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This qualitatively)Tj T* -0.0055 Tc -0.0083 Tw (up-graded replacement for Critical Incident Stress)Tj 0 -1.21 TD -0.0062 Tc -0.0468 Tw (Management, Second Edition, presents conceptual)Tj 0 -1.2075 TD -0.0679 Tc -0.0615 Tw (refinements and up-dates that reflect the evolving nature of)Tj T* -0.0368 Tc -0.0613 Tw (crisis intervention and disaster mental health that have)Tj 0 -1.21 TD -0.0677 Tc -0.0615 Tw (revolutionized the field since 1999.)Tj /F7 1 Tf 30 0 0 30 221.01 701.01 Tm /GS1 gs -0.0044 Tc 0.0484 Tw [(A)56.6(vailable NOW!)]TJ /TT9 1 Tf 12 0 0 12 266.01 624.99 Tm /GS2 gs -0.0514 Tc -0.0625 Tw (Catalog #EVE12)Tj 0 -1.125 TD -0.0052 Tc 0.0458 Tw (Paperback 248 pp \(2008\))Tj T* 0.0169 Tc 0.125 Tw (ISBN 978-1-883581-12-1)Tj /F8 1 Tf 14 0 0 14 266.01 579.84 Tm 0.0271 Tc 0 Tw ($38.00)Tj /F6 1 Tf 18 0 3.78 18 147.9 675.66 Tm -0.0062 Tc 0.0416 Tw [(A Ne)8.8(w Book b)32.1(y)0.5( Geor)8.8(ge S.)93.8( Ev)25.5(er)-21.2(ly)72.1(,)98.1( Jr)43.8(.)98.1( and)]TJ 4.8826 -1.0283 TD -0.0044 Tc 0.0148 Tw [( Jeffr)15.6(e)24.6(y)0.8( )73.9(T)78.9(.)99.9( Mitchell)]TJ /TT3 1 Tf 11 0 0 11 145.89 113.01 Tm -0.004 Tc 0.0359 Tw (Get your copy of this important new resource by ordering NOW!)Tj 2.4191 -1.0909 TD -0.0047 Tc 0.0197 Tw (Order by calling Chevron Publishing at 410-418-8002)Tj 3.2045 -1.0909 TD 0.0303 Tw (Order online at chevronpublishing.com)Tj ET q 65.5 631.5 187.5 -278.5 re W n /GS1 gs /Fm6 Do Q /GS1 gs 54.495 732.505 492.01 -673.01 re S endstream endobj 33 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F6 34 0 R /F7 35 0 R /F8 36 0 R /TT3 10 0 R /TT8 37 0 R /TT9 38 0 R >> /XObject << /Fm6 39 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> /ColorSpace << /Cs10 40 0 R >> >> endobj 41 0 obj << /FunctionType 0 /Domain [0 1] /Range [0 1 0 1 0 1 0 1] /BitsPerSample 8 /Size [255] /Length 701 /Filter /FlateDecode >> stream H P EKl& (&(b` fΛ ZTjUXSIRW[Ejlb7V0zqk%`AV! 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Levenson, Jr)109.2(., Psy)52.6(.D., CTS is Editor of the )]TJ /TT2 1 Tf 21.2933 0 TD -0.0057 Tc 0 Tw (International)Tj -21.2933 -1.2233 TD -0.0054 Tc 0.0361 Tw (Journal of Emergency Mental Health)Tj /TT5 1 Tf 14.7933 0 TD -0.0047 Tc 0.0362 Tw (, and a licensed psychologist)Tj -14.7933 -1.2233 TD 0.0015 Tc 0.1253 Tw [(practicing in New Y)78.2(ork City)44.8(. Dr)108.2(. Levenson is also Department)]TJ 0 -1.22 TD -0.006 Tc -0.0622 Tw [(Police Sur)40.7(geon, Ulster County Sheriff)-89.3()127(s)-0.7( Office, Kingston, New Y)80.7(ork.)]TJ 0 -1.2233 TD -0.005 Tc 0.0167 Tw (Correspondence to: drlevenson@att.net .)Tj /F1 1 Tf 14 0 0 14 114.15 656.34 Tm -0.0002 Tc 0.1377 Tw (Introduction to Special Issue Focusing on Resiliency and)Tj 5.5714 -1.1421 TD 0.0025 Tc 0.1383 Tw [(I)6.5(n)30.4(vulnerability in La)6.8(w Enf)13.2(o)6.1(r)13.2(cement)]TJ /TT2 1 Tf 10 0 0 10 84.99 509.64 Tm 0.0027 Tc 0.125 Tw (Psychology and the behavioral sciences have flirted)Tj -1.8 -1.398 TD -0.0024 Tc [(with the concept of normalcy or)36.6(, rather)30.6(, what constitutes)]TJ 0 -1.401 TD -0.0088 Tc -0.0625 Tw [(being normal for well over 100 years. Indeed, Freud wrote)]TJ T* -0.0031 Tc -0.04 Tw [(of the abilities of healthy individuals to be able to withstand)]TJ 0 -1.398 TD -0.003 Tc -0.0266 Tw [(the normal miseries of every-day life. 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More precisely)]TJ 0 -1.398 TD -0.0035 Tc -0.0278 Tw (stated, this school of thought was determined to reveal those)Tj 0 -1.401 TD 0.04 Tw (protective factors within individuals that help them survive)Tj T* 0.0146 Tc 0.125 Tw (emotionally intense environments, situations, or events.)Tj 0 -1.398 TD -0.0038 Tc 0.0475 Tw (What was in the make-up of these people that helped them)Tj 0 -1.401 TD -0.0187 Tc -0.0622 Tw (emerge relatively or virtually unscathed emotionally from trau-)Tj T* -0.0033 Tc 0.055 Tw (matic situations?)Tj 1.8 -1.998 TD 0.0172 Tc 0.125 Tw (As the )Tj /TT5 1 Tf 3.204 0 TD 0.0175 Tc (International Journal of Emergency Mental)Tj -5.004 -1.401 TD -0.0055 Tc 0 Tw (Health)Tj /TT2 1 Tf 2.694 0 TD -0.0035 Tc 0.0183 Tw [( has been at the forefront of providing the communi-)]TJ -2.694 -1.401 TD -0.0033 Tc 0.125 Tw (ties of scientists and practitioners with research regarding)Tj 0 -1.398 TD -0.01 Tw (the manner in which trauma affects us, so it has also been at)Tj 0 -1.401 TD -0.0036 Tc 0.095 Tw (the forefront in illuminating how traumatic events specifi-)Tj T* -0.0031 Tc -0.0056 Tw (cally affect law enforcement officers, their families, and the)Tj 0 -1.398 TD -0.0035 Tc -0.053 Tw (law enforcement community as a whole.)Tj 1.8 -2.001 TD 0.08 Tw (This issue of the)Tj /TT5 1 Tf 6.765 0 TD -0.0043 Tc [( Journal)]TJ /TT2 1 Tf 3.411 0 TD -0.0037 Tc 0.082 Tw [( is devoted to providing new)]TJ -11.976 -1.401 TD -0.0032 Tc -0.0256 Tw (insights into the factors of resilience and invulnerability that)Tj 0 -1.398 TD -0.003 Tc -0.0181 Tw [(promote healthy functioning in what is considered by many)60(,)]TJ 0 -1.401 TD -0.0002 Tc 0.125 Tw [(internationally)59.8(, to be the most stressful occupation of all.)]TJ T* -0.0033 Tc -0.0005 Tw (Each of the authors of the articles in this issue is considered)Tj 0 -1.398 TD -0.0192 Tw [(to be an expert in the law enforcement field. I would expect)]TJ 0 -1.401 TD -0.0029 Tc -0.045 Tw (their wisdom, kindly provided here by invitation, to be a sig-)Tj T* -0.0033 Tc -0.0307 Tw (nificant resource for the mental health critical care specialist)Tj 0 -1.398 TD -0.0029 Tc 0.125 Tw (who provides Critical Incident Stress Management and/or)Tj 0 -1.401 TD -0.0035 Tc -0.0458 Tw [(clinical services to the law enforcement community)59.5(.)]TJ ET endstream endobj 44 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 46 0 obj << /Length 266 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0049 Tc 0.0666 Tw [(86 )]TJ /TT3 1 Tf 2.1262 0 TD -0.0058 Tc (Authors Running head)Tj ET /Cs9 cs 0 scn /GS1 gs 46 65 507 -32 re f endstream endobj 47 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> /ColorSpace << /Cs9 24 0 R >> >> endobj 48 0 obj << /FunctionType 4 /Domain [0 1] /Range [0 1 0 1 0 1 0 1] /Length 20 /Filter /FlateDecode >> stream HN)-PZ.( endstream endobj 50 0 obj << /Length 6030 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.5 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.034 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3375 0 TD -0.0132 Tc 0 Tw (87)Tj /TT3 1 Tf 7 0 0 7 124.41 726.66 Tm -0.0061 Tc 0.0226 Tw [(International Journal of Emergency Mental Health, Vol. 10, No. 2, pp. 87-94 2008 Chevron Publishing ISSN 1522-4821)]TJ /TT4 1 Tf 10 0 0 10 102.99 508.86 Tm -0.0043 Tc 0 Tw (Abstract: )Tj /TT5 1 Tf 4.047 0 TD -0.0035 Tc 0.0583 Tw (Current estimates are that most people living in the United States will experience at least one)Tj -4.047 -1.302 TD -0.0197 Tw [(violent or life-thr)32.5(eatening event during their lives. Recent data suggest, however)107.5(, that most people exposed)]TJ 0 -1.299 TD 0.0035 Tc 0.125 Tw (to traumatic events do not experience serious disruptions in normal life functioning, and are in fact)Tj T* -0.0035 Tc 0.035 Tw [(r)34.7(esilient. The purpose of this article is to r)32.5(eview the constructs of r)32.5(esilience and r)29.5(ecovery)56.3(,)0( and to suggest)]TJ 0 -1.302 TD 0.0098 Tc 0.125 Tw (how early crisis intervention, historically linked with the mitigation or prevention of psychological)Tj 0 -1.299 TD 0.0314 Tc 0.1251 Tw [(distr)31.4(ess, may mor)31.4(e accurately be conceptualized in terms of fostering or enhancing r)25.4(esiliency)49.4(.)]TJ T* -0.0036 Tc 0.0856 Tw ([International Journal of Emergency Mental Health, 2008, 10\(2\), pp. 87-94].)Tj /TT1 1 Tf 9 0 0 9 196.41 411 Tm -0.0054 Tc 0.0056 Tw (Key words: )Tj /TT5 1 Tf 5.12 0 TD -0.0049 Tc 0.0066 Tw [(r)37.6(esilience, r)35.1(ecover)-4.9(y)55.6(,)-0.3( early crisis inter)-4.9(vention, CISM, CISD)]TJ ET /GS1 gs 66.99 124.245 m 300 124.245 l S BT 9 0 0 9 66.99 106.5 Tm /GS2 gs -0.0047 Tc 0.0611 Tw (Corresponding Author:Jeffrey M. Lating, Ph.D., Loyola College)Tj 0 -1.2233 TD 0.0115 Tc 0.1253 Tw [(in Maryland, 4501 North Charles Street, 220 D Beatty Hall,)]TJ 0 -1.22 TD -0.0024 Tc 0.125 Tw (Baltimore, MD 21210-2699. jlating@loyola.edu. 410-617-5341)Tj 0 -1.2233 TD -0.0136 Tc 0 Tw (\(fax\))Tj /F1 1 Tf 14 0 0 14 159.75 629.34 Tm 0.0021 Tc 0.1375 Tw (Crisis Intervention and Fostering Resiliency)Tj /TT2 1 Tf 10 0 0 10 84.99 368.64 Tm -0.0037 Tc 0.0094 Tw (Traumatic events are imbedded in the fabric of human)Tj -1.8 -1.398 TD -0.0031 Tc 0.0767 Tw [(history)62.9(, and their physical and emotional impact has been)]TJ 0 -1.401 TD -0.0035 Tc 0.002 Tw [(profound. )17.6(W)55.3(ithin the past decade, the attacks of September)]TJ T* -0.0037 Tc -0.0574 Tw [(1)34.3(1, 2001, the tsunami in south and southeast )53.4(Asia in Decem-)]TJ 0 -1.398 TD -0.0036 Tc -0.0132 Tw (ber of 2004, the bombings in Madrid of March of 2004, the)Tj 0 -1.401 TD 0.0228 Tw (bombings in London in July of 2005, Hurricane Katrina in)Tj T* -0.0037 Tc 0.0545 Tw [(August of 2005, the shootings at )17.3(V)61.5(i)1.1(r)17.3(ginia )17.3(T)73.1(ech in )50.3(April of)]TJ 0 -1.398 TD -0.0063 Tc -0.0623 Tw (2007, and daily murders and assaults are just some examples)Tj 0 -1.401 TD -0.0032 Tc 0.0775 Tw (that suggest the virtually inescapable nature of trauma. In)Tj T* -0.0103 Tc -0.0625 Tw (fact, Kessler and colleagues \(1995\) estimate that most people)Tj 0 -1.398 TD -0.0092 Tc (living in the United States will experience at least one violent)Tj 0 -1.401 TD -0.0034 Tc -0.009 Tw (or life-threatening event during their lives.)Tj 1.8 -2.001 TD -0.0035 Tc 0.0919 Tw [(One population that is vulnerable to the recurrent ef-)]TJ -1.8 -1.398 TD -0.0044 Tc -0.0625 Tw (fects of trauma is law enforcement officers. Whether it is the)Tj 0 -1.401 TD (risk of bodily harm, extended shifts, or emotionally distress-)Tj T* -0.0035 Tc 0 Tw (ing investigations such as child sexual abuse cases, the law)Tj 12 0 0 12 401.76 566.64 Tm -0.0076 Tc -0.0603 Tw [(S)21.1(tephen F)74.9(.)-0.3( Bono)]TJ 10 0 0 10 346.26 554.01 Tm 0.0018 Tc -0.0319 Tw [(V)115(eterans )52.9(A)7(f)16.8(fairs Maryland Health Care System)]TJ 12 0 0 12 146.4 566.64 Tm -0.0292 Tc -0.0604 Tw (Jeffrey M. Lating)Tj 10 0 0 10 128.76 554.01 Tm 0.0021 Tc -0.0534 Tw (Loyola College in Maryland)Tj 19.224 -18.537 TD -0.0033 Tc -0.0172 Tw (enforcement profession is particularly susceptible to the im-)Tj 0 -1.398 TD -0.0036 Tc -0.051 Tw [(pact of trauma. However)35.4(, despite the daunting nature of their)]TJ 0 -1.401 TD -0.0079 Tc -0.0626 Tw [(activities, most law enforcement of)16.1(ficers function ef)16.1(fectively)61.1(.)]TJ T* -0.0033 Tc 0.0795 Tw [(The purpose of this special edition of the Journal is to ex-)]TJ 0 -1.398 TD 0.0019 Tw (plore the construct of resiliency in law enforcement person-)Tj 0 -1.401 TD -0.0031 Tc 0.125 Tw (nel. The purpose of this article is to provide an historical)Tj T* -0.001 Tc (overview of the construct of resiliency and its relation to)Tj 0 -1.398 TD -0.0036 Tc 0.05 Tw (crisis intervention.)Tj /F1 1 Tf 11 0 0 11 321 237.99 Tm -0.0046 Tc 0.0728 Tw (Historical Perspectives)Tj /TT2 1 Tf 10 0 0 10 339 214.65 Tm -0.0037 Tc 0.0387 Tw [( )53.7(Although concerns about the emotional toll and reac-)]TJ -1.8 -1.401 TD -0.0035 Tc -0.0122 Tw (tions to traumatic events have been of interest for thousands)Tj 0 -1.398 TD -0.0109 Tc -0.0623 Tw [(of years \(Shay)61.1(, 1994\), it was not until 1980 that the Diagnostic)]TJ 0 -1.401 TD -0.0037 Tc 0.1064 Tw (and Statistical Manual of Mental Disorders, Third Edition)Tj T* -0.0069 Tc -0.0625 Tw [(\(DSM III; )53.1(American Psychiatric )47.1(Association, 1980\) specified)]TJ 0 -1.398 TD -0.0037 Tc 0.0557 Tw (a formal diagnosis of posttraumatic stress disorder \(PTSD\))Tj 0 -1.401 TD -0.0014 Tc 0.125 Tw (to address the signs and symptoms associated with expo-)Tj T* 0.0043 Tc (sure to traumatic events. It is notable that the diagnostic)Tj 0 -1.398 TD -0.0065 Tc -0.0621 Tw [(criteria were rationally)56.5(, not empirically)62.5(, derived, mainly from)]TJ 0 -1.401 TD -0.0039 Tc [(clinical observations of returning )14.1(V)64.3(ietnam war combat veter)17.1(-)]TJ T* -0.0225 Tw (ans \(Andreasen, 1983\).)Tj ET endstream endobj 51 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 53 0 obj << /Length 8862 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0053 Tc 0.0896 Tw [(88 )]TJ /TT3 1 Tf 2.1938 0 TD 0.0914 Tw (Lating and Bono Crisis Intervention and Fostering Resiliency)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm 0.0056 Tc 0.125 Tw (Earlier versions of DSM also addressed reactions to)Tj -1.8 -1.398 TD -0.0036 Tc 0.0906 Tw [(trauma. Predicated on Freud)50.4(s influential writings on trau-)]TJ 0 -1.401 TD -0.0066 Tc -0.0625 Tw [(matic neurosis, the DSM \(AP)86.4(A, 1952\) contained the diagnos-)]TJ T* -0.0033 Tc 0.0535 Tw (tic classification Gross Stress Reaction within the category)Tj 0 -1.398 TD -0.0034 Tc -0.0017 Tw (of Transient Situational Personality Disorders. This diagno-)Tj 0 -1.401 TD 0.0049 Tc 0.125 Tw (sis was intended to reflect the view that such conditions)Tj T* -0.0037 Tc -0.0185 Tw (were thought to be acute reactions of more or less normal)Tj 0 -1.398 TD 0.005 Tc 0.125 Tw (persons who have experienced intolerable stress \(DSM,)Tj 0 -1.401 TD 0.0096 Tc 0.1249 Tw [(1952, p. 40\). Moreover)33.6(, the diagnosis stated that when)]TJ T* 0 Tc 0.125 Tw (promptly and adequately treated, the condition may clear)Tj 0 -1.398 TD -0.003 Tc 0.006 Tw (rapidly \(p.40\). It was also implied that if the reactions per-)Tj 0 -1.401 TD 0.0075 Tc 0.125 Tw (sisted, then an alternative diagnosis, such as neurosis or)Tj T* -0.004 Tc 0.066 Tw [(psychosis should be considered \(W)35(ilson, 1995\). )50.2(According)]TJ 0 -1.398 TD -0.0038 Tc -0.0609 Tw [(to the most recent edition of the DSM \(DSM IV)71.2(; )50.2(A)8.5(P)86.2(A, 1994\),)]TJ 0 -1.401 TD -0.0037 Tc 0.0693 Tw (PTSD comprises 17 potential symptoms divided into three)Tj T* -0.048 Tw (clusters: re-experiencing the trauma, avoidance/numbing as-)Tj 0 -1.398 TD -0.0033 Tc 0.0021 Tw (sociated with reminders of the trauma, and hyperarousal.)Tj 1.8 -2.001 TD -0.0037 Tc 0.0125 Tw (Since the introduction of PTSD as a defined diagnostic)Tj -1.8 -1.401 TD -0.003 Tc -0.025 Tw (entity in 1980, literally thousands of articles and books have)Tj 0 -1.398 TD -0.0018 Tc 0.125 Tw [(been published related to its phenomenology)58.2(, assessment,)]TJ 0 -1.401 TD -0.0037 Tc -0.0585 Tw (and treatment. Epidemiologic studies have identified a broad)Tj T* -0.0174 Tc -0.0623 Tw (range of PTSD prevalence in the aftermath of traumatic events.)Tj 0 -1.398 TD -0.0119 Tc -0.0625 Tw [(For example, epidemiological data in New )27.1(Y)101.3(ork after Septem-)]TJ 0 -1.401 TD -0.0055 Tc (ber 11 found probable PTSD rates ranging from 7.5% to 20%)Tj T* -0.0028 Tc 0.0675 Tw (\(Galea et al., 2002\). In a web-based survey of a nationally)Tj 0 -1.398 TD 0.003 Tc 0.125 Tw (representative sample of 2273 adults, Schlenger and col-)Tj 0 -1.401 TD -0.015 Tc -0.0621 Tw (leagues \(2002\) reported probable PTSD prevalence rates rang-)Tj T* -0.008 Tc [(ing from 1)31(1.2% in New )28.1(Y)105.2(ork City to 2.7% in )16.1(W)95.8(ashington, DC)]TJ 0 -1.398 TD -0.0038 Tc 0.0549 Tw [(in the same period. In a sample of 2050 )50.6(American )50.6(Airlines)]TJ 0 -1.401 TD -0.0035 Tc 0.0825 Tw (flight attendants in the aftermath, more than 18% reported)Tj T* -0.0047 Tc -0.0625 Tw (symptoms consistent with probable PTSD \(Lating, Sherman,)Tj 0 -1.398 TD -0.0036 Tc -0.0622 Tw [(Everly)62.4(, Lowry)59.4(, & Peragine, 2004\). Current estimates suggest)]TJ 0 -1.401 TD -0.0031 Tc 0.0028 Tw (that typically 5% - 10% of individuals exposed to traumatic)Tj T* -0.0036 Tc 0.0975 Tw [(events will meet diagnostic criteria for PTSD \(Ozer)35.4(, Best,)]TJ 0 -1.398 TD -0.0053 Tc -0.0622 Tw [(Lipsey)63.7(, & )15.2(W)95.5(eiss, 2003\).)]TJ /F1 1 Tf 11 0 0 11 54 207.99 Tm 0.0343 Tw [(T)79.4(rauma and Resiliency)]TJ /TT2 1 Tf 10 0 0 10 72 184.65 Tm -0.0037 Tc 0.0593 Tw (While these numbers attest to the regrettable suffering)Tj -1.8 -1.401 TD -0.0033 Tc 0.0669 Tw (that traumatic events may cause, there is growing recogni-)Tj 0 -1.398 TD -0.0125 Tc -0.0624 Tw [(tion that many)62.5(, if not most, people exposed to traumatic events)]TJ 0 -1.401 TD -0.0048 Tc -0.0625 Tw (do not experience serious disruptions in normal life function-)Tj T* -0.0036 Tc 0.0288 Tw (ing \(Mancini & Bonanno, 2006\). These individuals may be)Tj 0 -1.398 TD 0.0257 Tc 0.125 Tw (considered to be exhibiting what is labeled resilience.)Tj 0 -1.401 TD -0.0034 Tc -0.0434 Tw (Bonanno \(2004\) defines resilience as the ability of adults in)Tj T* -0.0038 Tc 0.0107 Tw (otherwise normal circumstances who are exposed to an iso-)Tj 25.5 63.6 TD -0.0031 Tc -0.002 Tw (lated and potentially disruptive event, such as the death of a)Tj 0 -1.398 TD 0.0011 Tc 0.125 Tw (close relation or a violent or life-threatening situation, to)Tj 0 -1.401 TD -0.0012 Tc (maintain relatively stable, healthy levels of psychological)Tj T* (and physical functioning \(p. 20\). Kaminsky and his col-)Tj 0 -1.398 TD -0.0053 Tc -0.0622 Tw (leagues \(2007\) propose a model of disaster mental health that)Tj 0 -1.401 TD -0.0023 Tc 0.125 Tw (includes resistance, resilience, and recovery as a strategic)Tj T* -0.0043 Tc -0.0625 Tw (and integrative paradigm. They define resilience as the abil-)Tj 0 -1.398 TD -0.0012 Tc 0.1249 Tw (ity of an individual, a group, an organization, or even an)Tj 0 -1.401 TD -0.003 Tc 0.11 Tw [(entire population, to rapidly and effectively rebound from)]TJ T* 0.0088 Tc 0.125 Tw (psychological and/or behavioral perturbations associated)Tj 0 -1.398 TD -0.0033 Tc 0.0131 Tw (with critical incidents, terrorism, and even mass disaster \(p.)Tj 0 -1.401 TD -0.0106 Tc -0.0622 Tw (3\). Kaminsky et al. \(2007\) conceptualize resistance as a form)Tj T* -0.003 Tc 0.1083 Tw (of psychological/behavioral immunity to distress and dys-)Tj 0 -1.398 TD -0.0026 Tc 0.125 Tw (function \(p. 3\). For definitional purposes, it appears that)Tj 0 -1.401 TD -0.0038 Tc 0.1041 Tw [(Kaminsky and colleagues \(2007\) separate Bonanno)50.2(s con-)]TJ T* -0.003 Tc -0.0506 Tw [(struct of resiliency into concepts of resistance and resiliency)60(.)]TJ 0 -1.398 TD -0.0038 Tc -0.0195 Tw [(However)35.2(, what Bonanno)53.2(s and Kaminsky et al.)50.2(s definitions)]TJ 0 -1.401 TD -0.0032 Tc 0.125 Tw (both suggest is that although resilient people may experi-)Tj T* -0.0165 Tc -0.0625 Tw (ence discomfort following a traumatic event, their overall level)Tj 0 -1.398 TD -0.0038 Tc 0.0167 Tw (of functioning remains preserved.)Tj 1.8 -2.001 TD -0.0055 Tc -0.0625 Tw (Both Bonanno \(2004\) and Kaminsky et al. \(2007\) differ-)Tj -1.8 -1.401 TD 0.0041 Tc 0.1249 Tw [(entiate between resilience and recovery)64.1(. Bonanno \(2004\))]TJ 0 -1.398 TD 0.0082 Tc 0.125 Tw (states that recovering individuals often experience sub-)Tj 0 -1.401 TD -0.0033 Tc 0.0091 Tw (threshold symptom levels \(p.20-21\), whereas Kaminsky et)Tj T* -0.0029 Tc 0.069 Tw (al. \(2007\) suggest that recovery refers to the ability of an)Tj 0 -1.398 TD -0.0034 Tc -0.0161 Tw (individual, a group, an organization, or even an entire popu-)Tj 0 -1.401 TD -0.0026 Tc 0.0494 Tw (lation to literally recover the ability to adaptively function,)Tj T* -0.0028 Tc -0.0011 Tw [(both psychologically and behaviorally)63.2(, in the wake of a sig-)]TJ 0 -1.398 TD -0.0033 Tc 0.03 Tw (nificant clinical distress, impairment, or dysfunction subse-)Tj 0 -1.401 TD -0.0091 Tc -0.0625 Tw (quent to critical incidents, terrorism, and even mass disasters)Tj T* -0.0061 Tc -0.0621 Tw [(\(p. 5\). )15(While these dif)14.9(ferentiations will be addressed later)32.9(, the)]TJ 0 -1.398 TD -0.003 Tc -0.0358 Tw [(main focus of this article is resiliency)60(.)]TJ 1.8 -2.001 TD -0.0031 Tc 0.0672 Tw (The idea that individuals may be resilient in the after-)Tj -1.8 -1.401 TD -0.0506 Tw (math of traumatic events is actually quite different than what)Tj 0 -1.398 TD -0.0047 Tc -0.0622 Tw (many researchers conceptualized a decade ago. For example,)Tj 0 -1.401 TD -0.004 Tc 0.065 Tw [(McFarlane and )32(Y)103.2(ehuda \(1996\) considered the maintenance)]TJ T* -0.003 Tc -0.0344 Tw (of relatively stable and healthy functioning following a trau-)Tj 0 -1.398 TD 0.0088 Tw (matic event an anomaly that was likely predicated on either)Tj 0 -1.401 TD -0.0033 Tc -0.0188 Tw (incredible emotional fortitude or some type of excessive de-)Tj T* -0.0037 Tc 0.0667 Tw [(nial that warranted intervention. Moreover)38.3(, the assumption)]TJ 0 -1.398 TD -0.0033 Tc 0.0166 Tw (of many bereavement theorists has been that the absence of)Tj 0 -1.401 TD -0.0001 Tc 0.125 Tw (distress or depression following the death of a loved one)Tj T* -0.0031 Tc 0.0142 Tw [(was a form of defensive denial \(Bowlby)62.9(, 1980\), personality)]TJ 0 -1.398 TD -0.0033 Tc -0.0085 Tw (pathology \(Osterweis, Solomon, & Green, 1984\) or delayed)Tj 0 -1.401 TD -0.0003 Tc 0.125 Tw (grief \(Middleton, Moylan, Raphael, Burnett, & Martinek,)Tj T* -0.0516 Tc 0 Tw (1993\).)Tj ET endstream endobj 54 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 56 0 obj << /Length 8686 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.5 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.034 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3375 0 TD -0.0132 Tc 0 Tw (89)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm -0.0034 Tc -0.0556 Tw [(W)94.4(ortman and Silver \(1989\) are often credited as the first)]TJ -1.8 -1.398 TD 0.0079 Tc 0.1249 Tw (to suggest that no empirical basis existed to support the)Tj 0 -1.401 TD 0.0086 Tc 0.125 Tw (assertions that the absence of stress during bereavement)Tj T* -0.0139 Tc -0.0625 Tw (was somehow pathological or that delayed grief was expected.)Tj 0 -1.398 TD -0.0009 Tc 0.1254 Tw [(However)38.1(, at the time their study was released there were)]TJ 0 -1.401 TD 0.0344 Tc 0.125 Tw (minimal longitudinal data to support their contention)Tj T* -0.0061 Tc -0.0622 Tw (\(Bonanno, 2004\). Rubonis and Bickman \(1991\), in one of the)Tj 0 -1.398 TD -0.0036 Tc 0.0244 Tw (first comprehensive reviews of the relation between the oc-)Tj 0 -1.401 TD -0.004 Tc -0.0622 Tw [(currence of disaster and psychopathology)62(, evaluated 52 stud-)]TJ T* -0.0031 Tc 0.0514 Tw (ies and reported an overall psychopathology incidence rate)Tj 0 -1.398 TD -0.0185 Tw (of 17%. Relevant to the construct of resiliency was the find-)Tj 0 -1.401 TD 0.0493 Tw (ing that the effect of disaster on psychopathology appears)Tj T* -0.0114 Tc -0.0625 Tw (to diminish with time \(p.397\).)Tj /F1 1 Tf 11 0 0 11 66 522 Tm -0.0047 Tc 0.0318 Tw [(Empirical Evidence of )93.5(T)79.9(rauma and Resilienc)6.2(y)]TJ /TT2 1 Tf 10 0 0 10 84 498.66 Tm 0.0026 Tc 0.125 Tw (Developmental researchers have investigated various)Tj -1.8 -1.401 TD -0.003 Tc 0.1016 Tw (protective factors that foster generally healthy functioning)Tj T* -0.0031 Tc 0.0589 Tw (in those exposed to tragic life circumstances. Early on, the)Tj 0 -1.398 TD -0.0037 Tc 0.095 Tw (preponderance of this research was conducted on grieving)Tj 0 -1.401 TD -0.0036 Tc 0.0395 Tw (individuals following the loss of a loved one. Shuchter and)Tj T* -0.0034 Tc -0.0265 Tw (Zisook \(1993\) reported on survey data from a sample of 350)Tj 0 -1.398 TD -0.0127 Tc -0.0622 Tw (widows and widowers two months after their loss. They found)Tj 0 -1.401 TD -0.0037 Tc 0.0489 Tw [(that despite 70% of the respondents acknowledging it was)]TJ T* -0.0033 Tc 0.087 Tw (hard to believe that their spouse had died, only 20% re-)Tj 0 -1.398 TD -0.0034 Tc 0.0142 Tw (ported difficulty concentrating and even fewer \(17%\) noted)Tj 0 -1.401 TD -0.0029 Tc -0.049 Tw (difficulty making decisions. In a 1997 study of gay men who)Tj T* -0.0038 Tc -0.0011 Tw [(provided care for their partners with )50.4(AIDS \(S)17.2(tein, Folkman,)]TJ 0 -1.398 TD 0.0016 Tc 0.125 Tw (Trabasso & Richards, 1997\), the bereaved caregivers de-)Tj 0 -1.401 TD -0.0093 Tc -0.0625 Tw (scribed more positive beliefs about the relationship \(e.g., feel-)Tj T* -0.0034 Tc 0.0917 Tw (ings of personal strength\) than negative beliefs in the first)Tj 0 -1.398 TD -0.0035 Tc -0.0218 Tw [(few weeks following their partner)-36.5()53.5(s)-0.3( death. In addition, these)]TJ 0 -1.401 TD -0.0039 Tc -0.0625 Tw (more positive appraisals were predictive of well-being a year)Tj T* -0.0034 Tc 0.0001 Tw [(after their partner)-36.4()53.6(s)0.1( death.)]TJ 1.8 -1.998 TD -0.0149 Tc -0.0625 Tw (In a longitudinal study by Bonnano and colleagues \(2002\))Tj -1.8 -1.401 TD -0.0032 Tc 0.0395 Tw (that began several years before the death of the spouse and)Tj T* -0.0033 Tc 0.0195 Tw (continued for several years following the death, 46% of the)Tj 0 -1.398 TD 0.0035 Tc 0.125 Tw (participants evidenced no clinical depression at any time)Tj 0 -1.401 TD -0.007 Tc -0.062 Tw [(during the study)56(. Moreover)38(, of those demonstrating enhanced)]TJ T* -0.0036 Tc 0.1143 Tw (resilience, about 75% reported intense feelings of longing)Tj 0 -1.398 TD 0.0428 Tw (during the earliest months of bereavement but were able to)Tj 0 -1.401 TD -0.0042 Tc -0.06 Tw (maintain function.)Tj 1.8 -2.001 TD -0.003 Tc 0.1205 Tw (In a 2005 study that compared younger \(less than 65)Tj -1.8 -1.398 TD -0.0033 Tc -0.054 Tw (years of age\) bereaved adults following the death of a spouse)Tj 0 -1.401 TD -0.0037 Tc -0.0305 Tw (or a child with a matched group of non-bereaved individuals)Tj T* 0.105 Tw (\(those with intact marriages\), Bonanno, Moskowitz, Papa,)Tj 25.5 64.2 TD -0.0244 Tw (and Folkman \(2005\) reported that 52% of the bereaved indi-)Tj 0 -1.398 TD -0.0036 Tc 0.0164 Tw (viduals were considered resilient \(defined as scoring within)Tj 0 -1.401 TD -0.0027 Tc 0.125 Tw [(one standard deviation of the non-bereaved group)51.3(s mean)]TJ T* -0.0035 Tc 0.056 Tw (on assessed symptom levels\) at both 4 and 18 months post)Tj 0 -1.398 TD -0.0025 Tc 0.125 Tw (loss. In fact, by 18 months post loss, resilient individuals)Tj 0 -1.401 TD -0.0035 Tc 0.0928 Tw (were equivalent to non-bereaved individuals on the symp-)Tj T* -0.0032 Tc [(tom ratings. )50.8(A)59( second part of this study investigated resil-)]TJ 0 -1.398 TD -0.0024 Tc -0.0159 Tw (iency in gay men as they cared for their partners dying from)Tj 0 -1.401 TD -0.0035 Tc 0.0325 Tw (AIDS. It was notable that 50% of the caregivers fell within)Tj T* -0.0037 Tc -0.0122 Tw (one standard deviation of the mean level of depressed mood)Tj 0 -1.398 TD 0.0036 Tc 0.125 Tw (observed in the non-bereaved control and were therefore)Tj 0 -1.401 TD -0.0036 Tc 0.0691 Tw (considered resilient. Furthermore, even when more restric-)Tj T* -0.0033 Tw (tive criteria were used for comparison, 27% of the bereaved)Tj 0 -1.398 TD -0.0028 Tc 0.125 Tw (caregivers evidenced a resilient pattern, and an additional)Tj 0 -1.401 TD -0.0035 Tc 0.0427 Tw (9% of the caregivers considered depressed prior to the loss)Tj T* -0.0046 Tc -0.0625 Tw (actually improved after the loss and had low levels of depres-)Tj 0 -1.398 TD -0.0039 Tc 0.04 Tw (sion during bereavement.)Tj /F1 1 Tf 11 0 0 11 321 465.99 Tm -0.0043 Tc 0.0591 Tw (Resiliency following Disasters)Tj /TT2 1 Tf 10 0 0 10 339 442.65 Tm -0.0033 Tc -0.0157 Tw (While data on resiliency have most frequently explored)Tj -1.8 -1.401 TD -0.0034 Tc -0.057 Tw [(reactions following the death of a spouse or partner)35.6(, there are)]TJ 0 -1.398 TD -0.0029 Tc 0.1156 Tw (recent data on resiliency after September 11. In the study)Tj 0 -1.401 TD -0.0054 Tc -0.0625 Tw (noted previously concerning the 7.5% incidence rate of prob-)Tj T* -0.0035 Tc 0.0575 Tw (able PTSD in the aftermath of the terrorist attacks on New)Tj 0 -1.398 TD -0.0031 Tc 0.0155 Tw [(Y)104.1(ork \(Galea et al., 2002\), it is notable that the incidence re-)]TJ 0 -1.401 TD -0.0058 Tc -0.0625 Tw (solved to 0.6% six months after the initial data were collected)Tj T* -0.003 Tc 0.0188 Tw (\(Galea et al., 2003\). In another study following the terrorist)Tj 0 -1.398 TD -0.0036 Tc 0.0464 Tw (attacks on September 11, Bonanno, Galea, Bucciarelli, and)Tj 0 -1.401 TD -0.0037 Tc 0.0031 Tw (Vlahov \(2006\), using a representative sample of 2,752 New)Tj T* -0.0034 Tc -0.0045 Tw [(Y)103.8(ork residents, reported that more than 65% met criteria for)]TJ 0 -1.398 TD -0.0033 Tc -0.0249 Tw [(resilience, defined as having no or only one PTSD symptom)]TJ 0 -1.401 TD -0.0075 Tc -0.0623 Tw [(when assessed with the National )16.7(W)96.4(omen)46.5(s S)13.5(tudy PTSD mod-)]TJ T* -0.0036 Tc -0.0225 Tw (ule. Even among the 59 participants in the sample who were)Tj 0 -1.398 TD -0.003 Tc -0.0475 Tw (physically injured, or the 22 who were in the building during)Tj 0 -1.401 TD -0.0034 Tc 0.0483 Tw (the attack, close to 33% were resilient, although more than)Tj T* -0.0038 Tc 0.0712 Tw [(26% had probable PTSD. Moreover)38.2(, more than half of the)]TJ 0 -1.398 TD -0.0034 Tc -0.05 Tw (sample involved in the rescue were resilient, as were close to)Tj 0 -1.401 TD -0.0035 Tc 0.0325 Tw (54% who experienced the death of a friend or relative. The)Tj T* 0.008 Tc 0.125 Tw (effect of repeated or compound exposure to these tragic)Tj 0 -1.398 TD -0.0086 Tc -0.0624 Tw (events lowered resilience. For example, for those who experi-)Tj 0 -1.401 TD -0.0033 Tc -0.0441 Tw (enced the death of a friend or relative and also saw the attack)Tj T* -0.0035 Tc -0.0537 Tw (in person, 33% were resilient.)Tj 1.8 -1.998 TD -0.0152 Tc -0.0622 Tw [(Fraley)59.8(, Fazzari, Bonanno, and Dekel \(2006\) examined the)]TJ -1.8 -1.401 TD -0.0033 Tc 0.1128 Tw [(role that attachment style had on symptoms of PTSD and)]TJ T* -0.0074 Tc -0.0623 Tw (depression in a sample of 45 men and women who were high-)Tj 0 -1.398 TD -0.0033 Tc 0.0266 Tw [(exposure survivors \(i.e., in or near the )17.6(W)94.5(orld )17.6(T)37.5(rade Center\))]TJ ET endstream endobj 57 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 59 0 obj << /Length 8677 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0053 Tc 0.0896 Tw [(90 )]TJ /TT3 1 Tf 2.1938 0 TD 0.0914 Tw (Lating and Bono Crisis Intervention and Fostering Resiliency)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0038 Tc -0.0622 Tw (on September 11. Their results reveal that highly secure indi-)Tj 0 -1.398 TD 0.0025 Tc 0.125 Tw (viduals, defined broadly as those who deny or desire for)Tj 0 -1.401 TD -0.003 Tc -0.0368 Tw [(greater social contact following the tragedy)63(, as evidenced by)]TJ T* -0.0037 Tc 0.0656 Tw (modest self-reported PTSD assessed 7 months after the at-)Tj 0 -1.398 TD -0.0023 Tc 0.125 Tw (tacks, with a decline in these symptoms over the next 11)Tj 0 -1.401 TD -0.0035 Tc -0.0095 Tw (months for the former group. The researchers use these data)Tj T* 0.0039 Tc 0.125 Tw (to suggest that secure or attached individuals are able to)Tj 0 -1.398 TD -0.0034 Tc -0.0394 Tw (experience some type of personal growth or strength follow-)Tj 0 -1.401 TD 0.0009 Tc 0.125 Tw (ing the attacks, whereas highly dismissive adults showed)Tj T* 0.0025 Tc (neither an increase nor a decrease \(i.e., no obvious reac-)Tj 0 -1.398 TD 0.0037 Tc 0 Tw (tions\).)Tj /F1 1 Tf 11 0 0 11 54 549.99 Tm -0.0042 Tc 0.0159 Tw [( Factors that Influence Resiliency)]TJ /TT2 1 Tf 10 0 0 10 72 526.65 Tm -0.0028 Tc 0.125 Tw (There are several factors that have been purported to)Tj -1.8 -1.401 TD -0.0034 Tc -0.02 Tw [(influence the enhancement of resiliency)59.6(. Related to grieving)]TJ 0 -1.398 TD -0.0038 Tc -0.0514 Tw [(individuals, Bonanno, )17.2(W)94(ortman, and Nesse \(2004\) have pro-)]TJ 0 -1.401 TD -0.0034 Tc -0.0183 Tw (posed that resilient individuals benefit or find solace in talk-)Tj T* -0.0035 Tc 0.1031 Tw (ing or thinking about their deceased spouse, report fewest)Tj 0 -1.398 TD -0.0033 Tc -0.0466 Tw [(regrets about their behavior related to their spouse \(i.e., what)]TJ 0 -1.401 TD -0.003 Tc 0.0575 Tw (they did or failed to do\), and have less need to question or)Tj T* -0.0034 Tc 0.0462 Tw [(search for meaning in their spouse)50.6(s death. Personality and)]TJ 0 -1.398 TD -0.0031 Tc -0.0484 Tw [(coping styles also seem to influence resiliency)62.9(. In a phenom-)]TJ 0 -1.401 TD 0.0029 Tc 0.125 Tw (enological, qualitative study of female adult survivors of)Tj T* 0.0114 Tc (childhood sexual abuse conducted by Bogar and Hulse-)Tj 0 -1.398 TD -0.0031 Tc 0.0314 Tw (Killacky \(2006\), resiliency determinants defined as spe-)Tj 0 -1.401 TD 0.0072 Tc 0.125 Tw (cific innate and learned characteristics that contribute to)Tj T* -0.0039 Tc -0.0622 Tw (participants ability to become resilient adults, and resiliency)Tj 0 -1.398 TD -0.0031 Tc 0.125 Tw (processes defined as how participants in the study de-)Tj 0 -1.401 TD -0.0054 Tc -0.0621 Tw (scribed becoming resilient, were assessed. Their results iden-)Tj T* 0.0235 Tc 0.125 Tw (tified five resiliency determinants that included: being)Tj 0 -1.398 TD -0.0029 Tc 0.0137 Tw (interpersonally skilled or having the ability to interact posi-)Tj 0 -1.401 TD -0.003 Tc 0.0275 Tw (tively and effectively with others; being competent \(for ex-)Tj T* -0.0033 Tc -0.0488 Tw (ample, excelling in school, being creative, or participating in)Tj 0 -1.398 TD -0.0014 Tc 0.125 Tw (athletics\); having high interpersonal self worth or self-re-)Tj 0 -1.401 TD -0.0033 Tc -0.0293 Tw (gard, frequently developed through self talk; being spiritual;)Tj T* 0.011 Tc 0.125 Tw (and having helpful life circumstances such as being the)Tj 0 -1.398 TD -0.0027 Tc -0.0577 Tw [(youngest in the family)63.3(. Resiliency processes were reportedly)]TJ 0 -1.401 TD -0.0034 Tc -0.0625 Tw (fostered by: coping strategies, such as writing, using prayers,)Tj T* 0.0035 Tc 0.125 Tw [(keeping busy)57.5(, setting boundaries, and avoiding as neces-)]TJ 0 -1.398 TD 0.0022 Tc (sary; refocusing and moving on \(e.g., focusing on some-)Tj 0 -1.401 TD 0.0523 Tc (thing other than abuse\); active healing \(i.e., taking)Tj T* -0.0032 Tc 0.0494 Tw (responsibility for their own recovery and refuting the vic-)Tj 0 -1.398 TD -0.0036 Tc 0.0907 Tw (tim role, often through individual and group counseling\);)Tj 0 -1.401 TD -0.0033 Tc -0.0115 Tw (and active closure, or being able to integrate the trauma into)Tj T* -0.0036 Tc -0.0386 Tw (their current life stores without excessive emotional discom-)Tj 0 -1.398 TD -0.011 Tc 0 Tw (fort.)Tj 27.3 64.398 TD -0.0031 Tc 0.0536 Tw (Other factors that may influence resiliency come from)Tj -1.8 -1.398 TD -0.0077 Tc -0.0622 Tw (the September 11 data reviewed previously \(Bonanno, Galea,)Tj 0 -1.401 TD -0.003 Tc 0.122 Tw [(et al., 2006\). In this