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The Cost of PTSD
By Caterina Spinaris
Published: 10/18/2010

Prison tower 1 Sadly, the corrections workplace is one of the “natural” environments for the development of PTSD [Post-traumatic stress disorder]. That is because correctional workers are exposed to incidents that are considered traumatic, as they may experience, witness, or are confronted with events that involve actual or threatened death or serious injury, or a threat to the physical integrity of self or others.[1]

Correctional workers are directly or indirectly exposed to violence, death, physical assaults, assaults with weapons, and threats of bodily harm or death, all of which are known to increase the likelihood that individuals exposed to such conditions will develop PTSD symptoms.

In response, at least early on in their careers, correctional workers exposed to such incidents may experience helplessness, terror or horror, among other emotions. However, over time staff may become so hardened or emotionally numb (emotional numbing is a PTSD symptom, by the way), that they respond to traumatic incidents at work with anger or indifference.

Most people do not realize the toll PTSD takes on an individual’s overall health and well-being, their professional functioning, and their relationships with significant others.

When we hear about the condition of PTSD we may think of someone having nightmares and perhaps fear or anger issues. From the outside a PTSD diagnosis may not look like a big deal. We may even wonder if purported PTSD sufferers are exaggerating or why they can’t just “get over it.” If things were only that simple!

The reality is that PTSD is a complex condition that affects those who suffer from it to various degrees in just about every facet of their lives.

The reason for this is that PTSD is not simply a psychological state or a bad mood. PTSD involves biochemical and structural changes in the brain of people exposed to events which to them were traumatizing. That is, PTSD is a tenacious neurobiological condition that manifests as a variety of physical, psychological, social and spiritual symptoms.

Here is a very brief summary of some key areas impacted by PTSD.

PTSD affects people’s physical health. Those afflicted by it may experience heart palpitations and arrhythmias, high blood pressure, headaches, muscle tension and gastro-intestinal problems, among others.

PTSD can be devastating on the sufferer’s psychological health and social interactions. Social dysfunction and violence increase with PTSD. People withdraw, act “paranoid,” or become easily enraged. Substance abuse increases with PTSD. And to make matters worse, in addition to its own symptoms, PTSD often co-exists with other disorders, such as major depressive disorder, generalized anxiety disorder and panic disorder. Suicidal thinking also increases with PTSD symptoms independently of any other existing disorder. Individuals and their families suffer. Quality of life plummets.

Spiritually, PTSD is characterized by bleakness, indifference and lack of hope. It deals a serious blow to people’s capacity for compassion, perhaps our highest spiritual quality.

Those who suffer from less than the required number symptoms for a PTSD diagnosis, that is people who have partial (subclinical) PTSD, similarly experience its devastation, only to a lesser degree. Trauma-exposed individuals who meet some, but not all, criteria for PTSD have clinically significant distress; co-morbid disorders, such as major depressive disorder; and associated impairments in functioning comparable to that of full PTSD. The presence of partial PTSD also significantly raises the risk of suicidal thoughts.

Therefore, substantially greater numbers of individuals are impaired or disabled after trauma than is suggested by simply considering the rates of full PTSD.

How do these realities impact the corrections workplace?

Not surprisingly, PTSD ends up being very costly to administrators. PTSD has been found to result in increased staff turnover, sick leave, use of health services, and short-term and long-term disability. It also lowers morale and results in under par performance on the job. (For a literature review and additional research findings, see http://www.rpnas.com/public/pdfs/PTSDInCorrections.pdf.) For example, due to their difficulty in concentrating, correctional staff is more prone to make mistakes. Due to increased anger and irritability, they are more likely to go off on inmates, use excessive force, or make coworkers’ life harder than it already is. With fears for their safety, they are more likely to be compromised by inmates, such as to bring contraband or to overlook inmates’ illegal behaviors in exchange for protection for themselves.

Given the toll of PTSD on individuals, families and their employers, it clearly behooves us to do our utmost to ensure preventative, resilience-building trainings for correctional workers as well as provision of sufficient specialized treatment services. The alternative—doing nothing—is simply much more costly in the long run.

1. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders (4th edition). Washington: American Psychiatric Association.

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