Transcript Journal of Abnormal Psychology, 59

Resiliency and First Responders
Jim Ungvarsky, PsyD, LMFT
Regis University
Sharon Trivette, PsyD, LPC
El Paso County Sheriff’s Office
Copyright 2013 Ungvarsky and Trivette
Question
• In a study1 of hospitalized survivors of motor
vehicle accidents, approximately what percentage
did not develop PTSD?
a. 95%
c. 40%
b. 80%
1 Bryant,
d. 17%
R.A., Harvey, A.G., Guthrie, R.M., & Moulds, M.L. (2000). A prospective study of psychophysiological arousal, acute stress disorder,
and posttraumatic stress disorder. Journal of Abnormal Psychology, 109, 341-344.
Question
• In a study of PTSD among veterans serving in
Iraq2, approximately what percentage had no
psychological distress when examined within
one year of their return to the U.S.?
a. 73%
b. 63%
2
c. 40%
d. 3%
Sutker, P.B., Davis, J.M., Uddo, M., & Ditta, S.R. (1995). War zone stress, personal resources, and
PTSD in Persian Gulf War returnees, Journal of Abnormal Psychology, 59, 444-452.
Question
• A 2002 study conducted by Resnick and others
found that what percentage of Manhattan
residents did not report having a single PTSD
symptom the in the year following 9/11?
a. 60%
b. 40%
c. 20%
d. 10%
Learning Objectives
• Differentiate between reactive vs. proactive
models of mental health
• Distinguish the subtleties between prevention
of illness and promotion of health
• Gain skills to promote resiliency in the face of
traumatic events
• Identify the components of resiliency
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Research Questions
• What can we learn from first responders?
• What differentiates those who get PTSD from
those who don’t?
• How do we enhance factors that promote
resiliency in adults?
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Why focus on Law Enforcement?
• “Research suggests that police work is among
the most stressful occupations in the world
and officers typically suffer a variety of
physiological, psychological, and behavioral
effects and symptoms.”
McCraty, Atikson, Global Advances in Health and Medicine,
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Why Study Law Enforcement?
• Officers are exposed to numerous Potentially
Traumatic Events (PTEs)
• Keeping Law Enforcement Officers healthy is
in the best interest of the communities that
they serve.
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Why Study Law Enforcement?
• Stress among police has the potential to affect
society directly and in more critical ways than
other occupations.
• Those in the occupation of law enforcement
may be encouraged to detach from others and
disassociate from their feelings.
McCraty, Atikson, Global Advances in Health and Medicine
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Operational Sources of Stress for Law
Enforcement Officers
•
•
•
•
Major disasters
Traffic incidents
Shooting incidents
Interpersonal violence,
including domestic
violence calls
• Negative or
confrontational
interactions with
individuals
• Sense of personal
endangerment
• Fear of
revenge/retaliation
from criminals
• Subservience to an
ambivalent, watchful
public
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Non-Operational Sources of Stress for
the Law Enforcement Officer
• Shift schedules
• Authoritarian
management styles
• Poor interpersonal
relationships with
supervisors
• Interdepartmental
politics
• Lack of adequate
planning and resources
• Lack of promotion and
transfer opportunities
• Excessive paperwork
• Lack of autonomy in
performing duties
• Lack of recognition for
work accomplishments
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Predictors of PTSD Reactions
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•
•
•
•
•
Lack of social support
Low intelligence
Lack of education
Family background
Prior psychiatric history
Dissociative reactions
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Predictors of Symptoms* among 1st
Responders to a Potentially Traumatic
Event
• Proximity
• Duration
• Intensity of Exposure
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Ease
•Adaptive state
•Resilience
Dis-ease
•Maladaptive state
•Vulnerability
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• How do we conceptualize functioning
following a potentially traumatic event?
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Severe
Moderate
DELAYED
RECOVERY
Mild
Disruptions in normal functioning
CHRONIC
RESILIENT
Event
Time
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Research
• 50%-60% of the US population is exposed to
traumatic stress
• Only 5%-10% develop PTSD (Ozer at al., 2003)
• Est. chronic PTSD range from 6.6% to 17.8% of
those exposed to PTE
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Pathogenic or Negative Responses
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•
•
•
Traumatic stress symptoms
Secondary traumatic stress
Compassion fatigue
Burnout
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Resilient Responses
• Compassion satisfaction (Stamm)
– Positive feelings
•
•
•
•
about helping others, finding meaning in one’s effort
and challenges, fulfilling one’s potential, contributing
to the work setting and even to the greater good of
society, and the overall pleasure derived from being
able
• to do one’s work well.