study)60(, the authors noted that married)]TJ T* -0.0037 Tc 0.0206 Tw (people were more resilient than those who were unmarried,)Tj 0 -1.398 TD 0.0173 Tc 0.125 Tw [(divorced, or separated. Moreover)32.3(, males in this sample)]TJ 0 -1.401 TD -0.004 Tc 0.0073 Tw [(showed more resilience than did females, and )50.4(Asian )50.4(Ameri-)]TJ T* -0.0032 Tc 0.0444 Tw [(cans as a group showed the highest rates of resiliency)59.8(.)]TJ /F1 1 Tf 11 0 0 11 309 612 Tm -0.0043 Tc 0.0348 Tw (Resiliency and Crisis Intervention)Tj /TT2 1 Tf 10 0 0 10 327 588.66 Tm -0.0032 Tc -0.0093 Tw (Interventions seem to work more effectively when they)Tj -1.8 -1.401 TD 0.0005 Tc 0.125 Tw (are predicated on an underlying theoretical or conceptual)Tj T* -0.0038 Tc 0.0412 Tw (basis. Having a conceptual framework from which to work)Tj 0 -1.398 TD -0.0033 Tc 0.0944 Tw (not only provides a contextual structure but, perhaps even)Tj 0 -1.401 TD -0.0032 Tc 0.1222 Tw [(more importantly)62.8(, provides tar)17.8(gets by establishing a theo-)]TJ T* 0.02 Tw (retical goal when applying a technique. It is from this basic)Tj 0 -1.398 TD -0.0005 Tc 0.125 Tw (premise that crisis intervention and resiliency are consid-)Tj 0 -1.401 TD -0.0052 Tc 0 Tw (ered.)Tj 1.8 -2.001 TD -0.0033 Tc 0.0618 Tw (According to Everly and Mitchell \(2000\), the goals of)Tj -1.8 -1.398 TD -0.0029 Tc 0.0721 Tw [(early crisis intervention are: stabilization \(i.e., cessation of)]TJ 0 -1.401 TD -0.0035 Tc -0.0171 Tw (escalating distress\); mitigation of acute signs and symptoms)Tj T* -0.0032 Tc 0.0292 Tw (of distress, dysfunction, or impairment; restoration of inde-)Tj 0 -1.398 TD -0.0036 Tc 0.0714 Tw (pendent and adaptive functioning; and facilitated access to)Tj 0 -1.401 TD -0.0158 Tc -0.0625 Tw [(the next level of care. Moreover)32.2(, some of the purported mecha-)]TJ T* -0.0034 Tc -0.0169 Tw [(nisms of action in crisis intervention include cathartic venti-)]TJ 0 -1.398 TD -0.0093 Tc -0.062 Tw [(lation \(Pennebaker)35.7(, 1999\), of)14.7(fering group cohesion and social)]TJ 0 -1.401 TD -0.0255 Tc -0.0624 Tw [(support \(Flannery)58.5(, 1998\), imparting information \(NIMH, 2002\),)]TJ T* -0.0036 Tc 0.0422 Tw (serving as an advocate or a liaison \(NIMH, 2002\), meeting)Tj 0 -1.398 TD -0.0016 Tc 0.125 Tw (basic needs \(NIMH, 2002\), and providing stress manage-)Tj 0 -1.401 TD -0.0197 Tc -0.0622 Tw (ment and problem-solving techniques \(Everly & Lating, 2002\).)Tj 1.8 -2.001 TD -0.0033 Tc 0.0725 Tw (There are a number of crisis intervention systems that)Tj -1.8 -1.398 TD -0.0122 Tc -0.0622 Tw (have been utilized following traumatic events, including those)Tj 0 -1.401 TD -0.0038 Tc -0.0249 Tw [(associated with the )53.3(American Red Cross, the National Or)17.2(ga-)]TJ T* -0.004 Tc 0.0501 Tw [(nization for )14.1(V)64.2(ictims )53.1(Assistance \(NOV)125(A\), and the Salvation)]TJ 0 -1.398 TD -0.0031 Tc 0.1167 Tw [(Army)62.9(. One of the earliest and most frequently used crisis)]TJ 0 -1.401 TD -0.0038 Tc 0.0242 Tw (intervention models is Critical Incident Stress Management)Tj T* -0.023 Tc -0.0622 Tw (\(CISM; Everly & Mitchell, 2000\). CISM refers to an integrated,)Tj 0 -1.398 TD -0.0037 Tc -0.0012 Tw (multi-component, comprehensive crisis intervention system)Tj 0 -1.401 TD -0.001 Tc 0.125 Tw (from the pre-crisis phase, through the acute phase, to the)Tj T* -0.0023 Tc (post-crisis intervention phase.)Tj 1.8 -1.998 TD -0.0035 Tc 0.0535 Tw (One of the most commonly employed CISM interven-)Tj -1.8 -1.401 TD 0.0023 Tc 0.125 Tw (tions, and one that has generated considerable debate re-)Tj T* -0.0031 Tc -0.0173 Tw [(garding its ef)17.9(fectiveness and ef)17.9(ficacy \(Devilly)59.9(, Gist, Cotton,)]TJ 0 -1.398 TD -0.0036 Tc 0.0357 Tw (2006; Mitchell, 2003\) is Critical Incident Stress Debriefing)Tj 0 -1.401 TD -0.0052 Tc -0.0621 Tw (\(CISD\), a seven-phase small group structured discussion that)Tj T* -0.0034 Tc -0.032 Tw (may take up to several hours to complete and often provided)Tj ET endstream endobj 60 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 62 0 obj << /Length 9172 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.5 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.034 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3375 0 TD -0.0132 Tc 0 Tw (91)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0623 Tw (one to 14 days after the trauma \(Everly & Mitchell, 2000\). The)Tj 0 -1.398 TD 0.0017 Tc 0.125 Tw (seven phases of the CISD are: 1\) Introduction: introduce)Tj 0 -1.401 TD -0.0036 Tc 0.0307 Tw (team members, explain the process and set expectations, 2\))Tj T* -0.0034 Tc 0.0794 Tw (Fact: to allow participants to describe the event from their)Tj 0 -1.398 TD 0 Tc 0.125 Tw (perspective, 3\) Thought: to allow participants to describe)Tj 0 -1.401 TD -0.0058 Tc -0.0621 Tw (cognitive reactions and to transition into emotional reactions,)Tj T* -0.0035 Tc 0 Tw (4\) Reaction: to allow participants to discuss at an emotional)Tj 0 -1.398 TD -0.0032 Tc 0.0705 Tw (level the worst part of the event for them, 5\) Symptom: to)Tj 0 -1.401 TD 0.0043 Tw (allow participants to identify personal symptoms of distress)Tj T* -0.0079 Tc -0.0621 Tw [(and transition again to a cognitive framework, 6\) )19.2(T)65.9(eaching: to)]TJ 0 -1.398 TD 0.0043 Tc 0.125 Tw (educate participants about normal reactions and adaptive)Tj 0 -1.401 TD -0.0155 Tc -0.0625 Tw (coping responses, and 7\) Re-entry: to answer questions, clarify)Tj T* -0.007 Tc -0.062 Tw (ambiguities, and facilitate closure \(Mitchell, 2006\).)Tj 1.8 -1.998 TD -0.004 Tc 0.1143 Tw (While the goals and mechanisms of action associated)Tj -1.8 -1.401 TD -0.0031 Tc -0.0137 Tw (with crisis intervention may have historically been linked to)Tj T* -0.0065 Tc -0.0625 Tw (the mitigation or prevention of the effects of distress, it seems)Tj 0 -1.398 TD -0.0033 Tc 0.1008 Tw (more accurate to conceptualize early crisis intervention as)Tj 0 -1.401 TD -0.0105 Tc -0.0624 Tw [(being predicated on enhancing or fostering resiliency)58.5(. In other)]TJ T* -0.0034 Tc 0.0761 Tw (words, in the aftermath of a crisis situation the preponder-)Tj 0 -1.398 TD 0.0807 Tw (ance of people, although possibly experiencing some tran-)Tj 0 -1.401 TD -0.0031 Tc 0.035 Tw (sient distress, will end up functioning reasonably well \(i.e.,)Tj T* -0.0259 Tw (resilient\). This is not a new tenet, and in fact appears consis-)Tj 0 -1.398 TD 0.0036 Tc 0.125 Tw (tent with the description noted previously in the original)Tj 0 -1.401 TD -0.0033 Tc -0.043 Tw (edition of the DSM that implied that with adequate and early)Tj T* -0.0028 Tc 0.0314 Tw [(intervention, the condition \(i.e., distress\) may clear rapidly)60.2(.)]TJ 0 -1.398 TD -0.0037 Tc 0.0733 Tw (There are also components of CISM that support this con-)Tj 0 -1.401 TD -0.0036 Tc 0.0825 Tw (tention, considering that from its inception CISM has pur-)Tj T* 0.0184 Tc 0.125 Tw (ported not to be a form of psychotherapy and thus not)Tj 0 -1.398 TD -0.0032 Tc -0.0179 Tw (designed to specifically treat, but to recognize, subthreshold)Tj 0 -1.401 TD -0.0034 Tc 0.096 Tw (levels of functioning and to refer as warranted to the next)Tj T* -0.0031 Tc -0.0625 Tw (level of care.)Tj 1.8 -1.998 TD -0.0036 Tc -0.0443 Tw (Conceptualizing crisis intervention as a triaging form of)Tj -1.8 -1.401 TD -0.0034 Tc 0.0615 Tw (assessment helps to distinguish the constructs of resiliency)Tj T* -0.0035 Tc 0.0747 Tw [(and recovery)62.5(. )17.2(Whereas assessment of function, on an indi-)]TJ 0 -1.398 TD -0.0029 Tc 0.0333 Tw (vidual or group basis, may be thought of as a way to foster)Tj 0 -1.401 TD -0.0034 Tc -0.0282 Tw [(resiliency)59.6(, trauma treatment is more consistent with the con-)]TJ T* 0.0835 Tw [(struct of recovery)62.6(. However)35.6(, since most crisis intervention)]TJ 0 -1.398 TD 0.001 Tc 0.125 Tw (techniques are administered soon after a traumatic event,)Tj 0 -1.401 TD -0.0035 Tc -0.0623 Tw (there may be occasions when there is minimal opportunity or)Tj T* -0.0034 Tc 0.0457 Tw (capability to distinguish between those evidencing signs of)Tj 0 -1.398 TD -0.0035 Tc 0.0491 Tw (being resilient and those experiencing sub-threshold symp-)Tj 0 -1.401 TD -0.003 Tw [(toms requiring mechanisms to foster recovery)59.5(.)]TJ 1.8 -2.001 TD 0.0706 Tw (From a CISM perspective, this distinction is most rel-)Tj -1.8 -1.398 TD -0.0068 Tc -0.0621 Tw (evant when employing small group interventions where there)Tj 0 -1.401 TD -0.0014 Tc 0.125 Tw (is the possibility that resilient and recovering participants)Tj T* -0.003 Tc 0.0358 Tw [(may be grouped together)51(. )17.9(This is why it is important to ad-)]TJ 25.5 64.8 TD -0.0033 Tc -0.0355 Tw (here to a core tenet of group crisis intervention and to ensure)Tj 0 -1.398 TD -0.0034 Tc 0.0228 Tw (the homogeneity of the group with regard to incident expo-)Tj 0 -1.401 TD -0.0078 Tc -0.0625 Tw (sure when organizing a debriefing \(Everly & Mitchell, 2008\).)Tj T* -0.0034 Tc 0.0128 Tw [(Moreover)38.6(, in an ef)14.6(fort not to vicariously expose individuals)]TJ 0 -1.398 TD -0.0031 Tc -0.0499 Tw [(who may be in dif)14.9(ferent phases of resilience and recovery)62.9(, or)]TJ 0 -1.401 TD -0.003 Tc -0.0013 Tw (who may not be from the same primary group \(e.g., law en-)Tj T* -0.0039 Tc -0.0621 Tw (forcement officers, firefighters, military\), it seems prudent to)Tj 0 -1.398 TD -0.0072 Tc -0.0625 Tw (remember that a basic premise of the Fact Phase of CISD is to)Tj 0 -1.401 TD -0.0034 Tc -0.0461 Tw (help re-establish a cognitive frame of reference, and not nec-)Tj T* -0.0029 Tc 0.0963 Tw [(essarily disclose all the \(potentially graphic\) details of the)]TJ 0 -1.398 TD -0.0035 Tc 0.0144 Tw (incident. In fact, according to Mitchell \(2003\), the instruc-)Tj 0 -1.401 TD -0.0033 Tc -0.028 Tw (tions provided by a CISM team during a CISD strongly sug-)Tj T* 0.0012 Tc 0.125 Tw (gest that only a very brief and general description of the)Tj 0 -1.398 TD -0.0093 Tc -0.0617 Tw (experience be given... \(192\).)Tj 1.8 -2.001 TD 0.0112 Tc 0.125 Tw (There are some who believe that crisis intervention)Tj -1.8 -1.401 TD -0.0036 Tc 0.0479 Tw (should entail screening individuals for possible risk factors)Tj 0 -1.398 TD -0.0113 Tc -0.062 Tw [(associated with PTSD \(Litz, Gray)63.7(, Bryant, & )48.9(Adler)39.7(, 2002\) and)]TJ 0 -1.401 TD -0.0036 Tc 0.1186 Tw (then targeting those individuals for intervention while ex-)Tj T* 0.0415 Tw (cluding those who display resilience \(Mancini & Bonanno,)Tj 0 -1.398 TD -0.0032 Tc 0.042 Tw (2006\). In situations where this is possible it may be worth-)Tj 0 -1.401 TD -0.0049 Tc -0.0624 Tw [(while to attempt; however)34.1(, logistics and timing may preclude)]TJ T* -0.0034 Tc 0.02 Tw (this from being a consistent, viable option.)Tj 1.8 -1.998 TD -0.0032 Tc 0.0709 Tw (It is not the purpose of this article to contribute to the)Tj -1.8 -1.401 TD -0.0529 Tw (debate regarding the effectiveness or efficacy of debriefings.)Tj T* 0.0091 Tc 0.125 Tw (Nor is it intended to discern whether debriefings can or)Tj 0 -1.398 TD -0.0032 Tc 0.0294 Tw (should be able to accurately differentiate between the resil-)Tj 0 -1.401 TD -0.0029 Tc 0.085 Tw (ience and recovery of participants, although this may be a)Tj T* -0.0034 Tc -0.0517 Tw (relevant empirical question worthy of quantitative investiga-)Tj 0 -1.398 TD 0.0002 Tc 0.125 Tw (tion. Instead, the purpose of this article is to reinforce to)Tj 0 -1.401 TD -0.0027 Tc 0.0261 Tw [(those who are likely already aware, and more relevantly)63.3(, to)]TJ T* -0.0075 Tc -0.0625 Tw (instill in those who may not appreciate it, that the overarching)Tj 0 -1.398 TD -0.0003 Tc 0.125 Tw (goal of early crisis intervention should be fostering resil-)Tj 0 -1.401 TD -0.0042 Tc -0.0622 Tw (iency for the preponderance of those seen following a critical)Tj T* -0.0053 Tc -0.0625 Tw (incident, and determining how to access the appropriate level)Tj 0 -1.398 TD -0.0031 Tc 0.03 Tw [(of care for those in need of assistance to recovery)59.9(.)]TJ /F1 1 Tf 11 0 0 11 400.89 201.99 Tm 0.021 Tc 0 Tw (REFERENCES)Tj /TT2 1 Tf 10 0 0 10 321 184.65 Tm -0.0132 Tc -0.0625 Tw [(American Psychiatric )52.8(Association \(1952\). )]TJ /TT5 1 Tf 16.185 0 TD -0.0138 Tc (Diagnostic and sta-)Tj -14.985 -1.401 TD -0.0038 Tc -0.0562 Tw [(tistical manual of mental disor)32.2(ders.)]TJ /TT2 1 Tf 13.86 0 TD -0.0048 Tc -0.0712 Tw [( W)93.1(ashington, )-15.2(DC: )34.7(Au-)]TJ -13.86 -1.398 TD -0.0039 Tc 0 Tw [(thor)44.1(.)]TJ -1.2 -1.8 TD -0.0132 Tc -0.0625 Tw [(American Psychiatric )52.8(Association \(1980\). )]TJ /TT5 1 Tf 16.185 0 TD -0.0138 Tc (Diagnostic and sta-)Tj -14.985 -1.401 TD -0.0041 Tc 0.1078 Tw [(tistical manual of mental disor)28.9(ders)]TJ /TT2 1 Tf 14.265 0 TD -0.0034 Tc 0.1108 Tw [( \(3rd ed.\). )15.4(W)97.4(ashing-)]TJ -14.265 -1.401 TD -0.0046 Tc -0.0418 Tw [(ton, DC: )50.1(Author)49.4(.)]TJ -1.2 -1.8 TD -0.0132 Tc -0.0625 Tw [(American Psychiatric )52.8(Association \(1994\). )]TJ /TT5 1 Tf 16.185 0 TD -0.0138 Tc (Diagnostic and sta-)Tj -14.985 -1.398 TD -0.0041 Tc 0.1166 Tw [(tistical manual of mental disor)31.9(ders)]TJ /TT2 1 Tf 14.301 0 TD -0.0033 Tc 0.1175 Tw [( \(4th ed.\). )18.5(W)97.5(ashing-)]TJ -14.301 -1.401 TD -0.0046 Tc -0.0418 Tw [(ton, DC: )50.1(Author)49.4(.)]TJ ET endstream endobj 63 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 67 0 obj << /Length 11725 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0053 Tc 0.0896 Tw [(92 )]TJ /TT3 1 Tf 2.1938 0 TD 0.0914 Tw (Lating and Bono Crisis Intervention and Fostering Resiliency)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0034 Tc -0.0529 Tw [(Andreasen, N. C. \(1983\). Posttraumatic stress disorder)53.6(. In H.)]TJ 1.2 -1.398 TD -0.0152 Tc -0.0624 Tw [(I. Kaplan, )50.9(A. M. Freedman, & B. J. Sadock \(Eds.\), )]TJ /TT5 1 Tf 19.089 0 TD -0.0191 Tc 0 Tw [(Compr)28.9(e-)]TJ -19.089 -1.401 TD -0.0036 Tc -0.0018 Tw (hensive textbook of psychiatry)Tj /TT2 1 Tf 11.964 0 TD -0.0028 Tc -0.0033 Tw [( \(V)126.2(ol. 2, 3rd ed., pp.)]TJ 8.436 0 TD -0.0583 Tc 0 Tw (1517-)Tj -20.4 -1.401 TD -0.0215 Tc -0.0625 Tw [(1525\). Baltimore: )11.5(W)58.3(illiams & )17.5(W)58.3(ilkins.)]TJ -1.2 -1.8 TD -0.0174 Tc -0.0622 Tw [(Bogar)36.6(, C. E., & Hulse-Killacky)60.6(, D. \(2006\). Resiliency determi-)]TJ 1.2 -1.398 TD -0.0034 Tc -0.0157 Tw (nants and resiliency processes among female adult survi-)Tj 0 -1.401 TD -0.0036 Tc -0.019 Tw (vors of childhood sexual abuse. )Tj /TT5 1 Tf 12.681 0 TD -0.0042 Tc -0.02 Tw (Journal of Counseling &)Tj -12.681 -1.401 TD -0.0109 Tc 0 Tw (Development)Tj /TT2 1 Tf 5.16 0 TD 0 Tc (,)Tj /TT5 1 Tf 0.246 0 TD -0.01 Tc -0.06 Tw [( 84,)]TJ /TT2 1 Tf 1.404 0 TD -0.0104 Tc [( 318-327.)]TJ -8.01 -1.8 TD -0.0038 Tc 0.0206 Tw [(Bonanno G)116.2(.)-2.2( )50.2(A. \(2004\). Loss, trauma, and human resilience:)]TJ 1.2 -1.398 TD 0.0021 Tc 0.125 Tw (Have we underestimated the human capacity to thrive)Tj 0 -1.401 TD -0.0028 Tc 0.0038 Tw (after extremely aversive events? )Tj /TT5 1 Tf 13.086 0 TD -0.0042 Tc 0.005 Tw (American Psychologist,)Tj -13.086 -1.401 TD -0.019 Tc 0 Tw (59)Tj /TT2 1 Tf 0.969 0 TD -0.0156 Tc -0.06 Tw (, 2028.)Tj -2.169 -1.8 TD -0.0207 Tc -0.0621 Tw [(Bonanno, G)114.3(.)-9.2( )54.7(A., Galea, S., Bucciarelli, )48.7(A., & )21.7(Vlahov)57.3(, D. \(2006\).)]TJ 1.2 -1.398 TD -0.0031 Tc 0.0016 Tw [(Psychological resilience after disaster: New )30.1(Y)104.1(ork City in)]TJ 0 -1.401 TD -0.0034 Tc -0.0056 Tw (the aftermath of the September 11th terrorist attack. )Tj /TT5 1 Tf 20.739 0 TD -0.0053 Tc 0 Tw (Psy-)Tj -20.739 -1.401 TD -0.0038 Tc -0.005 Tw (chological Science, 17)Tj /TT2 1 Tf 8.934 0 TD -0.0036 Tc -0.01 Tw (, 181-186.)Tj -10.134 -1.8 TD 0.0344 Tw [(Bonanno, G)116.5(.)-3( )50.4(A., Moskowitz, J. )14.4(T)76.3(., Papa, )53.4(A., & Folkman, S.)]TJ 1.2 -1.398 TD 0.025 Tw (\(2005\). Resilience to loss in bereaved spouses, bereaved)Tj 0 -1.401 TD -0.003 Tc 0.117 Tw (parents, and bereaved gay men. )Tj /TT5 1 Tf 13.35 0 TD -0.004 Tc 0.1175 Tw (Journal of Personality)Tj -13.35 -1.401 TD -0.0042 Tc -0.0083 Tw [(and Social Psychology)49.8(, 88)]TJ /TT2 1 Tf 10.434 0 TD -0.0036 Tc -0.01 Tw (, 827-843.)Tj -11.634 -1.8 TD -0.0141 Tc -0.0622 Tw [(Bonanno, G)114.9(.)-2.4( )52(A., )19(W)92.7(ortman, C. B., Lehman, D. R., )16(T)71.7(weed, R. G)114.9(.)-3.1(,)]TJ 1.2 -1.398 TD -0.0032 Tc -0.05 Tw [(Haring, M., Sonnega, J.,)-78.2(e)18.4(t)18.4( )]TJ 10.4444 0 TD -0.0216 Tc -0.0625 Tw (al. \(2002\). Resilience to loss and)Tj -10.4444 -1.401 TD 0.0076 Tc 0.125 Tw [(chronic grief: )52.6(A)60.8( prospective study from preloss to 18)]TJ T* -0.004 Tc 0.035 Tw (months postloss. )Tj /TT5 1 Tf 6.924 0 TD -0.0038 Tc 0.038 Tw (Journal of Personality and Social Psy-)Tj -6.924 -1.398 TD -0.01 Tc -0.058 Tw [(chology)50(, 83)]TJ /TT2 1 Tf 4.449 0 TD -0.0106 Tc -0.0574 Tw [(, 1)28.4(150-1)28.4(164.)]TJ -5.649 -1.8 TD -0.0072 Tc -0.0622 Tw [(Bonanno, G)118.8(.)1.5( )46.9(A., )10.9(W)96.6(ortman, C. B., & Neese, R. M. \(2004\). Pro-)]TJ 1.2 -1.401 TD -0.0037 Tc 0.0258 Tw (spective patterns of resilience and maladjustment during)Tj T* -0.0047 Tc 0 Tw (widowhood. )Tj /TT5 1 Tf 5.16 0 TD -0.004 Tc -0.0184 Tw (Psychology & Aging, 19)Tj /TT2 1 Tf 9.636 0 TD -0.0038 Tc -0.02 Tw (, 260-271.)Tj -15.996 -1.8 TD -0.0028 Tc -0.028 Tw [(Bowlby)63.2(, J. \(1980\). )]TJ /TT5 1 Tf 7.524 0 TD -0.004 Tc -0.0297 Tw [(Loss: Sadness and depr)29(ession: V)107(ol. 3. )14.3(At-)]TJ -6.324 -1.398 TD -0.0042 Tc -0.03 Tw (tachment and loss)Tj /TT2 1 Tf 7.095 0 TD -0.0039 Tc [(. New )29.1(Y)103.3(ork: Basic Books.)]TJ -8.295 -1.8 TD -0.0103 Tc -0.062 Tw [(Devilly)58.7(, G)115.7(.)-0.3( J., Gist, R., & Cotton, P)106.7(.)-0.2( \(2006\). Ready! 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New )28.4(Y)102.6(ork: Guilford Press.)]TJ -5.73 -1.8 TD 0.0142 Tc 0.1252 Tw [(Middleton, )14.4(W)103(., Moylan, )53.4(A., Raphael, B., Burnett, P)104.2(., &)]TJ 1.2 -1.401 TD -0.0139 Tc -0.0617 Tw [(Martinek, N. \(1993\). )52.1(A)8.3(n)]TJ 9.6 0 TD -0.0035 Tc 0.125 Tw (international perspective on be-)Tj ET endstream endobj 68 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 70 0 obj << /Length 6446 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.5 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.034 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3375 0 TD -0.0132 Tc 0 Tw (93)Tj /TT2 1 Tf 10 0 0 10 78 722.64 Tm -0.0037 Tc -0.0325 Tw (reavement related concepts.)Tj /TT5 1 Tf 10.971 0 TD -0.0042 Tc -0.035 Tw [( Australian and New Zealand)]TJ -10.971 -1.398 TD -0.0038 Tc -0.0484 Tw [(Journal of Psychiatry)53(,)0.1( 27)]TJ /TT2 1 Tf 9.876 0 TD -0.05 Tw (, 457-463.)Tj -11.076 -1.8 TD -0.0031 Tc 0.0375 Tw [(Mitchell, J. )17.9(T)76.7(.)-0.1( \(2006\). )]TJ /TT5 1 Tf 9.039 0 TD -0.0042 Tc 0.0401 Tw [(Critical Incident S)31.8(t)2.8(r)28.8(ess Management)]TJ -7.839 -1.401 TD -0.0277 Tw [(\(CISM\): Gr)31.8(oup crisis intervention )]TJ /TT2 1 Tf 13.659 0 TD -0.0026 Tc -0.03 Tw [(\(4th ed.\). 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662.672 l 89.174 662.765 l 89.408 662.861 l 89.649 662.963 l 89.897 663.073 l 90.145 663.186 l 90.394 663.307 l 90.648 663.434 l 90.903 663.565 l 91.159 663.7 l 91.413 663.845 l 91.665 663.99 l 91.92 664.146 l 92.171 664.302 l 92.419 664.466 l 92.663 664.635 l 92.904 664.808 l 93.142 664.985 l 93.372 665.17 l 93.595 665.354 l 93.814 665.549 l 94.027 665.744 l 94.229 665.942 l 94.424 666.147 l 94.608 666.356 l 94.782 666.569 l 94.945 666.785 l 95.097 667.008 l 95.238 667.232 l 95.366 667.461 l 95.48 667.691 l 95.582 667.925 l 95.667 668.166 l 95.78 668.152 l 95.894 668.135 l 96.008 668.117 l 96.121 668.095 l 96.237 668.071 l 96.354 668.049 l 96.474 668.024 l 96.598 667.999 l 96.857 667.369 l 97.123 666.711 l 97.403 666.03 l 97.686 665.332 l 97.973 664.617 l 98.263 663.888 l 98.404 663.516 l 98.547 663.144 l 98.688 662.772 l 98.83 662.393 l 98.968 662.018 l 99.103 661.639 l 99.365 660.881 l 99.492 660.499 l 99.613 660.119 l 99.733 659.74 l 99.847 659.365 l 99.957 658.986 l 100.063 658.61 l 100.162 658.238 l 100.254 657.866 l 100.339 657.501 l 100.42 657.134 l 100.495 656.772 l 100.559 656.415 l 99.662 656.415 l f* 56.823 663.271 m 56.823 664.603 l 57.12 664.791 l 57.404 665 l 57.673 665.237 l 57.935 665.495 l 58.186 665.775 l 58.426 666.073 l 58.658 666.388 l 58.884 666.721 l 59.104 667.064 l 59.316 667.423 l 59.521 667.791 l 59.724 668.166 l 59.925 668.552 l 60.12 668.938 l 60.315 669.331 l 60.509 669.724 l 60.702 670.118 l 60.897 670.511 l 61.091 670.9 l 61.289 671.283 l 61.492 671.658 l 61.696 672.023 l 61.906 672.381 l 62.122 672.724 l 62.345 673.054 l 62.572 673.369 l 62.808 673.667 l 63.056 673.943 l 63.311 674.198 l 63.578 674.432 l 63.857 674.641 l 64.144 674.822 l 64.24 674.4 l 64.346 673.939 l 64.403 673.695 l 64.463 673.444 l 64.53 673.188 l 64.601 672.926 l 64.675 672.657 l 64.753 672.388 l 64.835 672.115 l 64.923 671.842 l 65.018 671.569 l 65.118 671.293 l 65.221 671.025 l 65.331 670.751 l 65.447 670.486 l 65.571 670.224 l 65.699 669.969 l 65.833 669.718 l 65.975 669.473 l 66.124 669.235 l 66.279 669.009 l 66.442 668.793 l 66.616 668.587 l 66.794 668.393 l 66.981 668.212 l 67.176 668.046 l 67.378 667.893 l 67.59 667.756 l 67.81 667.635 l 68.04 667.533 l 68.107 667.302 l 68.154 667.118 l 68.186 666.969 l 68.196 666.902 l 68.203 666.838 l 68.206 666.774 l 68.203 666.706 l 68.199 666.64 l 68.196 666.565 l 68.171 666.388 l 68.139 666.168 l 66.655 665.797 l 65.345 665.464 l 64.197 665.17 l 63.195 664.911 l 62.32 664.681 l 61.562 664.478 l 60.899 664.302 l 60.323 664.146 l 59.812 664.008 l 59.352 663.884 l 58.93 663.771 l 58.53 663.668 l 58.133 663.569 l 57.729 663.473 l 57.297 663.374 l 56.823 663.271 l f* 79.923 663.937 m 79.647 664.012 l 79.373 664.086 l 79.098 664.16 l 78.825 664.231 l 78.551 664.305 l 78.276 664.377 l 78.003 664.447 l 77.73 664.518 l 77.458 664.585 l 77.185 664.656 l 76.912 664.727 l 76.644 664.794 l 76.371 664.865 l 76.103 664.932 l 75.833 665 l 75.564 665.071 l 74.93 665.474 l 74.328 665.882 l 73.754 666.292 l 73.208 666.704 l 72.695 667.118 l 72.209 667.536 l 71.749 667.957 l 71.32 668.386 l 70.916 668.818 l 70.542 669.257 l 70.195 669.703 l 69.868 670.157 l 69.574 670.617 l 69.301 671.088 l 69.053 671.566 l 68.83 672.055 l 68.632 672.554 l 68.458 673.065 l 68.305 673.585 l 68.174 674.12 l 68.069 674.668 l 67.983 675.229 l 67.919 675.802 l 67.877 676.393 l 67.856 676.995 l 67.852 677.619 l 67.871 678.253 l 67.906 678.908 l 67.963 679.581 l 68.037 680.272 l 68.129 680.984 l 68.238 681.714 l 68.476 682.181 l 68.702 682.634 l 68.922 683.067 l 69.138 683.484 l 69.348 683.881 l 69.553 684.263 l 69.755 684.632 l 69.953 684.983 l 70.155 685.319 l 70.354 685.645 l 70.555 685.956 l 70.76 686.257 l 70.966 686.548 l 71.179 686.828 l 71.399 687.097 l 71.622 687.359 l 71.855 687.61 l 72.096 687.855 l 72.348 688.096 l 72.613 688.326 l 72.886 688.556 l 73.176 688.779 l 73.478 688.999 l 73.797 689.215 l 74.132 689.431 l 74.483 689.644 l 74.855 689.856 l 75.245 690.069 l 75.656 690.281 l 76.091 690.493 l 76.549 690.713 l 77.026 690.933 l 77.599 691.032 l 78.156 691.12 l 78.69 691.195 l 79.211 691.262 l 79.714 691.311 l 80.2 691.351 l 80.674 691.379 l 81.137 691.393 l 81.588 691.393 l 82.031 691.383 l 82.462 691.358 l 82.884 691.319 l 83.302 691.269 l 83.713 691.202 l 84.121 691.125 l 84.525 691.032 l 84.927 690.926 l 85.328 690.802 l 85.728 690.667 l 86.128 690.518 l 86.535 690.352 l 86.943 690.175 l 87.353 689.98 l 87.776 689.771 l 88.2 689.548 l 88.633 689.307 l 89.075 689.052 l 89.532 688.779 l 89.996 688.493 l 90.474 688.192 l 90.967 687.873 l 91.474 687.536 l 91.522 687.413 l 91.573 687.289 l 91.622 687.161 l 91.672 687.037 l 92.104 687.037 l 92.561 686.123 l 92.78 685.677 l 93 685.238 l 93.216 684.802 l 93.429 684.367 l 93.637 683.927 l 93.843 683.484 l 94.049 683.035 l 94.254 682.574 l 94.452 682.103 l 94.65 681.618 l 94.75 681.367 l 94.849 681.115 l 94.948 680.856 l 95.044 680.594 l 95.143 680.325 l 95.238 680.049 l 95.337 679.769 l 95.433 679.482 l 95.483 679.468 l 95.533 679.451 l 95.582 679.433 l 95.635 679.411 l 95.734 679.365 l 95.833 679.315 l 95.77 678.483 l 95.703 677.676 l 95.667 677.283 l 95.627 676.89 l 95.585 676.503 l 95.543 676.125 l 95.49 675.749 l 95.436 675.377 l 95.376 675.009 l 95.309 674.648 l 95.235 674.286 l 95.158 673.932 l 95.069 673.582 l 94.973 673.235 l 94.866 672.888 l 94.754 672.547 l 94.63 672.207 l 94.491 671.871 l 94.346 671.538 l 94.187 671.208 l 94.016 670.879 l 93.836 670.554 l 93.637 670.227 l 93.429 669.905 l 93.202 669.587 l 92.961 669.267 l 92.706 668.949 l 92.433 668.63 l 92.146 668.315 l 91.838 667.999 l 91.792 667.858 l 91.707 667.713 l 91.59 667.564 l 91.441 667.415 l 91.26 667.263 l 91.051 667.107 l 90.818 666.955 l 90.563 666.799 l 90.286 666.647 l 89.99 666.491 l 89.678 666.339 l 89.352 666.187 l 89.012 666.034 l 88.661 665.885 l 88.308 665.74 l 87.946 665.598 l 87.58 665.46 l 87.216 665.322 l 86.85 665.191 l 86.49 665.067 l 86.136 664.943 l 85.789 664.829 l 85.452 664.716 l 85.126 664.614 l 84.818 664.518 l 84.525 664.429 l 84.251 664.348 l 84 664.273 l 83.773 664.21 l 83.567 664.153 l 83.394 664.107 l 83.252 664.072 l 83.04 664.065 l 82.828 664.058 l 82.618 664.054 l 82.409 664.047 l 82.2 664.04 l 81.991 664.033 l 81.783 664.026 l 81.573 664.019 l 81.369 664.008 l 81.159 664.001 l 80.953 663.99 l 80.748 663.983 l 80.538 663.973 l 80.334 663.962 l 80.128 663.951 l 79.923 663.937 l f* 97.898 671.725 m 97.884 672.001 l 97.877 672.271 l 97.877 672.544 l 97.884 672.809 l 97.898 673.078 l 97.916 673.344 l 97.941 673.606 l 97.973 673.872 l 98.005 674.134 l 98.044 674.396 l 98.082 674.654 l 98.129 674.914 l 98.221 675.434 l 98.317 675.951 l 98.416 676.464 l 98.554 677.24 l 98.596 677.502 l 98.636 677.761 l 98.671 678.023 l 98.699 678.285 l 98.726 678.547 l 98.748 678.809 l 98.766 679.075 l 98.773 679.34 l 98.776 679.61 l 98.773 679.875 l 98.763 680.148 l 98.852 680.173 l 98.936 680.198 l 99.025 680.223 l 99.113 680.247 l 99.199 680.272 l 99.287 680.297 l 99.375 680.322 l 99.46 680.347 l 99.51 680.247 l 99.563 680.145 l 99.613 680.035 l 99.662 679.914 l 99.96 679.847 l 100.261 679.772 l 100.562 679.695 l 100.862 679.613 l 101.165 679.525 l 101.47 679.433 l 101.77 679.337 l 102.075 679.242 l 102.38 679.139 l 102.683 679.032 l 102.989 678.926 l 103.297 678.816 l 103.909 678.593 l 104.529 678.363 l 105.152 678.13 l 105.779 677.895 l 106.409 677.658 l 107.046 677.428 l 107.365 677.315 l 107.688 677.205 l 108.01 677.095 l 108.336 676.989 l 108.662 676.882 l 108.988 676.78 l 109.317 676.681 l 109.646 676.585 l 109.646 675.487 l 109.459 675.466 l 109.263 675.445 l 109.062 675.417 l 108.853 675.384 l 108.64 675.349 l 108.424 675.31 l 108.201 675.271 l 107.978 675.225 l 107.752 675.175 l 107.521 675.126 l 107.292 675.072 l 107.061 675.013 l 106.831 674.952 l 106.604 674.891 l 106.378 674.825 l 106.151 674.754 l 105.932 674.683 l 105.712 674.609 l 105.499 674.534 l 105.291 674.452 l 105.088 674.372 l 104.894 674.286 l 104.706 674.201 l 104.525 674.113 l 104.355 674.021 l 104.193 673.929 l 104.04 673.833 l 103.898 673.734 l 103.77 673.635 l 103.651 673.532 l 103.547 673.429 l 103.455 673.323 l 103.406 673.326 l 103.35 673.326 l 103.279 673.32 l 103.2 673.306 l 103.113 673.288 l 103.017 673.266 l 102.91 673.242 l 102.794 673.209 l 102.538 673.139 l 102.248 673.051 l 101.926 672.951 l 101.575 672.838 l 101.196 672.717 l 100.792 672.586 l 100.36 672.448 l 99.907 672.31 l 99.432 672.165 l 98.94 672.02 l 98.426 671.871 l 97.898 671.725 l f* 63.482 676.585 m 63.326 676.766 l 63.138 676.949 l 62.926 677.138 l 62.688 677.329 l 62.426 677.52 l 62.143 677.715 l 61.839 677.913 l 61.516 678.112 l 61.176 678.31 l 60.821 678.508 l 60.457 678.707 l 60.078 678.905 l 59.692 679.103 l 59.298 679.301 l 58.898 679.496 l 58.495 679.691 l 58.091 679.879 l 57.687 680.067 l 57.283 680.251 l 56.883 680.432 l 56.103 680.782 l 55.363 681.108 l 54.673 681.412 l 54.049 681.689 l 53.766 681.813 l 53.508 681.933 l 53.27 682.043 l 53.06 682.146 l 53.018 682.333 l 52.99 682.486 l 52.98 682.553 l 52.976 682.617 l 52.976 682.68 l 52.983 682.744 l 52.993 682.812 l 53.008 682.883 l 53.029 682.964 l 53.057 683.052 l 53.129 683.268 l 53.228 683.541 l 53.936 683.707 l 54.655 683.874 l 55.378 684.04 l 56.111 684.207 l 56.844 684.37 l 57.585 684.526 l 57.957 684.6 l 58.331 684.675 l 58.703 684.746 l 59.079 684.813 l 59.451 684.876 l 59.826 684.937 l 60.202 684.997 l 60.581 685.05 l 60.956 685.099 l 61.332 685.146 l 61.706 685.188 l 62.082 685.223 l 62.458 685.255 l 62.837 685.28 l 63.209 685.302 l 63.584 685.316 l 63.96 685.322 l 64.332 685.322 l 64.706 685.319 l 65.079 685.308 l 65.076 685.188 l 65.072 685.067 l 65.068 684.951 l 65.058 684.83 l 65.037 684.586 l 65.008 684.345 l 64.973 684.101 l 64.929 683.853 l 64.887 683.602 l 64.842 683.35 l 64.792 683.099 l 64.743 682.84 l 64.69 682.581 l 64.643 682.319 l 64.594 682.057 l 64.552 681.788 l 64.512 681.519 l 64.477 681.246 l 64.48 681.119 l 64.487 680.98 l 64.498 680.835 l 64.512 680.687 l 64.547 680.368 l 64.591 680.032 l 64.629 679.685 l 64.661 679.326 l 64.675 679.149 l 64.686 678.968 l 64.69 678.792 l 64.69 678.618 l 64.686 678.444 l 64.675 678.271 l 64.654 678.104 l 64.629 677.945 l 64.594 677.785 l 64.552 677.633 l 64.498 677.489 l 64.438 677.35 l 64.364 677.223 l 64.275 677.099 l 64.18 676.989 l 64.066 676.886 l 63.941 676.795 l 63.804 676.712 l 63.649 676.642 l 63.482 676.585 l f* 97.898 682.146 m 97.874 682.181 l 97.849 682.224 l 97.828 682.273 l 97.803 682.329 l 97.782 682.39 l 97.76 682.461 l 97.742 682.536 l 97.721 682.617 l 97.682 682.797 l 97.64 682.992 l 97.601 683.208 l 97.559 683.435 l 97.47 683.924 l 97.42 684.178 l 97.368 684.437 l 97.311 684.699 l 97.247 684.961 l 97.212 685.093 l 97.175 685.22 l 97.136 685.347 l 97.098 685.471 l 97.027 685.585 l 96.952 685.701 l 96.868 685.826 l 96.779 685.953 l 96.581 686.23 l 96.372 686.526 l 96.149 686.835 l 95.922 687.15 l 95.691 687.476 l 95.472 687.798 l 95.366 687.961 l 95.26 688.12 l 95.161 688.277 l 95.069 688.432 l 94.98 688.585 l 94.895 688.733 l 94.821 688.875 l 94.754 689.016 l 94.693 689.152 l 94.643 689.279 l 94.601 689.403 l 94.573 689.516 l 94.551 689.626 l 94.544 689.725 l 94.551 689.817 l 94.569 689.899 l 94.878 689.931 l 95.188 689.966 l 95.5 690.005 l 95.812 690.051 l 96.124 690.101 l 96.439 690.154 l 96.754 690.21 l 97.069 690.27 l 97.385 690.334 l 97.7 690.402 l 98.019 690.472 l 98.334 690.547 l 98.652 690.625 l 98.971 690.703 l 99.29 690.784 l 99.613 690.869 l 100.25 691.043 l 100.895 691.224 l 101.536 691.411 l 102.181 691.599 l 102.822 691.79 l 103.467 691.981 l 104.111 692.172 l 104.756 692.364 l 104.756 692.505 l 104.76 692.612 l 104.763 692.654 l 104.767 692.69 l 104.773 692.718 l 104.784 692.743 l 104.795 692.76 l 104.812 692.775 l 104.83 692.782 l 104.852 692.789 l 104.912 692.796 l 104.986 692.796 l 105.018 692.714 l 105.057 692.626 l 105.103 692.531 l 105.152 692.431 l 105.918 692.431 l 105.907 692.3 l 105.871 692.152 l 105.811 691.981 l 105.73 691.794 l 105.631 691.588 l 105.514 691.372 l 105.379 691.138 l 105.227 690.894 l 105.063 690.635 l 104.887 690.37 l 104.699 690.093 l 104.502 689.813 l 104.296 689.527 l 104.082 689.233 l 103.864 688.939 l 103.64 688.645 l 103.186 688.053 l 102.734 687.469 l 102.294 686.91 l 101.877 686.381 l 101.49 685.897 l 101.154 685.464 l 101.005 685.273 l 100.874 685.099 l 100.757 684.943 l 100.661 684.809 l 100.353 684.533 l 100.056 684.275 l 99.91 684.147 l 99.773 684.019 l 99.637 683.888 l 99.51 683.753 l 99.449 683.687 l 99.39 683.615 l 99.333 683.545 l 99.276 683.47 l 99.219 683.396 l 99.166 683.318 l 99.117 683.236 l 99.067 683.155 l 99.021 683.07 l 98.979 682.981 l 98.936 682.889 l 98.897 682.794 l 98.859 682.694 l 98.823 682.595 l 98.791 682.489 l 98.763 682.379 l 98.649 682.351 l 98.54 682.327 l 98.426 682.301 l 98.317 682.273 l 98.21 682.244 l 98.104 682.213 l 97.998 682.181 l 97.898 682.146 l f* 66.807 688.369 m 66.69 688.418 l 66.581 688.468 l 66.474 688.517 l 66.375 688.567 l 66.291 688.875 l 66.202 689.187 l 66.109 689.505 l 66.011 689.832 l 65.804 690.498 l 65.585 691.177 l 65.362 691.872 l 65.132 692.576 l 64.902 693.284 l 64.679 693.993 l 64.569 694.347 l 64.463 694.701 l 64.356 695.052 l 64.158 695.746 l 64.066 696.086 l 63.977 696.426 l 63.896 696.759 l 63.21 698.304 l 63.139 698.629 l 63.076 698.948 l 63.019 699.26 l 62.97 699.565 l 62.927 699.862 l 62.895 700.153 l 62.875 700.436 l 63.136 700.464 l 63.409 700.461 l 63.693 700.419 l 63.987 700.347 l 64.283 700.248 l 64.592 700.121 l 64.907 699.968 l 65.225 699.794 l 65.551 699.6 l 65.885 699.387 l 66.829 697.949 l 67.168 697.712 l 67.509 697.464 l 67.856 697.209 l 68.556 696.685 l 68.908 696.423 l 69.259 696.164 l 69.613 695.909 l 69.963 695.658 l 70.314 695.42 l 70.661 695.194 l 71.008 694.981 l 71.352 694.786 l 71.692 694.613 l 72.029 694.457 l 72.362 694.326 l 72.688 694.223 l 73.01 694.149 l 73.325 694.106 l 73.632 694.1 l 73.931 694.127 l 73.963 693.95 l 73.984 693.805 l 73.988 693.741 l 73.991 693.681 l 73.988 693.621 l 73.977 693.561 l 73.963 693.497 l 73.944 693.426 l 73.921 693.351 l 73.81 693.061 l 73.701 692.796 l 73.562 692.768 l 73.418 692.725 l 73.262 692.671 l 73.094 692.608 l 72.921 692.534 l 72.744 692.448 l 72.56 692.353 l 72.369 692.251 l 72.177 692.141 l 71.979 692.02 l 71.781 691.896 l 71.578 691.765 l 71.377 691.631 l 71.175 691.492 l 70.976 691.348 l 70.779 691.202 l 70.584 691.053 l 70.392 690.905 l 70.205 690.753 l 70.024 690.603 l 69.85 690.451 l 69.683 690.302 l 69.524 690.154 l 69.372 690.012 l 69.234 689.87 l 69.103 689.732 l 68.986 689.601 l 68.883 689.473 l 68.791 689.353 l 68.713 689.24 l 68.652 689.133 l 68.607 689.034 l 68.139 689.034 l 68.09 688.91 l 68.043 688.787 l 68.022 688.723 l 68.005 688.659 l 67.987 688.599 l 67.973 688.535 l 67.824 688.521 l 67.676 688.503 l 67.527 688.485 l 67.378 688.464 l 67.232 688.443 l 67.087 688.418 l 66.945 688.393 l 66.807 688.369 l f* q 48.7 705.441 67.026 -87.002 re W n 92.104 690.366 m 92.012 690.582 l 91.901 690.794 l 91.779 690.996 l 91.636 691.195 l 91.48 691.383 l 91.314 691.567 l 91.133 691.744 l 90.942 691.91 l 90.736 692.077 l 90.524 692.233 l 90.305 692.381 l 90.078 692.527 l 89.84 692.665 l 89.601 692.799 l 89.352 692.926 l 89.101 693.05 l 88.849 693.168 l 88.59 693.278 l 88.331 693.383 l 88.073 693.487 l 87.815 693.582 l 87.556 693.674 l 87.301 693.759 l 87.05 693.844 l 86.802 693.922 l 86.557 693.996 l 86.32 694.068 l 86.089 694.131 l 85.65 694.251 l 85.251 694.361 l 85.328 694.719 l 85.42 695.066 l 85.526 695.406 l 85.646 695.732 l 85.778 696.05 l 85.919 696.363 l 86.072 696.663 l 86.231 696.961 l 86.401 697.248 l 86.582 697.528 l 86.766 697.807 l 87.155 698.345 l 87.566 698.871 l 87.779 699.129 l 88.207 699.638 l 88.64 700.149 l 88.856 700.407 