Study pinpoints five most likely causes of post-traumatic stress in
police officers

Date:
August 11, 2020
Source:
NYU Langone Health / NYU School of Medicine
Summary:
A combination of genetic and emotional differences may lead to post-
traumatic stress (PTS) in police officers, a new study finds. Based
on biological studies of officers in major cities, the study showed
that the most significant PTS predictors are the tendency to startle
at sudden sounds, early career displays of mental health symptoms
(e.g., anxiety and depression), and certain genetic differences,
including some known to influence a person's immune system.



FULL STORY ==========================================================================
A combination of genetic and emotional differences may lead to
post-traumatic stress (PTS) in police officers, a new study finds.


========================================================================== Based on biological studies of officers in major cities, the study showed
that the most significant PTS predictors are the tendency to startle at
sudden sounds, early career displays of mental health symptoms (e.g.,
anxiety and depression), and certain genetic differences, including some
known to influence a person's immune system.

"If we can identify major risk factors that cause PTS and treat them
before they have the chance to develop into full-blown post-traumatic
stress disorder, or PTSD, we can improve the quality of life for police officers and perhaps other emergency responders, and better help them
deal with the stressors of their work," says senior study author Charles Marmar, MD, the Lucius N.

Littauer Professor of Psychiatry at NYU Grossman School of Medicine.

Publishing online Aug. 10 in the journal Translational Psychiatry,
the study authors employed a mathematical computer program developed by scientists at NYU Langone Health and the University of Minnesota. They
used a combination of statistical analyses to test which of a large number
of features linked by past studies to PTSD were the best at predicting
its occurrence in police officers.

Some of this winnowing that determined the best predictors was
accomplished using machine learning, mathematical models trained with
data to find patterns.

These algorithms enabled researchers to track how experiences, situations,
and characteristics may have interacted over time to lead to PTS symptoms,
and represent the first use of such techniques in PTS research in police officers, the authors say.

"Based on these techniques, our study identified specific causes of PTS,
rather than possible links," says Marmar, also chair of the Department
of Psychiatry at NYU Langone.



==========================================================================
He adds that the need for better information is urgent. An estimated eight
out of every 100 people experience PTS in their lifetimes, according to
the National Institute of Mental Health. Police officers are particularly vulnerable, he says, facing an average of three traumatic experiences
for every sixth months of service. Common symptoms include nightmares, aggression, and distressing flashbacks of the traumatic event, which can
lead to poor sleep, anxiety, depression, and increased risk of suicide.

In the new study, the investigators analyzed data collected on 207 police officers from departments in New York City, San Francisco, Oakland,
and San Jose who had PTS. All officers had experienced at least one life-threatening event during their first year on the job.

Using the computer program, the investigators searched for patterns in 148 different characteristics previously thought to be involved in PTS. They
mapped out 83 different possible combinations of factors, or pathways,
which could have influenced the officers as they developed the condition.

Then, they identified factors which appeared most frequently, and found
that every pathway to PTS shared one of five causes. Besides the tendency
to startle easily, severe distress following a traumatic experience, and a
set of emotional health problems, such as anxiety and depression, played a
key role in PTS. Genetic causes included mutations in the HDC gene, which
is linked to problems in the immune system and mutations in the MR gene,
which is involved in the body's immediate reaction to threats, known
as the fight-or-flight response. If all five factors were eliminated, researchers say, the officers would not be expected to develop PTS.

"Because the factors we identified are causal, they should be actionable
as well," says lead study investigator Glenn Saxe, MD, a professor in
NYU Langone's Department of Child and Adolescent Psychiatry. "Several of
the causal factors we identified -- the HDC gene, the MR gene, and the
startle response - - point to well-mapped nerve circuits, which should
allow us to find drugs and behavioral therapies that might help. Down the
road, we see the possibility of using information collected from patients
about causal factors to select the interventions that would provide the
most benefit to them." Saxe says other future interventions might target factors that may not cause PTS on their own, but frequently contribute to
its development. For example, the study found that difficulty adjusting
to work contributed to PTS development in 60 percent of the causal
pathways. Therefore, a straightforward solution, like giving more support
to new police officers who are having difficulty adjusting to police work,
may reduce their risk of getting PTS, according to Saxe.

Moving forward, the researchers plan to apply the same algorithm technique
in a much larger group of traumatized adults and children, focusing on
a more extensive set of characteristics and experiences.

Funding for the study was provided by National Institute of Mental
Health grant R01 MH056350 and Substance Abuse and Mental Health Services Administration grants U79 SM080049 and U79 SM080013.

In addition to Marmar and Saxe, other NYU Langone researchers include
Leah J.

Morales, BS; and Isaac Galatzer-Levy, PhD. Other study authors are Sisi
Ma, PhD; and Constantin Aliferis, MD PhD, at the University of Minnesota
in Minneapolis.


========================================================================== Story Source: Materials provided by NYU_Langone_Health_/_NYU_School_of_Medicine. Note: Content may be edited
for style and length.


========================================================================== Journal Reference:
1. Glenn N. Saxe, Sisi Ma, Leah J. Morales, Isaac R. Galatzer-Levy,
Constantin Aliferis, Charles R. Marmar. Computational
causal discovery for post-traumatic stress in police
officers. Translational Psychiatry, 2020; 10 (1) DOI:
10.1038/s41398-020-00910-6 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2020/08/200810213211.htm

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