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More Research Needed to Understand PTSD-Related Injuries

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Editor’s Note: This article is the last in four-part series addressing challenges related to workers’ compensation and pension benefits for psychological injuries. Read the first article about why first responders suffering from PTSD must be eligible for compensation. Read the second article about why states need clearer laws on PTSD compensation claims. Read the third article about why employers struggle to determine compensation claims for PTSD.

By Dr. Chuck RussoProgram Director of Criminal Justice at American Military University and
Dr. Stephanie Myers-Hunziker, Faculty Member, Criminal Justice at American Military University

The mental health and overall wellbeing of police officers, firefighters, and other first responders is a topic of critical importance that requires further research. The research that has been conducted highlights the impact psychological stress has on the life and career of first responders, but much more research must be done to prove how pervasive it is among first responders. Only through research will lawmakers and public and private leaders understand the severity of the problem and why PTSD-related injuries must qualify under workers’ compensation and pension plans.

Research on PTSD in Law Enforcement

A study of 100 suburban police officers explored the relationship between job-related stressors and post-traumatic stress disorder (PTSD). Researchers reported a statistically significant relationship between exposure to duty-related stress and symptoms of PTSD (Robinson et al., 1997). In addition, several researchers have confirmed that exposure to life and death threats showed the strongest correlation to PTSD (Robinson et al., 1997; Yehuda, 2002; Pietrzak et al., 2014).

[Free Magazine: Understanding and Managing Law Officer Stress]

Research also found that less experienced officers—those with 11 years or less in law enforcement—displayed PTSD symptoms at a higher rate than more experienced officers (Robinson et al., 1997). Researchers speculated that less experienced officers have not yet developed successful coping mechanisms for stressful occurrences that their more experienced counterparts developed over time.

In the Netherlands, police officers from five of the seven largest police agencies in the country were examined for internal and external risk factors for post-traumatic stress symptoms. Researchers identified 37 critical police incidents in the country (Carlier et al., 1997). Personnel were then invited to participate in the study whenever they experienced a work-related critical incident. Several officers—262 in all—volunteered for the study. Although there are obvious selection biases here, it is important to note that researchers found that post-traumatic stress symptoms were detected in 34 percent of participants, and that actual PTSD was detected in seven percent of the sample.

Researchers noted that emotional or mental exhaustion at the time of trauma was highly correlated to post-traumatic stress symptoms. This exhaustion is frequently experienced among personnel who respond to traumatic incidents, as many first responders spend hours on scene after the neutralization of the threat occurs.

Research on PTSD in the Fire Service

PTSD has the potential to impact all public safety professionals, not only law enforcement officers. Corneil, Beaton, Murphy, Johnson, and Pike (1999) examined urban firefighters in two countries, the United States and Canada, to determine the risk of PTSD amongst their ranks. Researchers utilized a 15-item measure of post-traumatic stress symptomology. Both United States and Canadian samples presented with similar rates of PTSD: 90 percent of the U.S. sample and 85 percent of the Canadian sample reported exposure to at least one traumatic incident within the past year and both had “high odds ratios for PTSD due to the work strain variable” (p. 139). PTSD experienced by U.S. and Canadian firefighters was reported as four to six times greater than that experienced by crime victims in the U.S.

[Free Magazine: Understanding and Coping with Responder Stress]

Similarly, in a study of more than 400 German firefighters, 18 percent met the diagnostic criteria for PTSD (Wagner, Heinrichs, & Ehlert, 1998). Experiencing distressing missions and longer time as a firefighter correlated highest to PTSD from the sampled population. German firefighters with PTSD expressed higher levels of traumatic stress, substance use, and body complaints compared to fellow firefighters without PTSD.

[Related: The Challenge of Recognizing PTSD in Firefighters]

Based on existing research, it seems evident that PTSD-related symptoms plague those who work in public safety. More comprehensive research on a larger population of first responders is needed to confirm how many first responders suffer from psychological injuries and to help build a case on why these types of injuries should be included in workers’ compensation and pension benefits.

About the Authors:  

ptsd-relatedDr. Chuck Russo is the Program Director of Criminal Justice at American Military University (AMU). He began his career in law enforcement in 1987 in Central Florida and was involved all areas of patrol, training, special operations and investigations before retiring from law enforcement in 2013. Dr. Russo continues to design and instruct courses, as well as act as a consultant for education, government and industry throughout the world. His recent research and presentations focus on emerging technology and law enforcement applications, post-traumatic stress, nongovernment intelligence actors, and online learning.

ptsd-relatedDr. Stephanie Myers-Hunziker is a Professor of Criminal Justice at American Military University.  She has a tremendous amount of practical work and research experience working inside public agencies. Early in her professional career, Dr. Myers-Hunziker was awarded a National Institute of Justice fellowship for her dissertation research on police interactions with juveniles. While conducting other research sponsored by the National Institute of Justice she has on several occasions worked inside police departments.  Her specialty is helping public organizations identify their goals and better understand how to achieve them. To that end, Dr. Myers-Hunziker has published an article on the art of identifying and implementing best practices from the field.

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Carlier, I., Lamberts, R., & Gersons, B. (1997). Risk factors for posttraumatic stress symptomatology in police officers: A prospective analysis. The Journal of Nervous and Mental Disease, 185(8), 498-506.

Corneil, W., Beaton, R., Murphy, S., Johnson, C., & Pike, K. (2016). Exposure to traumatic incidents and prevalence of posttraumatic stress symptomology in urban firefighters in two countries. Journal of Occupational Health Psychology, 4(2), 131-141.

Pietrzak, R. H., Feder, A., Singh, R., Schechter, C. B., Bromet, E. J., Katz, C. L., . . . Southwick, S. M. (2014). Trajectories of PTSD risk and resilience in World Trade Center responders: An 8-year prospective cohort study. Psychological Medicine, 44(1), 205-19. doi:

Robinson, H., Sigman, M., & Wilson, J. (1997). Duty-related stressor sand PTSD symptoms in suburban police officers. Psychological Reports, 81, 835-845.

Wagner, D., Heinrichs, M., & Ehlert, U. (1998). Prevalence of symptoms of posttraumatic stress disorder in German professional firefighters. The American Journal of Psychiatry, 155(12), 1727-1732.

Yehuda, R. (2002). Post-traumatic stress disorder. The New England Journal of Medicine, 346(2), 108-14. Retrieved from


Dr. Chuck Russo

Dr. Chuck Russo is the Department Chair of Human Justice at AMU. His law enforcement career involved all areas of patrol, training, special operations and investigations. He continues to design and instruct courses. His recent research focuses on emerging technology in law enforcement, post-traumatic stress, and nongovernment intelligence actors.

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