l 89.072 700.662 l 89.288 700.921 l 89.497 701.183 l 89.706 701.449 l 89.911 701.718 l 90.11 701.99 l 90.305 702.27 l 90.492 702.554 l 90.669 702.844 l 90.843 703.141 l 91.006 703.446 l 91.152 703.489 l 91.264 703.52 l 91.318 703.535 l 91.363 703.541 l 91.41 703.549 l 91.455 703.553 l 91.506 703.553 l 91.554 703.549 l 91.611 703.541 l 91.672 703.535 l 91.817 703.513 l 92.005 703.482 l 92.121 702.763 l 92.238 702.015 l 92.355 701.24 l 92.473 700.442 l 92.529 700.035 l 92.586 699.624 l 92.692 698.789 l 92.791 697.945 l 92.841 697.521 l 92.882 697.092 l 92.926 696.667 l 92.965 696.239 l 93 695.813 l 93.028 695.385 l 93.057 694.964 l 93.081 694.538 l 93.099 694.12 l 93.114 693.703 l 93.124 693.288 l 93.131 692.877 l 93.127 692.474 l 93.124 692.073 l 93.11 691.677 l 93.092 691.291 l 93.067 690.908 l 93.038 690.532 l 92.915 690.518 l 92.795 690.501 l 92.674 690.483 l 92.557 690.461 l 92.443 690.44 l 92.33 690.416 l 92.104 690.366 l f* 75.262 693.894 m 75.241 694.258 l 75.227 694.627 l 75.227 694.999 l 75.234 695.37 l 75.249 695.743 l 75.277 696.115 l 75.309 696.49 l 75.348 696.866 l 75.397 697.241 l 75.453 697.616 l 75.514 697.988 l 75.581 698.363 l 75.653 698.739 l 75.73 699.111 l 75.815 699.487 l 75.9 699.855 l 75.989 700.227 l 76.084 700.595 l 76.18 700.96 l 76.275 701.324 l 76.478 702.043 l 76.683 702.755 l 76.884 703.449 l 77.086 704.133 l 77.277 704.796 l 77.461 705.444 l 77.642 705.349 l 77.815 705.22 l 77.989 705.057 l 78.156 704.866 l 78.318 704.65 l 78.478 704.406 l 78.634 704.14 l 78.789 703.853 l 78.945 703.545 l 79.098 703.223 l 79.249 702.883 l 79.707 701.792 l 80.019 701.03 l 80.178 700.641 l 80.341 700.255 l 80.507 699.869 l 80.677 699.482 l 80.854 699.107 l 81.035 698.735 l 81.223 698.374 l 81.414 698.023 l 81.615 697.69 l 81.821 697.369 l 82.038 697.067 l 82.261 696.784 l 82.494 696.521 l 82.735 696.285 l 82.986 696.076 l 83.252 695.891 l 83.22 695.672 l 83.195 695.466 l 83.181 695.367 l 83.164 695.271 l 83.143 695.179 l 83.118 695.088 l 83.104 695.045 l 83.086 694.999 l 83.068 694.956 l 83.047 694.914 l 83.026 694.875 l 83 694.832 l 82.972 694.794 l 82.941 694.755 l 82.908 694.715 l 82.873 694.676 l 82.834 694.638 l 82.792 694.602 l 82.746 694.566 l 82.697 694.531 l 82.643 694.496 l 82.586 694.461 l 82.122 694.428 l 81.662 694.396 l 81.201 694.361 l 80.745 694.329 l 80.284 694.294 l 79.828 694.258 l 79.37 694.227 l 78.91 694.187 l 78.453 694.152 l 77.999 694.117 l 77.542 694.082 l 77.086 694.043 l 76.629 694.007 l 76.176 693.968 l 75.72 693.933 l 75.262 693.894 l f* Q 1 1 1 rg 499.314 520.993 m 483.245 502.004 l 457.484 489.37 l 457.096 489.244 l 483.399 476.377 l 499.487 456.957 l 516.54 477.301 l 516.54 477.363 l 540.811 488.883 l 541.143 489.127 l 516.293 501.449 l 499.314 520.993 l f q 456.995 521.144 84.589 -64.499 re W n 0 0.286 0.388 RG 0.46 w 2.613 M /GS3 gs 499.314 520.993 m 483.245 502.004 l 457.484 489.37 l 457.096 489.244 l 483.399 476.377 l 499.487 456.957 l 516.54 477.301 l 516.54 477.363 l 540.811 488.883 l 541.143 489.127 l 516.293 501.449 l 499.314 520.993 l S Q 0 0.286 0.388 RG 1.381 w 2.613 M /GS3 gs 499.487 470.672 m 511.722 470.672 521.64 478.989 521.64 489.249 c 521.64 499.508 511.722 507.825 499.487 507.825 c 487.253 507.825 477.335 499.508 477.335 489.249 c 477.335 478.989 487.253 470.672 499.487 470.672 c S 0.46 w 499.663 472.282 m 511.896 472.282 520.026 480.699 520.026 489.249 c 520.026 497.798 511.548 506.215 499.314 506.215 c 487.08 506.215 478.95 497.798 478.95 489.249 c 478.95 480.699 487.428 472.282 499.663 472.282 c S 0.137 0.122 0.125 RG 499.663 472.282 m 499.663 472.282 l S 0 0.286 0.388 rg 486.077 498.984 0.354 -2.62 re f 488.74 496.868 m 488.733 496.868 l 487.423 498.984 l 487.003 498.984 l 487.003 496.364 l 487.346 496.364 l 487.346 498.481 l 487.354 498.481 l 488.686 496.364 l 489.083 496.364 l 489.083 498.984 l 488.74 498.984 l 488.74 496.868 l f* 489.327 498.67 m 490.214 498.67 l 490.214 496.364 l 490.568 496.364 l 490.568 498.67 l 491.455 498.67 l 491.455 498.984 l 489.327 498.984 l 489.327 498.67 l f* 493.684 496.678 m 492.104 496.678 l 492.104 497.554 l 493.538 497.554 l 493.538 497.868 l 492.104 497.868 l 492.104 498.67 l 493.659 498.67 l 493.659 498.984 l 491.75 498.984 l 491.75 496.364 l 493.684 496.364 l 493.684 496.678 l f* 494.468 498.681 m 495.352 498.681 l 495.527 498.681 495.822 498.648 495.822 498.243 c 495.822 497.857 495.549 497.791 495.29 497.791 c 494.468 497.791 l 494.468 498.681 l h 494.468 497.488 m 495.326 497.488 l 495.749 497.488 495.793 497.236 495.793 497.021 c 495.793 496.923 495.804 496.525 495.855 496.364 c 496.289 496.364 l 496.289 496.423 l 496.18 496.485 496.162 496.54 496.158 496.685 c 496.136 497.16 l 496.121 497.525 495.972 497.59 495.822 497.653 c 495.99 497.751 496.187 497.893 496.187 498.28 c 496.187 498.835 495.757 498.984 495.326 498.984 c 494.115 498.984 l 494.115 496.364 l 494.468 496.364 l 494.468 497.488 l f* 498.358 496.868 m 498.351 496.868 l 497.041 498.984 l 496.621 498.984 l 496.621 496.364 l 496.964 496.364 l 496.964 498.481 l 496.971 498.481 l 498.303 496.364 l 498.701 496.364 l 498.701 498.984 l 498.358 498.984 l 498.358 496.868 l f* 499.693 497.441 m 500.113 498.594 l 500.12 498.594 l 500.507 497.441 l 499.693 497.441 l h 500.635 497.127 m 500.893 496.364 l 501.28 496.364 l 500.332 498.984 l 499.931 498.984 l 498.945 496.364 l 499.31 496.364 l 499.584 497.127 l 500.635 497.127 l f* 500.865 498.67 m 501.75 498.67 l 501.75 496.364 l 502.104 496.364 l 502.104 498.67 l 502.991 498.67 l 502.991 498.984 l 500.865 498.984 l 500.865 498.67 l f* 503.305 498.984 0.353 -2.62 re f 506.651 497.674 m 506.651 498.24 506.351 499.054 505.374 499.054 c 504.396 499.054 504.097 498.24 504.097 497.674 c 504.097 497.109 504.396 496.295 505.374 496.295 c 506.351 496.295 506.651 497.109 506.651 497.674 c h 506.286 497.674 m 506.286 497.058 505.943 496.609 505.374 496.609 c 504.804 496.609 504.461 497.058 504.461 497.674 c 504.461 498.291 504.804 498.74 505.374 498.74 c 505.943 498.74 506.286 498.291 506.286 497.674 c f* 508.72 496.868 m 508.712 496.868 l 507.402 498.984 l 506.982 498.984 l 506.982 496.364 l 507.326 496.364 l 507.326 498.481 l 507.333 498.481 l 508.665 496.364 l 509.062 496.364 l 509.062 498.984 l 508.72 498.984 l 508.72 496.868 l f* 510.055 497.441 m 510.474 498.594 l 510.482 498.594 l 510.869 497.441 l 510.055 497.441 l h 510.996 497.127 m 511.255 496.364 l 511.642 496.364 l 510.693 498.984 l 510.292 498.984 l 509.307 496.364 l 509.672 496.364 l 509.945 497.127 l 510.996 497.127 l f* 512.244 498.984 m 511.89 498.984 l 511.89 496.364 l 513.572 496.364 l 513.572 496.678 l 512.244 496.678 l 512.244 498.984 l f* 494.073 493.808 m 494.022 494.246 493.671 494.665 492.996 494.665 c 492.234 494.665 491.774 494.107 491.774 493.301 c 491.774 492.294 492.358 491.906 492.953 491.906 c 493.15 491.906 493.952 491.95 494.098 492.94 c 493.755 492.94 l 493.635 492.33 493.237 492.221 493.007 492.221 c 492.358 492.221 492.139 492.695 492.139 493.312 c 492.139 494.001 492.522 494.352 492.996 494.352 c 493.248 494.352 493.631 494.268 493.73 493.808 c 494.073 493.808 l f* 494.839 494.293 m 495.722 494.293 l 495.897 494.293 496.193 494.26 496.193 493.856 c 496.193 493.469 495.919 493.403 495.66 493.403 c 494.839 493.403 l 494.839 494.293 l h 494.839 493.1 m 495.697 493.1 l 496.12 493.1 496.163 492.848 496.163 492.633 c 496.163 492.534 496.174 492.137 496.225 491.977 c 496.66 491.977 l 496.66 492.035 l 496.55 492.097 496.532 492.152 496.528 492.297 c 496.506 492.772 l 496.492 493.137 496.342 493.202 496.193 493.264 c 496.361 493.363 496.558 493.505 496.558 493.892 c 496.558 494.446 496.127 494.596 495.697 494.596 c 494.485 494.596 l 494.485 491.977 l 494.839 491.977 l 494.839 493.1 l f* 497.046 494.596 0.354 -2.62 re f 497.747 494.282 m 498.634 494.282 l 498.634 491.976 l 498.988 491.976 l 498.988 494.282 l 499.874 494.282 l 499.874 494.596 l 497.747 494.596 l 497.747 494.282 l f* 500.188 494.596 0.354 -2.62 re f 503.295 493.808 m 503.245 494.246 502.894 494.665 502.219 494.665 c 501.457 494.665 500.997 494.107 500.997 493.301 c 500.997 492.294 501.581 491.906 502.175 491.906 c 502.373 491.906 503.175 491.95 503.321 492.94 c 502.978 492.94 l 502.858 492.33 502.46 492.221 502.23 492.221 c 501.581 492.221 501.362 492.695 501.362 493.312 c 501.362 494.001 501.745 494.352 502.219 494.352 c 502.471 494.352 502.854 494.268 502.953 493.808 c 503.295 493.808 l f* 504.186 493.053 m 504.605 494.206 l 504.613 494.206 l 504.999 493.053 l 504.186 493.053 l h 505.127 492.739 m 505.386 491.976 l 505.773 491.976 l 504.825 494.596 l 504.423 494.596 l 503.438 491.976 l 503.802 491.976 l 504.076 492.739 l 505.127 492.739 l f* 506.375 494.596 m 506.021 494.596 l 506.021 491.977 l 507.704 491.977 l 507.704 492.29 l 506.375 492.29 l 506.375 494.596 l f* 491.654 490.209 0.354 -2.621 re f 494.317 488.092 m 494.31 488.092 l 493 490.208 l 492.58 490.208 l 492.58 487.589 l 492.923 487.589 l 492.923 489.705 l 492.931 489.705 l 494.262 487.589 l 494.66 487.589 l 494.66 490.208 l 494.317 490.208 l 494.317 488.092 l f* 497.313 489.42 m 497.262 489.858 496.911 490.278 496.236 490.278 c 495.474 490.278 495.014 489.719 495.014 488.913 c 495.014 487.906 495.598 487.518 496.193 487.518 c 496.39 487.518 497.192 487.562 497.338 488.552 c 496.995 488.552 l 496.875 487.942 496.477 487.833 496.247 487.833 c 495.598 487.833 495.379 488.307 495.379 488.924 c 495.379 489.613 495.762 489.964 496.236 489.964 c 496.488 489.964 496.871 489.88 496.97 489.42 c 497.313 489.42 l f* 497.736 490.209 0.354 -2.621 re f 499.035 489.905 m 499.695 489.905 l 500.177 489.905 500.479 489.573 500.479 488.913 c 500.479 488.253 500.181 487.891 499.721 487.891 c 499.035 487.891 l 499.035 489.905 l h 498.681 487.589 m 499.727 487.589 l 500.588 487.589 500.843 488.347 500.843 488.935 c 500.843 489.69 500.424 490.208 499.742 490.208 c 498.681 490.208 l 498.681 487.589 l f* 503.183 487.902 m 501.603 487.902 l 501.603 488.778 l 503.037 488.778 l 503.037 489.092 l 501.603 489.092 l 501.603 489.894 l 503.157 489.894 l 503.157 490.208 l 501.249 490.208 l 501.249 487.589 l 503.183 487.589 l 503.183 487.902 l f* 505.306 488.092 m 505.299 488.092 l 503.989 490.208 l 503.569 490.208 l 503.569 487.589 l 503.912 487.589 l 503.912 489.705 l 503.92 489.705 l 505.252 487.589 l 505.649 487.589 l 505.649 490.208 l 505.306 490.208 l 505.306 488.092 l f* 505.894 489.894 m 506.78 489.894 l 506.78 487.588 l 507.134 487.588 l 507.134 489.894 l 508.021 489.894 l 508.021 490.208 l 505.894 490.208 l 505.894 489.894 l f* 494.782 485.054 m 494.768 485.342 494.677 485.89 493.761 485.89 c 493.126 485.89 492.86 485.488 492.86 485.079 c 492.86 484.623 493.246 484.503 493.418 484.463 c 493.954 484.339 l 494.385 484.237 494.512 484.149 494.512 483.875 c 494.512 483.5 494.082 483.434 493.827 483.434 c 493.491 483.434 493.104 483.572 493.104 484.047 c 492.772 484.047 l 492.772 483.803 492.816 483.584 493.038 483.383 c 493.155 483.277 493.345 483.131 493.83 483.131 c 494.279 483.131 494.855 483.303 494.855 483.923 c 494.855 484.339 494.6 484.543 494.261 484.623 c 493.513 484.795 l 493.359 484.831 493.203 484.904 493.203 485.127 c 493.203 485.525 493.578 485.587 493.801 485.587 c 494.096 485.587 494.432 485.459 494.45 485.054 c 494.782 485.054 l f* 495.001 485.506 m 495.888 485.506 l 495.888 483.2 l 496.242 483.2 l 496.242 485.506 l 497.129 485.506 l 497.129 485.82 l 495.001 485.82 l 495.001 485.506 l f* 497.785 485.517 m 498.668 485.517 l 498.843 485.517 499.139 485.484 499.139 485.079 c 499.139 484.693 498.865 484.627 498.606 484.627 c 497.785 484.627 l 497.785 485.517 l h 497.785 484.324 m 498.643 484.324 l 499.066 484.324 499.11 484.072 499.11 483.857 c 499.11 483.758 499.121 483.361 499.172 483.2 c 499.605 483.2 l 499.605 483.259 l 499.496 483.321 499.478 483.376 499.474 483.521 c 499.453 483.996 l 499.438 484.361 499.288 484.426 499.139 484.488 c 499.307 484.587 499.503 484.729 499.503 485.116 c 499.503 485.67 499.073 485.82 498.643 485.82 c 497.431 485.82 l 497.431 483.2 l 497.785 483.2 l 497.785 484.324 l f* 501.907 483.514 m 500.328 483.514 l 500.328 484.39 l 501.761 484.39 l 501.761 484.704 l 500.328 484.704 l 500.328 485.506 l 501.882 485.506 l 501.882 485.82 l 499.974 485.82 l 499.974 483.2 l 501.907 483.2 l 501.907 483.514 l f* 504.206 485.054 m 504.191 485.342 504.1 485.89 503.184 485.89 c 502.549 485.89 502.283 485.488 502.283 485.079 c 502.283 484.623 502.67 484.503 502.842 484.463 c 503.378 484.339 l 503.808 484.237 503.936 484.149 503.936 483.875 c 503.936 483.5 503.506 483.434 503.25 483.434 c 502.914 483.434 502.527 483.572 502.527 484.047 c 502.196 484.047 l 502.196 483.803 502.239 483.584 502.462 483.383 c 502.579 483.277 502.768 483.131 503.253 483.131 c 503.703 483.131 504.279 483.303 504.279 483.923 c 504.279 484.339 504.023 484.543 503.684 484.623 c 502.936 484.795 l 502.783 484.831 502.626 484.904 502.626 485.127 c 502.626 485.525 503.002 485.587 503.224 485.587 c 503.52 485.587 503.856 485.459 503.874 485.054 c 504.206 485.054 l f* 506.563 485.054 m 506.548 485.342 506.457 485.89 505.542 485.89 c 504.906 485.89 504.64 485.488 504.64 485.079 c 504.64 484.623 505.027 484.503 505.198 484.463 c 505.735 484.339 l 506.166 484.237 506.293 484.149 506.293 483.875 c 506.293 483.5 505.863 483.434 505.607 483.434 c 505.271 483.434 504.885 483.572 504.885 484.047 c 504.553 484.047 l 504.553 483.803 504.596 483.584 504.819 483.383 c 504.935 483.277 505.126 483.131 505.611 483.131 c 506.06 483.131 506.636 483.303 506.636 483.923 c 506.636 484.339 506.38 484.543 506.041 484.623 c 505.293 484.795 l 505.14 484.831 504.983 484.904 504.983 485.127 c 504.983 485.525 505.359 485.587 505.582 485.587 c 505.877 485.587 506.213 485.459 506.231 485.054 c 506.563 485.054 l f* 488.941 480.002 m 490.225 480.002 l 490.225 480.316 l 488.941 480.316 l 488.941 481.118 l 490.4 481.118 l 490.4 481.432 l 488.587 481.432 l 488.587 478.812 l 488.941 478.812 l 488.941 480.002 l f* 493.129 480.122 m 493.129 480.688 492.83 481.502 491.853 481.502 c 490.875 481.502 490.576 480.688 490.576 480.122 c 490.576 479.557 490.875 478.742 491.853 478.742 c 492.83 478.742 493.129 479.557 493.129 480.122 c h 492.765 480.122 m 492.765 479.506 492.422 479.057 491.853 479.057 c 491.283 479.057 490.94 479.506 490.94 480.122 c 490.94 480.739 491.283 481.188 491.853 481.188 c 492.422 481.188 492.765 480.739 492.765 480.122 c f* 495.18 481.432 m 495.18 479.776 l 495.18 479.206 494.815 479.057 494.491 479.057 c 494.173 479.057 493.827 479.214 493.827 479.783 c 493.827 481.432 l 493.472 481.432 l 493.472 479.685 l 493.472 479.195 493.775 478.742 494.48 478.742 c 495.198 478.742 495.534 479.195 495.534 479.732 c 495.534 481.432 l 495.18 481.432 l f* 497.749 479.316 m 497.741 479.316 l 496.432 481.432 l 496.012 481.432 l 496.012 478.813 l 496.355 478.813 l 496.355 480.929 l 496.362 480.929 l 497.694 478.813 l 498.092 478.813 l 498.092 481.432 l 497.749 481.432 l 497.749 479.316 l f* 498.934 481.129 m 499.595 481.129 l 500.076 481.129 500.378 480.797 500.378 480.137 c 500.378 479.477 500.08 479.115 499.62 479.115 c 498.934 479.115 l 498.934 481.129 l h 498.581 478.813 m 499.628 478.813 l 500.489 478.813 500.744 479.571 500.744 480.159 c 500.744 480.914 500.325 481.432 499.641 481.432 c 498.581 481.432 l 498.581 478.813 l f* 501.488 479.889 m 501.907 481.042 l 501.914 481.042 l 502.301 479.889 l 501.488 479.889 l h 502.429 479.575 m 502.688 478.812 l 503.075 478.812 l 502.126 481.432 l 501.725 481.432 l 500.74 478.812 l 501.105 478.812 l 501.378 479.575 l 502.429 479.575 l f* 502.659 481.118 m 503.546 481.118 l 503.546 478.812 l 503.9 478.812 l 503.9 481.118 l 504.786 481.118 l 504.786 481.432 l 502.659 481.432 l 502.659 481.118 l f* 505.1 481.432 0.354 -2.62 re f 508.446 480.122 m 508.446 480.688 508.147 481.502 507.168 481.502 c 506.191 481.502 505.891 480.688 505.891 480.122 c 505.891 479.557 506.191 478.742 507.168 478.742 c 508.147 478.742 508.446 479.557 508.446 480.122 c h 508.081 480.122 m 508.081 479.506 507.738 479.057 507.168 479.057 c 506.6 479.057 506.256 479.506 506.256 480.122 c 506.256 480.739 506.6 481.188 507.168 481.188 c 507.738 481.188 508.081 480.739 508.081 480.122 c f* 510.514 479.316 m 510.507 479.316 l 509.197 481.432 l 508.778 481.432 l 508.778 478.813 l 509.121 478.813 l 509.121 480.929 l 509.128 480.929 l 510.46 478.813 l 510.857 478.813 l 510.857 481.432 l 510.514 481.432 l 510.514 479.316 l f* 498.731 516.76 m 500.589 516.76 l 500.588 514.853 l 502.127 515.856 l 503.014 514.412 l 501.367 513.453 l 503.026 512.513 l 502.173 511.033 l 500.578 511.958 l 500.578 510.012 l 498.738 510.012 l 498.737 511.915 l 497.109 510.976 l 496.256 512.522 l 497.867 513.44 l 496.226 514.4 l 497.077 515.836 l 498.731 514.853 l 498.731 516.76 l f* 0 0.286 0.388 RG 498.731 516.76 m 500.589 516.76 l 500.588 514.853 l 502.127 515.856 l 503.014 514.412 l 501.367 513.453 l 503.026 512.513 l 502.173 511.033 l 500.578 511.958 l 500.578 510.012 l 498.738 510.012 l 498.737 511.915 l 497.109 510.976 l 496.256 512.522 l 497.867 513.44 l 496.226 514.4 l 497.077 515.836 l 498.731 514.853 l 498.731 516.76 l s 1 1 1 rg 499.868 515.921 m 499.647 516.31 499.455 515.915 y 499.641 510.927 l 499.711 510.788 499.741 510.941 y 499.868 515.921 l f* 499.515 514.331 m 499.388 514.41 499.33 514.478 y 499.009 514.82 499.003 515.083 y 498.994 515.313 499.074 515.445 y 499.139 515.587 499.343 515.662 y 499.464 515.709 499.48 515.697 y 499.641 515.694 499.719 515.565 y 499.979 515.378 499.641 515.383 y 499.48 515.407 499.432 515.443 y 499.232 515.389 499.273 515.094 y 499.312 514.918 499.418 514.726 499.503 514.682 c 499.515 514.331 l f* 1 1 1 RG 0.23 w 499.515 514.331 m 499.388 514.41 499.33 514.478 y 499.009 514.82 499.003 515.083 y 498.994 515.313 499.074 515.445 y 499.139 515.587 499.343 515.662 y 499.464 515.709 499.48 515.697 y 499.641 515.694 499.719 515.565 y 499.979 515.378 499.641 515.383 y 499.48 515.407 499.432 515.443 y 499.232 515.389 499.273 515.094 y 499.312 514.918 499.418 514.726 499.503 514.682 c 499.515 514.331 l s 499.64 515.552 m 499.614 515.555 499.586 515.544 499.563 515.556 c 499.551 515.561 499.547 515.575 499.551 515.585 c 499.554 515.592 499.572 515.604 499.584 515.599 c 499.608 515.59 499.614 515.56 499.64 515.552 c f* 499.64 515.552 m 499.614 515.555 499.586 515.544 499.563 515.556 c 499.551 515.561 499.547 515.575 499.551 515.585 c 499.554 515.592 499.572 515.604 499.584 515.599 c 499.608 515.59 499.614 515.56 499.64 515.552 c s 499.622 511.931 m 499.623 511.931 499.638 512.023 499.682 512.093 c 499.722 512.154 499.754 512.186 499.818 512.253 c 499.852 512.29 499.903 512.36 499.938 512.403 c 500.063 512.559 499.96 512.726 v 499.913 512.797 499.785 512.908 v 499.787 512.567 l 499.786 512.486 499.57 512.24 y 499.515 512.171 499.487 512.138 499.462 511.943 c 499.441 511.719 499.625 511.48 v 499.614 511.841 l 499.617 511.901 499.622 511.931 v f* 499.622 511.931 m 499.623 511.931 499.638 512.023 499.682 512.093 c 499.722 512.154 499.754 512.186 499.818 512.253 c 499.852 512.29 499.903 512.36 499.938 512.403 c 500.063 512.559 499.96 512.726 v 499.913 512.797 499.785 512.908 v 499.787 512.567 l 499.786 512.486 499.57 512.24 y 499.515 512.171 499.487 512.138 499.462 511.943 c 499.441 511.719 499.625 511.48 v 499.614 511.841 l 499.617 511.901 499.622 511.931 v s 499.822 514.115 m 499.842 514.058 499.542 513.743 y 499.516 513.713 499.486 513.679 499.451 513.641 c 499.263 513.437 499.272 513.268 v 499.282 513.033 499.512 512.812 v 499.54 512.789 499.579 512.747 v 499.569 513.069 l 499.544 513.1 499.516 513.147 499.492 513.218 c 499.467 513.269 499.536 513.378 v 499.657 513.488 500.047 513.952 v 500.048 513.952 500.161 514.145 500.072 514.273 c 499.984 514.4 499.833 514.501 v 499.822 514.115 l f* 499.822 514.115 m 499.842 514.058 499.542 513.743 y 499.516 513.713 499.486 513.679 499.451 513.641 c 499.263 513.437 499.272 513.268 v 499.282 513.033 499.512 512.812 v 499.54 512.789 499.579 512.747 v 499.569 513.069 l 499.544 513.1 499.516 513.147 499.492 513.218 c 499.467 513.269 499.536 513.378 v 499.657 513.488 500.047 513.952 v 500.048 513.952 500.161 514.145 500.072 514.273 c 499.984 514.4 499.833 514.501 v 499.822 514.115 l s 499.748 511.322 m 499.759 511.281 499.753 511.23 499.703 511.172 c 499.594 511.015 l 499.715 511.067 499.773 511.14 v 499.774 511.14 499.846 511.212 499.83 511.345 c 499.816 511.408 499.754 511.51 v 499.748 511.322 l f* 499.748 511.322 m 499.759 511.281 499.753 511.23 499.703 511.172 c 499.594 511.015 l 499.715 511.067 499.773 511.14 v 499.774 511.14 499.846 511.212 499.83 511.345 c 499.816 511.408 499.754 511.51 v 499.748 511.322 l s 0 0.286 0.388 rg 524.613 491.654 m 524.759 491.743 525.206 492.418 525.223 492.39 c 525.49 491.966 525.856 491.538 526.636 491.538 c 527.417 491.538 528.05 491.92 528.05 492.39 c 528.05 491.92 528.659 491.561 529.44 491.561 c 530.219 491.561 530.609 491.922 530.852 492.413 c 530.862 492.455 l 531.007 492.363 531.705 491.902 531.682 491.877 c 529.489 490.315 534.022 487.057 528.713 485.176 c 528.441 485.099 528.318 484.914 v 528.269 485.004 527.879 485.182 y 522.15 486.432 526.977 490.092 524.613 491.654 c f* 0 0.286 0.388 RG 1 J 1 j 0.46 w 524.613 491.654 m 524.759 491.743 525.206 492.418 525.223 492.39 c 525.49 491.966 525.856 491.538 526.636 491.538 c 527.417 491.538 528.05 491.92 528.05 492.39 c S 0.137 0.122 0.125 RG 528.05 492.39 m 528.05 492.39 l S 0 0.286 0.388 RG 528.05 492.39 m 528.05 491.92 528.659 491.561 529.44 491.561 c 530.219 491.561 530.609 491.922 530.852 492.413 c S 0.137 0.122 0.125 RG 530.852 492.413 m 530.862 492.455 l S 0 0.286 0.388 RG 530.862 492.455 m 531.007 492.363 531.705 491.902 531.682 491.877 c 529.489 490.315 534.022 487.057 528.713 485.176 c 528.441 485.099 528.318 484.914 v S 0.137 0.122 0.125 RG 528.318 484.914 m 528.318 484.914 l S 0 0.286 0.388 RG 528.318 484.914 m 528.269 485.004 527.879 485.182 y 522.15 486.432 526.977 490.092 524.613 491.654 c S 1 1 1 rg 526.669 486.36 m 527.182 488.436 l 525.88 489.587 l 527.513 489.589 l 528.029 491.501 l 528.626 489.581 l 530.385 489.585 l 528.968 488.344 l 529.584 486.36 l 528.152 487.635 l 526.669 486.36 l f* 0.137 0.122 0.125 rg 467.859 490.222 m 467.676 490.184 467.578 490.172 467.464 489.941 c 467.423 489.858 467.38 489.763 467.323 489.687 c 467.097 489.355 467.14 488.96 467.168 488.604 c 467.196 488.553 467.225 488.482 467.225 488.425 c 467.225 488.349 467.303 488.3 467.323 488.221 c 467.366 488.055 467.507 487.992 467.591 487.865 c 467.648 487.813 467.845 487.673 467.845 487.699 c 467.845 488.03 467.747 488.382 467.676 488.655 c 467.577 489.037 467.704 489.406 467.789 489.814 c 467.845 489.967 467.831 490.069 467.859 490.222 c f* 0.137 0.122 0.125 RG 0 J 467.859 490.222 m 467.676 490.184 467.578 490.172 467.464 489.941 c 467.423 489.858 467.38 489.763 467.323 489.687 c 467.097 489.355 467.14 488.96 467.168 488.604 c 467.196 488.553 467.225 488.482 467.225 488.425 c 467.225 488.349 467.303 488.3 467.323 488.221 c 467.366 488.055 467.507 487.992 467.591 487.865 c 467.648 487.813 467.845 487.673 467.845 487.699 c 467.845 488.03 467.747 488.382 467.676 488.655 c 467.577 489.037 467.704 489.406 467.789 489.814 c 467.845 489.967 467.831 490.069 467.859 490.222 c s 469.454 486.374 m 469.504 486.21 469.513 486.065 469.773 485.973 c 469.867 485.939 469.975 485.905 470.061 485.857 c 470.439 485.669 470.873 485.726 471.266 485.768 c 471.321 485.796 471.398 485.824 471.461 485.827 c 471.545 485.831 471.596 485.904 471.682 485.926 c 471.863 485.972 471.927 486.102 472.064 486.184 c 472.117 486.237 472.264 486.422 472.235 486.421 c 471.869 486.406 471.485 486.3 471.186 486.224 c 470.768 486.117 470.353 486.214 469.899 486.272 c 469.727 486.315 469.624 486.355 469.454 486.374 c f* 469.454 486.374 m 469.504 486.21 469.513 486.065 469.773 485.973 c 469.867 485.939 469.975 485.905 470.061 485.857 c 470.439 485.669 470.873 485.726 471.266 485.768 c 471.321 485.796 471.398 485.824 471.461 485.827 c 471.545 485.831 471.596 485.904 471.682 485.926 c 471.863 485.972 471.927 486.102 472.064 486.184 c 472.117 486.237 472.264 486.422 472.235 486.421 c 471.869 486.406 471.485 486.3 471.186 486.224 c 470.768 486.117 470.353 486.214 469.899 486.272 c 469.727 486.315 469.624 486.355 469.454 486.374 c s 473.771 487.826 m 473.951 487.875 474.047 487.892 474.145 488.129 c 474.18 488.215 474.217 488.312 474.268 488.391 c 474.47 488.735 474.459 489.135 474.406 489.489 c 474.374 489.538 474.346 489.623 474.342 489.68 c 474.328 489.877 474.175 490.026 474.194 489.967 c 474.14 490.13 474.055 490.093 473.961 490.216 c 473.901 490.263 473.769 490.356 473.771 490.33 c 473.794 490 473.829 489.7 473.919 489.432 c 474.045 489.056 473.868 488.649 473.812 488.237 c 473.767 488.081 473.788 487.98 473.771 487.826 c f* 473.771 487.826 m 473.951 487.875 474.047 487.892 474.145 488.129 c 474.18 488.215 474.217 488.312 474.268 488.391 c 474.47 488.735 474.459 489.135 474.406 489.489 c 474.374 489.538 474.346 489.623 474.342 489.68 c 474.328 489.877 474.175 490.026 474.194 489.967 c 474.14 490.13 474.055 490.093 473.961 490.216 c 473.901 490.263 473.769 490.356 473.771 490.33 c 473.794 490 473.829 489.7 473.919 489.432 c 474.045 489.056 473.868 488.649 473.812 488.237 c 473.767 488.081 473.788 487.98 473.771 487.826 c s 472.25 491.578 m 472.208 491.744 472.195 491.832 471.94 491.935 c 471.847 491.973 471.742 492.012 471.658 492.063 c 471.291 492.268 470.854 492.23 470.458 492.204 c 470.402 492.179 470.324 492.154 470.261 492.154 c 470.177 492.154 470.123 492.083 470.035 492.065 c 469.853 492.027 469.781 491.899 469.641 491.823 c 469.583 491.772 469.429 491.594 469.457 491.594 c 469.823 491.593 470.212 491.682 470.514 491.746 c 470.938 491.834 471.347 491.719 471.798 491.642 c 471.968 491.591 472.081 491.604 472.25 491.578 c f* 472.25 491.578 m 472.208 491.744 472.195 491.832 471.94 491.935 c 471.847 491.973 471.742 492.012 471.658 492.063 c 471.291 492.268 470.854 492.23 470.458 492.204 c 470.402 492.179 470.324 492.154 470.261 492.154 c 470.177 492.154 470.123 492.083 470.035 492.065 c 469.853 492.027 469.781 491.899 469.641 491.823 c 469.583 491.772 469.429 491.594 469.457 491.594 c 469.823 491.593 470.212 491.682 470.514 491.746 c 470.938 491.834 471.347 491.719 471.798 491.642 c 471.968 491.591 472.081 491.604 472.25 491.578 c s 0 0.286 0.388 rg 470.766 486.551 m 472.302 486.551 473.549 487.682 473.549 489.078 c 473.549 490.474 472.302 491.606 470.766 491.606 c 469.229 491.606 467.983 490.474 467.983 489.078 c 467.983 487.682 469.229 486.551 470.766 486.551 c f* 0 0.286 0.388 RG 1.841 w 470.766 486.551 m 472.302 486.551 473.549 487.682 473.549 489.078 c 473.549 490.474 472.302 491.606 470.766 491.606 c 469.229 491.606 467.983 490.474 467.983 489.078 c 467.983 487.682 469.229 486.551 470.766 486.551 c s 468.5 490.554 m 467.061 491.663 l 466.934 491.548 467.078 491.401 466.84 490.925 c 466.75 490.744 466.744 490.305 466.659 490.095 c 466.659 490.057 466.68 490.134 466.659 490.095 c 466.638 490 466.447 489.579 466.469 489.484 c 466.447 489.484 466.469 489.484 y 466.405 489.216 466.405 488.968 466.426 488.7 c 466.436 488.5 466.481 488.455 466.643 487.782 c 466.686 487.61 466.848 487.162 466.89 486.971 c 466.932 486.799 467.019 486.445 467.082 486.292 c 467.104 486.254 466.998 486.273 467.082 486.292 c 468.627 487.419 l 468.592 487.487 468.677 487.346 468.627 487.419 c 468.504 487.689 468.247 488.101 468.197 488.395 c 468.123 488.715 468.123 489.058 468.148 489.378 c 468.148 489.402 468.29 489.845 468.296 489.869 c 468.38 490.18 468.346 490.188 468.5 490.554 c f* 0.46 w 468.5 490.554 m 467.061 491.663 l 466.934 491.548 467.078 491.401 466.84 490.925 c 466.75 490.744 466.744 490.305 466.659 490.095 c 466.659 490.057 466.68 490.134 466.659 490.095 c 466.638 490 466.447 489.579 466.469 489.484 c 466.447 489.484 466.469 489.484 y 466.405 489.216 466.405 488.968 466.426 488.7 c 466.436 488.5 466.481 488.455 466.643 487.782 c 466.686 487.61 466.848 487.162 466.89 486.971 c 466.932 486.799 467.019 486.445 467.082 486.292 c 467.104 486.254 466.998 486.273 467.082 486.292 c 468.627 487.419 l 468.592 487.487 468.677 487.346 468.627 487.419 c 468.504 487.689 468.247 488.101 468.197 488.395 c 468.123 488.715 468.123 489.058 468.148 489.378 c 468.148 489.402 468.29 489.845 468.296 489.869 c 468.38 490.18 468.346 490.188 468.5 490.554 c s 472.291 491.133 m 473.463 492.519 l 473.353 492.65 473.199 492.512 472.731 492.768 c 472.553 492.865 472.113 492.89 471.906 492.983 c 471.867 492.984 471.943 492.96 471.906 492.983 c 471.811 493.008 471.396 493.214 471.299 493.197 c 471.3 493.218 471.299 493.197 y 471.033 493.271 470.784 493.281 470.514 493.271 c 470.313 493.27 470.267 493.227 469.583 493.093 c 469.41 493.058 468.954 492.915 468.761 492.88 c 468.586 492.845 468.227 492.774 468.071 492.717 c 468.031 492.697 468.055 492.802 468.071 492.717 c 469.14 491.134 l 469.209 491.167 469.064 491.088 469.14 491.134 c 469.416 491.246 469.839 491.485 470.137 491.522 c 470.461 491.583 470.805 491.569 471.124 491.531 c 471.149 491.53 471.646 491.448 471.669 491.44 c 471.972 491.347 471.916 491.318 472.291 491.133 c f* 472.291 491.133 m 473.463 492.519 l 473.353 492.65 473.199 492.512 472.731 492.768 c 472.553 492.865 472.113 492.89 471.906 492.983 c 471.867 492.984 471.943 492.96 471.906 492.983 c 471.811 493.008 471.396 493.214 471.299 493.197 c 471.3 493.218 471.299 493.197 y 471.033 493.271 470.784 493.281 470.514 493.271 c 470.313 493.27 470.267 493.227 469.583 493.093 c 469.41 493.058 468.954 492.915 468.761 492.88 c 468.586 492.845 468.227 492.774 468.071 492.717 c 468.031 492.697 468.055 492.802 468.071 492.717 c 469.14 491.134 l 469.209 491.167 469.064 491.088 469.14 491.134 c 469.416 491.246 469.839 491.485 470.137 491.522 c 470.461 491.583 470.805 491.569 471.124 491.531 c 471.149 491.53 471.646 491.448 471.669 491.44 c 471.972 491.347 471.916 491.318 472.291 491.133 c s 469.286 486.905 m 468.185 485.464 l 468.301 485.338 468.447 485.483 468.928 485.25 c 469.11 485.162 469.551 485.16 469.763 485.077 c 469.801 485.077 469.724 485.098 469.763 485.077 c 469.859 485.057 470.283 484.871 470.379 484.893 c 470.379 484.872 470.379 484.893 y 470.648 484.832 470.897 484.834 471.166 484.857 c 471.367 484.869 471.411 484.914 472.086 485.081 c 472.259 485.124 472.707 485.29 472.898 485.333 c 473.071 485.377 473.427 485.466 473.58 485.531 c 473.618 485.552 473.6 485.447 473.58 485.531 c 472.433 487.059 l 472.366 487.023 472.507 487.109 472.433 487.059 c 472.163 486.934 471.752 486.674 471.456 486.623 c 471.136 486.546 470.791 486.543 470.47 486.565 c 470.445 486.565 470 486.702 469.975 486.708 c 469.604 486.803 469.664 486.804 469.286 486.905 c f* 469.286 486.905 m 468.185 485.464 l 468.301 485.338 468.447 485.483 468.928 485.25 c 469.11 485.162 469.551 485.16 469.763 485.077 c 469.801 485.077 469.724 485.098 469.763 485.077 c 469.859 485.057 470.283 484.871 470.379 484.893 c 470.379 484.872 470.379 484.893 y 470.648 484.832 470.897 484.834 471.166 484.857 c 471.367 484.869 471.411 484.914 472.086 485.081 c 472.259 485.124 472.707 485.29 472.898 485.333 c 473.071 485.377 473.427 485.466 473.58 485.531 c 473.618 485.552 473.6 485.447 473.58 485.531 c 472.433 487.059 l 472.366 487.023 472.507 487.109 472.433 487.059 c 472.163 486.934 471.752 486.674 471.456 486.623 c 471.136 486.546 470.791 486.543 470.47 486.565 c 470.445 486.565 470 486.702 469.975 486.708 c 469.604 486.803 469.664 486.804 469.286 486.905 c s 473.026 487.733 m 474.903 486.591 l 475.018 486.718 474.861 486.85 475.05 487.347 c 475.122 487.536 475.086 487.973 475.149 488.19 c 475.145 488.229 475.132 488.15 475.149 488.19 c 475.161 488.287 475.309 488.724 475.279 488.817 c 475.3 488.82 475.279 488.817 y 475.315 489.09 475.291 489.337 475.244 489.601 c 475.214 489.8 475.165 489.839 474.937 490.494 c 474.878 490.662 474.673 491.091 474.612 491.277 c 474.553 491.444 474.432 491.788 474.354 491.935 c 474.329 491.97 474.436 491.962 474.354 491.935 c 472.927 490.662 l 472.969 490.598 472.871 490.73 472.927 490.662 c 473.077 490.405 473.373 490.021 473.451 489.732 c 473.556 489.422 473.464 489.084 473.47 488.764 c 473.473 488.739 473.401 488.297 473.396 488.273 c 473.334 487.897 473.248 488.052 473.051 487.733 c 473.026 487.733 l f* 473.026 487.733 m 474.903 486.591 l 475.018 486.718 474.861 486.85 475.05 487.347 c 475.122 487.536 475.086 487.973 475.149 488.19 c 475.145 488.229 475.132 488.15 475.149 488.19 c 475.161 488.287 475.309 488.724 475.279 488.817 c 475.3 488.82 475.279 488.817 y 475.315 489.09 475.291 489.337 475.244 489.601 c 475.214 489.8 475.165 489.839 474.937 490.494 c 474.878 490.662 474.673 491.091 474.612 491.277 c 474.553 491.444 474.432 491.788 474.354 491.935 c 474.329 491.97 474.436 491.962 474.354 491.935 c 472.927 490.662 l 472.969 490.598 472.871 490.73 472.927 490.662 c 473.077 490.405 473.373 490.021 473.451 489.732 c 473.556 489.422 473.464 489.084 473.47 488.764 c 473.473 488.739 473.401 488.297 473.396 488.273 c 473.334 487.897 473.248 488.052 473.051 487.733 c 473.026 487.733 l s 1 1 1 rg 469.211 488.122 m 469.185 488.319 469.309 488.613 469.309 488.81 c 469.284 488.785 469.556 488.564 469.531 488.54 c 469.604 488.54 469.704 488.515 469.704 488.54 c 469.902 488.933 469.803 488.736 469.951 489.203 c 469.974 489.277 469.926 489.89 469.975 489.988 c 470 490.013 470.295 489.553 470.295 489.497 c 470.295 489.301 470.517 490.013 470.591 489.816 c 470.665 489.669 470.419 489.154 470.542 489.055 c 470.739 488.908 470.863 489.276 470.838 489.473 c 470.937 489.08 470.813 488.785 470.715 488.589 c 470.612 488.382 470.245 488.456 470.073 488.171 c 470 488.049 470 487.877 469.926 487.754 c 469.876 487.705 469.803 487.729 469.778 487.656 c 469.211 488.122 l f* 1 1 1 RG 1 J 469.211 488.122 m 469.185 488.319 469.309 488.613 469.309 488.81 c 469.284 488.785 469.556 488.564 469.531 488.54 c 469.604 488.54 469.704 488.515 469.704 488.54 c 469.902 488.933 469.803 488.736 469.951 489.203 c 469.974 489.277 469.926 489.89 469.975 489.988 c 470 490.013 470.295 489.553 470.295 489.497 c 470.295 489.301 470.517 490.013 470.591 489.816 c 470.665 489.669 470.419 489.154 470.542 489.055 c 470.739 488.908 470.863 489.276 470.838 489.473 c 470.937 489.08 470.813 488.785 470.715 488.589 c 470.612 488.382 470.245 488.456 470.073 488.171 c 470 488.049 470 487.877 469.926 487.754 c 469.876 487.705 469.803 487.729 469.778 487.656 c S 470.288 487.389 m 470.288 487.462 470.362 487.462 470.387 487.511 c 470.682 487.708 471.053 487.757 471.2 488.076 c 471.299 488.297 471.275 488.518 471.225 488.739 c 471.225 488.837 471.077 488.911 471.102 489.034 c 471.176 489.009 471.423 488.887 