland, New Zealand. N Z Med J. 2011; 124(1341): 12-17.

Wood AM, Froh JJ, Geraghty AW: Gratitude and well-being: A review and theoretical integration. Clin Psychol Rev. 2010; 30(7): 890-905.

Wood AM, Maltby J, Gillett R, et al.: The role of gratitude in the development of social support, stress, and depression: Two longi-tudinal studies. J Res Personality. 2008; 42(4): 854-871.

Kong F, Ding K, Zhao J, et al.: The relationships among gratitude, self-esteem, social support and life satisfaction among under-graduate students. J Happiness Stud. 2015; 16(2): 477-489.

Karatzias T, Chouliara Z, Power K, et al.: Life satisfaction in people with post-traumatic stress disorder. J Ment Health. 2013; 22(6): 501-508.

Seidl JNT, Pastorek NJ, Lillie R, et al.: Factors related to satisfaction with life in veterans with mild traumatic brain Injury. Rehabil Psychol. 2015; 60(4): 335-343.

McCullough ME, Tsang JA, Emmons RA: Gratitude in intermediate affective terrain: Links of grateful moods to individual differences and daily emotional experience. J Pers Soc Psychol. 2004; 86(2): 295-309.

Brooks GR: Counseling and psychotherapy with male military veterans. In Brooks GR, Good GE, (eds.): The New Handbook of Psychotherapy and Counseling with Men: A Comprehensive Guide to Settings, Problems, and Treatment Approaches. Vol 1. San Francisco: Jossey-Bass, 2001: 206-226.

Hassell K: Police Organizational Cultures and Patrol Practices. New York: LFB Scholarly Publishing LLC, 2006.

Gilmartin KM: Emotional Survival for Law Enforcement: A Guide for Officers and Their Families. San Diego, CA: Praeger, 2002.

Published

03/01/2017

How to Cite

McCanlies, PhD, E. C., J. K. Gu, MPH, M. E. Andrew, PhD, C. M. Burchfiel, PhD, and J. M. Violanti, PhD. “Resilience Mediates the Relationship Between Social Support and Post-Traumatic Stress Symptoms in Police Officers”. Journal of Emergency Management, vol. 15, no. 2, Mar. 2017, pp. 107-16, doi:10.5055/jem.2017.0319.