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What is Resilience
“ability of adults in otherwise normal
circumstances who are exposed to an isolated
and potentially highly disruptive event, such
as the death of a close relation or a violent or
life-threatening situation, to maintain
relatively stable, healthy levels of
psychological and physical functioning”
Bonanno
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What is Resilience
• The process of adapting well in the face of
adversity, trauma, tragedy, threats, or even
significant sources of stress – such as family
and relationship problems, serious health
problems, or workplace and financial
stressors. (American Psychological
Association)
• It refers to the ability of “bouncing back” from
difficult experiences
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Ordinary vs Extraordinary
• Research supports that we all commonly
demonstrate resilient behavior
• Being resilient does not mean a person
doesn’t experience sadness or distress – these
feelings are ordinary.
• Resilient people have an extraordinary trait to
survive such experiences without it holding
them back
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Common Questions
• Where does resilience come from?
• Do some people have more of it than others?
• Is there some unique quality only special
people have?
• What role does the environment and culture
play in hindering or helping one’s resilience?
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The Simple Answer
• Resilience is not a trait people either have or
do not have; regardless of race, age, gender,
creed, etc.
• It involves behaviors, thought, and actions
that can be learned and developed by anyone.
• In fact, those we would define as resilient
often have the skill thanks to action learning
through life experiences that involve
considerable emotional distress.
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Building a Scaffold of Resiliency
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Standard One
Connections & Community
• Forge positive relations with others helps increase
one’s emotional strength
• Feelings of belonging and emotional connection to a
community
• Perceived influence over the community
• Perceived opportunities for fulfilling one’s needs
(including need for belonging)
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Standard Two
Collective Efficacy
• What people choose to do as a group, the effort they
put into it, and the perception of the group’s ability
to accomplish its major tasks
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Standard Three
Coping & Appropriate Perspective
• See Crisis Events as They Are
– Crisis events are not viewed as insurmountable
problems
– You can not change what has happened. You can
however control how you respond to that event
– Don’t make mountains out of molehills
– When confronting mountains, view them in
perspective of the greater challenge ahead
– Appraise PTEs as being less threatening
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Standard Four
Accept Challenge
• Surrender yourself to the fact that change is part of
life
• Accept that from time-to-time certain goals may no
longer be attainable as a result of adverse situations
beyond your control
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Standard Five
Contribution
• Take Action
– Do something about achieving your goals
– If you don’t have any, get some!
– Set achievable goals rather than wasting time on
“learning to fly without any wings.”
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Standard Six
Control
• Be Decisive
– Do not avoid facing adversity – confront the
problem head-on and take decisive action to
improve the situation or ensure it does not repeat
itself in your life
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Standard Seven
Competence
• Self Improve
– Be active in finding ways to improve yourself and
don’t be frightened to get to know yourself better
– Find reasons to have a strong sense of self-worth
and value to the world
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Standard Eight
Confidence
• Develop an Ego
– Take the time to find reasons why you are
important and focus energy on developing
confidence
– Trust yourself and your instincts so that they can
better help you and your world to problem solve
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Standard Eight
Confidence
• Self-Efficacy
– The individual beliefs that one holds regarding
one’s own capability to exercise some measure of
control over in how one functions and of
environmental events
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Standard Nine
Optimism
• Be Hopeful
– Find the optimistic outlook for even the most
devastating event
– Learn to see what you want rather than worrying
about what you fear – which is what we often
confuse as what we see.
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Standard Ten
Character & Self-Care
• Take Care of Yourself
– Pay attention to your own needs and feelings –
but don’t be self-centered
– Keep yourself healthy, fit , and well. Invest energy
into eating well, gentle exercise, and maintaining a
positive frame of mind
• Hardiness
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Dimensions of Resilience
Physical
Relationships
Spiritual
Emotional
Mental
Next Steps
• Resiliency training
– Heart Math
– Biofeedback
• Efficacious use of resources
• Utilizing the law enforcement community as a
support system
Copyright 2013 Ungvarsky and Trivette
Thank you