471.472 488.96 c 471.62 489.157 471.694 489.623 471.62 489.869 c 471.842 489.476 471.891 488.887 471.743 488.395 c 471.793 488.395 472.089 488.764 472.138 488.739 c 472.163 488.715 472.064 488.199 472.039 488.15 c 471.867 487.929 471.694 487.683 471.398 487.56 c 470.288 487.389 l f* 470.288 487.389 m 470.288 487.462 470.362 487.462 470.387 487.511 c 470.682 487.708 471.053 487.757 471.2 488.076 c 471.299 488.297 471.275 488.518 471.225 488.739 c 471.225 488.837 471.077 488.911 471.102 489.034 c 471.176 489.009 471.423 488.887 471.472 488.96 c 471.62 489.157 471.694 489.623 471.62 489.869 c 471.842 489.476 471.891 488.887 471.743 488.395 c 471.793 488.395 472.089 488.764 472.138 488.739 c 472.163 488.715 472.064 488.199 472.039 488.15 c 471.867 487.929 471.694 487.683 471.398 487.56 c S 0 0.286 0.388 rg 499.514 463.28 m 499.605 463.307 499.676 463.252 499.768 463.307 c 499.953 463.389 500.116 463.444 500.277 463.581 c 500.392 463.664 500.461 463.801 500.578 463.911 c 500.624 463.939 500.698 463.94 500.716 463.856 c 500.739 463.746 500.81 463.719 500.878 463.691 c 501.225 463.554 501.572 463.637 501.919 463.691 c 502.313 463.746 502.59 464.103 502.961 464.268 c 503.146 464.378 503.286 464.589 503.47 464.626 c 503.609 464.653 503.771 464.653 503.887 464.762 c 503.956 464.818 503.933 464.9 v 504.187 464.928 504.372 465.12 504.535 465.339 c 504.581 465.367 504.65 465.421 504.719 465.394 c 504.696 465.394 l 506.409 467.563 l 506.385 467.617 l 506.362 467.7 506.408 467.783 506.362 467.864 c 501.202 466.464 l 501.178 466.271 500.971 466.025 500.854 465.859 c 500.876 465.889 500.464 466.128 500.503 466.205 c 500.748 466.697 500.687 467.153 500.432 467.592 c 500.385 467.702 500.339 467.743 500.271 467.839 c 500.094 468.083 499.808 468.223 499.507 468.168 c 499.438 468.168 l 499.137 468.223 498.928 468.086 498.708 467.893 c 498.608 467.806 498.431 467.619 498.385 467.509 c 498.13 467.07 498.235 466.534 498.432 466.106 c 498.467 466.028 498.051 465.892 498.072 465.863 c 497.957 466.027 497.748 466.274 497.725 466.467 c 492.564 467.867 l 492.518 467.784 492.564 467.702 492.541 467.619 c 492.518 467.564 l 494.231 465.396 l 494.207 465.396 l 494.277 465.424 494.346 465.368 494.393 465.341 c 494.555 465.122 494.74 464.929 494.994 464.902 c 494.971 464.819 495.041 464.765 y 495.156 464.655 495.318 464.655 495.457 464.627 c 495.641 464.591 495.781 464.38 495.966 464.271 c 496.336 464.106 496.614 463.749 497.008 463.694 c 497.355 463.639 497.702 463.557 498.049 463.694 c 498.118 463.721 498.188 463.749 498.211 463.859 c 498.229 463.943 498.304 463.941 498.35 463.914 c 498.466 463.804 498.535 463.667 498.651 463.584 c 498.813 463.447 498.974 463.392 499.16 463.31 c 499.253 463.255 499.322 463.31 499.415 463.282 c 499.514 463.28 l f 0 0.286 0.388 RG 4 M 499.514 463.28 m 499.605 463.307 499.676 463.252 499.768 463.307 c 499.953 463.389 500.116 463.444 500.277 463.581 c 500.392 463.664 500.461 463.801 500.578 463.911 c 500.624 463.939 500.698 463.94 500.716 463.856 c 500.739 463.746 500.81 463.719 500.878 463.691 c 501.225 463.554 501.572 463.637 501.919 463.691 c 502.313 463.746 502.59 464.103 502.961 464.268 c 503.146 464.378 503.286 464.589 503.47 464.626 c 503.609 464.653 503.771 464.653 503.887 464.762 c 503.956 464.818 503.933 464.9 v 504.187 464.928 504.372 465.12 504.535 465.339 c 504.581 465.367 504.65 465.421 504.719 465.394 c 504.696 465.394 l 506.409 467.563 l 506.385 467.617 l 506.362 467.7 506.408 467.783 506.362 467.864 c 501.202 466.464 l 501.178 466.271 500.971 466.025 500.854 465.859 c 500.876 465.889 500.464 466.128 500.503 466.205 c 500.748 466.697 500.687 467.153 500.432 467.592 c 500.385 467.702 500.339 467.743 500.271 467.839 c 500.094 468.083 499.808 468.223 499.507 468.168 c 499.438 468.168 l 499.137 468.223 498.928 468.086 498.708 467.893 c 498.608 467.806 498.431 467.619 498.385 467.509 c 498.13 467.07 498.235 466.534 498.432 466.106 c 498.467 466.028 498.051 465.892 498.072 465.863 c 497.957 466.027 497.748 466.274 497.725 466.467 c 492.564 467.867 l 492.518 467.784 492.564 467.702 492.541 467.619 c 492.518 467.564 l 494.231 465.396 l 494.207 465.396 l 494.277 465.424 494.346 465.368 494.393 465.341 c 494.555 465.122 494.74 464.929 494.994 464.902 c 494.971 464.819 495.041 464.765 y 495.156 464.655 495.318 464.655 495.457 464.627 c 495.641 464.591 495.781 464.38 495.966 464.271 c 496.336 464.106 496.614 463.749 497.008 463.694 c 497.355 463.639 497.702 463.557 498.049 463.694 c 498.118 463.721 498.188 463.749 498.211 463.859 c 498.229 463.943 498.304 463.941 498.35 463.914 c 498.466 463.804 498.535 463.667 498.651 463.584 c 498.813 463.447 498.974 463.392 499.16 463.31 c 499.253 463.255 499.322 463.31 499.415 463.282 c 499.514 463.28 l s 1 1 1 rg 495.295 466.808 m 497.598 466.247 l 497.586 466.247 497.586 466.261 497.574 466.261 c 497.633 466.083 497.702 465.904 497.748 465.712 c 497.812 465.444 497.748 465.149 497.737 464.875 c 497.621 464.929 497.609 465.012 v 497.563 465.204 497.563 465.341 497.517 465.533 c 497.505 465.547 497.436 465.615 497.424 465.643 c 497.348 465.824 497.251 465.849 497.089 465.945 c 496.903 466.041 496.718 466.192 496.545 466.274 c 496.175 466.439 495.781 466.467 495.422 466.644 c 495.411 466.659 495.376 466.672 495.365 466.714 c 495.356 466.743 495.26 466.741 495.295 466.808 c f 495.862 466.343 m 495.885 466.315 495.908 466.261 495.931 466.247 c 496.036 466.192 496.14 466.205 496.244 466.205 c 496.221 466.219 496.198 466.247 496.175 466.247 c 496.047 466.247 495.966 466.288 495.862 466.343 c f 496.209 465.986 m 496.314 465.986 496.406 466 496.51 465.986 c 496.522 465.972 496.51 465.945 496.499 465.931 c 496.406 465.904 496.314 465.849 496.221 465.821 c 496.198 465.807 496.163 465.821 y 496.116 465.78 495.997 465.762 496.013 465.807 c 496.036 465.876 496.116 465.917 496.175 465.959 c f 496.221 465.519 m 496.256 465.519 496.29 465.506 496.325 465.533 c 496.394 465.588 496.51 465.67 496.591 465.684 c f 496.499 465.314 m 496.602 465.314 496.73 465.286 496.811 465.327 c 496.846 465.355 496.892 465.409 496.915 465.478 c 496.765 465.451 496.672 465.355 496.522 465.355 c f 497.216 465.217 m 497.193 465.217 497.17 465.231 497.147 465.217 c 497.065 465.163 496.973 465.149 496.915 465.067 c 496.892 465.026 496.892 464.971 496.892 464.929 c 496.915 464.929 496.938 464.916 496.95 464.929 c 497.008 465.039 497.112 465.067 497.17 465.163 c f 497.008 464.71 m 497.008 464.696 497.008 464.668 497.008 464.655 c 497.147 464.614 497.239 464.737 497.343 464.833 c 497.424 464.902 497.343 464.957 497.274 464.902 c 497.239 464.875 497.181 464.833 497.135 464.792 c 497.1 464.751 497.042 464.778 496.996 464.737 c 497.008 464.723 497.008 464.71 v f 497.447 464.6 m 497.505 464.6 497.517 464.668 497.563 464.696 c f 497.702 464.586 m 497.702 464.559 497.702 464.545 497.702 464.517 c 497.725 464.517 l 497.725 464.49 497.725 464.449 497.725 464.421 c f 493.05 467.263 m 493.12 467.276 493.178 467.249 493.235 467.221 c 493.247 467.221 493.27 467.194 493.293 467.18 c 493.363 467.153 493.432 467.125 493.501 467.098 c 493.721 467.029 493.953 467.043 494.161 466.92 c 494.242 466.878 494.335 466.837 494.415 466.81 c 494.635 466.754 494.832 466.754 495.052 466.714 c 495.087 466.7 495.122 466.659 495.168 466.659 c 494.936 466.672 494.705 466.631 494.462 466.672 c 494.335 466.7 494.207 466.686 494.08 466.727 c 494.045 466.741 494.034 466.782 493.999 466.796 c 493.872 466.837 493.756 466.782 493.64 466.823 c 493.594 466.837 493.536 466.837 493.49 466.864 c 493.328 466.92 493.224 467.07 493.096 467.208 c 493.085 467.221 493.108 467.249 493.085 467.263 c f 493.316 466.782 m 493.363 466.727 493.397 466.659 493.467 466.631 c 493.582 466.604 493.687 466.521 493.802 466.494 c 493.941 466.453 494.069 466.425 494.207 466.412 c 494.381 466.384 494.543 466.384 494.717 466.329 c 494.728 466.329 494.764 466.321 494.774 466.315 c 495.041 466.192 495.318 466.247 495.585 466.247 c 495.596 466.329 495.561 466.439 495.48 466.453 c 495.353 466.48 495.237 466.412 495.11 466.398 c 494.948 466.371 494.797 466.371 494.635 466.398 c 494.578 466.412 494.531 466.425 494.485 466.453 c 494.335 466.521 494.184 466.453 494.034 466.521 c 493.976 466.549 493.93 466.563 493.872 466.59 c 493.71 466.631 493.548 466.659 493.397 466.727 c f 493.872 466.11 m 494.127 466.096 494.393 466.164 494.647 466.083 c 494.693 466.068 494.728 466 494.786 465.986 c 494.879 465.972 494.971 466 495.064 466.014 c 495.26 466.055 495.457 466 495.654 466.041 c 495.307 465.766 494.855 465.863 494.462 465.89 c 494.369 465.89 494.3 465.972 494.219 465.986 c 494.149 465.986 494.069 465.986 493.999 466.014 c 493.964 466.027 493.941 466.055 493.907 466.068 c f 494.543 465.478 m 494.531 465.492 494.555 465.506 494.555 465.519 c 494.763 465.506 494.971 465.575 495.179 465.615 c 495.411 465.656 495.642 465.561 495.874 465.656 c 495.839 465.643 495.803 465.627 495.77 465.615 c 495.365 465.478 495.006 465.506 494.613 465.492 c f 494.994 465.094 m 495.122 465.067 495.283 465.094 495.411 465.094 c 495.573 465.122 495.743 465.082 495.908 465.122 c 496.024 465.149 496.013 465.245 496.151 465.396 c 495.978 465.383 495.897 465.368 495.688 465.383 c 495.557 465.39 495.469 465.3 495.341 465.259 c 495.237 465.231 495.237 465.286 495.156 465.217 c f 495.434 464.765 m 495.619 464.751 495.793 464.765 495.978 464.806 c 495.989 464.819 496.013 464.833 496.024 464.847 c 496.094 464.875 496.175 464.847 496.244 464.902 c 496.292 464.94 496.325 464.984 496.383 465.012 c 496.394 465.026 496.418 465.163 496.406 465.163 c 496.36 465.176 496.29 465.094 496.244 465.067 c 496.209 465.067 496.198 465.026 496.163 465.012 c 496.013 464.957 496.001 465.039 495.862 464.943 c 495.781 464.888 495.515 464.902 495.445 464.806 c f 495.943 464.463 m 496.07 464.449 496.186 464.504 496.302 464.545 c 496.406 464.586 496.522 464.641 496.614 464.737 c 496.418 464.792 496.244 464.627 496.047 464.572 c 496.024 464.572 495.966 464.531 495.978 464.477 c f 496.221 464.298 m 496.244 464.216 496.348 464.229 496.394 464.257 c 496.487 464.326 496.626 464.353 496.649 464.49 c 496.602 464.49 496.568 464.504 496.522 464.477 c 496.487 464.449 496.464 464.421 496.441 464.38 c 496.394 464.312 496.302 464.367 496.256 464.284 c f 496.637 464.078 m 496.73 464.078 496.822 464.078 496.915 464.078 c 496.903 464.188 496.938 464.298 497.008 464.38 c 497.008 464.395 497.008 464.421 497.008 464.436 c 496.95 464.463 496.903 464.395 496.857 464.353 c 496.822 464.312 496.822 464.243 496.834 464.188 c 496.776 464.188 496.718 464.161 496.684 464.106 c f 497.112 464.01 m 497.216 464.037 497.274 464.147 497.366 464.188 c f 497.378 464.023 m 497.447 464.023 497.482 464.133 497.54 464.188 c f 497.644 464.01 m 497.728 464.01 497.818 463.968 497.899 464.01 c 497.899 464.051 l 497.841 464.078 497.818 464.188 497.748 464.161 c 497.737 464.161 497.725 464.092 497.702 464.065 c 497.69 464.065 497.679 464.065 497.667 464.065 c 497.644 464.051 497.633 464.01 497.644 464.01 c f 503.631 466.806 m 501.329 466.244 l 501.341 466.244 501.341 466.257 501.352 466.257 c 501.294 466.079 501.225 465.901 501.179 465.709 c 501.114 465.442 501.179 465.146 501.19 464.872 c 501.306 464.927 501.318 465.009 v 501.365 465.201 501.365 465.338 501.41 465.53 c 501.422 465.544 501.491 465.613 501.502 465.64 c 501.579 465.821 501.676 465.846 501.838 465.942 c 502.023 466.038 502.208 466.189 502.382 466.272 c 502.752 466.436 503.146 466.464 503.504 466.642 c 503.516 466.656 503.55 466.67 503.562 466.711 c 503.57 466.74 503.666 466.739 503.631 466.806 c f 503.065 466.341 m 503.041 466.313 503.018 466.258 502.995 466.245 c 502.891 466.189 502.787 466.203 502.683 466.203 c 502.706 466.217 502.729 466.245 502.752 466.245 c 502.879 466.245 502.96 466.286 503.065 466.341 c f 502.718 465.984 m 502.613 465.984 502.521 465.997 502.417 465.984 c 502.405 465.97 502.417 465.942 502.428 465.928 c 502.521 465.901 502.613 465.847 502.706 465.819 c 502.729 465.806 502.764 465.819 y 502.81 465.778 502.93 465.76 502.914 465.806 c 502.891 465.874 502.81 465.915 502.752 465.956 c f 502.706 465.517 m 502.672 465.517 502.637 465.503 502.602 465.53 c 502.532 465.586 502.417 465.668 502.336 465.682 c f 502.428 465.311 m 502.324 465.311 502.197 465.284 502.116 465.325 c 502.081 465.352 502.035 465.407 502.012 465.476 c 502.162 465.448 502.255 465.352 502.405 465.352 c f 501.711 465.215 m 501.734 465.215 501.757 465.229 501.78 465.215 c 501.861 465.16 501.954 465.146 502.012 465.064 c 502.035 465.023 502.035 464.968 502.035 464.927 c 502.012 464.927 501.989 464.913 501.977 464.927 c 501.919 465.037 501.815 465.064 501.757 465.16 c f 501.919 464.707 m 501.919 464.693 501.919 464.666 501.919 464.652 c 501.78 464.611 501.688 464.735 501.584 464.83 c 501.502 464.899 501.584 464.954 501.653 464.899 c 501.688 464.872 501.746 464.83 501.792 464.789 c 501.827 464.748 501.885 464.776 501.931 464.735 c 501.932 464.735 501.919 464.721 501.919 464.707 c f 501.48 464.597 m 501.422 464.597 501.41 464.666 501.365 464.693 c f 501.225 464.583 m 501.225 464.556 501.225 464.542 501.225 464.515 c 501.202 464.515 l 501.202 464.488 501.202 464.446 501.202 464.419 c f 505.876 467.261 m 505.807 467.274 505.749 467.247 505.691 467.22 c 505.679 467.22 505.657 467.192 505.633 467.178 c 505.564 467.151 505.495 467.124 505.425 467.096 c 505.205 467.027 504.973 467.041 504.766 466.917 c 504.684 466.876 504.592 466.835 504.511 466.808 c 504.291 466.753 504.095 466.753 503.875 466.711 c 503.84 466.697 503.805 466.656 503.759 466.656 c 503.99 466.67 504.222 466.629 504.464 466.67 c 504.592 466.697 504.719 466.684 504.846 466.725 c 504.881 466.739 504.893 466.78 504.927 466.794 c 505.055 466.835 505.17 466.78 505.286 466.822 c 505.333 466.835 505.39 466.835 505.437 466.863 c 505.598 466.917 505.703 467.068 505.83 467.205 c 505.842 467.22 505.819 467.247 505.842 467.261 c f 505.61 466.78 m 505.564 466.725 505.529 466.656 505.46 466.629 c 505.344 466.602 505.24 466.52 505.124 466.492 c 504.986 466.451 504.858 466.424 504.719 466.409 c 504.546 466.382 504.384 466.382 504.21 466.327 c 504.199 466.327 504.163 466.318 504.152 466.314 c 503.886 466.19 503.608 466.245 503.343 466.245 c 503.331 466.327 503.365 466.437 503.447 466.45 c 503.574 466.478 503.69 466.409 503.817 466.396 c 503.979 466.368 504.129 466.368 504.291 466.396 c 504.349 466.409 504.396 466.424 504.442 466.45 c 504.592 466.519 504.742 466.451 504.893 466.519 c 504.951 466.546 504.997 466.561 505.055 466.588 c 505.217 466.629 505.379 466.656 505.529 466.725 c f 505.055 466.108 m 504.8 466.094 504.534 466.162 504.28 466.08 c 504.233 466.066 504.199 465.997 504.141 465.984 c 504.048 465.97 503.956 465.997 503.863 466.011 c 503.666 466.053 503.47 465.997 503.273 466.038 c 503.62 465.764 504.071 465.86 504.464 465.888 c 504.558 465.888 504.627 465.97 504.708 465.984 c 504.777 465.984 504.858 465.984 504.928 466.011 c 504.963 466.026 504.986 466.053 505.02 466.066 c f 504.384 465.477 m 504.396 465.49 504.372 465.504 504.372 465.517 c 504.164 465.504 503.956 465.572 503.747 465.614 c 503.516 465.654 503.285 465.558 503.053 465.654 c 503.088 465.641 503.124 465.625 503.157 465.613 c 503.562 465.476 503.921 465.504 504.314 465.49 c f 503.933 465.092 m 503.806 465.065 503.643 465.092 503.516 465.092 c 503.354 465.119 503.184 465.08 503.018 465.119 c 502.903 465.147 502.915 465.242 502.775 465.393 c 502.949 465.38 503.03 465.366 503.238 465.38 c 503.37 465.389 503.458 465.297 503.586 465.257 c 503.69 465.229 503.69 465.284 503.77 465.216 c f 503.493 464.762 m 503.308 464.748 503.134 464.762 502.949 464.804 c 502.938 464.817 502.915 464.831 502.903 464.845 c 502.833 464.872 502.752 464.845 502.683 464.899 c 502.635 464.938 502.602 464.981 502.544 465.009 c 502.533 465.023 502.509 465.16 502.521 465.16 c 502.567 465.174 502.637 465.092 502.683 465.064 c 502.718 465.064 502.729 465.023 502.764 465.009 c 502.915 464.954 502.926 465.037 503.065 464.941 c 503.146 464.886 503.412 464.899 503.482 464.804 c f 502.984 464.46 m 502.857 464.447 502.741 464.502 502.625 464.543 c 502.521 464.584 502.405 464.638 502.313 464.735 c 502.509 464.789 502.683 464.625 502.88 464.57 c 502.903 464.57 502.961 464.529 502.949 464.474 c f 502.706 464.295 m 502.683 464.213 502.579 464.227 502.533 464.254 c 502.44 464.323 502.301 464.35 502.278 464.488 c 502.324 464.488 502.359 464.502 502.405 464.474 c 502.44 464.447 502.463 464.419 502.486 464.378 c 502.533 464.309 502.625 464.364 502.672 464.282 c f 502.29 464.076 m 502.197 464.076 502.104 464.076 502.012 464.076 c 502.023 464.186 501.989 464.295 501.919 464.378 c 501.919 464.391 501.919 464.419 501.919 464.433 c 501.977 464.46 502.023 464.391 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29.6226 82.2701 228.2961 Tm (t)Tj 29.857 16.2634 -16.2629 29.858 89.2402 232.243 Tm (h)Tj 30.07 15.8661 -15.8656 30.071 101.7797 239.0411 Tm ( )Tj 30.3135 15.3958 -15.3953 30.3145 107.2275 241.98 Tm (A)Tj 30.6162 14.7848 -14.7843 30.6172 126.7249 251.83 Tm (n)Tj 30.8393 14.3136 -14.3131 30.8403 139.6404 258.059 Tm (n)Tj 31.0079 13.9444 -13.9439 31.0089 152.644 264.069 Tm (i)Tj 31.1209 13.6904 -13.6899 31.1219 158.5598 266.739 Tm (v)Tj 31.2909 13.2973 -13.2969 31.2919 169.4134 271.504 Tm (e)Tj 31.4329 12.9581 -12.9577 31.4339 178.6181 275.423 Tm (r)Tj 31.5465 12.6788 -12.6784 31.5475 188.5218 279.501 Tm (s)Tj 31.6726 12.3604 -12.36 31.6736 196.2606 282.613 Tm (a)Tj 31.8342 11.9379 -11.9375 31.8353 208.6432 287.424 Tm (r)Tj 31.9956 11.4982 -11.4978 31.9967 218.6858 291.202 Tm (y)Tj 32.1029 11.1953 -11.1949 32.104 231.7574 295.881 Tm ( )Tj 32.2628 10.7256 -10.7252 32.2639 237.5802 297.968 Tm (T)Tj 32.4213 10.2366 -10.2363 32.4224 255.9666 304.057 Tm (r)Tj 32.5258 9.8996 -9.8993 32.5269 266.1862 307.282 Tm (i)Tj 32.6291 9.5535 -9.5532 32.6302 272.3951 309.21 Tm (b)Tj 32.7816 9.0165 -9.0162 32.7827 286.1226 313.257 Tm (u)Tj 32.8811 8.6464 -8.6461 32.8822 299.1772 316.862 Tm (t)Tj 32.9302 8.4576 -8.4573 32.9313 306.8879 318.899 Tm (e)Tj 33.0267 8.0724 -8.0721 33.0278 316.5846 321.377 Tm (s)Tj 33.0741 7.8759 -7.8756 33.0752 324.6743 323.347 Tm ( )Tj 33.2124 7.2705 -7.2702 33.2135 330.6921 324.846 Tm (&)Tj 33.3441 6.6406 -6.6404 33.3452 354.4613 329.969 Tm ( )Tj 33.4679 5.9855 -5.9853 33.469 360.5251 331.309 Tm (M)Tj 33.6186 5.0713 -5.0711 33.6197 391.8221 336.772 Tm (e)Tj 33.6868 4.5964 -4.5963 33.6879 401.7238 338.306 Tm (m)Tj 33.7789 3.8613 -3.8612 33.78 423.4861 341.19 Tm (o)Tj 33.8329 3.3558 -3.3557 33.834 435.3077 342.532 Tm (r)Tj 33.8574 3.0984 -3.0983 33.8585 445.9633 343.569 Tm (i)Tj 33.9013 2.5741 -2.574 33.9024 452.4561 344.176 Tm (e)Tj 33.9205 2.3073 -2.3072 33.9216 462.4197 344.937 Tm (s)Tj 33.9378 2.0373 -2.0372 33.9389 470.7345 345.486 Tm ( )Tj 33.9663 1.4878 -1.4877 33.9674 476.9133 345.881 Tm (B)Tj 33.9929 0.64 -0.64 33.994 498.9935 346.747 Tm (o)Tj 33.9989 0.0591 -0.0591 34 510.8972 346.975 Tm (o)Tj 33.9947 -0.5343 0.5343 33.9958 522.8037 347.023 Tm (k)Tj /F22 1 Tf 11.9996 0 0 12 62.8693 153.254 Tm (All members and interested parties and organizations are invited to participate through the )Tj -0.5281 -1.2 TD (purchase of a tribute message. Funds raised through the sale of tribute space and books will )Tj 9.2383 -1.2 TD [(support ICISF as well as the 10th W)18.1(orld Congress.)]TJ ET /Cs11 cs 1 scn 35.009 397.808 529.483 -13.317 re f 35.009 397.808 m 34.509 397.808 l 34.509 383.991 l 564.991 383.991 l 564.991 398.308 l 34.509 398.308 l 34.509 397.808 l 35.009 397.808 l 35.009 397.308 l 563.991 397.308 l 563.991 384.991 l 35.509 384.991 l 35.509 397.808 l 35.009 397.808 l 35.009 397.308 l 35.009 397.808 l f q 118.615 274.809 m 111.397 201.171 l 276.596 184.971 l 283.823 258.618 l 118.615 274.809 l W n 276.596 184.971 m 111.397 201.171 l 115.688 244.946 l 127.012 250.698 l 117.993 268.461 l 118.615 274.809 l 138.495 272.861 l 134.005 270.777 l 140.052 257.727 l 151.932 263.235 l 147.892 271.94 l 149.161 271.815 l 152.796 263.73 l 159.053 266.54 l 159.078 266.484 l 167.183 270.049 l 283.823 258.618 l 276.596 184.971 l 132.682 270.147 m 120.892 264.459 l 127.147 251.508 l 138.936 257.196 l 132.682 270.147 l W n q 166.1575 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c 130.472 268.837 130.287 268.662 130.046 268.373 c 129.569 267.787 129.077 266.392 128.571 264.189 c 128.065 261.987 127.789 260.082 127.742 258.476 c 127.382 261.826 126.993 264.076 126.574 265.224 c 126.383 265.746 125.826 265.931 124.9 265.779 c 124.552 266.041 124.258 266.113 124.018 265.998 c 123.858 265.92 123.744 265.761 123.675 265.519 c 123.369 264.366 123.133 263.412 122.967 262.657 c 122.915 262.509 122.908 262.396 122.947 262.316 c 123 262.207 123.096 262.186 123.236 262.253 c 123.346 262.306 123.425 262.399 123.471 262.532 c 123.746 263.19 123.953 263.718 124.094 264.115 c 124.235 264.513 124.311 264.714 124.321 264.719 c 124.361 264.739 124.457 264.564 124.61 264.196 c 125.098 262.982 125.544 261.177 125.949 258.781 c 126.317 256.563 126.516 254.682 126.547 253.137 c 126.553 252.845 126.565 252.679 126.584 252.639 c 126.633 252.564 126.778 252.53 127.02 252.537 c 127.648 252.533 128.071 252.583 128.29 252.689 c 128.599 252.838 128.745 253.222 128.729 253.84 c 128.579 258.828 129.167 263.152 130.492 266.814 c 130.631 267.188 130.765 267.406 130.894 267.468 c 131.073 267.555 131.278 267.384 131.51 266.955 c 132.114 265.908 132.64 264.221 133.089 261.895 c 133.529 259.688 133.744 257.771 133.732 256.144 c 133.718 255.842 133.728 255.657 133.762 255.587 c 133.839 255.428 134.11 255.362 134.576 255.39 c 134.997 255.409 135.297 255.462 135.477 255.549 c 135.706 255.66 135.816 255.903 135.806 256.28 c 135.759 256.811 135.716 257.344 135.679 257.879 c 135.803 260.067 135.944 261.76 136.104 262.956 c 136.095 263.026 136.076 263.09 136.047 263.15 c W n q 15.7563 -1.5451 1.8756 19.129 120.7104 251.9158 cm /Im8 Do Q Q q 118.615 274.809 m 111.397 201.171 l 276.596 184.971 l 283.823 258.618 l 118.615 274.809 l W n 140.052 257.727 m 134.005 270.777 l 138.495 272.861 l 147.892 271.94 l 151.932 263.235 l 140.052 257.727 l W n q 19.0986 -1.8728 1.5474 15.7815 132.3957 258.012 cm /Im9 Do Q Q q 118.615 274.809 m 111.397 201.171 l 276.596 184.971 l 283.823 258.618 l 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>> stream # endstream endobj 119 0 obj << /Length 5967 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.65 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.0132 Tc 0 Tw (95)Tj /TT3 1 Tf 7 0 0 7 122.49 726.66 Tm -0.0061 Tc 0.0218 Tw [(International Journal of Emergency Mental Health, Vol. 10, No. 2, pp. 95-108 2008 Chevron Publishing ISSN 1522-4821)]TJ /TT4 1 Tf 10 0 0 10 104.01 469.35 Tm -0.0042 Tc 0 Tw (Abstract: )Tj /TT5 1 Tf 4.11 0 TD -0.0037 Tc 0.1224 Tw [(This paper discusses the development of a new model of police officer r)32.3(esiliency)53.3(. Following)]TJ -4.11 -1.299 TD -0.0036 Tc -0.0072 Tw [(Antonovsky)128.4(s definition of r)32.4(esilience, the model is built on the view that the r)29.4(esilience of a person or gr)32.4(oup)]TJ 0 -1.302 TD -0.0497 Tw (reflects the extent to which they can call upon their psychological and physical resources and competencies)Tj 0 -1.299 TD -0.0037 Tc 0.0446 Tw (in ways that allow them to render challenging events coherent, manageable, and meaningful. The model)Tj T* 0.0124 Tc 0.1251 Tw [(posits that a police officer)-35.6()126.4(s)-0.3( capacity to r)33.4(ender challenging experiences meaningful, coher)30.4(ent, and)]TJ 0 -1.302 TD -0.0036 Tc 0.0328 Tw (manageable reflects the interaction of person, team, and organizational factors. The paper argues that a)Tj 0 -1.299 TD 0.0026 Tc 0.125 Tw (model that encompasses these factors can be developed using theories drawn from the literatures of)Tj T* -0.0037 Tc 0.117 Tw (occupational health and empowerment. 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[International Journal of Emergency)Tj T* -0.0033 Tc 0.097 Tw (Mental Health, 2008, 10\(2\), pp. 95-108].)Tj 9 0 0 9 232.65 279.51 Tm -0.0047 Tc 0.0078 Tw (Key words:police, stress, trauma, resiliency model)Tj ET /GS1 gs 66 131.265 m 557.01 131.265 l S BT 9 0 0 9 66 113.49 Tm /GS2 gs 0.0317 Tw [(Douglas Paton and Kar)32(ena J. Burke, School of Psychology)52(, University of T)85.3(asmania, Launceston, T)85.3(asmania, )12(Australia; John M. 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Correspondence concerning this article should be addressed to:)Tj 0 -1.22 TD -0.0023 Tc 0 Tw (Douglas.Paton@utas.edu.au.)Tj /F1 1 Tf 14 0 0 14 165 639.36 Tm -0.0057 Tc 0.1344 Tw [(Stress Shield:)35( A Model of P)32.9(olice Resiliency)]TJ /TT2 1 Tf 10 0 0 10 84 234.15 Tm -0.0092 Tc -0.0621 Tw (Police officers are regularly exposed to critical incidents.)Tj -1.8 -1.401 TD -0.0033 Tc 0.005 Tw (Although this work traditionally is viewed as a precursor to)Tj 0 -1.398 TD -0.0037 Tc 0.0957 Tw (the development of acute and chronic posttraumatic stress)Tj 0 -1.401 TD -0.0055 Tc -0.0623 Tw (reactions, growing evidence for it to be associated with adap-)Tj T* -0.0045 Tc -0.0621 Tw (tive and positive \(e.g., posttraumatic growth, enhanced sense)Tj 0 -1.398 TD -0.0035 Tc 0.1225 Tw (of professional efficacy\) outcomes \(Aldwin, Levenson, &)Tj 0 -1.401 TD -0.0209 Tc -0.0624 Tw [(Spiro, 1994; )48.2(Armeli, Gunthert, & Cohen, 2001; Paton, )15.2(V)65.3(iolanti,)]TJ 12 0 0 12 403.41 593.64 Tm -0.0279 Tc -0.0611 Tw [(John M. )13.9(V)64.3(iolanti)]TJ 10 0 0 10 361.41 581.01 Tm 0.0015 Tc -0.0557 Tw [(S)23.7(tate University of New )31.6(Y)102.7(ork at Buf)16.5(falo)]TJ 12 0 0 12 151.5 593.64 Tm -0.0249 Tc -0.0625 Tw (Douglas Paton)Tj 10 0 0 10 138 581.01 Tm 0.0015 Tc -0.0417 Tw [(University of )17.3(T)72.3(asmania)]TJ 12 0 0 12 150.66 554.64 Tm -0.0181 Tc -0.0625 Tw (Peter Johnston)Tj 10 0 0 10 145.41 542.01 Tm 0.0046 Tc 0.125 Tw (Massey University)Tj 12 0 0 12 399.99 556.65 Tm -0.0071 Tc -0.0604 Tw (Karena J. 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However)38.6(, because police of)14.6(ficers are called upon)]TJ 0 -1.401 TD -0.0046 Tc -0.0622 Tw (repeatedly to deal with increasingly complex and threatening)Tj T* -0.0033 Tc -0.0335 Tw (incidents, it is appropriate to expand the scope of this defini-)Tj 0 -1.398 TD -0.0011 Tc 0.125 Tw [(tion to include the development of one)52.9(s capacity to deal)]TJ 0 -1.401 TD -0.0045 Tc -0.0621 Tw [(with future events. Consequently)58.5(, the definition adopted here)]TJ T* -0.0035 Tc -0.0479 Tw (embodies the notion of adaptive capacity \(Klein, Nicholls,)Tj 0 -1.398 TD -0.0031 Tc 0.0338 Tw (& Thomalla, 2003\). Resiliency thus defines the capacity of)Tj 0 -1.401 TD -0.0035 Tc -0.0522 Tw (agencies and officers to draw upon their own individual, col-)Tj T* -0.0428 Tw (lective, and institutional resources and competencies to cope)Tj 0 -1.398 TD 0.0781 Tw (with, adapt to, and develop from the demands, challenges,)Tj 0 -1.401 TD -0.0275 Tw (and changes encountered during and after a critical incident,)Tj T* 0.0081 Tw [(mass emer)17.5(gency)59.5(, or disaster)50.5(.)]TJ 1.8 -1.998 TD -0.0039 Tc -0.039 Tw (Understanding and managing resilience involves adopt-)Tj -1.8 -1.401 TD -0.0034 Tc 0.0088 Tw (ing a perspective that assumes that salutary outcomes occur)Tj T* 0.0035 Tc 0.125 Tw (when individuals and groups can use their psychological)Tj 0 -1.398 TD -0.0032 Tc -0.0137 Tw (and physical resources and competencies in ways that allow)Tj 0 -1.401 TD -0.0056 Tc -0.0622 Tw (them to render challenging events coherent, manageable, and)Tj T* -0.0035 Tc -0.0048 Tw [(meaningful \(Antonovsky)59.5(, 1990\). In emer)17.5(gency populations,)]TJ 0 -1.398 TD -0.0034 Tc 0.0393 Tw (critical incidents create a sense of psychological disequi-)Tj 0 -1.401 TD -0.0056 Tc -0.0625 Tw (librium that represents that period when the existing interpre-)Tj T* -0.0037 Tc -0.0621 Tw (tive frameworks or schemas that guide officers expectations)Tj 0 -1.398 TD -0.0032 Tc -0.0506 Tw (and actions have lost their capacity to organize experience in)Tj 0 -1.401 TD 0.0027 Tc 0.125 Tw (meaningful and manageable ways \(Janoff-Bulman, 1992;)Tj T* -0.0031 Tc 0.0283 Tw (Paton, 1994\). The challenge is to identify those factors that)Tj 0 -1.398 TD -0.0034 Tc 0.0366 Tw (can be developed prior to exposure that predict officers ca-)Tj 0 -1.401 TD -0.0033 Tc -0.0375 Tw (pacity to develop a schema that broaden the range of \(unpre-)Tj T* 0.019 Tc 0.125 Tw (dictable\) experiences that officers can render coherent,)Tj 0 -1.398 TD -0.0039 Tc 0.0111 Tw [(meaningful, and manageable \(Fredrickson, )14.2(T)36.9(ugade, )17.2(W)93.9(augh,)]TJ 0 -1.401 TD -0.0198 Tc -0.0622 Tw (& Larkin, 2003; Paton, 1994, 2006\). Building on recent empiri-)Tj T* -0.0034 Tc 0.1137 Tw (cal research into how protective services officers adapt to)Tj 0 -1.398 TD 0.0039 Tc 0.125 Tw (highly challenging circumstances \(Burke & Paton, 2006;)Tj 0 -1.401 TD -0.0134 Tc -0.0623 Tw (Johnston & Paton, 2003\), in this paper we outline a new model)Tj T* -0.0034 Tc -0.0325 Tw [(of adaptive capacity)59.6(. In constructing the S)17.6(tress Shield model)]TJ 0 -1.398 TD -0.0032 Tc -0.0531 Tw (of resilience, it is essential that the theories used to inform its)Tj 0 -1.401 TD -0.008 Tc -0.0625 Tw (development can integrate personal, team, and organizational)Tj T* -0.0026 Tc 0.0175 Tw (levels of analysis.)Tj /F1 1 Tf 11 0 0 11 54 180 Tm -0.0046 Tc 0.028 Tw [(Integrating Officer)52.7(,)38.9( )91.4(T)60.9(eam,)36.3( and)]TJ 0 -1.0909 TD -0.0032 Tc 0.1409 Tw (Organizational Factors)Tj /TT2 1 Tf 10 0 0 10 72 144.66 Tm -0.0029 Tc 0.0156 Tw (Although typically investigated at the level of the indi-)Tj -1.8 -1.401 TD -0.0037 Tc 0.0238 Tw [(vidual of)17.3(ficer)35.3(, this paper ar)17.3(gues that the comprehensive un-)]TJ T* -0.0059 Tc -0.0625 Tw (derstanding of resilience must integrate organizational, team,)Tj 0 -1.398 TD -0.0035 Tc -0.0036 Tw (and individual perspectives, with the organizational level of)Tj 0 -1.401 TD -0.0003 Tc 0.125 Tw (analysis having greater influence in this process than has)Tj 25.5 63.399 TD -0.0037 Tc 0.0206 Tw (hitherto been acknowledged. This argument is based on the)Tj 0 -1.398 TD -0.0035 Tc 0.0794 Tw (fact that the police organization defines the context within)Tj 0 -1.401 TD -0.0464 Tw (which officers experience and interpret critical incidents and)Tj T* 0.045 Tw (their sequelae and within which future capabilities are nur-)Tj 0 -1.398 TD -0.0034 Tc 0.0994 Tw (tured or restricted \(Paton, 2006\). Officers respond to inci-)Tj 0 -1.401 TD -0.0037 Tc -0.0123 Tw (dents as members of law enforcement agencies in which the)Tj T* -0.0036 Tc 0.0009 Tw (organizational culture influences their thoughts and actions,)Tj 0 -1.398 TD -0.0037 Tc 0.1158 Tw (representing the context in which challenging experiences)Tj 0 -1.401 TD -0.0036 Tc -0.0367 Tw (\(using a schema whose nature derives from patterns of inter-)Tj T* -0.0026 Tc 0.125 Tw (action with colleagues, senior officers, and organizational)Tj 0 -1.398 TD -0.0059 Tc -0.0622 Tw [(procedures over time\) are interpreted \(Paton, Smith, Ramsay)63.1(,)]TJ 0 -1.401 TD -0.0038 Tc 0.0983 Tw [(& )50.4(Akande, 1999; Paton, Smith, )17.4(V)64.4(iolanti, & Eranen, 2000;)]TJ T* -0.0036 Tc 0.0101 Tw [(W)94.2(eick, & Sutclif)17.4(fe, 2007\). However)35.4(, the or)17.4(ganization is not)]TJ 0 -1.398 TD -0.0033 Tc 0.1122 Tw (the only influence. Several person- and team-level factors)Tj 0 -1.401 TD 0.0987 Tw (\(e.g., coping, social support\) have also been implicated as)Tj T* -0.0032 Tc -0.05 Tw (playing complementary roles in predicting resilience \(Paton,)Tj 0 -1.398 TD -0.0186 Tc -0.0622 Tw (2006\), and they must be included in any comprehensive model.)Tj /F1 1 Tf 11 0 0 11 309 465.99 Tm -0.0048 Tc 0.0182 Tw (Modeling Resilience)Tj /TT2 1 Tf 10 0 0 10 327 442.65 Tm -0.0037 Tc 0.05 Tw (The development of models of resilience faces several)Tj -1.8 -1.401 TD -0.0038 Tc 0.0466 Tw [(conceptual challenges. )50.1(Although resilience is evident when)]TJ 0 -1.398 TD -0.0109 Tc -0.0622 Tw (officers successfully adapt to actual critical incident demands,)Tj 0 -1.401 TD 0.0017 Tc 0.125 Tw (research into resilience must be undertaken prior to such)Tj T* -0.0035 Tc 0.1068 Tw (events occurring to ensure that intervention can be under-)Tj 0 -1.398 TD -0.0029 Tc 0.0435 Tw (taken to arm officers with a capability to adapt before they)Tj 0 -1.401 TD -0.0093 Tc -0.0625 Tw (experience critical incidents. This would not be a problem if it)Tj T* -0.0032 Tc 0.0106 Tw (were possible to predict exactly what officers will be called)Tj 0 -1.398 TD 0.0001 Tc 0.125 Tw [(upon to confront. However)33.1(, because critical incidents are)]TJ 0 -1.401 TD -0.0027 Tc 0.0292 Tw (characterized by considerable diversity \(e.g., mass casualty)Tj T* -0.0035 Tc 0.0458 Tw (incidents, school shootings, biohazard attack\), police agen-)Tj 0 -1.398 TD -0.0524 Tw [(cies cannot predict what their of)17.4(ficers will encounter)50.4(. Conse-)]TJ 0 -1.401 TD -0.0026 Tc 0.0156 Tw [(quently)63.4(, any model used to guide this activity must identify)]TJ T* -0.0035 Tc 0.0478 Tw (the resources and competencies that facilitate the proactive)Tj 0 -1.398 TD -0.0028 Tc 0.0172 Tw (development of a general capacity to adapt \(i.e., render any)Tj 0 -1.401 TD -0.0038 Tc -0.0492 Tw (future experience meaningful and manageable\) to unpredict-)Tj T* 0.04 Tw (able circumstances.)Tj 1.8 -1.998 TD -0.0037 Tc 0.0379 Tw (This introduces a second conceptual problem. There is)Tj -1.8 -1.401 TD -0.0031 Tc 0.0137 Tw (currently no measure capable of capturing the diverse ways)Tj T* -0.0037 Tc 0.0007 Tw (in which police officers can experience meaningfulness and)Tj 0 -1.398 TD -0.0033 Tc 0.0195 Tw (manageability in the context of their work. Until such mea-)Tj 0 -1.401 TD -0.0034 Tc 0.0985 Tw (sures are developed, what is needed is a measure that can)Tj T* -0.0056 Tc -0.0621 Tw (capture the experience of coherent, meaningful, and manage-)Tj 0 -1.398 TD -0.0036 Tc -0.0543 Tw (able outcomes irrespective of the specific outcomes officers)Tj 0 -1.401 TD -0.0034 Tc 0.0757 Tw (experience. The construct of job satisfaction can fulfil this)Tj T* -0.0199 Tc 0 Tw (role.)Tj ET endstream endobj 123 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 125 0 obj << /Length 8253 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.65 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.0132 Tc 0 Tw (97)Tj 11 0 0 11 66 723.99 Tm -0.0045 Tc 0.0273 Tw (Satisfaction and Resilience)Tj /TT2 1 Tf 10 0 0 10 84 700.65 Tm -0.0074 Tc -0.0621 Tw [(Thomas and )13.6(T)72.4(ymon \(1994\) found a relationship between)]TJ -1.8 -1.401 TD -0.004 Tc 0.065 Tw (perceptions of meaning found in work tasks \(meaningful-)Tj 0 -1.398 TD -0.0035 Tc -0.0064 Tw [(ness\) and enhanced job satisfaction. Spreitzer)35.5(, Kizilos, and)]TJ 