Elijah McClain - The Association Between Abusive Policing and PTSD Symptoms Among U.S. Police Officers

The problem of abusive policing practices has garnered increasing national attention and has been identified as a major public health concern in the U.S. (American Public Health Association, 2016; Cooper & Fullilove, 2016; Cooper, Moore, Gruskin, & Krieger, 2004). Although no widely accepted definition of abusive policing practices exists, we conceptualize police abuse against civilians to include the excessive or undue use of lethal and nonlethal force; excessive or undue use of threats of force; threat of and completed forcible rape, sexual assault, or sexual coercion (including use of authority to obtain sexual favors); and use of psychological aggression or discriminatory slurs (e.g., racial slurs, sexual harassment) based on prior literature documenting these exposures in the U.S. population (Cooper et al., 2004; DeVylder, Oh, et al., 2017; Fedina et al., 2018; Hyland, Langton, & Davis, 2015; Son & Rome, 2004).

The Bureau of Justice Police–Public Contact Survey found that rates of excessive use of force were 2.8% among African Americans, 1.4% among Latinos, and 1% among non-Hispanic Whites based on data from 2002–2011 (Hyland et al., 2015). African Americans also experienced disproportionately higher 12-month rates of nonfatal force (14%) during police stops compared to non-Hispanic Whites (6.9%; Hyland et al., 2015), and lower income appears to increase risk for exposure for both African American men and non-Hispanic White men (Motley & Joe, 2018). Similarly, data from the Survey of Police–Public Encounters has shown that physical and sexual violence by police is reported by approximately 6.1% and 2.8% of respondents, respectively, in a general population sample of adult residents of major northeastern U.S. cities (DeVylder, Oh, et al., 2017). DeVylder, Oh, and colleagues (2017) also found that less severe abusive practices—such as psychological violence (e.g., threats, discriminatory slurs) and neglect (i.e. failure to respond when called)—are notably higher in the general adult population at lifetime rates of 18.6% and 18.8%, respectively. Such exposures have been linked to greater impairments in mental health—including depression, psychological distress, suicidal ideation, and psychosis (DeVylder, Cogburn, et al., 2017; DeVylder, Frey, et al., 2017; DeVylder, Oh, et al., 2017; Oh, DeVylder, & Hunt, 2017; Sewell, Jefferson, & Lee, 2016)—and physical health, suggesting that police abuse exposure is a significant and underrecognized public health issue in the U.S. (DeVylder, 2017).

Despite these recent findings, efforts to curb exposure to police abuse face an uphill battle, as initiatives may be seen as “antipolice” or politically unpopular among particular groups (Garces, 2018). However, strategies to address police violence may be more acceptable if abusive practices are shown to have a negative or traumatic impact on police officers themselves. On average, police officers experience more than three traumatic events every 6 months in their service (e.g., fatal accidents, murders, suicides, and life-threatening incidents against themselves or others; Patterson, 2001), and about one third (35%) of police officers who are exposed to traumatic events develop post-traumatic stress, which puts them at greater risk of developing post-traumatic stress disorder (PTSD; Komarovskaya et al., 2011; Papazoglou, 2012). PTSD has a substantial impact on physical and psychological health, as PTSD symptoms have been linked to physical health problems (e.g., chronic pain, cardio-respiratory, and gastrointestinal symptoms) and PTSD has been documented as a comorbid condition with anxiety, depression, and substance abuse and addiction (Javidi & Yadollahie, 2012; Pacella, Hruska, & Delahanty, 2013).

Given the lack of prior research on PTSD among police officers, research on PTSD among war veterans may be useful in understanding the potential impact of abusive police practices on the mental health of police officers. One study showed that the largest independent predictor of PTSD symptoms among Vietnam War veterans was whether or not the veteran engaged in “harm to civilians or prisoners” (Dohrenwend, Yager, Wall, & Adams, 2013, p. 224). Other similar studies examining the relationship between killing in war and various mental health and functioning outcomes among veterans who served in Vietnam and Iraq found that killing was significantly associated with PTSD symptoms and peri-traumatic dissociation, functional impairment in multiple domains, current violent behavior, alcohol abuse, and current relationship problems (Maguen et al., 2009, 2010). These findings in veterans are consistent with theoretical work emphasizing guilt as a factor that strengthens the association between trauma exposure and PTSD symptoms (Lee, Scragg, & Turner, 2001), which has been confirmed in several empirical studies of veterans (Henning & Frueh, 1997; Owens, Steger, Whitesell, & Herrera, 2009). There is additional evidence that guilt related to killing unarmed civilians may be the most significant explanatory factor for PTSD symptoms among veterans (Hendin & Haas, 1991). Perpetration of violence and abusive practices, which are likely to be complicated by emotions of shame and guilt, may likewise be associated with greater odds of PTSD symptoms among police officers. However, this has not been widely tested. Indeed, although they did not specifically examine abusive behavior or excessive use of violence, Komarovskaya et al. (2011) found that approximately 10% of police officers reported having to kill or seriously injure someone in the line of duty, and these actions were significantly associated with PTSD symptoms.

Understanding whether abusive police practices are associated with mental health difficulties among police officers may help to incentivize and guide efforts to reduce the prevalence of police violence, thereby alleviating risk for this exposure among communities that are frequently served by social workers. The aim of the present study, therefore, was to examine the relationship between PTSD symptoms and perpetration of violence against civilians among active-duty police officers working in the U.S., adjusting for childhood trauma history and workplace trauma exposure. We hypothesized that all types of trauma exposure would be associated with greater severity of PTSD symptoms and that perpetration of abusive police practices would be independently related to PTSD symptoms even when considering the effects of childhood trauma and workplace trauma exposure.