The impact of perceived intensity and frequency of police work occupational stressors on the cortisol awakening response (CAR): Findings from the BCOPS study
Introduction
Over the course of what may ultimately be a decades long career police officers are repeatedly exposed to conditions and incidents unique to their job that they may perceive and respond to as stressful (North et al., 2002, Paton, 2005, Paton et al., 2009). With little or no warning, officers may find themselves responding to events ranging from domestic disturbances to involvement in complex, evolving natural disasters or acts of terrorism. Events at the more challenging end of the critical incident spectrum (e.g., terrorist acts, shootings, assaults) result in officers encountering, over periods of several days or weeks, unpredictable, evolving, and escalating demands (Paton and Violanti, 2007). Further, the burden of societal responsibility and strict legal norms are placed on officers as they deal with these demands. One may surmise that police officers are often in a state of psychological inflexibility faced with a multitude of difficult and challenging work demands.
In general, the perception of an event or condition as a stressor triggers the response of several biological systems to aid the body in dealing with the stressor. Primary among them is the hypothalamic-pituitary-adrenal (HPA) axis which responds to a stressor by releasing cortisol, the species-specific hormone in man from the adrenal gland. The cortisol response is frequently used as a biomarker of HPA axis status or function. The axis acts in a classic negative feed-back fashion where the circulating cortisol acts to “shut-off” the signals that trigger the response allowing a return to homeostasis. The return to homeostasis confers stability to the system through change or allostasis (McEwen, 1998, McEwen, 2007, McEwen, 2008, McEwen and Wingfield, 2003). It seems intuitive that, repeated or sustained activation of the HPA axis may cause an increase in the allostatic load, the unwanted “wear-and-tear” on the system that occurs with the need to constantly respond to various stressors. The constant adaptation of the HPA axis to various demands may ultimately result in pathological function of the HPA axis where the response is exaggerated or minimal. This alteration in the response of HPA axis may be reflected in the pattern of the cortisol secretion or the amount of the hormone. For example, in a non-compromised functioning of HPA axis the CAR is characterized by a pronounced peak in cortisol shortly after awakening which gradually diminishes over the next 30 to 40 min. Here, we hypothesized that the constant need for police officers to respond to a variety of stressors may compromise the functioning of HPA axis and be reflected in a disturbed CAR pattern.
To our knowledge, no recent study has examined the effect of the perceived intensity of stressors and the frequency of occurrence in police work on the CAR pattern. We hypothesize in the present study that the perceived intensity of specific police work stressors as most stressful (high) or least stressful (low) will have a differential effect on the awakening cortisol patterns among police officers.
Section snippets
Study population
Study participants for the current analyses were officers enrolled in the Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) study. The BCOPS study was a cross-sectional study aimed at investigating the associations of occupational stressors experienced in police work with the psychological and physiological health of police officers. A total of 710 police officers who worked at the Buffalo Police Department in New York were invited to participate in the BCOPS study; 464 (65.4%)
Participant demographic and lifestyle characteristics
The demographic and lifestyle characteristics of the study participants (n = 338) are presented in Table 1. The study population consists of 78% males and the majority was white (79%), married (77%), and had a rank of patrol officer (65%). The mean age was 42.9 years (range: 27–74 years). The distribution of demographic and lifestyle characteristics of the participants did not vary significantly across tertiles of the major stress index except for police rank, age, and years of service (Table 2).
Discussion
The present study examined the possible association of the major and minor stressors from the Spielberger Police Stress Survey with the CAR pattern. Results indicated a significant negative association between the stress index of the top five most stressful events and slope of the CAR pattern. As the highly rated stress index increased, the pattern tended to flatten over time. Officers with zero stress index showed a steep and steady increase in cortisol from baseline while officers with
Conflict of interest
The authors declare that there are no conflict of interest.
Contributors
All authors contributed substantially to the conception and design of the study. J.M.V. oversaw data acquisition and cleaning data. D.F., M.E.A., T.A.H., L.E.C., D.B.M., and C.M.B. analyzed and interpreted the data. J.M.V. wrote the first draft of the manuscript and all authors contributed to its review and critical revision. All authors have approved the final version of the article.
Role of funding source
This study was supported by the Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health- Contract No. 200-2003-01580. The sponsor had no involvement in the study design; in the collection, analysis and interpretation of data; the writing of the report; nor in the decision to submit the article for publication. The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for
Disclaimer
The findings and conclusions in this report are those of the authors and do not necessarily represent the views of the National Institute for Occupational Safety and Health.
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