0 -1.401 TD -0.0038 Tc -0.0543 Tw (Nason \(1997\) observed a positive relationship between com-)Tj T* -0.0035 Tc 0.0458 Tw (petence \(manageability\) and job satisfaction. These find-)Tj 0 -1.398 TD -0.0033 Tc -0.0278 Tw (ings have been echoed in the critical incident literature, with)Tj 0 -1.401 TD -0.0036 Tc -0.0531 Tw (finding meaning and benefit in emergency work being mani-)Tj T* -0.0034 Tc 0.0556 Tw [(fest in changes in levels of job satisfaction \(Britt, )50.7(Adler)38.6(, &)]TJ 0 -1.398 TD -0.0102 Tc -0.0621 Tw [(Bartone, 2001; Hart & Cooper)34.8(, 2001; North et al., 2002\).)]TJ 1.8 -2.001 TD 0.0259 Tc 0.125 Tw (Because the job satisfaction construct can capture)Tj -1.8 -1.401 TD -0.0035 Tc 0.0536 Tw (changes in the meaningfulness and manageability facets of)Tj 0 -1.398 TD -0.0034 Tc 0.0517 Tw [(resilience, as well as the implications of the coexistence of)]TJ 0 -1.401 TD 0.0069 Tw (positive and negative aspects of officers experience, it rep-)Tj T* -0.0033 Tc -0.0195 Tw (resents a construct capable of acting as an indicator of offic-)Tj 0 -1.398 TD 0.051 Tc 0.125 Tw (ers resilience and their future capacity to adapt to)Tj 0 -1.401 TD -0.01 Tc -0.0625 Tw (unpredictable and challenging critical incidents. Having iden-)Tj T* -0.0036 Tc -0.0522 Tw (tified a means of measuring adaptive outcomes, the next task)Tj 0 -1.398 TD -0.0041 Tc -0.0622 Tw (is to identify the personal, team, and organizational level fac-)Tj 0 -1.401 TD -0.0034 Tc 0.0084 Tw (tors that influence resilience.)Tj /F1 1 Tf 11 0 0 11 66 410.01 Tm -0.0044 Tc 0.0425 Tw (Organizational Characteristics, Coping, and)Tj 0 -1.0909 TD -0.0042 Tc 0 Tw (Resilience)Tj /TT2 1 Tf 10 0 0 10 84 374.64 Tm -0.0039 Tc -0.0625 Tw (Hart and Cooper \(2001\) proposed a conceptual model of)Tj -1.8 -1.398 TD -0.0036 Tc 0.0792 Tw (organizational health that predicts that interaction between)Tj 0 -1.401 TD 0.0517 Tw (individual and organizational factors influences the experi-)Tj T* -0.0032 Tc 0.1081 Tw (ence of salutary outcomes. Of particular relevance for the)Tj 0 -1.398 TD -0.0034 Tc 0.0465 Tw (present paper was the central role that Hart and Cooper af-)Tj 0 -1.401 TD -0.0038 Tc 0.02 Tw (forded organizational climate. Organizational climate de-)Tj T* 0.0239 Tc 0.125 Tw (scribes officers perceptions of how their organization)Tj 0 -1.398 TD -0.0035 Tc 0.0985 Tw (functions, and these perceptions influence both their well-)Tj 0 -1.401 TD -0.0071 Tw (being and their performance within their organizational role)Tj T* -0.0076 Tc -0.0625 Tw (\(Hart & Cooper\).)Tj 1.8 -1.998 TD -0.0083 Tc (Burke and Paton \(2006\) tested the ability of this model to)Tj -1.8 -1.401 TD -0.0034 Tc 0.0458 Tw (predict satisfaction in the context of emergency responders)Tj T* -0.0033 Tc -0.0514 Tw (\(police, fire, paramedic\) experience of critical incidents. The)Tj 0 -1.398 TD -0.0043 Tc -0.0625 Tw (model tested how interaction between organizational climate)Tj 0 -1.401 TD -0.0039 Tc 0.0514 Tw [(\(measured using the )17.1(T)69.9(eam Climate Inventory [Anderson &)]TJ T* -0.0037 Tc 0.0142 Tw [(W)94.1(est, 1998]\), of)17.3(ficers)68.3( experience of or)17.3(ganizational and op-)]TJ 0 -1.398 TD -0.0033 Tc 0.0767 Tw (erational practices prescribed by the organizational culture)Tj 0 -1.401 TD -0.0035 Tc 0.0225 Tw (\(measured using the Police Daily Hassles and Uplifts Scale)Tj T* -0.0037 Tc -0.0412 Tw [([Hart, )14.5(W)97.1(earing, & Headey)62.3(, 1993]\), and of)14.3(ficers)71.3( problem-fo-)]TJ 0 -1.398 TD -0.0036 Tc 0.1041 Tw (cused and emotion-focused coping styles \(measured using)Tj 0 -1.401 TD 0.04 Tw [(the COPE Inventory \(Carver)35.5(, Scheier)35.5(, & )17.5(W)94.3(eintraub, 1989\).)]TJ 25.5 63.399 TD -0.0034 Tc 0.1119 Tw (Job Satisfaction was measured by the Job Satisfaction In-)Tj 0 -1.398 TD -0.0032 Tc 0.0132 Tw (ventory \(Brayfield & Rothe, 1987\). The results are summa-)Tj 0 -1.401 TD -0.0104 Tc -0.0617 Tw (rized in Figure 1.)Tj 1.8 -2.001 TD -0.0016 Tc 0.125 Tw (The model accounted for 44% of the variance in job)Tj -1.8 -1.398 TD -0.0035 Tc 0.0121 Tw (satisfaction. Organizational climate was the best single pre-)Tj 0 -1.401 TD -0.0031 Tc -0.0205 Tw (dictor of job satisfaction \(Figure 1\) and, by inference, repre-)Tj T* -0.0074 Tc -0.0622 Tw (sents a significant influence on officers ability to render their)Tj 0 -1.398 TD -0.0122 Tc -0.0625 Tw (critical incident experiences meaningful and manageable. The)Tj 0 -1.401 TD -0.0061 Tc (relationship between organizational climate and how officers)Tj T* -0.0036 Tc 0.0038 Tw (deal with the consequences of critical incidents was evident)Tj 0 -1.398 TD 0.0456 Tw (in the influence of climate on coping \(Figure 1\). Organiza-)Tj 0 -1.401 TD -0.0037 Tc 0.0321 Tw (tional climate had a negative influence on emotion-focused)Tj T* -0.0075 Tc -0.0625 Tw (coping, resulting in an increase in negative work experiences.)Tj 0 -1.398 TD -0.006 Tc -0.0626 Tw [(Similarly)66(, climate had a direct positive influence on problem-)]TJ 0 -1.401 TD 0.0022 Tc 0.125 Tw (focused coping, resulting in an increase in positive work)Tj T* -0.0037 Tc 0.0009 Tw (experiences. Organizational climate also demonstrated a di-)Tj 0 -1.398 TD -0.0038 Tc -0.0135 Tw (rect negative influence on negative \(hassles\) work experi-)Tj 0 -1.401 TD -0.0036 Tc 0.0462 Tw (ences and a direct positive influence on positive \(uplifts\))Tj T* -0.0038 Tc 0.0925 Tw (work experiences. Positive and negative work experiences)Tj 0 -1.398 TD -0.0033 Tc -0.0462 Tw (made relatively equal and separate contributions to job satis-)Tj 0 -1.401 TD -0.0038 Tc 0 Tw (faction.)Tj 1.8 -2.001 TD -0.0036 Tc 0.0033 Tw (Given that satisfaction assesses perceived meaning, the)Tj -1.8 -1.398 TD -0.0042 Tc -0.0622 Tw (culture or climate of an organization represents one source of)Tj 0 -1.401 TD -0.0034 Tc 0.0088 Tw (officers ability to impose and sustain coherence and mean-)Tj T* -0.0033 Tc -0.0156 Tw (ing on critical incident outcomes. The important role played)Tj 0 -1.398 TD -0.0486 Tw (by organizational climate indicates that police agencies have)Tj 0 -1.401 TD -0.0027 Tc -0.0357 Tw (a key role in facilitating staff adaptability and resilience.)Tj 1.8 -2.001 TD -0.0062 Tc -0.0623 Tw (This model \(Figure 1\) accounted for 44% of the variance)Tj -1.8 -1.398 TD -0.0033 Tc 0.0333 Tw (in job satisfaction, leaving a substantial portion of the vari-)Tj 0 -1.401 TD -0.0035 Tc -0.0555 Tw (ance to be explained. Hart and Cooper \(2001\) argued that the)Tj T* -0.0113 Tc -0.0622 Tw [(inclusion of individual \(e.g., personality)63.7(, hardiness\) and group)]TJ 0 -1.398 TD 0.0069 Tc 0.125 Tw (\(e.g., peer and supervisor support\) constructs could help)Tj 0 -1.401 TD -0.0034 Tc 0.0275 Tw (account for additional variance. There are other reasons for)Tj T* -0.0039 Tc -0.0083 Tw [(developing the model further)50.1(.)]TJ /TT5 1 Tf 11 0 0 11 321 209.34 Tm 0.018 Tc 0.125 Tw (Developing the Model)Tj /TT2 1 Tf 10 0 0 10 339 189.66 Tm -0.0038 Tc 0.04 Tw (Although this model \(Figure 1\) provides a sound basis)Tj -1.8 -1.401 TD -0.0036 Tc 0.0872 Tw (for the relationship between organizational culture and of-)Tj T* -0.0034 Tc 0.0357 Tw (ficer resilience, additional elements are required to account)Tj 0 -1.398 TD -0.0037 Tc 0.0381 Tw (for how officers experiences of the work environment and)Tj 0 -1.401 TD -0.0035 Tc 0.0243 Tw (critical incidents are translated into schemas that contribute)Tj T* -0.0031 Tc -0.0375 Tw (to or detract from the officers capacity to learn from experi-)Tj 0 -1.398 TD -0.0027 Tc 0.0089 Tw (ence in ways that facilitate their future capacity to adapt.)Tj ET endstream endobj 126 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 128 0 obj << /Length 9851 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0049 Tc 0.0854 Tw [(98 )]TJ /TT3 1 Tf 2.1825 0 TD -0.0054 Tc 0.0869 Tw (Paton, Violanti, Johnston, Burke, Clarke, Keenan Stress Shield: Police Resiliency)Tj /TT2 1 Tf 10 0 0 10 72 459.66 Tm -0.0031 Tc 0.0738 Tw (As outlined above, any theory used must meet certain)Tj -1.8 -1.401 TD -0.0034 Tc -0.0387 Tw (criteria. First, it must encompass personal, team, and organi-)Tj T* -0.0029 Tc 0.0624 Tw [(zational levels of analysis. Secondly)63.1(, it must contribute to-)]TJ 0 -1.398 TD -0.0038 Tc 0.0608 Tw (ward explaining how challenging experiences are rendered)Tj 0 -1.401 TD -0.0035 Tc 0.0379 Tw (meaningful and manageable \(by predicting change in satis-)Tj T* 0.12 Tw (faction\). One such construct is empowerment. In the next)Tj 0 -1.398 TD 0.1175 Tw (section, reasons why empowerment represents a construct)Tj 0 -1.401 TD 0.0415 Tw (that informs an understanding of resilience are discussed.)Tj /F1 1 Tf 11 0 0 11 54 329.01 Tm 0.0065 Tc 0 Tw (Empowerment)Tj /TT2 1 Tf 10 0 0 10 72 305.64 Tm -0.0035 Tc 0.1224 Tw (The first issue is whether a relationship between em-)Tj -1.8 -1.398 TD -0.0003 Tc 0.125 Tw (powerment and satisfaction can be demonstrated. Several)Tj 0 -1.401 TD -0.0039 Tc 0.0884 Tw (studies have demonstrated that empowerment predicts sat-)Tj T* -0.0275 Tw (isfaction in individuals and teams \(Kirkman & Rosen, 1999;)Tj 0 -1.398 TD -0.0069 Tc -0.0625 Tw (Koberg, Boss, Senjem, & Goodman, 1999\). The second issue)Tj 0 -1.401 TD -0.0038 Tc 0.0322 Tw (is whether empowerment theories can encapsulate the indi-)Tj T* -0.0057 Tc -0.0625 Tw (vidual, team, and organizational influences in ways that posi-)Tj 0 -1.398 TD 0.0002 Tc 0.125 Tw (tively influence the meaningfulness and manageability of)Tj 0 -1.401 TD -0.0031 Tc 0.0439 Tw (experiences \(captured by job satisfaction\). It is to a discus-)Tj T* -0.0036 Tc 0.1206 Tw (sion of how empowerment satisfies this criterion that this)Tj 0 -1.398 TD -0.0039 Tc 0.0575 Tw (paper now turns.)Tj /TT5 1 Tf 11 0 0 11 54 132.36 Tm 0.0078 Tc 0.1251 Tw [(Empowerment as an Enabling Pr)29.6(ocess)]TJ /TT2 1 Tf 10 0 0 10 72 112.65 Tm -0.0039 Tc 0.05 Tw (Empowerment is a well-used construct in the manage-)Tj -1.8 -1.401 TD -0.0031 Tc 0.0194 Tw (ment literature, usually in relation to processes such as par-)Tj 0 -1.398 TD -0.0162 Tc -0.0622 Tw (ticipation and delegation \(Conger & Konungo, 1988\). Because)Tj 0 -1.401 TD -0.0033 Tc 0.0375 Tw (delegation, as an attribute of organizational culture, can in-)Tj 25.5 39.099 TD -0.0031 Tc 0.1167 Tw (fluence resilience \(e.g., delegating responsibility for crisis)Tj 0 -1.398 TD -0.0073 Tc -0.0622 Tw (decision making \(Paton & Flin, 1999\), this facet of empower-)Tj 0 -1.401 TD -0.0033 Tc 0.0065 Tw [(ment may contribute to increasing resilience. However)35.7(, it is)]TJ T* -0.0039 Tc -0.0464 Tw (the finding that empowerment has demonstrated strong links)Tj 0 -1.398 TD -0.0034 Tc 0.0692 Tw [(to motivating action under conditions of uncertainty \(Con-)]TJ 0 -1.401 TD -0.0037 Tc -0.0171 Tw [(ger & Konungo; Spreitzer)35.3(, 1997\) that renders the concept of)]TJ T* -0.0019 Tc 0.125 Tw [(empowerment capable of providing valuable insights into)]TJ 0 -1.398 TD -0.0037 Tc 0.0509 Tw (how resilience can be developed and sustained.)Tj 1.8 -2.001 TD -0.0181 Tc -0.062 Tw (Motivational interpretations of empowerment derive from)Tj -1.8 -1.401 TD -0.0034 Tc 0.0123 Tw (a theoretical perspective that argues that if people have suf-)Tj 0 -1.398 TD -0.0026 Tc 0.125 Tw (ficient resources \(psychological, social, and physical\) and)Tj 0 -1.401 TD -0.0472 Tw (the capacity to use them, they will be able to effectively con-)Tj T* -0.0022 Tc 0.125 Tw (front the challenges presented by events and the environ-)Tj 0 -1.398 TD 0.0587 Tc 0.1324 Tw [(ment \(Conger & Konungo, 1988; Spreitzer)40.7(, 1997\).)]TJ 0 -1.401 TD -0.0003 Tc 0.125 Tw (Empowerment theories argue that the potential to use re-)Tj T* -0.0005 Tc (sources to accomplish tasks derives from the relationship)Tj 0 -1.398 TD -0.0104 Tc -0.0621 Tw [(between the or)13.6(ganization and the of)16.6(ficer)55.6(. Empowerment theo-)]TJ 0 -1.401 TD -0.0035 Tc 0.1137 Tw (ries thus afford opportunities to develop models that inte-)Tj T* -0.0034 Tc 0 Tw (grate personal, team, and organizational factors.)Tj 1.8 -1.998 TD -0.0076 Tc -0.062 Tw (Conger & Konungo \(1988\) conceptualize empowerment)Tj -1.8 -1.401 TD -0.0035 Tc 0.045 Tw (as an enabling process that facilitates the conditions neces-)Tj T* -0.0029 Tc 0.05 Tw (sary to effectively confront \(i.e., develop meaning, compe-)Tj 0 -1.398 TD -0.0036 Tc 0.1215 Tw (tence, etc.\) future challenges. Conger and Konungo argue)Tj 0 -1.401 TD -0.0037 Tc 0.0872 Tw (that individual differences in meaning and competence re-)Tj T* -0.0033 Tc 0.1122 Tw (flect the degree to which the environment \(i.e., the police)Tj 0 -1.398 TD -0.004 Tc 0.0867 Tw [(or)17(ganization\) enables actions to occur)50(. Empowerment thus)]TJ 0 -1.401 TD 0.0073 Tc 0.125 Tw (describes a process that uses organizational strategies to)Tj T* -0.0036 Tc -0.0091 Tw (remove conditions that foster powerlessness \(e.g., organiza-)Tj /TT3 1 Tf -24.525 65.235 TD -0.0047 Tc -0.0454 Tw (Figure 1: The relationship between personal characteristics, organizational climate, work experiences and job)Tj 12.45 -1.2 TD -0.0049 Tc -0.0242 Tw (satisfaction. 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Tc (.62)Tj 0.102 -14.37 TD (.33)Tj 4.65 3.57 TD (.40)Tj -8.802 -0.399 TD (.10)Tj 8.301 7.2 TD -0.0244 Tc (-.87)Tj -7.701 -0.03 TD (-.20)Tj 24.021 -6.672 TD 0 Tc (R)Tj 5.8 0 0 5.8 450.84 575.85 Tm -0.0064 Tc (2 )Tj 10 0 0 10 455.49 572.49 Tm -0.0052 Tc -0.035 Tw (= .44)Tj /TT12 1 Tf 18 0 0 18 291.51 667.29 Tm 0 Tc 0 Tw <004a>Tj ET 0.24 w /GS1 gs 196.72 674.48 96.96 -1.16 re B* endstream endobj 129 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R /TT12 130 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 132 0 obj << /Length 9978 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 427.65 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.0132 Tc 0 Tw (99)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0034 Tc 0.0183 Tw (tional hassles\) and encourage organizational practices \(e.g.,)Tj 0 -1.398 TD -0.0033 Tc -0.062 Tw (organizational and operational uplifts, self-efficacy informa-)Tj 0 -1.401 TD -0.0035 Tc 0.0191 Tw [(tion, competencies\) that develop officers learned resource-)]TJ T* -0.0038 Tc 0.0025 Tw (fulness \(Johnston & Paton, 2003\).)Tj 1.8 -1.998 TD -0.0041 Tc -0.0433 Tw [(Thomas and )13.9(V)115.1(elthouse \(1990\) complement this position)]TJ -1.8 -1.401 TD -0.0034 Tc 0.0225 Tw (by adding that beliefs about future competence derive from)Tj T* -0.0013 Tc 0.125 Tw (the schema or interpretive framework, developed through)Tj 0 -1.398 TD -0.0084 Tc -0.0621 Tw (the enabling process of empowerment, which provides mean-)Tj 0 -1.401 TD -0.0033 Tc -0.0015 Tw (ing to officers experiences and builds their capacity to deal)Tj T* -0.0031 Tc -0.0075 Tw (with future challenges. 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For it to inform the development)Tj T* -0.0031 Tc 0.065 Tw (of resilience, it is necessary to identify how empowerment)Tj 0 -1.398 TD -0.0033 Tc 0.0431 Tw (cycles contribute to the development of future adaptive ca-)Tj 0 -1.401 TD -0.0034 Tc -0.0521 Tw [(pacity)62.6(. )17.2(The environmental assessment process translates into)]TJ T* -0.0039 Tc 0.0867 Tw (two outcomes: task assessment and global assessment.)Tj /TT3 1 Tf -24.21 -6.213 TD -0.0049 Tc -0.0079 Tw (Figure 2: The cycle of environmental events, task assessments, and behaviour. Adapted from Johnston and)Tj 6.786 -1.2 TD -0.0047 Tc -0.0485 Tw (Paton \(2003\). 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(Paton, Violanti, Johnston, Burke, Clarke, Keenan Stress Shield: Police Resiliency)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm -0.004 Tc 0.1233 Tw [(According to )14(Thomas and )17(V)112.2(elthouse \(1990\), of)17(ficers)]TJ -1.8 -1.398 TD 0.0048 Tc 0.125 Tw (task assessments comprise several components. 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Importantly)59.8(, Bandura points out that there is a)]TJ T* -0.0151 Tc -0.0625 Tw (direct relationship between the level of self-efficacy \(i.e., com-)Tj 0 -1.398 TD -0.0033 Tc 0.0183 Tw (petence\) and the level of effort and persistence that officers)Tj 0 -1.401 TD -0.0036 Tc 0.055 Tw (invest in facing challenging events, thus making an impor-)Tj T* -0.0031 Tc 0.0594 Tw (tant contribution to officers capacity to adapt to the unex-)Tj 0 -1.398 TD 0.0109 Tc 0 Tw (pected.)Tj 1.8 -2.001 TD -0.0076 Tc -0.0625 Tw (The third component, choice, reflects the extent to which)Tj -1.8 -1.401 TD 0.0225 Tc 0.125 Tw (officers perceive that their behavior is self-determined)Tj 0 -1.398 TD -0.0064 Tc -0.0619 Tw [(\(Spreitzer)32.6(, 1997\). )47.9(A)55.8( sense of choice is achieved when of)11.6(ficers)]TJ 0 -1.401 TD -0.0028 Tc -0.005 Tw (believe they are actively involved in defining how they per-)Tj T* -0.0078 Tc -0.0622 Tw (form their role \(a prominent item when officers report uplifts\))Tj 0 -1.398 TD -0.0033 Tc 0.0025 Tw (rather than just being passive recipients \(as is often the case)Tj 0 -1.401 TD -0.0034 Tc 0.0639 Tw (when officers describe hassles\). The sense of choice is en-)Tj T* -0.0017 Tc 0.125 Tw (hanced when the organization delegates responsibility for)Tj 0 -1.398 TD -0.0035 Tc -0.0155 Tw (planning and task performance to officers. This facet of em-)Tj 0 -1.401 TD -0.0016 Tc 0.125 Tw (powerment is comparable to the coherence component of)Tj T* -0.0097 Tc -0.0622 Tw [(resilience. )50.3(A)58.5( sense of choice is particularly important for deal-)]TJ 0 -1.398 TD -0.0035 Tc 0.0136 Tw (ing with emergent, contingent, emergency demands and for)Tj 0 -1.401 TD 0.0044 Tc 0.125 Tw (creative crisis decision-making and the development and)Tj T* -0.0018 Tc (maintenance of situational awareness when responding to)Tj 0 -1.398 TD -0.0032 Tc -0.0388 Tw [(critical incidents \(Paton & Flin, 1999\). )53.9(An ability to exercise)]TJ 0 -1.401 TD -0.0035 Tc -0.0307 Tw (choice also facilitates learning from training and operational)Tj T* -0.0045 Tc -0.0622 Tw (experiences and, in an empowering climate, facilitates others)Tj 0 -1.398 TD -0.0035 Tc 0.0117 Tw (to do likewise and pass on learning.)Tj 1.8 -2.001 TD -0.0032 Tc 0.125 Tw (The final component, impact, describes the degree to)Tj -1.8 -1.401 TD -0.0005 Tc (which officers perceive that they can influence important)Tj 0 -1.398 TD -0.0126 Tc -0.0624 Tw [(or)14.4(ganizational outcomes \(Spreitzer)35.4(, 1997\). )11.5(Where choice con-)]TJ 0 -1.401 TD -0.0037 Tc 0.1221 Tw [(cerns control over one)53.3(s work behaviors, impact concerns)]TJ T* -0.0036 Tc -0.035 Tw (the notion of personal control over organizational outcomes.)Tj 25.5 64.8 TD 0.0611 Tw (Parallels can be drawn between the choice and impact ele-)Tj 0 -1.398 TD -0.0053 Tc -0.0621 Tw (ments of empowerment and perceived control, another factor)Tj 0 -1.401 TD -0.0032 Tc 0.0655 Tw (that has been widely implicated in thinking on stress resil-)Tj T* 0.015 Tw [(ience and adaptability)59.9(.)]TJ 1.8 -1.998 TD -0.0122 Tc -0.0622 Tw (The ability to draw a direct comparison between the com-)Tj -1.8 -1.401 TD -0.0037 Tc 0.0037 Tw (ponents of task assessment and the concepts of meaningful-)Tj T* 0.0231 Tc 0.1249 Tw [(ness, manageability)62.1(, and coherence adds weight to the)]TJ 0 -1.398 TD -0.0038 Tc 0.125 Tw (argument that empowerment can encapsulate resilience in)Tj 0 -1.401 TD -0.0037 Tc 0.1108 Tw (police organizations. This comparison also illustrates how)Tj T* 0.0557 Tw (hassles and uplifts can affect core empowerment processes)Tj 0 -1.398 TD -0.0035 Tc -0.039 Tw (such as meaning and choice \(see Figure 4\), thus affording an)Tj 0 -1.401 TD -0.0037 Tc -0.0333 Tw (opportunity to see that empowerment research complements)Tj T* -0.0035 Tc 0.11 Tw (the earlier model \(see Figure 1\) and how their integration)Tj 0 -1.398 TD -0.0038 Tc -0.0444 Tw (contributes to the development of a comprehensive model of)Tj 0 -1.401 TD -0.0067 Tc -0.06 Tw (police resilience.)Tj 1.8 -2.001 TD 0.0017 Tc 0.125 Tw (Before continuing to advance this argument, there is)Tj -1.8 -1.398 TD -0.0036 Tc 0.0733 Tw (one final form of assessment that remains to be discussed:)Tj 0 -1.401 TD -0.0039 Tc 0.051 Tw (global assessment, which further establishes empowerment)Tj T* -0.0032 Tc 0.045 Tw (as a construct that plays an important role in informing the)Tj 0 -1.398 TD -0.0005 Tc 0.125 Tw (understanding of officers resilience and their capacity to)Tj 0 -1.401 TD -0.0035 Tc 0.065 Tw (adapt to future incidents.)Tj 1.8 -2.001 TD -0.0037 Tc -0.0286 Tw (Although task assessments are localized within a singu-)Tj -1.8 -1.398 TD -0.0034 Tc 0.016 Tw (lar task and time period, global assessments refer to an out-)Tj 0 -1.401 TD -0.009 Tc -0.0625 Tw (come of empowerment that embodies a capacity to generalize)Tj T* -0.0036 Tc 0.0481 Tw (expectancies and learning across tasks and over time. Tho-)Tj 0 -1.398 TD -0.0039 Tc 0.0114 Tw [(mas and )14.1(V)115.3(elthouse \(1990\) observed that global assessments)]TJ 0 -1.401 TD -0.0058 Tc -0.0623 Tw (describe a capacity to fill in gaps when faced with new and/or)Tj T* -0.0037 Tc -0.0114 Tw (unfamiliar situations. This aspect of empowerment is essen-)Tj 0 -1.398 TD -0.0032 Tc 0.0594 Tw (tial for adaptive capacity in a profession where one cannot)Tj 0 -1.401 TD -0.0034 Tc 0.0745 Tw (predict what he or she will be called upon to confront and)Tj T* 0.0746 Tw (thus must be able to use current experiences as a basis for)Tj 0 -1.398 TD -0.0032 Tc -0.0015 Tw [(preparing to deal with future risk and uncertainty)59.8(.)]TJ 1.8 -2.001 TD -0.0036 Tc 0.0706 Tw (Both global and task assessments, and thus the capac-)Tj -1.8 -1.401 TD -0.0026 Tc 0.1113 Tw (ity to adapt, are influenced by officers interpretive styles)Tj 0 -1.398 TD -0.0036 Tc 0.0619 Tw (\(Figure 2\), with these schemas comprising separate but re-)Tj 0 -1.401 TD -0.0041 Tc 0.0634 Tw [(lated components \(Thomas & )17(V)112.1(elthouse, 1990\). )50(According)]TJ T* -0.0038 Tc -0.0371 Tw [(to )14.2(Thomas and )17.2(V)115.4(elthouse, interpretive frameworks are influ-)]TJ 0 -1.398 TD -0.0034 Tc 0.0256 Tw (enced by the work context, with management practices \(in-)Tj 0 -1.401 TD -0.0036 Tc 0.0725 Tw (tervention; see Figure 2\) having an important influence on)Tj T* -0.0038 Tc 0.0684 Tw (how the schemas are developed and sustained.)Tj /TT5 1 Tf 11 0 0 11 309 119.34 Tm 0.0104 Tc 0.1257 Tw (Empowerment Schema and Resilience)Tj /TT2 1 Tf 10 0 0 10 327 99.66 Tm -0.0038 Tc 0.1092 Tw (The first schema component concerns the attributions)Tj -1.8 -1.401 TD -0.0033 Tc -0.06 Tw (made by officers to account for success or failure. Empower-)Tj ET endstream endobj 137 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 139 0 obj << /Length 8273 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (101)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0034 Tc 0.055 Tw (ment is greater when officers attribute causes for failure to)Tj 0 -1.398 TD -0.0026 Tc 0.125 Tw (external \(i.e., other than personal shortcomings\), transient)Tj 0 -1.401 TD -0.0124 Tc -0.0622 Tw (\(i.e., likely to change over time\), and specific \(e.g., limited to a)Tj T* -0.0028 Tc 0.0199 Tw [(specific day or event\) factors.)]TJ 1.8 -1.998 TD -0.0037 Tc 0.1019 Tw (The role of this schema component is consistent with)Tj -1.8 -1.401 TD -0.0032 Tc 0.0883 Tw (findings in the literature of critical incident stress. For ex-)Tj T* -0.0039 Tc 0.0418 Tw [(ample, Paton and S)14.1(tephens \(1996\) discuss how an of)17.1(ficer)-39.9()53.1(s)]TJ 0 -1.398 TD -0.0018 Tc 0.125 Tw (frequent experience of successful outcomes under normal)Tj 0 -1.401 TD -0.0035 Tc -0.0245 Tw (circumstances can lead to the development of the helper ste-)Tj T* -0.003 Tc 0.01 Tw (reotype. The schema of the helper stereotype fuels officers)Tj 0 -1.398 TD -0.0029 Tc -0.0281 Tw (expectations that they will always be resourceful, in control,)Tj 0 -1.401 TD 0.0095 Tc 0.125 Tw (and able to put things right. The suddenness, scale, and)Tj T* -0.0035 Tc -0.0462 Tw (complexity of mass emergencies and disasters make it inevi-)Tj 0 -1.398 TD -0.0033 Tc -0.0455 Tw (table that officers will have to deal with failure at some point)Tj 0 -1.401 TD -0.0164 Tc -0.0623 Tw (or with not being able to perform at their expected level \(Paton,)Tj T* -0.0033 Tc 0.0214 Tw (1994\). Under these circumstances, the helper stereotype re-)Tj 0 -1.398 TD -0.0034 Tc -0.0036 Tw (sults in officers internalizing failure \(Raphael, 1986\) rather)Tj 0 -1.401 TD -0.0033 Tc -0.025 Tw [(than, more correctly)59.7(, attributing a given problem to environ-)]TJ T* -0.0034 Tc -0.0209 Tw [(mental complexity)62.6(. Similarly)59.6(, or)14.6(ganizational hassles such as)]TJ 0 -1.398 TD -0.0035 Tc -0.0386 Tw (reporting practices that supersede concern for officers well-)Tj 0 -1.401 TD -0.006 Tc -0.0622 Tw (being or that project blame on officers increase the likelihood)Tj T* -0.0036 Tc -0.0512 Tw (that officers will perceive problems as emanating from inter-)Tj 0 -1.398 TD -0.0281 Tw (nal sources \(MacLeod & Paton, 1999\). In contrast, feedback)Tj 0 -1.401 TD 0.0791 Tw (processes that differentiate personal and environmental in-)Tj T* 0.0165 Tc 0.125 Tw (fluences on outcomes contribute to the development of)Tj 0 -1.398 TD 0.0501 Tc (attributional schemas that sustain adaptive capacity)Tj 0 -1.401 TD -0.0043 Tc -0.0275 Tw (\(MacLeod & Paton\).)Tj 1.8 -2.001 TD -0.0057 Tc -0.0622 Tw (A second schema component, envisioning, refers to how)Tj -1.8 -1.398 TD -0.0035 Tc 0.0043 Tw (officers anticipate future events and outcomes. It influences)Tj 0 -1.401 TD -0.0032 Tc 0.0289 Tw (the quality of the attributional processes brought to bear on)Tj T* -0.0071 Tc -0.0625 Tw (critical incident experiences. Officers who anticipate positive)Tj 0 -1.398 TD -0.0037 Tc 0.0322 Tw (rather than negative outcomes experience stronger task and)Tj 0 -1.401 TD -0.0038 Tc -0.002 Tw [(global assessments and, thus, empowerment. )14.3(W)55(ith regard to)]TJ T* -0.0035 Tc -0.0216 Tw (response problems, the existence of a learning culture in po-)Tj 0 -1.398 TD -0.0032 Tc 0.0225 Tw (lice agencies that interprets problems as catalysts for future)Tj 0 -1.401 TD 0.0231 Tc 0.125 Tw (development and not as failure \(Paton, 2006; Paton &)Tj T* -0.0074 Tc -0.0625 Tw (Stephens, 1996\) will increase positive expectations regarding)Tj 0 -1.398 TD -0.0057 Tc (performance and well-being.)Tj 1.8 -2.001 TD -0.0035 Tc 0.0807 Tw (The final schema component, evaluation, refers to the)Tj -1.8 -1.401 TD -0.0033 Tc 0.1081 Tw (standards by which one evaluates success or failure. Tho-)Tj 0 -1.398 TD -0.0039 Tc 0.0224 Tw [(mas and )17(V)112.3(elthouse \(1990\) ar)14.1(gue that individuals who adopt)]TJ 0 -1.401 TD -0.008 Tc -0.0621 Tw (less absolutist and more realistic standards experience greater)Tj T* -0.0035 Tc -0.0136 Tw (empowerment. This observation is reinforced by findings in)Tj 0 -1.398 TD -0.0083 Tc -0.0625 Tw (the critical incident literature. Officers who have realistic per-)Tj 25.5 61.998 TD -0.004 Tc 0.018 Tw (formance expectations, and who acknowledge environmen-)Tj 0 -1.398 TD -0.0033 Tc 0.0325 Tw (tal limitations on their outcomes, are better able to adapt to)Tj 0 -1.401 TD 0.0082 Tc 0.125 Tw (highly threatening circumstances \(Paton, 1994; Raphael,)Tj T* -0.0516 Tc 0 Tw (1986\).)Tj 1.8 -1.998 TD -0.0034 Tc -0.0167 Tw (In addition to being able to predict satisfaction and thus)Tj -1.8 -1.401 TD -0.0008 Tc 0.1249 Tw [(inform understanding of how meaning and manageability)]TJ T* -0.0003 Tc 0.125 Tw (develop, by mediating the relationship between organiza-)Tj 0 -1.398 TD -0.0036 Tc 0.062 Tw (tional characteristics and satisfaction, empowerment repre-)Tj 0 -1.401 TD -0.0089 Tc -0.0623 Tw [(sents a mechanism that illustrates how an of)18.1(ficer)-41.9()54.1(s)0( experience)]TJ T* -0.0032 Tc 0.0543 Tw (of organizational culture \(e.g., hassles and uplifts\) is trans-)Tj 0 -1.398 TD -0.0036 Tc -0.0037 Tw (lated, via the above schema components, into resilience and)Tj 0 -1.401 TD -0.0033 Tc 0.0742 Tw [(future adaptive capacity)59.7(. Having identified the potential of)]TJ T* -0.0067 Tc -0.0625 Tw (empowerment theories to inform understanding of resilience,)Tj 0 -1.398 TD -0.0033 Tc -0.0093 Tw (the next issue involves identifying its organizational predic-)Tj 0 -1.401 TD 0.0125 Tc 0 Tw (tors.)Tj 1.8 -2.001 TD 0.0146 Tc 0.125 Tw (Several antecedents to psychological empowerment)Tj -1.8 -1.398 TD -0.0072 Tc -0.0625 Tw (have been identified. Prominent among these are social struc-)Tj 0 -1.401 TD -0.0035 Tc -0.0036 Tw (tural variables \(access to resources and information, organi-)Tj T* -0.0033 Tc 0.0765 Tw (zational trust, peer cohesion, and supervisory support\) and)Tj 0 -1.398 TD -0.007 Tc -0.0625 Tw (personal characteristics \(personality\). This literature can con-)Tj 0 -1.401 TD -0.004 Tc -0.0624 Tw [(tribute to identifying the predictors of empowerment that can)]TJ T* -0.0036 Tc -0.0116 Tw (be included in the Stress Shield model.)Tj /TT5 1 Tf 11 0 0 11 321 383.34 Tm 0.0107 Tc 0.1253 Tw [(Access to Resour)29.8(ces)]TJ /TT2 1 Tf 10 0 0 10 339 363.66 Tm 0.0081 Tc 0.125 Tw (Having insufficient, inadequate, or inappropriate re-)Tj -1.8 -1.401 TD -0.0035 Tc 0.0381 Tw (sources to perform response tasks contributes to critical in-)Tj T* 0.006 Tc 0.125 Tw (cident stress risk \(Carafano, 2003; Paton, 1994\). Having)Tj 0 -1.398 TD -0.0033 Tc 0.0667 Tw (resources \(physical, social, and informational\) allows indi-)Tj 0 -1.401 TD -0.0034 Tc 0.0428 Tw (viduals to take initiative and enhance their sense of control)Tj T* -0.0035 Tc -0.034 Tw (\(impact\) and self-efficacy \(competence\) over environmental)Tj 0 -1.398 TD -0.0043 Tw (challenges \(Gist & Mitchell, 1992; Lin, 1998; Paton, 1994\).)Tj 0 -1.401 TD -0.0052 Tc -0.0623 Tw (One resource that plays a pivotal role in predicting empower-)Tj T* -0.0072 Tc -0.0625 Tw (ment is information.)Tj 1.8 -1.998 TD -0.0036 Tc -0.0492 Tw (Crisis information management systems capable of pro-)Tj -1.8 -1.401 TD -0.0034 Tc -0.025 Tw (viding pertinent information in conditions of uncertainty are)Tj T* 0.0191 Tc 0.125 Tw (essential to adaptive capacity in emergency responders)Tj 0 -1.398 TD -0.0032 Tc -0.0396 Tw (\(Paton & Flin, 1999\) and play an important role in creating a)Tj 0 -1.401 TD -0.004 Tc 0.0619 Tw (sense of purpose and meaning \(Conger & Konungo, 1988\))Tj T* -0.0037 Tc -0.0512 Tw [(among of)17.3(ficers \(Figure 3\). However)35.3(, information itself is not)]TJ 0 -1.398 TD -0.0036 Tc -0.0138 Tw (enough. The social context in which information is received)Tj 0 -1.401 TD -0.0034 Tc -0.05 Tw (is an equally important determinant of empowerment. In this)Tj T* 0.001 Tc 0.125 Tw (context, one aspect of the agency-officer relationship be-)Tj 0 -1.398 TD -0.0031 Tc 0.0009 Tw (comes particularly important, and that is trust.)Tj ET endstream endobj 140 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 143 0 obj << /Length 7904 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0057 Tc 0.0855 Tw [(102 )]TJ /TT3 1 Tf 2.7337 0 TD -0.0054 Tc 0.0869 Tw (Paton, Violanti, Johnston, Burke, Clarke, Keenan Stress Shield: Police Resiliency)Tj /TT5 1 Tf 11 0 0 11 54 723.36 Tm 0.0138 Tc 0 Tw [(T)57.2(r)-3.4(ust)]TJ /TT2 1 Tf 10 0 0 10 72 703.65 Tm -0.0035 Tc -0.015 Tw (Trust is a prominent determinant of the effectiveness of)Tj -1.8 -1.401 TD 0.089 Tw (interpersonal relationships, group processes, and organiza-)Tj 0 -1.398 TD -0.0132 Tc -0.0621 Tw (tional relationships \(Barker & Camarata, 1998; Herriot, Hirsh,)Tj 0 -1.401 TD -0.0183 Tc [(& Reilly)62.7(, 1998\), and it plays a crucial role in empowering of)14.7(fic-)]TJ T* -0.0035 Tc 0.0168 Tw (ers \(Spreitzer & Mishra, 1999\). People functioning in trust-)Tj 0 -1.398 TD 0.0121 Tw (ing, reciprocal relationships are left feeling empowered and)Tj 0 -1.401 TD -0.0105 Tc -0.0625 Tw (are more likely to experience meaning in their work. Trust has)Tj T* -0.0056 Tc -0.0622 Tw [(been identified as a predictor of a person)54.4(s ability to deal with)]TJ 0 -1.398 TD -0.0116 Tc (complex, high-risk events \(Siegrist & Cvetkovich, 2000\), par-)Tj 0 -1.401 TD -0.0031 Tc 0.0894 Tw (ticularly when relying on others to provide information or)Tj T* 0.0176 Tc 0 Tw (assistance.)Tj 1.8 -1.998 TD 0.0025 Tc 0.125 Tw [(T)37.3(rust influences one)53.5(s perception of other)-36.5()56.5(s)0.4( motives,)]TJ -1.8 -1.401 TD -0.003 Tc -0.0313 Tw (their competence, and the credibility of the information they)Tj T* -0.0036 Tc -0.0127 Tw (provide \(Earle, 2004\). People are more willing to commit to)Tj 0 -1.398 TD -0.0031 Tc 0.1221 Tw (acting cooperatively in high-risk situations when they be-)Tj 0 -1.401 TD -0.0035 Tc 0.0045 Tw (lieve those with whom they must collaborate or work under)Tj T* -0.006 Tc -0.0622 Tw (are competent, dependable, and likely to act with integrity \(in)Tj 0 -1.398 TD 0.0041 Tc 0.125 Tw (the present and in the future\) and care for their interests)Tj 0 -1.401 TD -0.0036 Tc 0.06 Tw (\(Dirks, 1999\). Organizations functioning with cultures that)Tj T* 0.0244 Tw (value openness and trust create opportunities for officers to)Tj 0 -1.398 TD 0.0455 Tw (engage in learning and growth, thus contributing to the de-)Tj 0 -1.401 TD -0.018 Tc -0.0625 Tw (velopment of officers adaptive capacity \(competence\) \(Barker)Tj T* -0.0038 Tc -0.0106 Tw (& Camarata, 1998; Siegrist & Cvetkovich, 2000\) \(Figures 3)Tj 0 -1.398 TD -0.0031 Tc 0.042 Tw (and 4\). The quality of this aspect of the interpersonal envi-)Tj 0 -1.401 TD -0.0033 Tc -0.0172 Tw (ronment is also influenced by officers dispositional charac-)Tj T* 0.0016 Tc 0 Tw (teristics.)Tj /TT5 1 Tf 11 0 0 11 309 723.36 Tm 0.0212 Tc 0.1273 Tw (Dispositional Influences)Tj /TT2 1 Tf 10 0 0 10 327 703.65 Tm -0.0023 Tc 0.125 Tw (Although less extensively researched than other vari-)Tj -1.8 -1.401 TD -0.0033 Tc 0.1031 Tw (ables, one dispositional factor that has attracted interest is)Tj 0 -1.398 TD -0.0032 Tc -0.01 Tw (the personality dimension of conscientiousness, particularly)Tj 0 -1.401 TD -0.0035 Tc 0.0587 Tw (with regard to its attributes of achievement orientation and)Tj T* -0.0034 Tc -0.0167 Tw [(dependability \(McNaus & Kelly)59.6(, 1999\). Conscientious indi-)]TJ 0 -1.398 TD -0.0037 Tc 0.0106 Tw (viduals experience a stronger sense of meaning and compe-)Tj 0 -1.401 TD -0.0032 Tc 0.0133 Tw (tence in their work, particularly during times of change and)Tj T* -0.0034 Tc -0.0212 Tw (disruption \(e.g., responding to critical incidents in which of-)Tj 0 -1.398 TD -0.001 Tc 0.125 Tw (ficers need to adapt to unpredictable, emergent demands\))Tj 0 -1.401 TD -0.0038 Tc 0.0343 Tw [(\(Thomas & )17.2(V)112.4(elthouse, 1990\), demonstrate greater levels of)]TJ T* -0.0035 Tc 0.0238 Tw (perseverance in these efforts \(Behling, 1998\), and are more)Tj 0 -1.398 TD -0.0118 Tc -0.0621 Tw (committed to contributing to collective efforts \(Hough, 1998\).)Tj 0 -1.401 TD -0.0033 Tc 0.0569 Tw (This contributes positively to both the level of cooperation)Tj T* 0.0048 Tc 0.125 Tw (with and support for coworkers that they demonstrate in)Tj 0 -1.398 TD -0.0037 Tc -0.0183 Tw (work contexts and to sustaining a cohesive team response to)Tj 0 -1.401 TD -0.0045 Tc -0.06 Tw (complex events.)Tj /TT5 1 Tf 11 0 0 11 309 460.35 Tm 0.0126 Tc 0.1257 Tw (Modeling Empowerment and Resilience)Tj /TT2 1 Tf 10 0 0 10 327 440.64 Tm -0.0037 Tc 0.1164 Tw (Using these variables, Johnston and Paton \(2003\) de-)Tj -1.8 -1.398 TD -0.0124 Tc -0.0625 Tw (scribed how empowerment mediated the relationship between)Tj 0 -1.401 TD -0.0035 Tc 0.0038 Tw (the above predictors and resilience \(job satisfaction\) in hos-)Tj T* -0.0032 Tc 0.01 Tw (pital staff dealing with critical incidents. Psychological em-)Tj 0 -1.398 TD 0.0499 Tc 0.1249 Tw [(powerment was measured using Spreitzer)-40.1()52.9(s)0.5( \(1995a\))]TJ 0 -1.401 TD -0.0038 Tc -0.0193 Tw (empowerment scale. Trust was measured using the interper-)Tj T* -0.0035 Tc 0.123 Tw [(sonal trust at work scale \(Cook & )17.5(W)94.4(all, 1980\). )53.5(Access to)]TJ 0 -1.398 TD 0.0016 Tc 0.125 Tw [(resources and information was assessed using Spreitzer)-37.4()52.6(s)]TJ 0 -1.401 TD -0.0038 Tc 0.095 Tw (\(1995b\) social structural measures. Conscientiousness was)Tj T* -0.0031 Tc 0.125 Tw [(assessed using Costa and McCrae)47.9(s \(1992\) conscientious-)]TJ 0 -1.398 TD -0.0035 Tc -0.0231 Tw (ness scale. The results are summarized in Figure 3.)Tj ET 0.99 w 1000 M /GS1 gs 55.995 223.005 102.71 -26.01 re 190.495 227.505 70.01 -37.01 re 67.995 167.505 64.01 -39.01 re 182.995 166.505 91.01 -33.81 re 423.495 166.005 85.01 -35.51 re 187.495 106.105 75.01 -25.11 re 275.995 106.505 75.01 -26.01 re 178.995 112.505 180.51 -38.01 re S BT /TT12 1 Tf 17.2128 -5.2644 5.2644 17.2128 407.414 164.8589 Tm /GS2 gs 0 Tc 0 Tw <004a>Tj ET 0.24 w /GS1 gs 260.431 217.301 m 418.225 169.042 l 417.886 167.932 l 260.092 216.192 l b* BT 13.8021 -11.5538 11.5538 13.8021 166.51 164.1398 Tm /GS2 gs <004a>Tj ET 0.24 w /GS1 gs 137.768 197.282 m 178.53 163.16 l 177.914 162.424 l 137.152 196.546 l b* BT 15.4341 9.2618 9.2618 -15.4341 408.9694 130.058 Tm /GS2 gs <004a>Tj ET 0.24 w /GS1 gs 351.793 87.216 m 416.925 126.301 l 416.225 127.467 l 351.093 88.383 l b* BT 18 0 0 18 408.69 141.99 Tm /GS2 gs <004a>Tj ET 0.24 w /GS1 gs 313.82 149.08 96.96 -1.06 re B* /Cs9 cs 0 scn 0.99 w 287.995 166.005 89.51 -34.01 re B* BT /TT3 1 Tf 9 0 0 9 69 207.66 Tm 0 0 0 1 k /GS2 gs 0.0171 Tc (Conscientiousness)Tj 14.6567 -12.89 TD 0.0081 Tc (Information)Tj 26.0033 6.1667 TD -0.0021 Tc 0.1389 Tw (Job Satisfaction)Tj -14.02 0.61 TD 0.0081 Tc 0 Tw (Global/Task)Tj -0.2967 -1.0533 TD 0.0054 Tc (Assessments)Tj -11.9333 0.5533 TD 0.0137 Tc (Empowerment)Tj -12.66 0.28 TD 0.0159 Tc (Critical)Tj -0.4567 -1.0567 TD 0.0101 Tc (Incidents)Tj 14.79 7.5233 TD -0.007 Tc (Trust)Tj 8.85 -12.5233 TD 0.0196 Tc (Resource)Tj 0.5833 -1.0567 TD 0.0054 Tc (Access)Tj /TT12 1 Tf 0 -17.9997 -17.9997 0 228.5022 180.6915 Tm 0 Tc <004a>Tj ET 0.24 w /GS1 gs 221.32 190.58 1.16 -18.36 re B* BT 0 17.9997 -17.9997 0 227.5022 117.5115 Tm /GS2 gs <004a>Tj ET /GS1 gs 220.422 107.022 1.16 18.36 re B* BT /TT3 1 Tf 48 0 0 48 137.64 135.99 Tm (})Tj 30 0 0 30 276.15 141.99 Tm (})Tj ET 0.99 w 175.495 174.505 208.51 -49.01 re S BT 10 0 0 10 392.01 152.01 Tm /GS2 gs -0.0201 Tc (.37)Tj -16.65 -3.552 TD (.17)Tj -6.402 6.6 TD (.18)Tj 16.281 2.571 TD (.28)Tj 4.119 -9.771 TD (.26)Tj -13.8 6.9 TD (.20)Tj 28.422 -3.249 TD 0 Tc (R)Tj 5.8 0 0 5.8 518.85 150.36 Tm -0.0064 Tc (2 )Tj 10 0 0 10 523.5 147 Tm -0.0052 Tc -0.035 Tw (= .51)Tj -44.25 11.799 TD -0.0049 Tc -0.0534 Tw (Figure 3: The relationship between empowerment and job satisfaction. Adapted from Johnston \(2002\))Tj 14.964 -1.2 TD -0.0053 Tc -0.065 Tw (and Johnston and Paton \(2003\).)Tj ET endstream endobj 144 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R /TT12 130 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> /ColorSpace << /Cs9 24 0 R >> >> endobj 145 0 obj << /FunctionType 4 /Domain [0 1] /Range [0 1 0 1 0 1 0 1] /Length 20 /Filter /FlateDecode >> stream HN)-PZ.( endstream endobj 147 0 obj << /Length 8484 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (103)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm -0.0038 Tc -0.0473 Tw (The model shown in Figure 3 provided good support for)Tj -1.8 -1.398 TD -0.0092 Tc -0.0622 Tw (the role of empowerment as a predictor of resilience, account-)Tj 0 -1.401 TD -0.0033 Tc 0.0218 Tw (ing for some 51% of the variance in job satisfaction. It also)Tj T* -0.0038 Tc 0.0175 Tw (supports the inclusion of empowerment in the Stress Shield)Tj 0 -1.398 TD -0.0095 Tc -0.0623 Tw [(model. However)35.5(, before doing so, other social structural \(e.g.,)]TJ 0 -1.401 TD -0.0036 Tc -0.0199 Tw [(senior of)14.4(ficer attitudes and behavior)38.4(, levels of peer cohesion)]TJ T* 0.0021 Tc 0.125 Tw (and support\) and dispositional \(e.g.., hardiness\) variables)Tj 0 -1.398 TD -0.0035 Tc 0.095 Tw (capable of predicting adaptive capacity through empower-)Tj 0 -1.401 TD -0.0284 Tw (ment can be identified.)Tj /TT5 1 Tf 11 0 0 11 66 577.35 Tm 0.0147 Tc 0.125 Tw (Senior Officer Support and Empowerment)Tj /TT2 1 Tf 10 0 0 10 84 557.64 Tm -0.0032 Tc -0.0611 Tw (Senior officers play a central role in developing and sus-)Tj -1.8 -1.398 TD -0.0036 Tc 0.0609 Tw [(taining empowering environments \(Liden, )17.5(W)94.2(ayne, & Spar)17.4(-)]TJ 0 -1.401 TD -0.0149 Tc -0.0623 Tw [(r)5.2(o)5.2(w)60.1(, 2000; Paton & S)15.1(tephens, 1996\). )15.1(They have a major role in)]TJ T* -0.0037 Tc 0.0037 Tw (creating and sustaining a climate of trust and empowerment)Tj 0 -1.398 TD -0.0033 Tc -0.025 Tw (as a result of their being responsible for translating the orga-)Tj 0 -1.401 TD -0.0031 Tc -0.0114 Tw (nizational culture into the day-to-day values and procedures)Tj T* -0.0034 Tc 0.0795 Tw (that sustain the schema officers engage to plan for and re-)Tj 0 -1.398 TD -0.0035 Tc 0.0384 Tw (spond to critical incidents.)Tj 1.8 -2.001 TD -0.007 Tc -0.0625 Tw (Leadership practices such as positive reinforcement help)Tj -1.8 -1.401 TD -0.0186 Tc (create an empowering team environment \(Manz & Sims, 1989;)Tj 0 -1.398 TD -0.0032 Tc 0.0631 Tw (Paton, 1994\). This is particularly true when senior officers)Tj 0 -1.401 TD -0.0038 Tc 0.0636 Tw (focus on constructive discussion of response problems and)Tj T* -0.0033 Tc 0.034 Tw (how these problems can be resolved in the future; this type)Tj 0 -1.398 TD -0.0071 Tc -0.0625 Tw (of approach from both coworkers and senior officers empow-)Tj 0 -1.401 TD -0.0051 Tc -0.0624 Tw [(ers employees \(Quinn & Spreitzer)33.9(, 1997\). It does so by draw-)]TJ T* 0.0049 Tc 0.125 Tw [(ing one)49.9(s emphasis away from personal weaknesses in a)]TJ 0 -1.398 TD -0.0034 Tc 0.0244 Tw (difficult or challenging situation and placing it on an active)Tj 0 -1.401 TD -0.0035 Tc -0.0611 Tw (approach of anticipating how to exercise control in the future)Tj T* -0.0034 Tc -0.0545 Tw [(\(Paton & S)17.6(tephens, 1996\). In this way)59.6(, the behavior of senior)]TJ 0 -1.398 TD -0.0035 Tc 0.0436 Tw (officers contributes to the development of the attributional,)Tj 0 -1.401 TD -0.0039 Tc -0.0358 Tw (envisioning, and evaluative schema components \(see above\))Tj T* -0.0035 Tc 0.0975 Tw (that are instrumental in translating officers organizational)Tj 0 -1.398 TD -0.008 Tw (experiences into resilient beliefs and competencies.)Tj 1.8 -2.001 TD 0.0712 Tw (Quality supervisor-subordinate relationships, of which)Tj -1.8 -1.401 TD 0.0019 Tc 0.125 Tw (supportive supervisor behavior is a crucial factor \(Liden,)Tj 0 -1.398 TD -0.0032 Tc 0.0797 Tw [(Sparrow)59.8(, & )18.2(W)94.6(ayne, 1997\), create the conditions necessary)]TJ 0 -1.401 TD -0.0035 Tc 0.0257 Tw (for personal growth \(Cogliser & Schriesheim, 2000\) by en-)Tj T* -0.0038 Tc -0.0125 Tw (hancing general feelings of competence \(global assessment\))Tj 0 -1.398 TD -0.0033 Tc 0.0453 Tw [(\(see Figure 4\). )54(Additionally)59.7(, quality supervisor)17.7(-subordinate)]TJ 0 -1.401 TD -0.0035 Tc 0.0635 Tw (relationships encourage the creation of similar value struc-)Tj T* -0.0037 Tc 0.12 Tw (tures between officers \(Cogliser & Schriesheim\), building)Tj 0 -1.398 TD -0.0035 Tc -0.0136 Tw (shared schema, enabling employees to find increased mean-)Tj 0 -1.401 TD -0.0033 Tc 0.0516 Tw (ing in their task activities, and contributing to the develop-)Tj T* -0.0036 Tc 0.0407 Tw (ment of a sense of cohesion between colleagues.)Tj /TT5 1 Tf 11 0 0 11 321 723.36 Tm 0.0113 Tc 0.1258 Tw (Peer Cohesion and Empowerment)Tj /TT2 1 Tf 10 0 0 10 339 703.65 Tm -0.0035 Tc -0.0583 Tw (The quality of relationships between coworkers predicts)Tj -1.8 -1.401 TD 0.0036 Tc 0.1249 Tw [(the meaning that of)18.6(ficers)72.6( perceive in their work \(Major)36.6(,)]TJ 0 -1.398 TD -0.0156 Tc -0.0622 Tw [(Kozlowski, Chao, & Gardner)35.4(, 1995; Liden et al., 2000; Mullen)]TJ 0 -1.401 TD -0.0037 Tc 0.0143 Tw [(& Cooper)38.3(, 1994; Paton & S)14.3(tephens, 1996; Perry)62.3(, 1997\) and)]TJ T* -0.0036 Tc 0.0519 Tw (increases the level of social support provided to coworkers)Tj 0 -1.398 TD -0.0039 Tc -0.0393 Tw (\(George & Bettenhausen, 1990\). Members of cohesive work)Tj 0 -1.401 TD -0.0078 Tc -0.0625 Tw (teams are more willing to share their knowledge and skills, an)Tj T* -0.0037 Tc 0.0333 Tw (essential prerequisite for the development and maintenance)Tj 0 -1.398 TD 0 Tc 0.125 Tw (of the learning culture that is fundamental to agency and)Tj 0 -1.401 TD -0.0036 Tc -0.0585 Tw (officer resilience. Cohesive networks are also less dependent)Tj T* -0.001 Tc 0.125 Tw (on senior officers for obtaining important resources. Peer)Tj 0 -1.398 TD 0.0034 Tc (relationships are an alternative source for such resources)Tj 0 -1.401 TD -0.0032 Tc 0.054 Tw (\(Liden et al., 1997\), contributing to a greater sense of self-)Tj T* -0.0037 Tc -0.0458 Tw [(determination in one)50.3(s work \(see Figure 4\).)]TJ 1.8 -1.998 TD -0.0034 Tc 0.03 Tw [(T)73.4(aken together)35.6(, the social structural variables of senior)]TJ -1.8 -1.401 TD -0.0036 Tc 0.0122 Tw (officer support and peer cohesion can make a valuable con-)Tj T* -0.0032 Tc -0.0532 Tw (tribution to a model of resilience \(see Figure 4\). In the earlier)Tj 0 -1.398 TD -0.0039 Tc -0.0031 Tw (discussion of the choice and impact components of empow-)Tj 0 -1.401 TD 0.0481 Tw (erment \(see above\), a comparison was made between them)Tj T* 0.0006 Tc 0.1249 Tw [(and the construct of perceived control. Consequently)60.6(, the)]TJ 0 -1.398 TD -0.0034 Tc -0.0555 Tw (final variable proposed for the model, hardiness, is a disposi-)Tj 0 -1.401 TD -0.0036 Tc 0.0244 Tw (tional one that informs an understanding of the relationship)Tj T* 0.0175 Tw (between perceived control and resilience.)Tj /TT5 1 Tf 11 0 0 11 321 356.34 Tm 0.0124 Tc 0.1256 Tw [(Har)31.5(diness and Empowerment)]TJ /TT2 1 Tf 10 0 0 10 339 336.66 Tm -0.0031 Tc -0.0339 Tw (Hardiness has a long history as a predictor of resilience,)Tj -1.8 -1.401 TD -0.0103 Tc -0.0625 Tw (one which embraces the officer-agency relationship \(Bartone,)Tj T* -0.0035 Tc 0.005 Tw (2004\). Hardiness may be an important adjunct to empower-)Tj 0 -1.398 TD 0.0257 Tw (ment. Portraying empowerment as a multi-level process in-)Tj 0 -1.401 TD 0.0007 Tc 0.1249 Tw [(troduces another issue. )51.6(Although or)15.7(ganizational decisions)]TJ T* -0.0032 Tc 0.005 Tw (can provide the conditions necessary to enable officers, this)Tj 0 -1.398 TD -0.0071 Tc -0.0625 Tw (does not automatically imply that officers will be able to fully)Tj 0 -1.401 TD 0.0033 Tc 0.125 Tw (utilize these opportunities. It is necessary to have an en-)Tj T* -0.0038 Tc -0.0071 Tw (abling \(empowering\) environment and officers with the dis-)Tj 0 -1.398 TD -0.0036 Tc 0.1143 Tw (positional characteristics to be empowered \(see Figure 4\).)Tj 0 -1.401 TD -0.0037 Tc 0 Tw (The control, challenge, and commitment facets of hardiness)Tj T* -0.0033 Tc 0.125 Tw (represent a dispositional indicator of officers potential to)Tj 0 -1.398 TD -0.0038 Tc -0.0464 Tw (utilize environmental opportunities to learn from an empow-)Tj 0 -1.401 TD -0.0035 Tc 0.0237 Tw (ering environment. For this reason, hardiness is included in)Tj T* 0.0012 Tc 0.125 Tw (the model. It has an advantage over conscientiousness in)Tj 0 -1.398 TD -0.0036 Tc -0.0122 Tw (that hardiness is open to change through team and organiza-)Tj 0 -1.401 TD -0.0037 Tc -0.0174 Tw (tional intervention \(Bartone\).)Tj ET endstream endobj 148 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 150 0 obj << /Length 8855 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0057 Tc 0.0855 Tw [(104 )]TJ /TT3 1 Tf 2.7337 0 TD -0.0054 Tc 0.0869 Tw (Paton, Violanti, Johnston, Burke, Clarke, Keenan Stress Shield: Police Resiliency)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm -0.0039 Tc 0.104 Tw (Integrating the occupational health and empowerment)Tj -1.8 -1.398 TD -0.0036 Tc -0.055 Tw (models \(Figure 1 and 3\) with the additional factors described)Tj 0 -1.401 TD -0.0037 Tc -0.0427 Tw (above provides the foundation for the Stress Shield model of)Tj T* -0.0033 Tc 0.0457 Tw [(resiliency)59.7(. )17.3(The S)17.7(tress Shield model is depicted in Figure 4.)]TJ 0 -1.398 TD -0.0039 Tc 0.0243 Tw (Paths contributing to the development of empowerment are)Tj 0 -1.401 TD -0.0029 Tc 0.125 Tw (shown as solid lines. Paths proposed to reduce empower-)Tj T* -0.0034 Tc 0.015 Tw (ment are illustrated as hatched lines. Because it can capture)Tj 0 -1.398 TD -0.0038 Tc 0.0325 Tw (changes in perceived coherence, meaningfulness, and man-)Tj 0 -1.401 TD -0.0032 Tc 0.1091 Tw [(ageability)62.8(, satisfaction is retained as an outcome measure.)]TJ T* -0.0074 Tc -0.0622 Tw [(However)37.6(, because the occupational health and empowerment)]TJ 0 -1.398 TD -0.0038 Tc 0.015 Tw (literatures have not examined posttrauma outcomes specifi-)Tj 0 -1.401 TD -0.0032 Tc -0.0079 Tw [(cally)62.8(, a measure capable of capturing this aspect of of)14.8(ficers)]TJ T* -0.0045 Tc -0.0623 Tw (experience must be included in any test of the model. For this)Tj 0 -1.398 TD -0.0036 Tc 0.0894 Tw (reason, posttraumatic growth has been included as an out-)Tj 0 -1.401 TD -0.0041 Tc -0.0625 Tw (come measure in the model \(Figure 4\).)Tj /TT5 1 Tf 11 0 0 11 54 493.35 Tm 0.0317 Tc 0 Tw (Conclusion)Tj /TT2 1 Tf 10 0 0 10 72 473.64 Tm -0.0034 Tc 0.0194 Tw (Recognition of the fact that critical incidents can result)Tj -1.8 -1.398 TD -0.0036 Tc -0.015 Tw (in resilient \(adaptive and growth-oriented\) outcomes for po-)Tj 0 -1.401 TD -0.0031 Tc -0.0017 Tw (lice officers means that exercising duty of care requires that)Tj T* 0.023 Tw (police agencies have at their disposal a model that they can)Tj 0 -1.398 TD -0.0036 Tc -0.0275 Tw (use to guide the development and maintenance of resilience.)Tj 0 -1.401 TD -0.0037 Tc 0.065 Tw [(Furthermore, because police officers will encounter unpre-)]TJ 25.5 31.899 TD -0.0033 Tc 0.0351 Tw [(dictable and challenging circumstances repeatedly)62.7(, it is im-)]TJ 0 -1.398 TD -0.0065 Tc -0.0625 Tw (portant that resilience programs be designed as learning strat-)Tj 0 -1.401 TD -0.0027 Tc 0.0035 Tw (egies and that any model used to guide this activity identify)Tj T* -0.0035 Tc 0.0478 Tw (the resources and competencies that facilitate the proactive)Tj 0 -1.398 TD -0.0031 Tc -0.0162 Tw [(development of officers general capacity to adapt \(i.e., ren-)]TJ 0 -1.401 TD -0.0035 Tc 0.1165 Tw (der any future experience meaningful and manageable\) to)Tj T* -0.0038 Tc 0.0833 Tw (unpredictable circumstances. The Stress Shield model was)Tj 0 -1.398 TD -0.0036 Tc 0.0343 Tw (proposed as a means of achieving this goal.)Tj 1.8 -2.001 TD 0.0478 Tw (The Stress Shield model was developed by integrating)Tj -1.8 -1.401 TD -0.0031 Tc 0.075 Tw (and building on theoretically robust and empirically tested)Tj 0 -1.398 TD 0.0012 Tc 0.125 Tw (work. This approach increases the expected utility of the)Tj 0 -1.401 TD -0.0036 Tc 0.0825 Tw (model. The Stress Shield model describes resilience as re-)Tj T* -0.0313 Tw (sulting from the interaction between person, team, and orga-)Tj 0 -1.398 TD -0.0032 Tc 0.1064 Tw [(nizational factors. 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M., Levenson, M. R., & Spiro, )52.4(A., III. \(1994\). )13.4(V)63.5(ul-)]TJ 1.2 -1.401 TD -0.0033 Tc 0.055 Tw (nerability and resilience to combat exposure: Can stress)Tj 0 -1.398 TD -0.0031 Tc -0.0016 Tw (have lifelong effects? )Tj /TT5 1 Tf 8.784 0 TD -0.004 Tc (Psychology and Aging, 9)Tj /TT2 1 Tf 9.906 0 TD -0.0034 Tc -0.005 Tw (, 3444.)Tj -19.89 -1.8 TD -0.0032 Tc 0.0607 Tw [(Antonovsky)59.8(, )53.8(A. \(1990\). Personality and health: )14.8(T)73.6(esting the)]TJ 1.2 -1.401 TD -0.0033 Tc 0.0149 Tw [(sense of coherence model. In H. S. Friedman \(Ed.\), )]TJ /TT5 1 Tf 20.739 0 TD -0.0053 Tc 0 Tw (Per-)Tj -20.739 -1.401 TD -0.0086 Tc -0.0616 Tw (sonality and disease )Tj /TT2 1 Tf 8.001 0 TD -0.0083 Tc -0.0625 Tw [(\(pp. 155-177\). New )30.2(Y)104.9(ork: John )15.2(W)56.5(iley)]TJ -8.001 -1.398 TD -0.0047 Tc 0.03 Tw (& Sons.)Tj -1.2 -1.8 TD -0.0081 Tc -0.0625 Tw [(Anderson, N.R., & )15.9(W)95.7(est, M.A. \(1998\). 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Social structural characteristics of psy-)]TJ 1.2 -1.401 TD -0.0081 Tc -0.06 Tw (chological empowerment. )Tj /TT5 1 Tf 10.329 0 TD -0.0084 Tc -0.0633 Tw (Academy of Management Jour-)Tj -10.329 -1.401 TD -0.014 Tc -0.06 Tw (nal, 39)Tj /TT2 1 Tf 2.625 0 TD -0.0137 Tc (, 483-504.)Tj -3.825 -1.8 TD -0.0078 Tc -0.0623 Tw [(Spreitzer)37.2(, G)118.2(.M. \(1997\). )16.4(T)69(oward a common ground in defining)]TJ 1.2 -1.398 TD -0.0045 Tc 0 Tw (empowerment. )Tj /TT5 1 Tf 6.216 0 TD -0.0042 Tc 0.0537 Tw (Research in Organizational Change and)Tj -6.216 -1.401 TD -0.0067 Tc -0.06 Tw (Development, 10)Tj /TT2 1 Tf 6.621 0 TD -0.0063 Tc (, 31-62.)Tj -7.821 -1.8 TD -0.0232 Tc -0.062 Tw [(Spreitzer)36.8(, G)117.8(.M., Kizilos, M.A., & Nason, S.W)87.8(. \(1997\). )49(A)60( dimen-)]TJ 1.2 -1.401 TD -0.0032 Tc -0.0158 Tw (sional analysis of the relationship between psychological)Tj 0 -1.398 TD -0.0037 Tc 0.069 Tw (empowerment and effectiveness, satisfaction and strain.)Tj /TT5 1 Tf 0 -1.401 TD -0.0041 Tc -0.0333 Tw (Journal of Management, 23)Tj /TT2 1 Tf 10.911 0 TD -0.0038 Tc -0.035 Tw (, 679-704.)Tj -12.111 -1.8 TD -0.0234 Tc -0.0617 Tw [(Spreitzer)36.6(, G)114.6(.M., & Mishra, )52.1(A.K. \(1999\). Giving up control with-)]TJ 1.2 -1.401 TD 0.0061 Tc 0.125 Tw (out losing control: Trust and its substitutes effect on)Tj 0 -1.398 TD -0.0101 Tc -0.061 Tw (managers involving employees in decision making.)Tj /TT5 1 Tf 19.764 0 TD -0.0121 Tc -0.065 Tw [( Group)]TJ -19.764 -1.401 TD -0.0043 Tc -0.0017 Tw (& Organization Management, 24)Tj /TT2 1 Tf 13.206 0 TD -0.0038 Tc -0.005 Tw (, 155-187.)Tj -14.406 -1.8 TD -0.0046 Tc -0.0625 Tw [(Thomas, K.W)85.4(., & )19.4(T)72.2(ymon, )16.4(W)102.2(.)0.1( \(1994\). Does empowerment al-)]TJ 1.2 -1.401 TD -0.0033 Tc 0.03 Tw (ways work?: Understanding the role of intrinsic motiva-)Tj 0 -1.398 TD -0.0034 Tc 0.0066 Tw (tion and interpretation. )Tj /TT5 1 Tf 9.324 0 TD -0.0041 Tc (Journal of Management Systems,)Tj -9.324 -1.401 TD 0 Tc 0 Tw (6)Tj /TT2 1 Tf 0.474 0 TD -0.0281 Tc -0.06 Tw (, 84-99.)Tj -1.674 -1.8 TD -0.0118 Tc -0.0619 Tw [(Thomas, K.W)81.2(., & )18.4(V)116.4(elthouse, B.A. \(1990\). Cognitive elements)]TJ 1.2 -1.401 TD -0.0097 Tc -0.0621 Tw [(of empowerment: )50.3(An interpretive model of intrinsic mo-)]TJ 0 -1.398 TD -0.0034 Tc 0 Tw (tivation. )Tj /TT5 1 Tf 3.495 0 TD -0.0044 Tc -0.032 Tw [(Academy of Management Review)70.6(,)-2.2( 15)]TJ /TT2 1 Tf 14.466 0 TD -0.0038 Tc -0.035 Tw (, 666-681.)Tj -19.161 -1.8 TD -0.0031 Tc -0.0264 Tw [(W)94.8(eick, K.E., & Sutclif)17.9(fe, K. M. \(2007\). )]TJ /TT5 1 Tf 15.774 0 TD -0.0042 Tc -0.0275 Tw (Managing the unex-)Tj -14.574 -1.401 TD -0.0037 Tc 0.12 Tw (pected: Resilient performance in an age of uncertainty)Tj /TT2 1 Tf T* -0.0032 Tc 0.015 Tw (\(2nd ed.\). San Francisco: Jossey-Bass.)Tj /TT5 1 Tf 9 0 0 9 404.25 189.99 Tm -0.0048 Tc 0 Tw (Manuscript Received: September 26, 2007)Tj 0.8333 -1.7767 TD -0.0046 Tc -0.0334 Tw [(Accepted for Publication: April 14, 2008)]TJ ET endstream endobj 160 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 162 0 obj << /Length 338 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0057 Tc 0.0855 Tw [(108 )]TJ /TT3 1 Tf 2.7337 0 TD -0.0054 Tc 0.0869 Tw (Paton, Violanti, Johnston, Burke, Clarke, Keenan Stress Shield: Police Resiliency)Tj ET /Cs9 cs 0 scn /GS1 gs 39 69 513 -35 re f endstream endobj 163 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> /ColorSpace << /Cs9 24 0 R >> >> endobj 164 0 obj << /FunctionType 4 /Domain [0 1] /Range [0 1 0 1 0 1 0 1] /Length 20 /Filter /FlateDecode >> stream HN)-PZ.( endstream endobj 166 0 obj << /Length 5652 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (109)Tj /TT3 1 Tf 7 0 0 7 120.66 726.66 Tm -0.0061 Tc 0.021 Tw [(International Journal of Emergency Mental Health, Vol. 10, No. 2, pp. 109-124 2008 Chevron Publishing ISSN 1522-4821)]TJ /TT4 1 Tf 10 0 0 10 102 509.34 Tm -0.0082 Tc 0 Tw (Abstract: )Tj /TT5 1 Tf 3.891 0 TD -0.0625 Tw (For law enforcement and emergency services professionals, stress and resilience are not academic)Tj -3.891 -1.299 TD -0.0073 Tc (topics or luxuries; they are essential to the physical and mental health, as well as to optimum job functioning.)Tj T* -0.0035 Tc 0.093 Tw [(This article traces the history of the str)32.5(ess and r)32.5(esilience concepts in psychology)50.5(, the military)53.3(,)0.5( and law)]TJ 0 -1.302 TD 0.0193 Tw (enforcement, outlines the major risk and protective factors for traumatic stress responses, and presents a)Tj 0 -1.299 TD 0.0804 Tw [(general psychophysiological model of stress and coping. The article next applies these concepts to the)]TJ T* -0.0037 Tc 0.0169 Tw (proactive fostering of mental toughness and resilience, using lessons learned from sports psychology and)Tj 0 -1.302 TD -0.0036 Tc 0.0434 Tw [(the mental conditioning literature. It then describes psychological debriefing, mental health counseling,)]TJ 0 -1.299 TD 0.0731 Tw (and psychotherapeutic strategies for facilitating resilient recovery from critical incidents and traumatic)Tj T* 0.0114 Tc 0.125 Tw [(events. Although directed mainly to law enforcement, the principles set out in this article may be)]TJ 0 -1.302 TD 0.0088 Tc [(p)7(r)29.8(oductively applied to emer)29.8(gency medicine, public safety)53.8(, militar)-6.2(y)59.6(,)-0.1( and civilian trauma counseling)]TJ 0 -1.299 TD -0.0036 Tc 0.0905 Tw (settings. [International Journal of Emergency Mental Health, 2008, 10\(2\), pp. 109-124].)Tj 9 0 0 9 117.99 360.99 Tm -0.0049 Tc 0.0218 Tw [(Key wor)31.8(ds:law enfor)35.1(cement str)35.1(ess, mental toughness training, police psychology)51.8(, police str)31.8(ess, str)35.1(ess management,)]TJ 17.0467 -1.3333 TD -0.0052 Tc 0.0056 Tw (stress resilience.)Tj ET /GS1 gs 66.99 115.755 m 300 115.755 l S BT 9 0 0 9 66.99 98.01 Tm /GS2 gs -0.005 Tc 0.0001 Tw [(Corr)40.8(espondence concerning this article to:Laur)31.7(ence Miller)108.3(, PhD,)]TJ 0 -1.2233 TD -0.0046 Tc -0.0394 Tw [(Plaza Four)105.4(, Suite 101,399 W)85.4(.)0.5( Camino Gar)32.1(dens Blvd., Boca Raton,)]TJ T* -0.005 Tc -0.0074 Tw (Florida 33432. Email to:docmilphd@aol.com)Tj /F1 1 Tf 14 0 0 14 167.49 629.34 Tm -0.0006 Tc 0.1379 Tw [(Stress and Resilience in Law Enforcement)]TJ 5.1964 -1.1421 TD 0.0014 Tc 0.1375 Tw [(T)78.8(raining and Practice)]TJ /TT2 1 Tf 10 0 0 10 84.99 301.14 Tm -0.0007 Tc 0.125 Tw (Most productive people would describe their jobs as)Tj -1.8 -1.398 TD -0.0034 Tc -0.0155 Tw (stressful to some degree, and a certain degree of coping and)Tj 0 -1.401 TD -0.0029 Tc 0.0717 Tw (resilience is useful to navigate the daily challenges of any)Tj T* -0.0041 Tc -0.0591 Tw [(high-demand occupation \(Maddi & Khoshaba, 2005; Miller)34.9(,)]TJ 0 -1.398 TD -0.003 Tc -0.0399 Tw [(2008c\). )30.1(Y)104.2(et, in only a few professions police, firefighting,)]TJ 0 -1.401 TD -0.0035 Tc 0.1 Tw (emergency medical services, disaster management, search)Tj T* -0.0028 Tc 0.0805 Tw (and rescue, the military does this stress literally involve)Tj 0 -1.398 TD -0.0068 Tc -0.0622 Tw (making critical decisions in life-and-death situations for one-)Tj 0 -1.401 TD -0.0031 Tc 0.0154 Tw [(self and others. In these cases, stress and resilience are not)]TJ T* -0.0029 Tc 0.0105 Tw (academic topics or luxuries; they are essential to the physi-)Tj 0 -1.398 TD -0.0079 Tc -0.0623 Tw (cal and mental health, as well as to the optimum job function-)Tj 0 -1.401 TD 0.0026 Tc 0.125 Tw [(ing, of the personnel concerned. )53.6(Accordingly)62.6(, while the)]TJ 12 0 0 12 279.39 566.64 Tm -0.0335 Tc -0.0625 Tw (Laurence Miller)Tj 10 0 0 10 238.89 554.01 Tm 0.0012 Tc -0.0225 Tw (Independent Practice, Boca Raton, FL)Tj 8.211 -25.335 TD -0.0031 Tc -0.032 Tw (material in this article is directed mainly to the challenges of)Tj 0 -1.401 TD -0.0045 Tw (law enforcement work, it can be readily applied to all of the)Tj T* -0.004 Tc 0.125 Tw (high-demand professions noted above.)Tj /F1 1 Tf 11 0 0 11 321 240 Tm -0.0051 Tc 0.0277 Tw [(Histor)-13.3(y of Stress and )96.2(T)76.8(rauma in Psychology)74(,)]TJ 0 -1.0909 TD -0.0047 Tc 0.0395 Tw [(the Militar)-12.9(y)76.8(,)38.8( and La)8.9(w Enf)11.7(o)5.3(r)14.4(cement)]TJ /TT2 1 Tf 10 0 0 10 339 204.66 Tm -0.0114 Tc -0.0623 Tw [(Historically)63.6(, the pendulum of interest in stress syndromes)]TJ -1.8 -1.401 TD -0.0034 Tc -0.0444 Tw [(has swung back and forth between military and civilian trau-)]TJ T* -0.0274 Tc -0.0622 Tw [(mas \(Evans, 1992; Pizarro, Silver)38.6(, & Prouse, 2006; Rosen, 1975;)]TJ 0 -1.398 TD -0.016 Tc -0.0623 Tw [(T)39.8(rimble, 1981; )16.9(W)57.8(ilson, 1994\). During warfare, rulers and gen-)]TJ 0 -1.401 TD -0.0018 Tc 0.125 Tw (erals have always had an interest in knowing as much as)Tj T* -0.0032 Tc -0.0394 Tw (possible about factors that might adversely affect their fight-)Tj 0 -1.398 TD -0.0033 Tc 0.11 Tw [(ing forces. )17.7(T)73.5(o)0.1( this end, clinicians have been pressed into)]TJ 0 -1.401 TD -0.0034 Tc -0.0195 Tw (service to diagnose and treat soldiers with the aim of getting)Tj T* -0.0031 Tc 0.0106 Tw (them back to the front lines as quickly as possible.)Tj ET endstream endobj 167 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 169 0 obj << /Length 9149 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0063 Tc 0.0781 Tw (110 )Tj /TT3 1 Tf 2.3587 0 TD -0.0053 Tc 0.0812 Tw (Miller Stress and Resilience in Law Enforcement)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm -0.0036 Tc -0.0543 Tw (The ancient Greeks and Romans wrote eloquently about)Tj -1.8 -1.398 TD 0.0067 Tc 0.125 Tw (the trials and travails that could afflict the warrior mind)Tj 0 -1.401 TD -0.0036 Tc -0.0583 Tw (\(Sherman, 2005\) and these writings are echoed to the present)Tj T* -0.0123 Tc -0.0625 Tw [(day \(Grossman & Christensen, 2007\). One of the first modern)]TJ 0 -1.398 TD -0.0036 Tc 0.095 Tw (conceptualizations of posttraumatic stress was put forth in)Tj 0 -1.401 TD -0.0033 Tc 0.1001 Tw [(1678 by the army sur)17.7(geon Hof)17.7(fer)38.7(, who described what he)]TJ T* -0.0037 Tc 0 Tw (called )Tj /TT5 1 Tf 2.715 0 TD -0.0048 Tc (nostalgia)Tj /TT2 1 Tf 3.684 0 TD -0.0029 Tc 0.1014 Tw (, defined as a deterioration in the physical)Tj -6.399 -1.398 TD -0.0036 Tc -0.0155 Tw [(and mental health of homesick soldiers. This was attributed)]TJ 0 -1.401 TD -0.0033 Tc 0.0228 Tw (to the formation of abnormally vivid images in the affected)Tj T* -0.0036 Tc -0.0048 Tw [(soldier)-39.6()53.4(s)-0.2( brain by battle-induced overexcitation of the vital)]TJ 0 -1.398 TD 0.0014 Tc 0 Tw (spirits.)Tj 1.8 -2.001 TD -0.0094 Tc -0.062 Tw [(The )50.8(American Civil )17.8(W)97.4(ar introduced a new level of indus-)]TJ -1.8 -1.401 TD -0.0032 Tc -0.0365 Tw (trialized killing and, with it, a dramatic increase in reports of)Tj 0 -1.398 TD -0.0036 Tc 0.0357 Tw [(stress-related nervous ailments. Further advances in weap-)]TJ 0 -1.401 TD 0.0093 Tc 0.1251 Tw [(ons technology during the First )18.4(W)98.1(orld )12.4(W)95.1(ar produced an)]TJ T* -0.0038 Tc -0.062 Tw (unprecedented accumulation of horrific battlefield casualties)Tj 0 -1.398 TD -0.0063 Tc -0.0617 Tw [(from machine guns, poison gas, and long-range artillery)59.7(. )21.2(The)]TJ 0 -1.401 TD -0.0031 Tc 0.064 Tw (latter led to the widely applied concept of shell shock, ini-)Tj T* -0.003 Tc 0.0413 Tw (tially believed to be caused by the brain-concussive effects)Tj 0 -1.398 TD -0.0032 Tc -0.0345 Tw (of exploding shells, but later understood to be a form of psy-)Tj 0 -1.401 TD -0.0035 Tc -0.0507 Tw (chological incapacitation resulting from the trauma of battle.)Tj T* -0.0032 Tc -0.06 Tw (Indeed, the failure to confirm any definitive organic basis for)Tj 0 -1.398 TD -0.0033 Tw (many of these debilitating stress syndromes led to the even-)Tj 0 -1.401 TD -0.0157 Tc -0.0625 Tw (tual replacement of shell shock by the more mentalistic-sound-)Tj T* -0.0041 Tc -0.062 Tw (ing term, war neurosis \(Southard, 1919\).)Tj 1.8 -1.998 TD -0.0036 Tc 0.0117 Tw [(Kardiner)-39.6()53.4(s)-0.3( \(1941\) long-term study of soldiers with war)]TJ -1.8 -1.401 TD 0.11 Tw (neuroses led him to conclude that severe war trauma pro-)Tj T* 0 Tw (duced a constriction of the ego that prevented these patients)Tj 0 -1.398 TD -0.0037 Tc -0.0429 Tw [(from adapting to and mastering life)50.3(s subsequent challenges.)]TJ 0 -1.401 TD -0.0027 Tc 0.125 Tw (Kardiner elaborated a conceptualization of trauma termed)Tj /TT5 1 Tf T* -0.0046 Tc 0 Tw (physioneurosis)Tj /TT2 1 Tf 5.94 0 TD -0.0033 Tc 0.0488 Tw [( that is quite close to the modern concept of)]TJ -5.94 -1.398 TD -0.0035 Tc 0.0963 Tw [(posttraumatic stress disorder \(see below\). The features of)]TJ 0 -1.401 TD -0.0033 Tc 0.0493 Tw (this syndrome included: persistence of the startle response,)Tj T* -0.0034 Tc 0.0315 Tw [(irritability and proneness to explosive behavior)35.6(, fixation on)]TJ 0 -1.398 TD -0.0033 Tc 0.0781 Tw [(the trauma, constriction of the personality)59.7(, and a disturbed)]TJ 0 -1.401 TD -0.0055 Tc -0.0625 Tw (dream life, including vivid nightmares.)Tj 1.8 -2.001 TD -0.0038 Tc 0.0657 Tw [(The experiences of the Second )14.2(W)97(orld )17.2(W)94(ar contributed)]TJ -1.8 -1.398 TD -0.0032 Tc 0.125 Tw (surprisingly little to the development of new theories and)Tj 0 -1.401 TD -0.0186 Tc -0.0623 Tw (treatments for wartime trauma, except for its renaming as battle)Tj T* -0.0028 Tc 0.0477 Tw [(fatigue. In fact, resistance to the very concept of battle fa-)]TJ 0 -1.398 TD -0.0035 Tc 0.0455 Tw (tigue, with its implications of mental weakness and lack of)Tj 0 -1.401 TD -0.0034 Tc -0.0019 Tw (moral resolve, was widespread in both medical and military)Tj T* -0.0043 Tc -0.0625 Tw [(circles. There was a war on, plenty of good Joes were getting)]TJ 0 -1.398 TD -0.0028 Tc -0.0545 Tw (killed and wounded, and the army had little sympathy for the)Tj 0 -1.401 TD -0.0037 Tc -0.0305 Tw (whinings of a few slackers and nervous nellies who couldnt)Tj 25.5 63.399 TD -0.0085 Tc -0.0623 Tw (buck up and pull their weight an attitude that persists among)Tj 0 -1.398 TD -0.0029 Tc -0.0461 Tw [(today)51.1(s military and civilian fighting forces.)]TJ 1.8 -2.001 TD -0.0036 Tc 0.0653 Tw [(However)35.4(, it was becoming apparent that wartime psy-)]TJ -1.8 -1.401 TD -0.0037 Tc 0.1029 Tw (chological trauma could take place in circumstances other)Tj 0 -1.398 TD -0.0038 Tc 0.058 Tw [(than the actual battlefield. In )14.2(WWII, then Korea and )17.2(V)64.4(iet-)]TJ 0 -1.401 TD -0.0032 Tc 0.0344 Tw (nam, and most recently in the Persian Gulf wars, clinicians)Tj T* -0.0035 Tc 0.0615 Tw (began to learn about disabling stress syndromes associated)Tj 0 -1.398 TD -0.0037 Tc 0.0559 Tw (with large-scale bombings of civilian populations, prisoner)Tj 0 -1.401 TD -0.0042 Tc -0.0129 Tw [(of war and concentration camps, brainwashing of POW)52.8(s,)]TJ T* 0.0081 Tc 0.125 Tw (civilian atrocities, terrorism, and the threat of wholesale)Tj 0 -1.398 TD -0.0033 Tc 0.1078 Tw [(nuclear annihilation. In 1980, traumatic stress syndromes)]TJ 0 -1.401 TD -0.0028 Tc -0.0294 Tw (were finally codified as an identifiable type of psychopatho-)Tj T* -0.003 Tc 0.0217 Tw (logical syndrome )Tj /TT5 1 Tf 7.926 0 TD -0.004 Tc 0.0225 Tw (posttraumatic stress disorder)Tj /TT2 1 Tf 11.655 0 TD -0.0047 Tc [( \(PTSD\) )]TJ -19.581 -1.398 TD -0.0049 Tc -0.0622 Tw [(in the )55.4(American Psychiatric )49.4(Association)55.1(s of)19.1(ficial Diagnostic)]TJ 0 -1.401 TD -0.004 Tc -0.0412 Tw [(and S)17(tatistical Manual of Mental Disorders \(AP)83(A, 1980\) and)]TJ T* -0.021 Tc -0.0622 Tw [(it remains there in the current edition \(AP)90(A, 2000\). )12.1(W)97.9(ell known)]TJ 0 -1.398 TD -0.007 Tc (to trauma clinicians, the symptoms include heightened physi-)Tj 0 -1.401 TD -0.0033 Tc 0.125 Tw (ological arousal, alternating intrusive and numbing symp-)Tj T* 0.0477 Tc [(tomatology)62.7(, flashbacks and nightmares, and general)]TJ 0 -1.398 TD -0.0032 Tc -0.0533 Tw (restriction of life activities.)Tj 1.8 -2.001 TD -0.0004 Tc 0.125 Tw (In law enforcement and emergency services, this be-)Tj -1.8 -1.401 TD -0.0035 Tc -0.0237 Tw (came incorporated into the concept of critical incident stress)Tj 0 -1.398 TD -0.0034 Tc 0.0056 Tw [(\(Mitchell & Everly)62.6(, 1996, 2003\), and some authorities have)]TJ 0 -1.401 TD -0.0032 Tc 0.056 Tw [(gone so far as to characterize police trauma as the psycho-)]TJ T* -0.0119 Tc -0.0626 Tw [(logical aftermath of civilian combat \(V)54.1(iolanti, 1999\).)]TJ 1.8 -1.998 TD -0.0072 Tc 0 Tw (A )Tj /TT5 1 Tf 1.05 0 TD -0.0038 Tc 0.085 Tw (critical incident)Tj /TT2 1 Tf 6.384 0 TD -0.0028 Tc [( is defined as any event that has an)]TJ -9.234 -1.401 TD -0.0033 Tc 0.1044 Tw [(unusually powerful, negative impact on personnel. In the)]TJ T* -0.0031 Tc -0.057 Tw (present context, it is any event that a law enforcement officer)Tj 0 -1.398 TD -0.003 Tc 0.0875 Tw (may experience that is above and beyond the range of the)Tj 0 -1.401 TD -0.0031 Tc 0.0034 Tw (ordinary stresses and hassles that come with the job. Major)Tj T* -0.0188 Tw (classes of critical incidents include: a line-of-duty death; se-)Tj 0 -1.398 TD 0.02 Tw (rious injury to police personnel; a serious multiple-casualty)Tj 0 -1.401 TD -0.0003 Tc 0.125 Tw (incident such as a multiple school shooting or workplace)Tj T* -0.0033 Tc 0.1039 Tw (violence incident; the suicide of a police officer; the trau-)Tj 0 -1.398 TD -0.0019 Tc 0.125 Tw (matic death of children, especially where irresponsible or)Tj 0 -1.401 TD -0.0034 Tc 0.0362 Tw (frankly malevolent adults were involved; an event with ex-)Tj T* -0.005 Tc -0.0623 Tw (cessive media interest; or a victim who is a family member or)Tj 0 -1.398 TD -0.0036 Tc 0.125 Tw (otherwise well-known to one or more responding officers)Tj 0 -1.401 TD -0.0198 Tc -0.0622 Tw [(\(Everly & Mitchell, 1997\). Recent times have multiplied expo-)]TJ T* -0.0033 Tc 0.1188 Tw (nentially the range and scope of horrific law enforcement)Tj 0 -1.398 TD -0.0034 Tc 0.0306 Tw (critical incidents to include acts of mass terror and destruc-)Tj 0 -1.401 TD 0.0429 Tw (tion, involving multiple deaths of civilians, fellow officers,)Tj T* -0.0035 Tc 0.1063 Tw [(and other emer)14.5(gency personnel \(Henry)62.5(, 2004; Karlsson &)]TJ 0 -1.398 TD -0.0177 Tc -0.0624 Tw [(Christianson, 2003; Miller)36.3(, 1998b, 2006\).)]TJ ET endstream endobj 170 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 172 0 obj << /Length 8753 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (111)Tj 11 0 0 11 66 723.99 Tm -0.0052 Tc 0.0475 Tw [(Risk and Resiliency F)13.9(actor)8.4(s f)11.2(or )95.9(T)79.4(raumatic)]TJ 0 -1.0909 TD -0.0059 Tc 0.0773 Tw (Stress Responses)Tj /TT2 1 Tf 10 0 0 10 84 688.65 Tm -0.0033 Tc -0.015 Tw (Not everyone who experiences a traumatic critical inci-)Tj -1.8 -1.401 TD -0.0031 Tc 0.0749 Tw [(dent develops the same degree of psychological disability;)]TJ 0 -1.398 TD -0.0033 Tc -0.0119 Tw (there is significant variability among individuals in terms of)Tj 0 -1.401 TD -0.0101 Tc -0.0625 Tw (their degree of susceptibility and resilience to stressful events.)Tj T* -0.006 Tc -0.0622 Tw [(While many individuals are able to resolve acute critical inci-)]TJ 0 -1.398 TD -0.0035 Tc 0.11 Tw (dent stress through the use of informal social support and)Tj 0 -1.401 TD -0.0037 Tc 0.1179 Tw (other adaptive activities \(Bowman, 1997, 1999; 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The alarm-stage stress response also mobilizes)]TJ 0 -1.398 TD -0.0032 Tc 0.0829 Tw (the sympathetic nervous system and increases secretion of)Tj 0 -1.401 TD -0.0051 Tc -0.0625 Tw (adrenalin from the adrenal medulla.)Tj 1.8 -2.001 TD -0.0034 Tc 0.035 Tw (In the )Tj /TT5 1 Tf 2.604 0 TD -0.0039 Tc 0.0375 Tw (stage of resistance)Tj /TT2 1 Tf 7.452 0 TD -0.0028 Tc 0.0371 Tw (, the body goes into a kind of)Tj -11.856 -1.398 TD -0.003 Tc 0.0606 Tw (extended overdrive, as all systems stay on high alert while)Tj 0 -1.401 TD -0.0033 Tc -0.0083 Tw [(the or)14.7(ganism is coping with the stressor)35.7(, which may be any-)]TJ T* -0.0031 Tc 0.0439 Tw [(thing from a bad flu to a bad divorce. In the best case, the)]TJ 0 -1.398 TD -0.005 Tw (organism rallies and the crisis is eventually passed, with the)Tj 0 -1.401 TD -0.0035 Tc 0.0945 Tw [(individual becoming more resilient in the process. In this)]TJ ET endstream endobj 177 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 179 0 obj << /Length 9075 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (113)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0039 Tc 0.085 Tw (case, Nietzsche \(1969\) is right: Whatever doesnt kill me)Tj 0 -1.398 TD -0.0028 Tc 0.125 Tw [(makes me stronger)54.2(. Indeed, in some instances, adaptive)]TJ 0 -1.401 TD -0.0034 Tc 0.0685 Tw (responding to stress can lead to what has been called tran-)Tj T* 0.0202 Tc 0.125 Tw (scendent coping and posttraumatic growth \(Calhoun &)Tj 0 -1.398 TD -0.011 Tc -0.0625 Tw [(T)68.8(edeschi, 1999; )22(T)68.8(edeschi & Calhoun, 1995, 2004; )19(T)68.8(edeschi &)]TJ 0 -1.401 TD -0.044 Tc -0.0587 Tw [(Kilmer)34(, 2005\).)]TJ 1.8 -2.001 TD -0.0031 Tc 0.1036 Tw [(But no or)17.9(ganism can stay on red alert forever)50.9(. If the)]TJ -1.8 -1.398 TD -0.0034 Tc 0.0883 Tw (crisis is not resolved, at some point the individual reaches)Tj 0 -1.401 TD -0.0039 Tc 0 Tw (the )Tj /TT5 1 Tf 1.47 0 TD -0.004 Tc 0.0125 Tw (stage of exhaustion)Tj /TT2 1 Tf 7.674 0 TD -0.0031 Tc 0.012 Tw (, in which physiological reserves are)Tj -9.144 -1.401 TD -0.0033 Tc 0.05 Tw (finally depleted and the organism begins to deteriorate and)Tj 0 -1.398 TD -0.0093 Tw [(may even die. Sorry)62.7(, Nietzsche, but in this case, Whatever)]TJ 0 -1.401 TD -0.0154 Tc -0.0621 Tw [(doesn)20.6(t kill me can make me really)59.6(, really sick and I might)]TJ T* -0.0026 Tc [(die later)42.4(, anyway)63.4(.)]TJ 1.8 -1.998 TD 0.0036 Tc 0.125 Tw (More recent research has revealed that the stress re-)Tj -1.8 -1.401 TD -0.0035 Tc 0.0072 Tw (sponse may be more graded and nuanced, depending on the)Tj T* -0.0028 Tc -0.0332 Tw (individual, and in this may lie the psychophysiological basis)Tj 0 -1.398 TD -0.0034 Tc 0.0211 Tw [(for differences in coping and resilience. Dienstbier \(1989\))]TJ 0 -1.401 TD -0.0035 Tc 0.1163 Tw (has used the term )Tj /TT5 1 Tf 7.626 0 TD -0.005 Tc 0 Tw (toughness)Tj /TT2 1 Tf 3.96 0 TD -0.0028 Tc 0.1167 Tw [( to refer to a distinct psycho-)]TJ -11.586 -1.401 TD -0.0034 Tc -0.0425 Tw (physiological reaction pattern that characterizes animals and)Tj 0 -1.398 TD -0.0033 Tc 0.0177 Tw [(humans who cope ef)14.7(fectively with stress. )17.6(T)73.5(wo main physi-)]TJ 0 -1.401 TD -0.0034 Tc 0.106 Tw (ological systems underlie the toughness response.)Tj 1.8 -2.001 TD -0.0031 Tc -0.06 Tw [(The first involves a pathway from the brain)50.9(s hypothala-)]TJ -1.8 -1.398 TD 0.0007 Tc 0.125 Tw (mus to the sympathetic branch of the autonomic nervous)Tj 0 -1.401 TD -0.0029 Tc 0.0044 Tw (system, and from there to the adrenal medulla. The sympa-)Tj T* -0.0032 Tc 0.0406 Tw (thetic nervous system, or SNS, is responsible for the heart-)Tj 0 -1.398 TD -0.0035 Tc 0.0809 Tw (pounding, fight-or-flight response that mobilizes body and)Tj 0 -1.401 TD 0.0005 Tc 0.125 Tw [(mind to deal with challenging situations. )51.5(As part of this)]TJ T* 0.0194 Tc (response, the adrenal gland releases its main hormone,)Tj 0 -1.398 TD -0.0078 Tc 0 Tw (adrenalin.)Tj 1.8 -2.001 TD -0.0036 Tc 0.0322 Tw (The second system involved in the toughness response)Tj -1.8 -1.401 TD -0.0034 Tc 0.0595 Tw (also begins with the hypothalamus but acts through the pi-)Tj 0 -1.398 TD -0.0032 Tc 0.0533 Tw (tuitary gland which in turn stimulates the adrenal cortex to)Tj 0 -1.401 TD -0.0069 Tc -0.0622 Tw [(release cortisol the chief stress hormone involved in Selye)53.1(s)]TJ T* 0.0085 Tc 0.1251 Tw [(triphasic GAS response, discussed above. )17.6(T)73.3(ogether)38.5(, the)]TJ 0 -1.398 TD -0.0035 Tc -0.0241 Tw (pattern of SNS-adrenal medulla and pituitary-adrenal cortex)Tj 0 -1.401 TD -0.0034 Tc 0.045 Tw (responses to stressful events characterizes the nature of the)Tj T* 0.0043 Tc 0.125 Tw (toughness trait.)Tj 1.8 -1.998 TD -0.0031 Tc 0.0305 Tw (It is the flexibility and gradedness of response of these)Tj -1.8 -1.401 TD 0.0514 Tw [(two interrelated systems that defines an individual)50.8(s physi-)]TJ T* 0.0049 Tw (ological resilience or toughness. In resiliently tough organ-)Tj 0 -1.398 TD -0.0083 Tc -0.0623 Tw (isms animal or human the normal, everyday activity of the)Tj 0 -1.401 TD -0.0034 Tc 0.0227 Tw (two systems is low and modulated; tough individuals are at)Tj T* 0.1243 Tw (relative ease under most ordinary circumstances and their)Tj 0 -1.398 TD -0.0033 Tc -0.0292 Tw [(physiological responses reflect this relative quiescence. But)]TJ 0 -1.401 TD -0.0025 Tc 0.125 Tw (when faced with a stressful challenge or threat, the SNS-)Tj 25.5 64.599 TD -0.0031 Tc -0.0138 Tw (adrenal medulla system springs into action quickly and effi-)Tj 0 -1.398 TD -0.0144 Tc -0.0622 Tw [(ciently)60.6(, while the pituitary-adrenal cortex system remains rela-)]TJ 0 -1.401 TD -0.0032 Tc -0.0623 Tw [(tively stable. )53.8(As soon as the emer)14.8(gency is over)35.8(, the adrenalin)]TJ T* 0.0002 Tc 0.125 Tw (response returns quickly to normal, while the cortisol re-)Tj 0 -1.398 TD 0.0042 Tc 0.1252 Tw [(sponse stays low)58.2(. )19.4(The smoothness and ef)16.2(ficiency of the)]TJ 0 -1.401 TD -0.003 Tc 0.0435 Tw (physiological arousal pattern is what characterizes the psy-)Tj T* -0.0035 Tc 0.0771 Tw (chophysiological toughness response a response that has)Tj 0 -1.398 TD -0.0033 Tc 0.0394 Tw [(important aftereffects on the brain. Such a restrained reac-)]TJ 0 -1.401 TD -0.0037 Tc 0.0925 Tw (tion prevents depletion of catecholamines, important brain)Tj T* 0.021 Tw (neurotransmitters that affect mood and motivation.)Tj 1.8 -1.998 TD -0.0035 Tc -0.0332 Tw [(Not so with the untough. The physiological reactions)]TJ -1.8 -1.401 TD -0.0034 Tc 0.0427 Tw [(of less resilient individuals tend to be excessive and longer)]TJ T* -0.0027 Tc 0.0564 Tw [(lasting, even in the face of everyday hassles. The result is)]TJ 0 -1.398 TD -0.0036 Tc 0.0672 Tw [(more intense and disorganizing arousal, less effective cop-)]TJ 0 -1.401 TD -0.0175 Tw (ing, and faster depletion of brain catecholamines, which can)Tj T* -0.0034 Tc 0.0462 Tw [(lead to helplessness and depression. )17.5(W)55.4(ith each tribulation,)]TJ 0 -1.398 TD -0.0117 Tc -0.0624 Tw [(major or minor)36.3(, less resilient individuals tend to over)21.3(-respond,)]TJ 0 -1.401 TD -0.0038 Tc 0.0086 Tw (their arousal levels overwhelming them and rendering them)Tj T* -0.0005 Tc 0.125 Tw (unable to do much about the current situation, leading to)Tj 0 -1.398 TD -0.0029 Tc -0.0207 Tw (little confidence in their future ability to cope.)Tj 1.8 -2.001 TD -0.0032 Tc -0.0405 Tw [(That)50.8(s where the real psychological significance of psy-)]TJ -1.8 -1.401 TD -0.0036 Tc 0.0394 Tw [(chophysiological toughness comes in. Humans can do one)]TJ 0 -1.398 TD 0.0005 Tc 0.125 Tw (thing animals cant: we can reflect on our own thoughts,)Tj 0 -1.401 TD -0.0035 Tc 0.0707 Tw (feelings, and actions, conceptualize our responses in terms)Tj T* -0.0032 Tc -0.0185 Tw (of what kind of person that makes us, and thereby anticipate)Tj 0 -1.398 TD -0.01 Tc -0.0622 Tw [(how well react to future challenges. Dienstbier \(1989\) points)]TJ 0 -1.401 TD -0.0034 Tc 0.0575 Tw (out that the toughness response or its absence interacts)Tj T* 0.1205 Tw [(with a person)50.6(s psychological appraisal of his or her own)]TJ 0 -1.398 TD -0.0031 Tc -0.0495 Tw [(ability to cope with challenge. This in turn contributes to the)]TJ 0 -1.401 TD -0.0033 Tc 0.0435 Tw [(person)50.7(s self-image as an ef)17.7(fective master of adversity or a)]TJ T* -0.0171 Tw (helpless reactor a self-assessment that influences later psy-)Tj 0 -1.398 TD -0.0032 Tc 0.125 Tw (chophysiological reactions to stress.)Tj 1.8 -2.001 TD -0.003 Tc -0.01 Tw (This, then, is the psychophysiological rationale of most)Tj -1.8 -1.401 TD -0.0042 Tc 0.0917 Tw [(mental conditioning or mental toughness training pro-)]TJ 0 -1.398 TD -0.0096 Tc -0.0625 Tw (grams for law enforcement, emergency services, and the mili-)Tj 0 -1.401 TD -0.0035 Tc 0.0763 Tw [(tary \(Asken, 1993; Blum, 2000; Doss, 2007; Duran, 1999;)]TJ T* -0.012 Tc -0.0624 Tw [(Grossman & Christensen, 2007; Miller)33(, 2008a\): by learning to)]TJ 0 -1.398 TD -0.0036 Tc 0.0733 Tw [(control one)50.4(s perceptions, feelings, thoughts, and reactions)]TJ 0 -1.401 TD 0.0314 Tw (in advance, through progressive practice and rehearsal, and)Tj T* -0.0148 Tc -0.0621 Tw (in combination with proper operational training, the individual)Tj 0 -1.398 TD -0.0032 Tc 0.0065 Tw (can hopefully develop a core of resilient toughness a kind)Tj 0 -1.401 TD -0.0033 Tc -0.0261 Tw (of flexible psychological armor that will enable the person)Tj T* -0.0034 Tc 0.05 Tw (to face any challenge with improved confidence and effec-)Tj 0 -1.398 TD -0.0041 Tc -0.0623 Tw [(tiveness. )50.1(Although individuals dif)16.9(fer naturally in their innate)]TJ 0 -1.401 TD -0.0023 Tc 0.0111 Tw (resilience, just as they do in physical strength, virtually any)Tj T* -0.0034 Tc -0.0531 Tw (service member can reinforce his or her psychological armor)Tj ET endstream endobj 180 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 182 0 obj << /Length 9223 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0063 Tc 0.0781 Tw (114 )Tj /TT3 1 Tf 2.3587 0 TD -0.0053 Tc 0.0812 Tw (Miller Stress and Resilience in Law Enforcement)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0034 Tc 0.0982 Tw (and ramp up their toughness skills by appropriate training)Tj 0 -1.398 TD -0.0084 Tc -0.062 Tw [(and practice. )51.7(Additionally)60.6(, there are ef)18.6(fective reslience-based)]TJ 0 -1.401 TD -0.0032 Tc 0.0019 Tw (intervention strategies that peers and clinicians can apply to)Tj T* -0.004 Tc -0.0625 Tw (the treatment of service members following their exposure to)Tj 0 -1.398 TD -0.003 Tc -0.0613 Tw (a potentially traumatic critical incident.)Tj /F1 1 Tf 11 0 0 11 54 633.99 Tm -0.0046 Tc 0.0272 Tw [(T)80(oughness on the Field:)36.3( Mental Conditioning)]TJ 0 -1.0909 TD -0.0045 Tc 0.0591 Tw (in Competitive Sports)Tj /TT2 1 Tf 10 0 0 10 72 598.65 Tm -0.0036 Tc -0.0325 Tw (From the time of ancient Sparta, when athletic competi-)Tj -1.8 -1.401 TD 0.0003 Tc 0.125 Tw (tion served as actual preparation for warfare, sports have)Tj 0 -1.398 TD -0.0034 Tc 0.0964 Tw (always represented a form of ritualized combat \(Sherman,)Tj 0 -1.401 TD -0.0086 Tc -0.0619 Tw [(2005\) that)51.4(s why we take it so seriously)60.4(. )51.8(Accordingly)63.4(, much)]TJ T* -0.0035 Tc 0.0305 Tw (of the research and practical advice on mental toughness in)Tj 0 -1.398 TD -0.0032 Tc -0.0193 Tw (the public safety and emergency services professions comes)Tj 0 -1.401 TD -0.0017 Tc 0.125 Tw (from the domain of sports psychology \(Bull, Shambrook,)Tj T* 0.0042 Tc (James, & Brooks, 2005; Goldberg, 1998; Gould, Hodge,)Tj 0 -1.398 TD 0.0589 Tc 0.1742 Tw (Peterson, & Petlinchkoff, 1987; Jones, Hanton, &)Tj 0 -1.401 TD 0.0178 Tc 0.125 Tw [(Connaughton, 2002; Loehr)38.8(, 1995; )11.8(Thelwell, )14.8(W)94.6(eston, &)]TJ T* -0.0033 Tc 0.0633 Tw [(Greenlees, 2005\). In reviewing this literature, I have been)]TJ 0 -1.398 TD -0.0036 Tc 0.0862 Tw (able to distill the diverse components and conceptual con-)Tj 0 -1.401 TD -0.0031 Tc -0.01 Tw (structs of this field down to four primary qualities that char-)Tj T* -0.0017 Tc 0.125 Tw (acterize resilience and mental toughness in sports that, in)Tj 0 -1.398 TD -0.0033 Tc -0.061 Tw (turn, can be applied to the practical task of inculcating stress-)Tj 0 -1.401 TD -0.0046 Tc -0.0621 Tw (resistance in law enforcement, emergency services, and mili-)Tj T* 0.025 Tc 0.1251 Tw [(tary personnel \(Miller)34(, 2008a\). )16.1(These are confidence,)]TJ 0 -1.398 TD -0.0035 Tc -0.0116 Tw (motivation, focus, and resilience.)Tj /TT5 1 Tf 1.8 -2.001 TD -0.005 Tc 0 Tw (Confidence)Tj /TT2 1 Tf 4.509 0 TD -0.0033 Tc 0.0024 Tw [(. )51.2(A)58.9( professional athlete puts him- or herself)]TJ -6.309 -1.401 TD -0.0032 Tc 0.0255 Tw [(on the line with every game or competition. Excellent per-)]TJ 0 -1.398 TD -0.0023 Tc 0.125 Tw [(formers dont just do their craft, the are their craft. This)]TJ 0 -1.401 TD -0.0032 Tc -0.0293 Tw (orientation is probably familiar to those police officers, doc-)Tj T* -0.0034 Tc -0.035 Tw (tors, soldiers, performance artists, and others who view their)Tj 0 -1.398 TD -0.0033 Tc -0.0096 Tw (occupations as more of a calling than a job \(Hays & Brown,)Tj 0 -1.401 TD -0.0035 Tc 0.0789 Tw [(2004\). This takes confidence. Confident athletes have an)]TJ T* -0.0033 Tc -0.0113 Tw [(unshakable belief in their own abilities and, more pointedly)59.7(,)]TJ 0 -1.398 TD -0.0032 Tc 0.0595 Tw [(that these abilities are up to the task of beating their oppo-)]TJ 0 -1.401 TD -0.0033 Tc 0.105 Tw [(nent. They thrive on the pressure of competition because)]TJ T* -0.0032 Tc 0.0413 Tw (they possess the skills and temperament to cope adaptively)Tj 0 -1.398 TD -0.0034 Tc 0.0639 Tw [(with the stresses and anxieties of competition. Their reso-)]TJ 0 -1.401 TD 0.0637 Tw (luteness cannot be shaken by the performance or intimida-)Tj T* 0.0075 Tc 0.125 Tw [(tion of the other players. Confident athletes are able to)]TJ 0 -1.398 TD -0.003 Tc 0.0619 Tw (overcome their inevitable self-doubts by a variety of intui-)Tj 0 -1.401 TD -0.0036 Tc 0.11 Tw [(tive and learned coping mechanisms. Their confidence is)]TJ T* -0.001 Tc 0.125 Tw (stable and unbreakable precisely because it is based on a)Tj 0 -1.398 TD -0.0035 Tc 0.0785 Tw (track record of honest appraisal, real accomplishment, and)Tj 0 -1.401 TD -0.0033 Tc 0.125 Tw (continual training that allows them to draw strength from)Tj T* 0.0004 Tc (their own physical conditioning which, in turn, generates)Tj 25.5 64.8 TD -0.0032 Tc -0.0575 Tw (further confidence, in a positive cycle \(Bandura, 1977, 1986;)Tj 0 -1.398 TD -0.0038 Tc -0.0037 Tw [(Doss, 2006\). )50.3(And the development of positive performance)]TJ 0 -1.401 TD -0.0034 Tc -0.0122 Tw (expectations is a crucial factor in preparing personnel to op-)Tj T* -0.009 Tc -0.0621 Tw (erate under high-demand conditions \(Locke, Frederick, Le, &)Tj 0 -1.398 TD -0.0091 Tc -0.0625 Tw [(Bubko, 1984; Salas, Driskell, & Hughes, 1996\). In short, atti-)]TJ 0 -1.401 TD -0.0039 Tc 0.04 Tw [(tude does matter)50.1(.)]TJ /TT5 1 Tf 1.8 -2.001 TD 0.0081 Tc 0 Tw (Motivation)Tj /TT2 1 Tf 4.476 0 TD 0.0095 Tc 0.1255 Tw [(. )16(While confidence sustains the athlete)48.5(s)]TJ -6.276 -1.398 TD -0.0037 Tc 0.055 Tw [(performance, motivation spurs it forward. Confidence and)]TJ 0 -1.401 TD -0.0035 Tc 0.0034 Tw (motivation are reciprocal and mutually reinforcing: motiva-)Tj T* -0.0038 Tc -0.0464 Tw (tion impels performance which builds confidence which fur-)Tj 0 -1.398 TD 0.0073 Tc 0.125 Tw [(ther increases motivation and so on. Motivated athletes)]TJ 0 -1.401 TD -0.0033 Tc 0.027 Tw (have an insatiable desire to succeed and excel, a desire that)Tj T* -0.012 Tc -0.0625 Tw [(comes from within and cannot be compelled or coerced. They)]TJ 0 -1.398 TD -0.0033 Tc 0.125 Tw (strive to make the most of their abilities, to self-actualize)Tj 0 -1.401 TD -0.0034 Tc -0.0181 Tw [(\(Maslow)59.6(, 1968\). )18(They are willing to take risks and embrace)]TJ T* -0.0257 Tw (new challenges and the pressure of competition only height-)Tj 0 -1.398 TD -0.003 Tc -0.0186 Tw [(ens their drive to succeed \(Hays & Brown, 2004\). They can)]TJ 0 -1.401 TD -0.0052 Tc -0.0622 Tw (tie short-term performance to long-term goals in order to sus-)Tj T* 0.0037 Tc 0.125 Tw (tain their motivation over bad stretches because they are)Tj 0 -1.398 TD -0.0033 Tc 0.0049 Tw (committed to their craft for the long haul. Their motivation)Tj 0 -1.401 TD -0.0038 Tc 0.0145 Tw (produces a powerful work ethic that impels them to go the)Tj T* -0.0029 Tc -0.0494 Tw (extra mile in training and practice; they never coast, theyre)Tj 0 -1.398 TD -0.0033 Tc 0.0169 Tw [(always moving forward. They compete with themselves as)]TJ 0 -1.401 TD -0.0037 Tc -0.0308 Tw [(well as with others. )50.5(As with confidence, motivation must be)]TJ T* -0.0032 Tc 0.0999 Tw [(based on reality)59.8(, and these athletes use their stumbles and)]TJ 0 -1.398 TD -0.0034 Tc -0.0275 Tw (failures as learning experiences to do better next time.)Tj /TT5 1 Tf 1.8 -2.001 TD -0.0057 Tc 0 Tw (Focus)Tj /TT2 1 Tf 2.421 0 TD -0.0031 Tc 0.0505 Tw [(. If motivation is the fuel that drives the perfor-)]TJ -4.221 -1.401 TD -0.0033 Tc 0.0378 Tw (mance engine, focus is the guidance system that allows the)Tj 0 -1.398 TD -0.0034 Tc 0.0456 Tw [(engine to stay on track toward the athlete)50.6(s goals. )50.7(As used)]TJ 0 -1.401 TD -0.0053 Tc -0.0625 Tw (here, the term focus has two meanings: focus on the moment-)Tj T* -0.0036 Tc -0.0586 Tw (to-moment, here-and-now aspects of a particular training ex-)Tj 0 -1.398 TD -0.0056 Tc -0.0622 Tw (ercise or performance, and a more long-term, event-spanning)Tj 0 -1.401 TD -0.0031 Tc 0.075 Tw [(focus on career goals. Being fully focused on a particular)]TJ T* -0.0034 Tc -0.0184 Tw (performance task enables the athlete to persevere in the face)Tj 0 -1.398 TD -0.0033 Tc 0.0728 Tw [(of external distractions. Focus is also internal, and skilled)]TJ 0 -1.401 TD -0.0191 Tc -0.0622 Tw (athletes have learned to monitor their inner physical and mental)Tj T* -0.003 Tc 0.0127 Tw (states, to be able to run a self-system check as needed, both)Tj 0 -1.398 TD -0.0038 Tc 0.0382 Tw (to assess ongoing performance during a competition and to)Tj 0 -1.401 TD -0.0129 Tc -0.0621 Tw [(check themselves between performances. Focus also includes)]TJ T* -0.0029 Tc -0.0006 Tw (clarity of thinking, and many athletes will describe states of)Tj 0 -1.398 TD -0.0038 Tc 0.1158 Tw (almost supernatural mental sharpness during intense com-)Tj 0 -1.401 TD -0.0044 Tc -0.0625 Tw [(petitions. This comes about through intensive and protracted)]TJ T* -0.0032 Tc 0.0483 Tw (training, so that when critical situations arise, the athlete is)Tj 0 -1.398 TD -0.003 Tc -0.025 Tw [(not overwhelmed by anxiety and complexity)63(, but can switch)]TJ 0 -1.401 TD -0.0035 Tc -0.0433 Tw (into a smooth, efficient performance mode as needed \(cf. the)Tj T* -0.0021 Tc 0.125 Tw [(psychophysiological toughness response discussed earlier)36.9(,)]TJ 0 -1.398 TD -0.0194 Tc -0.0589 Tw [(Dienstbier)34.6(, 1989\).)]TJ ET endstream endobj 183 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 185 0 obj << /Length 8325 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (115)Tj /TT5 1 Tf 10 0 0 10 84 722.64 Tm -0.0042 Tc (Resilience)Tj /TT2 1 Tf 4.071 0 TD -0.0033 Tc 0.0328 Tw [(. )54(As used here, the term resilience describes)]TJ -5.871 -1.398 TD -0.0035 Tc 0.0243 Tw (the bounce-back that enables skilled athletes and other pro-)Tj 0 -1.401 TD -0.0033 Tc -0.0225 Tw (fessionals to endure and prevail over physical injuries, men-)Tj T* -0.0036 Tc 0.0206 Tw (tal shocks, and performance failures without burning out or)Tj 0 -1.398 TD 0.0237 Tw [(melting down. Resilient athletes dont fold under pressure.)]TJ 0 -1.401 TD -0.0031 Tc -0.0339 Tw (They adapt to extreme conditions by using their training and)Tj T* -0.0076 Tc -0.0625 Tw (experience to devise and implement moment-to-moment cor-)Tj 0 -1.398 TD -0.0033 Tc 0.0457 Tw (rections of their performance in response to rapidly-chang-)Tj 0 -1.401 TD -0.0032 Tc -0.0144 Tw [(ing circumstances. Even when knocked down, they quickly)]TJ T* 0.0156 Tc 0.125 Tw (regain equilibrium and self-control without being over-)Tj 0 -1.398 TD -0.0032 Tc -0.0494 Tw [(whelmed. They can endure physical pain and emotional dis-)]TJ 0 -1.401 TD -0.0034 Tc 0.1119 Tw (tress and maintain technique and sustained effort by what)Tj T* -0.003 Tc 0.0437 Tw (seems to be sheer force of will, but which is really a tough)Tj 0 -1.398 TD -0.0035 Tc 0.125 Tw (resilience that grows out of confidence and determination)Tj 0 -1.401 TD -0.0034 Tc 0.008 Tw (borne of training, perseverance, and expertise.)Tj 1.8 -2.001 TD -0.0038 Tc 0.0422 Tw (The core components of mental toughness are recipro-)Tj -1.8 -1.398 TD -0.0032 Tc -0.0432 Tw [(cal and interactive. Resilience partly depends on confidence)]TJ 0 -1.401 TD -0.0034 Tc -0.0505 Tw (which, in turn, is based on a track record of accomplishment.)Tj T* 0.0885 Tw (Specifically with law enforcement, Doss \(2006\) notes that)Tj 0 -1.398 TD -0.0038 Tc 0.1118 Tw [(when an of)14.2(ficer)-36.8()53.2(s)-0.1( confidence is degraded because of poor)]TJ 0 -1.401 TD -0.0036 Tc 0.0714 Tw (training or a negative outcome despite utilizing techniques)Tj T* -0.0033 Tc 0.0011 Tw (he thought would work, this may have a deteriorative effect)Tj 0 -1.398 TD 0.1064 Tw (on subsequent performance and the recovery process may)Tj 0 -1.401 TD 0.1242 Tw [(be painfully slow)62.7(. )15.2(This explains the seemingly obsessive)]TJ T* 0.0022 Tc 0.125 Tw [(nature of training that characterizes all high-performance)]TJ 0 -1.398 TD -0.0031 Tc 0.0475 Tw [(fields. Proper training not only helps build skill and profi-)]TJ 0 -1.401 TD 0.0187 Tw (ciency itself, it also helps inoculate the professional against)Tj T* -0.0033 Tc 0.0575 Tw (corrosive self-doubt and feelings of failure in the case of a)Tj 0 -1.398 TD -0.0163 Tc -0.0625 Tw [(bad outcome \(Miller)31.7(, 2006, 2008a\).)]TJ /F1 1 Tf 11 0 0 11 66 291.99 Tm -0.0049 Tc 0.0363 Tw (Fostering Recovery and Resilience)Tj 0 -1.0909 TD -0.0045 Tc 0.0659 Tw (Following traumatic Events)Tj /TT2 1 Tf 10 0 0 10 84 256.65 Tm -0.0052 Tc -0.0625 Tw (While mental toughness training and psychological con-)Tj -1.8 -1.401 TD -0.0036 Tc -0.0306 Tw (ditioning techniques can serve to inure and inoculate service)Tj 0 -1.398 TD -0.0033 Tc -0.0271 Tw (members to many kinds of potentially traumatizing stressful)Tj 0 -1.401 TD -0.0031 Tc 0.0988 Tw [(events, there will always be some critical incidents so ex-)]TJ T* -0.0034 Tc 0.0706 Tw (treme that they overwhelm or attenuate the coping mecha-)Tj 0 -1.398 TD 0.0073 Tw (nisms of even some of the most resiliently tough personnel.)Tj 0 -1.401 TD -0.0032 Tc -0.0234 Tw (In other cases, a particular event may have specific meaning)Tj T* -0.0034 Tc 0.052 Tw (to a particular officer and thus have a much greater impact)Tj 0 -1.398 TD -0.0033 Tc 0.0379 Tw [(than it would on someone else. In all these cases, we need)]TJ 0 -1.401 TD -0.0032 Tc -0.0506 Tw (additional strategies we can apply after the fact for maximiz-)Tj T* -0.0022 Tc 0.125 Tw (ing resilient recovery and return to normal functioning in)Tj 0 -1.398 TD -0.0039 Tc 0.0025 Tw (these service members.)Tj /TT5 1 Tf 11 0 0 11 321 723.36 Tm 0.0102 Tc 0.1258 Tw [(Critical Incident S)29.3(t)0.8(r)32(ess Debriefing)]TJ /TT2 1 Tf 10 0 0 10 339 703.65 Tm -0.0042 Tc -0.0625 Tw [(W)93.6(ell-known to emer)16.8(gency response clinicians, the inter)16.8(-)]TJ -1.8 -1.401 TD -0.0039 Tc [(vention of critical incident stress debriefing \(CISD\) will only)]TJ 0 -1.398 TD -0.0058 Tc -0.0623 Tw [(be summarized here. CISD is a structured group intervention)]TJ 0 -1.401 TD -0.0038 Tc 0.0557 Tw (designed to promote the emotional processing of traumatic)Tj T* 0.0015 Tc 0.125 Tw (events through the ventilation and normalization of reac-)Tj 0 -1.398 TD -0.0033 Tc 0.0456 Tw (tions, as well as to facilitate preparation for possible future)Tj 0 -1.401 TD -0.0035 Tc -0.0311 Tw [(crisis experiences. CISD is one component of an integrated,)]TJ T* -0.0097 Tc -0.0625 Tw (comprehensive crisis intervention program spanning the criti-)Tj 0 -1.398 TD -0.0063 Tc (cal incident continuum from pre-crisis, to crisis, to post-crisis)Tj 0 -1.401 TD -0.0036 Tc 0.0069 Tw (phases, and subsumed under the heading of critical incident)Tj T* 0.0021 Tc 0.125 Tw (stress management \(CISM\), which has been adopted and)Tj 0 -1.398 TD -0.0035 Tc 0.085 Tw (modified for law enforcement and emergency services de-)Tj 0 -1.401 TD 0.0786 Tw (partments throughout the United States, Great Britain, Eu-)Tj T* -0.0051 Tc -0.0622 Tw [(rope, )48.9(Australia, and other parts of the world \(Dyregrov)66.9(, 1989,)]TJ 0 -1.398 TD -0.0077 Tc -0.0625 Tw [(1997; Everly & Mitchell, 1997; Everly)58.3(, Flannery)61.3(, & Mitchell,)]TJ 0 -1.401 TD -0.0207 Tc -0.0619 Tw [(2000; Mitchell & Everly)63.3(, 1996, 2003\).)]TJ 1.8 -2.001 TD -0.0038 Tc -0.06 Tw (The full CISM program includes: individual and organi-)Tj -1.8 -1.398 TD -0.0151 Tc -0.062 Tw (zational pre-crisis preparation; large-scale demobilization pro-)Tj 0 -1.401 TD 0.0152 Tc 0.125 Tw (cedures following mass disasters; on-scene, one-on-one)Tj T* -0.0035 Tc 0.0466 Tw (supportive counseling for acute, individual crisis reactions;)Tj 0 -1.398 TD 0.045 Tw [(defusings, which represent a shorter)38.4(, compressed stress de-)]TJ 0 -1.401 TD -0.0375 Tw (briefing protocol for small groups under acute stress; critical)Tj T* -0.0012 Tc 0.125 Tw (incident stress debriefing, described more extensively be-)Tj 0 -1.398 TD -0.0028 Tc (low; family crisis intervention and supportive counseling;)Tj 0 -1.401 TD -0.0035 Tc 0.045 Tw (and referral for follow-up mental health services as needed)Tj T* -0.0165 Tc -0.0624 Tw [(\(Everly & Mitchell, 1997; Mitchell & Everly)58.5(, 1996, 2003\).)]TJ 1.8 -1.998 TD -0.0036 Tc 0.0614 Tw (A CISD debriefing is a peer-led, clinician-guided pro-)Tj -1.8 -1.401 TD -0.0024 Tc 0.125 Tw (cess that takes place within 24 to 72 hours of the critical)Tj T* -0.0036 Tc 0.0428 Tw (incident and consists of a single group meeting of approxi-)Tj 0 -1.398 TD -0.0032 Tc 0.105 Tw (mately 6-20 personnel that lasts about two to three hours.)Tj 0 -1.401 TD -0.0034 Tc 0.0255 Tw (The formal CISD process consists of seven key phases, de-)Tj T* -0.0003 Tc 0.125 Tw (signed to assist psychological integration, beginning with)Tj 0 -1.398 TD -0.0095 Tc -0.0621 Tw (more objective and descriptive levels of processing, progress-)Tj 0 -1.401 TD -0.0035 Tc -0.0332 Tw (ing to the more personal and emotional, and back to the edu-)Tj T* -0.0206 Tw (cative and integrative levels, focusing on both cognitive and)Tj 0 -1.398 TD -0.0032 Tc 0.0439 Tw [(emotional mastery of the traumatic event. These are intro-)]TJ 0 -1.401 TD -0.0429 Tw (duction, fact, thought, reaction, symptom, education, and re-)Tj T* 0.07 Tw [(entry phases. Throughout the process, reactions to critical)]TJ 0 -1.398 TD -0.0036 Tc -0.0031 Tw (incident stress are conceptualized as normal responses to an)Tj 0 -1.401 TD -0.0031 Tc 0.0334 Tw (abnormal situation and recovery and return to duty are em-)Tj T* -0.0034 Tc 0.0571 Tw (phasized, although the possible presence of residual symp-)Tj 0 -1.398 TD -0.0041 Tc 0.01 Tw (toms is acknowledged.)Tj ET endstream endobj 186 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 188 0 obj << /Length 8846 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0063 Tc 0.0781 Tw (116 )Tj /TT3 1 Tf 2.3587 0 TD -0.0053 Tc 0.0812 Tw (Miller Stress and Resilience in Law Enforcement)Tj /TT5 1 Tf 11 0 0 11 54 723.36 Tm 0.0249 Tc 0.1273 Tw (Salutogenic Debriefing)Tj /TT2 1 Tf 10 0 0 10 72 703.65 Tm 0.0006 Tc 0.125 Tw (One group of practitioners \(Dunning, 1999; Paton &)Tj -1.8 -1.401 TD -0.0119 Tc -0.0622 Tw (Smith, 1999; Paton et al., 2000; Stuhlmiller & Dunning, 2000;)Tj 0 -1.398 TD -0.0048 Tc -0.0625 Tw [(V)63.4(iolanti, 2000\) has advocated a radical shift in the theory and)]TJ 0 -1.401 TD -0.0032 Tc -0.0462 Tw [(practice of critical incident debriefing. Their criticism of the)]TJ T* -0.0034 Tc 0.125 Tw [(standard CISD model views it as pathologing stress reac-)]TJ 0 -1.398 TD -0.0036 Tw (tions and offering debriefing as a quick-fix, one-size-fits-all)Tj 0 -1.401 TD -0.0035 Tc 0.0042 Tw (package of therapeutic intervention. These authors propose)Tj T* 0.0085 Tw (an alternative salutogenic debriefing model that views criti-)Tj 0 -1.398 TD 0.1108 Tw (cal incident reactions as opportunities for adaptive coping)Tj 0 -1.401 TD -0.0039 Tc 0.0675 Tw (and personal growth.)Tj 1.8 -2.001 TD -0.0036 Tc -0.005 Tw (Consistent with the concepts of resilience and posttrau-)Tj -1.8 -1.398 TD 0.1143 Tw (matic growth, these authors propose that interventions for)Tj 0 -1.401 TD 0.0636 Tw (critical incidents should not foster the learned helplessness)Tj T* -0.0023 Tc 0.125 Tw (of a traumatized victim mentality but should encourage a)Tj 0 -1.398 TD -0.0035 Tc 0.0317 Tw (sense of competence, confidence, resilience, hardiness, and)Tj 0 -1.401 TD -0.0101 Tc -0.0619 Tw [(learned resourcefulness \(Almedom, 2005; )50(Antonovsky)64.9(, 1987;)]TJ T* -0.0037 Tc 0.0825 Tw [(Higgins, 1994; Kobassa et al., 1982; )14.3(T)73.1(edeschi & Calhoun,)]TJ 0 -1.398 TD -0.0193 Tc -0.0622 Tw [(1995; )14(T)72.5(edeschi & Kilmer)40.7(, 2005\).)]TJ 1.8 -2.001 TD -0.0033 Tc 0.0087 Tw (In fairness, the purpose of all traumatic stress interven-)Tj -1.8 -1.401 TD -0.0036 Tc 0.0788 Tw (tions, including CISD, is to reduce hopelessness and help-)Tj 0 -1.398 TD -0.0029 Tc 0.125 Tw (lessness and to foster adaptive and resilient coping in the)Tj 0 -1.401 TD -0.0032 Tc -0.013 Tw [(face of a potentially overwhelming event. But going too far)]TJ T* -0.0038 Tc 0.0685 Tw [(in the other direction and adopting a Clarence the )50.4(Angel)]TJ 0 -1.398 TD -0.0032 Tc 0.0428 Tw [(approach to intervention \(Miller)35.8(, 1998b\) may only serve to)]TJ 0 -1.401 TD 0.0048 Tc 0.125 Tw (put too much pressure on distressed officers who under-)Tj T* -0.003 Tc -0.0482 Tw (standably may not be able to bring themselves to the point of)Tj 0 -1.398 TD -0.0035 Tc -0.0344 Tw (turning a horrific episode into a personal growth experience,)Tj 0 -1.401 TD -0.0026 Tc -0.0515 Tw (and may therefore feel like theyre failures if they cant meet)Tj T* -0.003 Tc 0.1128 Tw (this excessively high bar of recovery and growth \(see be-)Tj 0 -1.398 TD -0.0041 Tc -0.0624 Tw [(low\). )53(As always, clinicians and law enforcement administra-)]TJ 0 -1.401 TD -0.0035 Tc 0.0157 Tw (tors alike have to use their professional judgment.)Tj 1.8 -2.001 TD 0.0371 Tw [(More broadly)59.5(, most authorities would endorse the idea)]TJ -1.8 -1.398 TD -0.0031 Tc -0.0556 Tw (that CISD, or any other systemized approach to intervention,)Tj 0 -1.401 TD 0.0349 Tc 0.125 Tw (should supplement and enhance not replace each)Tj T* -0.0034 Tc 0.0943 Tw [(individual)50.6(s natural coping resources \(McNally)62.6(, Bryant, &)]TJ 0 -1.398 TD -0.0032 Tc 0.0012 Tw [(Ehlers, 2003; Sheehan, Everly)62.8(, & Langlieb, 2004\). In other)]TJ 0 -1.401 TD -0.0061 Tc -0.0621 Tw (words, all psychological services for law enforcement should)Tj T* -0.0035 Tc -0.0195 Tw (be in the direction of empowering officers to deal with chal-)Tj 0 -1.398 TD -0.0032 Tc 0.0321 Tw [(lenges as independently and ef)14.8(fectively as possible \(Miller)35.8(,)]TJ 0 -1.401 TD -0.0034 Tc -0.0378 Tw [(2006, 2008a\). While many critical incidents will not require)]TJ T* -0.003 Tc -0.0433 Tw (any special intervention, and while the majority of those that)Tj 0 -1.398 TD -0.0032 Tc -0.057 Tw (do will be well served by a CISD approach, it is the responsi-)Tj 0 -1.401 TD -0.0033 Tc 0.0257 Tw (bility of departmental administrators, and the mental health)Tj T* 0.005 Tc 0.125 Tw (professionals who advise them, to ensure that debriefing)Tj 25.5 63.9 TD -0.0033 Tc -0.0505 Tw (modalities are used responsibly and that other forms of clini-)Tj 0 -1.398 TD -0.0031 Tc 0.106 Tw (cally appropriate psychotherapeutic intervention are avail-)Tj 0 -1.401 TD 0.0074 Tc 0.125 Tw [(able to those who need them. CISD, like all successful)]TJ T* -0.0036 Tc 0.0822 Tw (treatment modalities, must be a living, evolving organism.)Tj 0 -1.398 TD -0.0031 Tc -0.0586 Tw (Continued research and clinical ingenuity will hopefully fur-)Tj 0 -1.401 TD -0.0035 Tc -0.0307 Tw (ther texturize and expand the stress debriefing approach into)Tj T* -0.0038 Tc -0.0621 Tw (new and different applications \(Mitchell & Levenson, 2006\).)Tj /F1 1 Tf 11 0 0 11 309 606 Tm -0.0046 Tc 0.0263 Tw (Mental Health Services for Recovery and)Tj 0 -1.0909 TD -0.0042 Tc 0 Tw (Resilience)Tj /TT2 1 Tf 10 0 0 10 327 570.66 Tm -0.0052 Tc -0.0621 Tw (For some traumatized service members, a CISD debrief-)Tj -1.8 -1.401 TD -0.0032 Tc -0.0084 Tw (ing may not suffice and more extensive, intensive, and indi-)Tj T* -0.006 Tc -0.0621 Tw (vidualized approaches to fostering recovery may be required,)Tj 0 -1.398 TD -0.0035 Tc 0.0687 Tw [(involving the services of mental health professionals. Un-)]TJ 0 -1.401 TD -0.0034 Tc 0.0105 Tw [(fortunately)59.6(, sometimes for good reason \(Max, 2000\), police)]TJ T* -0.0032 Tc -0.0293 Tw (officers have traditionally shunned these services, often per-)Tj 0 -1.398 TD -0.0033 Tc 0.0575 Tw (ceiving its practitioners as ferrets and shills who are out to)Tj 0 -1.401 TD -0.0053 Tc -0.0623 Tw [(dig up dirt that their departments can use against them. Other)]TJ T* -0.0035 Tc 0.0634 Tw (cops may fear having their head shrunk, harboring a no-)Tj 0 -1.398 TD -0.0031 Tc -0.0249 Tw [(tion of the psychotherapy process as akin to brainwashing, a)]TJ 0 -1.401 TD -0.0035 Tc 0.0457 Tw (humiliating and emasculating experience in which they are)Tj T* -0.0033 Tc -0.0411 Tw [(forced to lie on a couch and sob about their inner child. Less)]TJ 0 -1.398 TD -0.003 Tc 0.0713 Tw [(dramatically and more commonly)60(, the idea of needing any)]TJ 0 -1.401 TD -0.0041 Tc -0.0625 Tw (kind of mental help implies weakness, cowardice, and lack)Tj T* -0.0029 Tc -0.0033 Tw (of ability to do the job. In the environment of many depart-)Tj 0 -1.398 TD -0.0106 Tc -0.0625 Tw (ments, some officers realistically fear censure, stigmatization,)Tj 0 -1.401 TD -0.0036 Tc 0.0508 Tw (ridicule, thwarted career advancement, and alienation from)Tj T* -0.0031 Tc -0.049 Tw [(colleagues if they are perceived as the type who folds under)]TJ 0 -1.398 TD -0.0098 Tc -0.0625 Tw [(pressure. Still others in the department who may have some-)]TJ 0 -1.401 TD -0.0033 Tc 0.0291 Tw (thing to hide may fear a colleague spilling his guts to the)Tj T* -0.0034 Tc -0.0207 Tw [(clinician and thereby blowing the malfeasor)-36.4()53.6(s)0.2( cover \(Miller)35.6(,)]TJ 0 -1.398 TD -0.0353 Tc -0.0599 Tw (1998b, 2006\).)Tj 1.8 -2.001 TD -0.0034 Tc -0.015 Tw (But the goal of law enforcement psychological services)Tj -1.8 -1.401 TD -0.0033 Tc -0.0261 Tw (following a critical incident should always be to make offic-)Tj 0 -1.398 TD -0.0037 Tc -0.0048 Tw [(ers stronger)35.3(, not weaker)53.3(. Sometimes a broken bone that has)]TJ 0 -1.401 TD -0.0033 Tc 0.0065 Tw (begun to heal crookedly has to be re-broken and reset prop-)Tj T* -0.0029 Tc -0.0409 Tw (erly for the individual to be able to walk normally again and,)Tj 0 -1.398 TD -0.0032 Tc -0.0625 Tw [(while the re-breaking may hurt, the pain is temporary and the)]TJ 0 -1.401 TD 0.0518 Tw [(effect is to restore and re-strengthen the limb. In the same)]TJ T* 0.0409 Tw [(way)62.8(, an of)14.8(ficer who is responding to critical incident stress)]TJ 0 -1.398 TD -0.0037 Tc -0.0429 Tw [(with an ossified, malformed defensive mindset that)53.3(s imped-)]TJ 0 -1.401 TD -0.0032 Tc -0.0269 Tw (ing his or her job performance and personal life may need to)Tj T* -0.0037 Tc 0.0122 Tw (have those defenses challenged in a supportive atmosphere,)Tj 0 -1.398 TD -0.0034 Tc -0.0625 Tw (so he or she can benefit from a healthy resetting of his mental)Tj 0 -1.401 TD -0.003 Tc -0.0353 Tw [(state to deal with life more adaptively and courageously)63(. He)]TJ T* -0.0032 Tc 0.012 Tw (or she needs to regain the psychological strength to learn to)Tj ET endstream endobj 189 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 191 0 obj << /Length 8882 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (117)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0035 Tc 0.0589 Tw [(walk the path of life again \(Miller)38.5(, 2006; Rudofossi, 2007;)]TJ 0 -1.398 TD -0.0186 Tc -0.06 Tw [(T)73.2(och, 2002\).)]TJ /TT5 1 Tf 11 0 0 11 66 675.36 Tm 0.0147 Tc 0.125 Tw [(Therapeutic S)28.3(trategies for Recovery and)]TJ 0 -1.1836 TD 0.0207 Tc 0 Tw (Resilience)Tj /TT2 1 Tf 10 0 0 10 84 642.66 Tm -0.0034 Tc -0.02 Tw (Psychotherapeutic strategies for law enforcement offic-)Tj -1.8 -1.401 TD -0.0229 Tc -0.0622 Tw [(ers have been covered in detail elsewhere \(Miller)37.1(, 2006; 2008a\).)]TJ T* -0.0035 Tc 0.0412 Tw (For purposes of the present discussion, the effectiveness of)Tj 0 -1.398 TD -0.0027 Tc 0.065 Tw (any therapeutic strategy in fostering resilient recovery will)Tj 0 -1.401 TD -0.048 Tw (be determined by the timeliness, tone, style, and intent of the)Tj T* -0.0034 Tc -0.0567 Tw [(intervention. Effective psychological interventions with law)]TJ 0 -1.398 TD -0.0036 Tc 0.0793 Tw (enforcement officers and other service personnel share the)Tj 0 -1.401 TD -0.0246 Tc -0.0625 Tw (following common elements \(Blau, 1994; Fullerton, McCarroll,)Tj T* -0.0037 Tc -0.0624 Tw [(Ursano, & )17(W)55.1(right, 1992; )17(W)100.1(ester & L)53.3(y)-2.1(ubelsky)59.3(, 2005\).)]TJ 1.2 -1.998 TD 0 Tc 0 Tw ()Tj /TT5 1 Tf 1.8 0 TD -0.0047 Tc (Briefness)Tj /TT2 1 Tf 3.684 0 TD -0.003 Tc 0.0371 Tw [(. Utilize only as much therapeutic contact)]TJ -3.684 -1.401 TD -0.0009 Tc 0.125 Tw [(as necessary to address the present problem. The)]TJ T* -0.0038 Tc 0.0288 Tw (officer does not want to become a professional pa-)Tj 0 -1.398 TD 0.0006 Tc 0 Tw (tient.)Tj -1.8 -2.001 TD 0 Tc ()Tj /TT5 1 Tf 1.8 0 TD -0.0043 Tc -0.055 Tw (Limited focus)Tj /TT2 1 Tf 5.31 0 TD -0.003 Tc -0.059 Tw [(. 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Therapeutic efforts are directed to re-)]TJ -4.236 -1.398 TD -0.0033 Tc -0.0278 Tw [(solve the current conflict or problem to reach a satis-)]TJ 0 -1.401 TD -0.0525 Tw (factory short-term conclusion, while planning for the)Tj T* -0.0028 Tc 0.0275 Tw [(future if necessary)60.2(.)]TJ -1.2 -1.998 TD -0.0036 Tc -0.0322 Tw [( In light of )17.7(V)61.6(iolanti)50.4(s \(1999\) conceptualization of police)]TJ -1.8 -1.401 TD -0.0032 Tc -0.0505 Tw [(work as civilian combat, it is interesting that a very similar)]TJ T* -0.0029 Tc -0.0057 Tw [(intervention model has recently been articulated by military)]TJ 0 -1.398 TD -0.0033 Tc -0.035 Tw [(psychologist and U.S. )50.7(Army Captain Bret Moore for dealing)]TJ 0 -1.401 TD -0.0148 Tc -0.0622 Tw [(with soldiers experiencing combat stress \(Munsey)60.2(, 2006\). )15.5(The)]TJ T* -0.0036 Tc -0.04 Tw (program goes under the acronym, BICEPS, which stands for)Tj 1.2 -1.998 TD 0 Tc 0 Tw ()Tj /TT5 1 Tf 1.8 0 TD -0.0046 Tc [(B)5.4(r)31.4(evity)]TJ /TT2 1 Tf 2.826 0 TD -0.0035 Tc 0.0326 Tw [(. )18(T)37.3(reatment is short, addressing the problem)]TJ -2.826 -1.401 TD 0.085 Tw (at hand.)Tj -1.8 -2.001 TD 0 Tc 0 Tw ()Tj /TT5 1 Tf 1.8 0 TD -0.0053 Tc [(Immediacy)48.7(.)]TJ /TT2 1 Tf 4.539 0 TD -0.0032 Tc -0.0007 Tw [( Intervention takes place quickly)59.8(, before)]TJ -4.539 -1.398 TD -0.0037 Tc 0.055 Tw (symptoms worsen.)Tj -1.8 -2.001 TD 0 Tc 0 Tw ()Tj /TT5 1 Tf 1.8 0 TD -0.0046 Tc (Centrality)Tj /TT2 1 Tf 4.014 0 TD -0.003 Tc -0.0415 Tw [(. Psychological treatment is set apart from)]TJ -4.014 -1.401 TD -0.0023 Tw (medical facilities, as a way to reduce the stigma sol-)Tj 0 -1.398 TD -0.0036 Tc -0.0429 Tw (diers might feel about seeking mental health services)Tj 0 -1.401 TD -0.0106 Tc -0.0625 Tw (\(although it could be argued that putting mental health)Tj T* -0.0034 Tc -0.0568 Tw (treatment in a special category might make some sol-)Tj 0 -1.398 TD -0.0041 Tc -0.0621 Tw (diers feel alienated from their colleagues whove suf-)Tj 0 -1.401 TD -0.0034 Tc 0.1009 Tw [(fered real injuries; accordingly)62.6(, clinicians should)]TJ T* -0.0037 Tc -0.0025 Tw (use their judgment\).)Tj 23.7 65.4 TD 0 Tc 0 Tw ()Tj /TT5 1 Tf 1.8 0 TD -0.0047 Tc (Expectancy)Tj /TT2 1 Tf 4.566 0 TD -0.0037 Tc 0.0879 Tw [(. )50.7(A)58.5( soldier experiencing problems with)]TJ -4.566 -1.398 TD -0.0032 Tc 0.0379 Tw [(combat stress is expected to return to duty)59.8(.)]TJ -1.8 -2.001 TD 0 Tc 0 Tw ()Tj /TT5 1 Tf 1.8 0 TD -0.0046 Tc [(P)5.4(r)31.4(oximity)]TJ /TT2 1 Tf 3.87 0 TD -0.0031 Tc -0.0211 Tw [(. Soldiers are treated as close to their units)]TJ -3.87 -1.401 TD -0.0034 Tc 0.1005 Tw (as possible and are not evacuated from the area of)Tj 0 -1.398 TD 0.0084 Tc 0 Tw (operations.)Tj -1.8 -2.001 TD 0 Tc ()Tj /TT5 1 Tf 1.8 0 TD 0.003 Tc (Simplicity)Tj /TT2 1 Tf 4.029 0 TD 0.0047 Tc 0.1249 Tw [(. Besides therapy)61.7(, the basics of a good)]TJ -4.029 -1.401 TD -0.0036 Tc 0.08 Tw [(meal, hot shower)35.4(, and a comfortable place to sleep)]TJ 0 -1.398 TD -0.0033 Tc 0.0158 Tw [(ensure a soldier)-39.3()53.7(s)-0.4( basic physical needs are met.)]TJ /TT5 1 Tf 11 0 0 11 321 579.36 Tm 0.0119 Tc 0.125 Tw (Utilizing Cognitive Defenses for Resilience)Tj /TT2 1 Tf 10 0 0 10 339 559.65 Tm 0.0183 Tc 0.1248 Tw [(In psychology)63.3(, defense mechanisms are the mental)]TJ -1.8 -1.401 TD -0.0036 Tc 0.1069 Tw (strategems the mind uses to protect itself from unpleasant)Tj 0 -1.398 TD 0.0037 Tw (thoughts, feelings, impulses, and memories. While the nor-)Tj 0 -1.401 TD -0.0525 Tw (mal use of such defenses enables the average person to avoid)Tj T* 0.0005 Tc 0.125 Tw (conflict and ambiguity and maintain some consistency to)Tj 0 -1.398 TD -0.0088 Tc -0.0621 Tw (their personality and belief system, most psychologists would)Tj 0 -1.401 TD -0.0034 Tc 0.0595 Tw [(agree that an overuse of defenses to wall off too much un-)]TJ T* -0.0032 Tc 0.1083 Tw [(pleasant thought and feeling leads to a rigid and dysfunc-)]TJ 0 -1.398 TD -0.0063 Tc -0.0624 Tw [(tional approach to coping with life. )53.8(Accordingly)65.7(, much of the)]TJ 0 -1.401 TD -0.003 Tc -0.007 Tw (ordinary psychotherapeutic process involves carefully help-)Tj T* -0.0035 Tc -0.0061 Tw (ing the patient to relinquish pathological defenses so that he)Tj 0 -1.398 TD -0.0625 Tw (or she can learn to deal with internal conflicts more construc-)Tj 0 -1.401 TD -0.0103 Tc 0 Tw [(tively)64.7(.)]TJ 1.8 -2.001 TD -0.011 Tc -0.0618 Tw [(However)40(, in the face of immediately traumatizing critical)]TJ -1.8 -1.398 TD -0.0033 Tc 0.016 Tw (incidents, the last thing the affected person needs is to have)Tj 0 -1.401 TD -0.0029 Tc 0.065 Tw [(his or her defenses stripped away)60.1(. If you sustain a broken)]TJ T* -0.0034 Tc -0.0281 Tw (leg on the battlefield, the medic binds and braces the limb as)Tj 0 -1.398 TD -0.003 Tc 0.0318 Tw (best he can and helps you quickly hobble out of the danger)Tj 0 -1.401 TD -0.0035 Tc -0.04 Tw [(zone, reserving more extensive medical treatment for a later)35.5(,)]TJ T* -0.0029 Tc 0.0461 Tw [(safer time and place. Similarly)63.1(, for an acute psychological)]TJ 0 -1.398 TD -0.0033 Tc 0.0021 Tw (trauma, the proper utilization of psychological defenses can)Tj 0 -1.401 TD 0.0775 Tw (serve as an important psychological splint that enables the)Tj T* -0.0037 Tc -0.015 Tw (person to function in the immediate posttraumatic aftermath)Tj 0 -1.398 TD -0.003 Tc 0 Tw (and eventually be able to productively resolve and integrate)Tj 0 -1.401 TD -0.0034 Tc -0.06 Tw (the traumatic experience when the luxury of therapeutic time)Tj T* -0.0067 Tc -0.0625 Tw (can be afforded \(Janik, 1991\).)Tj 1.8 -1.998 TD -0.0033 Tc -0.0412 Tw (Indeed, whether in their regular daily work or following)Tj -1.8 -1.401 TD -0.0371 Tw (critical incidents, law enforcement and public safety person-)Tj T* -0.0031 Tc 0.0068 Tw (nel usually need little help in applying defense mechanisms)Tj 0 -1.398 TD -0.004 Tc 0.0162 Tw [(on their own. Examples \(Durham, McCammon, & )50(Allison,)]TJ 0 -1.401 TD -0.0173 Tc -0.0627 Tw [(1985; Henry)57.7(, 2004; )18.5(T)71.5(aylor)39.7(,)-8.8( )15.5(W)95.5(ood, & Lechtman, 1983\) include:)]TJ 1.2 -2.001 TD -0.0052 Tc -0.0622 Tw [()-1455.1(Denial. Put it out of my mind; focus on other things;)]TJ 1.8 -1.398 TD -0.0036 Tc -0.015 Tw (avoid situations or people who remind me of it.)Tj -1.8 -2.001 TD -0.0037 Tc -0.0575 Tw [()-1453.6(Rationalization. I had no choice; things happens for)]TJ ET endstream endobj 192 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 194 0 obj << /Length 8605 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0063 Tc 0.0781 Tw (118 )Tj /TT3 1 Tf 2.3587 0 TD -0.0053 Tc 0.0812 Tw (Miller Stress and Resilience in Law Enforcement)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm -0.0035 Tc -0.0584 Tw (a reason; it could have been worse; other people have)Tj 0 -1.398 TD -0.0033 Tc 0.0744 Tw (it worse; most people would react the way Im do-)Tj 0 -1.401 TD -0.0054 Tc 0 Tw (ing.)Tj -1.8 -2.001 TD -0.0041 Tc 0.058 Tw [()-1454(Displacement/projection. It was Command)52.9(s fault)]TJ 1.8 -1.398 TD -0.0033 Tc -0.0445 Tw (for issuing such a stupid order; I didnt have the right)Tj 0 -1.401 TD -0.0142 Tc -0.0625 Tw (backup; theyre all trying to blame me for everything.)Tj -1.8 -2.001 TD -0.0032 Tc -0.0224 Tw [()-1453.1(Refocus on positive attributes. Hey)62.8(, this was just a)]TJ 1.8 -1.398 TD -0.0034 Tc -0.0355 Tw (fluke Im usually a great marksman; Im not gonna)Tj 0 -1.401 TD -0.055 Tw (let this jam me up.)Tj -1.8 -2.001 TD -0.0036 Tc 0.0755 Tw [()-1453.5(Refocus on positive behaviors. Okay)59.4(, Im gonna)]TJ 1.8 -1.398 TD -0.0083 Tc -0.0625 Tw (get more training, increase my knowledge and skill so)Tj 0 -1.401 TD -0.0012 Tc 0.125 Tw (Ill never be caught with my pants down like this)Tj T* -0.0016 Tc 0 Tw (again.)Tj -1.2 -1.998 TD -0.0034 Tc 0.0119 Tw (Janik \(1991\) proposes that, in the short term, clinicians)Tj -1.8 -1.401 TD -0.0046 Tc -0.0621 Tw (actively support and bolster psychological defenses that tem-)Tj T* -0.0031 Tc -0.0185 Tw [(porarily enable the officer to continue functioning. Just as a)]TJ 0 -1.398 TD 0.0294 Tw (physical crutch is an essential part of orthopedic rehabilita-)Tj 0 -1.401 TD -0.0034 Tc -0.017 Tw (tion when the leg-injured patient is learning to walk again, a)Tj T* -0.0031 Tc 0.02 Tw (psychological crutch is perfectly adaptive and productive if)Tj 0 -1.398 TD -0.0033 Tc -0.035 Tw (it enables the officer to get back on his emotional two feet as)Tj 0 -1.401 TD -0.0071 Tc -0.0625 Tw [(soon as possible after a traumatic critical incident. Only later)37.9(,)]TJ T* -0.0033 Tc 0.0081 Tw (when he or she is making the bumpy transition back to nor-)Tj 0 -1.398 TD -0.0019 Tc 0.125 Tw (mal life, are potentially maladaptive defenses revisited as)Tj 0 -1.401 TD -0.0039 Tc 0.055 Tw (possible impediments to progress.)Tj 1.8 -2.001 TD -0.0032 Tc 0.0225 Tw (And just as some orthopedic patients may always need)Tj -1.8 -1.398 TD -0.004 Tc -0.0625 Tw (one or another kind of assistive walking device, like a special)Tj 0 -1.401 TD -0.0034 Tc -0.0019 Tw (shoe or a cane, some degree of psychological defensiveness)Tj T* -0.0028 Tc 0.0944 Tw (may persist in officers so they can otherwise productively)Tj 0 -1.398 TD -0.0033 Tc -0.0583 Tw [(pursue their work and life tasks. Indeed, rare among us is the)]TJ 0 -1.401 TD -0.0032 Tc -0.0519 Tw [(person who is completely defense-free. Only when defenses)]TJ T* 0.1165 Tw (are used inappropriately and for too long past the point)Tj 0 -1.398 TD -0.0036 Tc 0.0105 Tw (where we should be walking on our own psychological two)Tj 0 -1.401 TD -0.0032 Tc 0.0465 Tw (feet do they constitute a crutch in the pejorative sense.)Tj /TT5 1 Tf 11 0 0 11 54 211.35 Tm 0.0149 Tc 0.125 Tw [(Survival Resour)34(ce T)50.4(raining)]TJ /TT2 1 Tf 10 0 0 10 72 191.64 Tm -0.0067 Tc -0.0622 Tw [(As noted earlier)38.3(, a recently evolving trend in trauma psy-)]TJ -1.8 -1.398 TD 0.011 Tc 0.125 Tw (chotherapy emphasizes the importance of accessing and)Tj 0 -1.401 TD -0.0035 Tc 0.0069 Tw [(bolstering the patient)50.5(s natural powers of resilience, and the)]TJ T* 0.0165 Tw (constructive marshalling of strength and resistance to stress)Tj 0 -1.398 TD 0.0579 Tw [(and disability \(Calhoun & )17.4(T)70.2(edeschi, 1999; Dunning, 1999;)]TJ 0 -1.401 TD -0.0033 Tc 0.125 Tw [(S)21.9(tuhlmiller & Dunning, 2000; )17.7(T)73.5(edeschi & Calhoun 1995;)]TJ T* -0.0118 Tc -0.0621 Tw [(T)74(edeschi & Kilmer)33.2(, 2005; )18.4(V)59.4(iolanti, 2000\). In this vein, Roger)]TJ 0 -1.398 TD -0.0036 Tc 0.002 Tw (Solomon \(1988, 1991, 1995\) has been ahead of the curve in)Tj 0 -1.401 TD -0.0034 Tc 0.1 Tw (capitalizing on the idea that constructive denial of vulner-)Tj 25.5 64.299 TD -0.002 Tc 0.125 Tw (ability and mortality can be an adaptive response for law)Tj 0 -1.398 TD -0.0037 Tc 0.0333 Tw (enforcement officers coping with ongoing critical incidents)Tj 0 -1.401 TD -0.0075 Tc -0.0617 Tw (and their immediate aftermath.)Tj 1.8 -2.001 TD -0.0036 Tc -0.045 Tw (Solomon \(1988, 1991\) points out that, following critical)Tj -1.8 -1.398 TD -0.0074 Tc -0.0623 Tw [(incidents characterized by fear)37.6(, danger)37.6(, injury)61.6(, or death, of)10.6(fic-)]TJ 0 -1.401 TD -0.0033 Tc -0.032 Tw (ers often dwell on their mistakes and overlook what they did)Tj T* -0.0035 Tc 0.0245 Tw (right in terms of coping with their emotions and getting the)Tj 0 -1.398 TD -0.0029 Tc -0.0467 Tw [(job done. Thus, being realistically reminded by the clinician)]TJ 0 -1.401 TD -0.0031 Tc 0.0963 Tw (of their own adaptive coping efforts may prove especially)Tj T* -0.0038 Tc -0.0444 Tw [(empowering because it draws upon strengths that came from)]TJ 0 -1.398 TD -0.0086 Tc -0.0621 Tw [(the of)15.4(ficer him- or herself. )18.5(T)71.2(ermed survival resource training,)]TJ 0 -1.401 TD -0.0041 Tc (this intervention allows officers to utilize the fear response to)Tj T* -0.0034 Tc 0.0444 Tw (tap into a state of controlled strength, increased awareness,)Tj 0 -1.398 TD -0.0029 Tc -0.056 Tw (confidence, and clarity of mind many of the features, noted)Tj 0 -1.401 TD -0.0036 Tc -0.0511 Tw [(earlier)35.4(, that characterize high-performance athletes.)]TJ 1.8 -2.001 TD -0.0034 Tc -0.0187 Tw (In this technique, the clinician encourages the officer to)Tj -1.8 -1.398 TD -0.0278 Tw (view the critical incident from a detached, objective point of)Tj 0 -1.401 TD -0.0087 Tc -0.062 Tw [(view)63.3(, like you were watching a movie of yourself, and to go)]TJ T* -0.0036 Tc 0.0268 Tw [(through the incident frame-by-frame. )50.3(At the point where)]TJ 0 -1.398 TD -0.0031 Tc -0.0412 Tw (he imagines himself fully engaging in this activity \(negotiat-)Tj 0 -1.401 TD -0.0035 Tc -0.0056 Tw [(ing with a hostage-taker)35.5(, arresting a dangerous felon, taking)]TJ T* -0.0018 Tc 0.1251 Tw [(cover)37.2(, firing his weapon, etc.\), the of)19.2(ficer is instructed to)]TJ 0 -1.398 TD -0.0031 Tc 0.0505 Tw (focus on the part of you enabling you to respond.)Tj 1.8 -2.001 TD -0.0035 Tc 0.0378 Tw (In most cases, the survival resource training procedure)Tj -1.8 -1.401 TD -0.0123 Tc -0.0625 Tw (leads to a mental reframe characterized by controlled strength,)Tj 0 -1.398 TD -0.0033 Tc -0.0284 Tw [(heightened awareness, confidence, and mental clarity)62.7(, as the)]TJ 0 -1.401 TD -0.003 Tc 0.0728 Tw (officer mentally zooms in on his capability to respond, in-)Tj T* -0.0036 Tc 0.0943 Tw [(stead of focusing on the immobilizing fear)35.4(, perceptions of)]TJ 0 -1.398 TD -0.0033 Tc 0.0437 Tw [(weakness, loss of control, or perceptual distortions. Often,)]TJ 0 -1.401 TD -0.0036 Tc -0.0167 Tw [(this results in the of)17.4(ficer)-39.6()53.4(s)0.2( being reminded of how he put his)]TJ T* -0.0033 Tc 0.0246 Tw (fear on hold and rose to the occasion in order to get the job)Tj 0 -1.398 TD -0.0032 Tc 0.0805 Tw [(done. The reframing thus focuses on resiliency instead of)]TJ 0 -1.401 TD -0.0033 Tc 0.0498 Tw [(vulnerability)62.7(, strength instead of weakness.)]TJ 1.8 -2.001 TD -0.0329 Tw (In addition to processing past critical incidents, realistic)Tj -1.8 -1.398 TD -0.0444 Tw (feelings of efficacy and competence can also shade over into)Tj 0 -1.401 TD -0.0034 Tc 0.0907 Tw (future incidents, as officers have reported increased confi-)Tj T* 0.0044 Tc 0.125 Tw (dence and ability to handle subsequent calls, such as ar-)Tj 0 -1.398 TD -0.0035 Tc 0.0459 Tw (rests, shooting incidents, domestic disturbances, and traffic)Tj 0 -1.401 TD -0.0053 Tc -0.0625 Tw [(chases. In addition, officers have felt more confident in other)]TJ T* -0.0033 Tc 0.0729 Tw (non-emergency but stressful situations, such as court testi-)Tj 0 -1.398 TD -0.0031 Tc 0.0762 Tw [(mony)62.9(, and personal matters, such as resolving family con-)]TJ 0 -1.401 TD -0.0077 Tc -0.0622 Tw [(flicts \(Solomon, 1988, 1991, 1995\). It is especially gratifying)]TJ T* -0.0034 Tc -0.0184 Tw (to clinicians and officers alike when their mutual efforts can)Tj 0 -1.398 TD -0.0033 Tc 0.0225 Tw (turn vicious cycles of demoralization and despair into posi-)Tj ET endstream endobj 195 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 197 0 obj << /Length 8411 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (119)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0031 Tc 0.039 Tw [(tive cycles of confidence and optimism. Indeed, this is the)]TJ 0 -1.398 TD 0.0384 Tw [(essence of the resilience model of psychotherapy)59.9(.)]TJ /TT5 1 Tf 11 0 0 11 66 675.36 Tm 0.0101 Tc 0.125 Tw (Finding Meaning In Adversity: Existential)Tj 0 -1.1836 TD 0.0338 Tc 0 Tw [(T)93.6(oughness)]TJ /TT2 1 Tf 10 0 0 10 84 642.66 Tm -0.0038 Tc -0.0008 Tw (As useful as salutogenic and growth-oriented therapeu-)Tj -1.8 -1.401 TD -0.0138 Tc -0.0622 Tw (tic approaches may sometimes be, trying to force-feed a posi-)Tj T* -0.0038 Tc -0.06 Tw (tive meaning or life lesson from a noxious experience can)Tj 0 -1.398 TD -0.0037 Tc -0.0513 Tw (sometimes be counterproductive: some bad things in life just)Tj 0 -1.401 TD 0.0381 Tw (plain suck and no amount of philosophical sugar-coating is)Tj T* -0.0031 Tc -0.0113 Tw [(going to make a turdball taste like a jelly donut. But human)]TJ 0 -1.398 TD -0.0037 Tc -0.0036 Tw (beings are meaning-making creatures, and people will natu-)Tj 0 -1.401 TD -0.0033 Tc 0.067 Tw (rally grope to find reasons or messages hidden in even the)Tj T* 0.0023 Tc 0.125 Tw [(most grotesque catastrophes. When this comes from the)]TJ 0 -1.398 TD -0.0034 Tc 0.0215 Tw [(officer him- or herself, it must be respected and nurtured in)]TJ 0 -1.401 TD -0.0032 Tc 0.02 Tw [(the psychotherapy process because a consolidation of one)50.8(s)]TJ T* -0.0104 Tc -0.0621 Tw [(worldview is, in itself, a resiliency-enhancing process \(Miller)34.6(,)]TJ 0 -1.398 TD -0.0388 Tc 0 Tw (1998b\).)Tj 1.8 -2.001 TD -0.0034 Tc -0.0014 Tw (In general, existential treatment strategies that focus on)Tj -1.8 -1.401 TD -0.0052 Tc -0.0622 Tw (a quest for meaning, rather than just alleviation of symptoms,)Tj 0 -1.398 TD -0.0033 Tc -0.0542 Tw (may productively channel the worldview conflicts generated)Tj 0 -1.401 TD -0.0029 Tc -0.0365 Tw [(by the traumatic event. This may include helping the officer)]TJ T* -0.0035 Tc 0.125 Tw (to formulate an acceptable survivor mission or profes-)Tj 0 -1.398 TD -0.0057 Tc -0.0625 Tw [(sional purpose \(Henry)63.3(, 2004; Rudofossi, 2007; Shalev et al.,)]TJ 0 -1.401 TD -0.0033 Tc 0.057 Tw [(1993\). In the best cases, the rift and subsequent reintegra-)]TJ T* -0.003 Tc -0.0556 Tw (tion of the personality may lead to an expanded self-concept,)Tj 0 -1.398 TD -0.0033 Tc 0.009 Tw (a renewed sense of purpose, and a new level of psychologi-)Tj 0 -1.401 TD -0.0036 Tc -0.0488 Tw (cal, spiritual, and career growth \(Bonanno, 2005; Calhoun &)Tj T* -0.0168 Tc -0.0624 Tw [(T)75(edeschi, 1999; Luthar)31.2(, Cicchetti, & Becker)37.2(, 2000; )19.3(T)69(edeschi &)]TJ 0 -1.398 TD -0.0037 Tc -0.0387 Tw [(Calhoun, 1995, 2004; )14.5(T)73.1(edeschi & Kilmer)38.3(, 2005\). Of course,)]TJ 0 -1.401 TD -0.0035 Tc 0.0183 Tw (not all traumatized service members will be able to achieve)Tj T* -0.0033 Tc 0.105 Tw (this successful reintegration of their ordeal and many will)Tj 0 -1.398 TD -0.0032 Tc 0.0065 Tw (struggle with at least some vestige of emotional injury for a)Tj 0 -1.401 TD 0.0017 Tc 0.125 Tw (long time, perhaps for life \(Everstine & Everstine, 1993;)Tj T* -0.0137 Tc -0.0621 Tw [(Matsakis, 1994; McCann & Pearlman, 1990; Miller)34.3(, 1998b\).)]TJ 1.8 -1.998 TD -0.0097 Tc -0.0625 Tw (Therefore, my main caution about these transformational)Tj -1.8 -1.401 TD -0.0033 Tc 0.1086 Tw (therapeutic conceptualizations is that they be presented as)Tj T* -0.0034 Tc -0.0538 Tw [(an opportunity)62.6(, not an obligation. )17.7(The extraction of meaning)]TJ 0 -1.398 TD -0.0033 Tc -0.0206 Tw (from adversity is something that must ultimately come from)Tj 0 -1.401 TD -0.0031 Tc -0.025 Tw (the officer him- or herself, not be foisted upon him or her by)Tj T* -0.0051 Tc -0.0625 Tw [(the clinician. Such existential forced conversions are often)]TJ 0 -1.398 TD -0.0035 Tc -0.0623 Tw [(motivated by a need to reinforce the clinician)50.5(s own meaning)]TJ 0 -1.401 TD 0.0061 Tc 0.125 Tw (system, or they may be part of what I call a therapeutic)Tj T* -0.0037 Tc 0.085 Tw [(Clarence-the-Angel fantasy \(Miller)35.3(, 1998b\), wherein the)]TJ 25.5 62.4 TD 0.0205 Tc 0.125 Tw (enlightened clinician swoops down and, by dint of the)Tj 0 -1.398 TD 0.005 Tc 0.1251 Tw [(therapist)56(s brilliantly insightful ministrations, rescues the)]TJ 0 -1.401 TD -0.0035 Tc 0.0107 Tw [(hapless patient from his or her darkest hour)50.5(.)]TJ 1.8 -2.001 TD -0.0029 Tc -0.0086 Tw [(Realistically)63.1(, as mental health clinicians, we can hardly)]TJ -1.8 -1.398 TD -0.0055 Tc -0.0625 Tw [(expect all or even most of our traumatized patients to miracu-)]TJ 0 -1.401 TD -0.0029 Tc 0.0925 Tw (lously transform their tragedy and acquire a fresh, revital-)Tj T* -0.0141 Tc -0.0623 Tw (ized, George Bailyean outlook on life how many of us would)Tj 0 -1.398 TD -0.0034 Tc 0.0835 Tw [(respond that well? But, as noted above, human beings do)]TJ 0 -1.401 TD -0.0036 Tc 0.0139 Tw [(crave meaning \(Y)98.4(alom, 1980\) and if a philosophical or reli-)]TJ T* -0.0032 Tc -0.0485 Tw (gious orientation can nourish the officer in his or her journey)Tj 0 -1.398 TD -0.0033 Tc 0.0018 Tw (back to the land of the living, then the therapeutic role must)Tj 0 -1.401 TD -0.0038 Tc 0.0725 Tw (sometimes stretch to include some measure of guidance in)Tj T* -0.0031 Tc -0.0333 Tw [(affairs of the spirit.)]TJ /F1 1 Tf 11 0 0 11 321 516 Tm -0.0046 Tc 0.1015 Tw (Organizational and Departmental Support)Tj /TT2 1 Tf 10 0 0 10 339 492.66 Tm 0.0587 Tc 0.125 Tw (Not all interventions involve psychotherapy or)Tj -1.8 -1.401 TD -0.0036 Tc 0.0142 Tw [(debriefings. Following a department-wide critical incident,)]TJ T* -0.0038 Tc -0.0625 Tw (such as a line-of-duty death, serial homicide investigation, or)Tj 0 -1.398 TD 0.0041 Tc 0.125 Tw (mass casualty rescue and recovery operation, the depart-)Tj 0 -1.401 TD -0.0043 Tc -0.0625 Tw (mental psychologist or consulting mental health professional)Tj T* -0.0037 Tc -0.0444 Tw (can advise and guide law enforcement agencies in encourag-)Tj 0 -1.398 TD -0.0038 Tc 0.015 Tw (ing and implementing several organizational response mea-)Tj 0 -1.401 TD -0.017 Tc -0.0617 Tw [(sures \(Alexander)34(, 1993; )46.4(Alexander & )19.4(W)95.9(alker)37(, 1994; )55.4(Alexander)]TJ T* -0.0202 Tc -0.0622 Tw [(&)6.4( )12.8(W)95.6(ells, 1991; DeAngelis, 1995; Fullerton et al., 1992; Palmer)33.8(,)]TJ 0 -1.398 TD -0.0038 Tc [(1983\). Many of these strategies are proactively applicable as)]TJ 0 -1.401 TD -0.0065 Tc -0.0625 Tw [(part of training before a critical incident occurs. Others apply)]TJ T* -0.0034 Tc -0.0445 Tw (even when there is no specific incident, but just involve cops)Tj 0 -1.398 TD -0.0335 Tw [(in a jam seeking support and relief. Some specific organiza-)]TJ 0 -1.401 TD 0.1243 Tw (tional and leadership measures that can promote recovery)Tj T* -0.0036 Tc 0.003 Tw [(and resilience include those that follow)59.4(.)]TJ 1.2 -1.998 TD -0.004 Tc -0.0358 Tw [()-1453.9(Encourage mutual support among peers and supervi-)]TJ 1.8 -1.401 TD -0.0023 Tc -0.0112 Tw [(sors. The former typically occurs anyway; the latter)]TJ T* -0.004 Tc -0.062 Tw [(may need some explicit reinforcement. )50.1(Although not)]TJ 0 -1.398 TD -0.0123 Tc -0.0625 Tw (typically team workers like firefighters or paramedics,)Tj 0 -1.401 TD -0.0032 Tc 0.0885 Tw [(police officers frequently work as partners and un-)]TJ T* -0.0038 Tc 0.0925 Tw (derstand that some degree of shared decision-mak-)Tj 0 -1.398 TD 0.0027 Tc 0.125 Tw (ing and mutual reassurance can enhance effective)Tj 0 -1.401 TD -0.0034 Tc 0.1094 Tw (performance on the job, as well as helping to deal)Tj T* -0.0029 Tc -0.005 Tw [(with tragedy)60.1(.)]TJ -1.8 -1.998 TD -0.0191 Tc -0.0625 Tw [()-1469(Utilize humor as a coping mechanism to facilitate emo-)]TJ 1.8 -1.401 TD -0.0035 Tc 0.0307 Tw [(tional insulation and group bonding. The first fore-)]TJ T* -0.0112 Tc -0.0625 Tw (stalls excessive identification with victims, the second)Tj 0 -1.398 TD -0.0037 Tc 0.0986 Tw (encourages mutual group support via a shared lan-)Tj 0 -1.401 TD -0.0032 Tc -0.0272 Tw [(guage. Of course, as noted earlier)38.8(, mental health cli-)]TJ ET endstream endobj 198 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 200 0 obj << /Length 10047 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0063 Tc 0.0781 Tw (120 )Tj /TT3 1 Tf 2.3587 0 TD -0.0053 Tc 0.0812 Tw (Miller Stress and Resilience in Law Enforcement)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm -0.0037 Tc 0.1109 Tw (nicians and departmental supervisors need to care-)Tj 0 -1.398 TD -0.0034 Tc 0.0729 Tw (fully monitor the line between adaptive humor that)Tj 0 -1.401 TD -0.0038 Tc -0.0625 Tw (encourages healing and gratuitous nastiness that only)Tj T* -0.0033 Tc 0.044 Tw [(serves to entrench cynicism and despair)50.7(.)]TJ -1.8 -1.998 TD -0.0018 Tc 0.125 Tw [()-1451.7(Make use of appropriate rituals that give meaning)]TJ 1.8 -1.401 TD -0.0031 Tc -0.0316 Tw (and dignity to an otherwise existentially disorienting)Tj T* -0.0262 Tw [(experience. This includes not only religious rites re-)]TJ 0 -1.398 TD -0.0035 Tc -0.0037 Tw (lated to mourning, but such respectful protocols as a)Tj 0 -1.401 TD 0.0014 Tc 0.125 Tw (military-style honor guard to attend bodies before)Tj T* -0.0038 Tc 0.0142 Tw (disposition, and the formal acknowledgement of ac-)Tj 0 -1.398 TD -0.0028 Tc 0.0428 Tw [(tions above and beyond the call of duty)60.2(.)]TJ -1.8 -2.001 TD -0.0032 Tc 0.125 Tw [()-1453.1(Make productive use of grief leadership. This in-)]TJ 1.8 -1.401 TD -0.0036 Tc -0.0567 Tw (volves the commanding officer demonstrating by ex-)Tj 0 -1.398 TD -0.0033 Tc 0.0622 Tw [(ample that it)50.7(s okay to express grief and mourn the)]TJ 0 -1.401 TD -0.0009 Tc 0.125 Tw (death of fallen comrades or civilians, and that the)Tj T* -0.0037 Tc -0.027 Tw [(dignified expression of one)50.3(s feelings about the trag-)]TJ 0 -1.398 TD -0.0031 Tc 0.0694 Tw [(edy will be supported, not denigrated. Indeed, this)]TJ 0 -1.401 TD -0.0098 Tc -0.062 Tw (healthy combination of masterful task-orientation and)Tj T* -0.0032 Tc 0.0991 Tw (validated expression of legitimate grief has largely)Tj 0 -1.398 TD 0.0015 Tc 0.125 Tw (characterized the response of rescue and recovery)Tj 0 -1.401 TD -0.0038 Tc 0.0513 Tw [(personnel at the New )32.3(Y)103.4(ork )14.3(W)97(orld )17.3(T)37(rade Center and)]TJ T* 0.0219 Tc 0.1249 Tw [(other mass-casualty disaster sites \(Henry)60.9(, 2004;)]TJ 0 -1.398 TD -0.0154 Tc -0.0617 Tw [(Regehr & Bober)32.6(, 2004\).)]TJ -1.8 -2.001 TD -0.0032 Tc 0.0875 Tw [()-1453.1(Show respect for psychological issues and psycho-)]TJ 1.8 -1.401 TD -0.0033 Tc 0.0168 Tw [(logical services. If the departmental brass dont be-)]TJ 0 -1.398 TD -0.0035 Tc 0.0558 Tw (lieve that encouraging the appropriate utilization of)Tj 0 -1.401 TD -0.003 Tc 0.0628 Tw (psychological services is a valid way of expressing)Tj T* -0.0034 Tc 0.0864 Tw (their concern and support for their troops welfare,)Tj 0 -1.398 TD -0.0028 Tc 0.0529 Tw [(then the rank and file won)15.2(t buy it, either)51.2(. Psycho-)]TJ 0 -1.401 TD 0.0014 Tc 0.125 Tw (logical referrals should be destigmatized and sup-)Tj T* -0.0031 Tc 0.0894 Tw (ported as a health and safety measure, the same as)Tj 0 -1.398 TD -0.0185 Tc -0.0625 Tw (with medical referrals and general fitness maintenance.)Tj -1.2 -2.001 TD -0.0035 Tc -0.0307 Tw [(In summary)62.5(, law enforcement of)14.5(ficers and other service)]TJ -1.8 -1.401 TD -0.0034 Tc -0.0407 Tw (members who cope resiliently with critical incidents prepare)Tj 0 -1.398 TD 0.1007 Tw (their minds and bodies proactively through rigorous train-)Tj 0 -1.401 TD -0.0035 Tc -0.0207 Tw (ing, and avail themselves of legitimate support services dur-)Tj T* -0.0028 Tc 0.0823 Tw [(ing and after a critical incident. In this way)63.2(, they become)]TJ 0 -1.398 TD -0.0032 Tc 0.0128 Tw (tough, act tough, and stay tough, while retaining the mental)Tj 0 -1.401 TD -0.0062 Tc -0.0621 Tw [(agility)59.8(, flexibility)59.8(, resiliency)62.8(, and humanity that are necessary)]TJ T* -0.0072 Tc (for top-notch law enforcement and emergency services work.)Tj /F1 1 Tf 11 0 0 11 133.89 120 Tm 0.021 Tc 0 Tw (REFERENCES)Tj /TT2 1 Tf 10 0 0 10 54 102.66 Tm -0.0035 Tc -0.0145 Tw [(Alexander)35.5(, D.A. & )18(W)94.3(alker)35.5(, L.G)116.5(. \(1994\). )51(A)58.7( study of methods)]TJ 1.2 -1.401 TD -0.0033 Tc -0.0519 Tw (used by Scottish police officers to cope with work-related)Tj T* -0.0035 Tc 0 Tw (stress.)Tj /TT5 1 Tf 2.451 0 TD -0.0037 Tc -0.015 Tw [( Stress Medicine, 10)]TJ /TT2 1 Tf 7.995 0 TD -0.0038 Tc -0.02 Tw (, 131-138.)Tj 13.854 64.8 TD -0.0135 Tc -0.0618 Tw [(Alexander)34.5(, D.A. & )16.9(W)96.3(ells, )52.9(A. \(1991\). Reactions of police of)16.5(fic-)]TJ 1.2 -1.398 TD -0.0033 Tc -0.038 Tw [(ers to body-handling after a major disaster: )50.8(A)58.9( before-and-)]TJ 0 -1.401 TD -0.004 Tc -0.06 Tw (after comparison. )Tj /TT5 1 Tf 7.059 0 TD -0.0624 Tw [(British Journal of Psychiatry)58.8(,)-1.1( 159)]TJ /TT2 1 Tf 13.197 0 TD -0.0048 Tc -0.065 Tw (, 547-)Tj -20.256 -1.401 TD -0.0583 Tc 0 Tw (555.)Tj -1.2 -1.8 TD -0.0067 Tc -0.0605 Tw [(Alexander)38.3(, F)77.3(.)-0.7( \(1950\). )]TJ /TT5 1 Tf 8.451 0 TD -0.0069 Tc -0.0617 Tw (Psychosomatic medicine: Its principles)Tj -7.251 -1.398 TD -0.0044 Tc 0.01 Tw (and applications)Tj /TT2 1 Tf 6.639 0 TD -0.0037 Tc 0.0118 Tw [(. New )32.4(Y)103.5(ork: Norton.)]TJ -7.839 -1.8 TD -0.0036 Tc 0.0302 Tw [(Almedom, )53.6(A.M. \(2005\). Resilience, hardiness, sense of co-)]TJ 1.2 -1.401 TD -0.0037 Tc 0.0764 Tw [(herence, and posttraumatic growth: )50.3(All paths leading to)]TJ T* 0.0082 Tc 0.125 Tw (light at the end of the tunnel? )Tj /TT5 1 Tf 14.016 0 TD 0.0075 Tc (Journal of Loss and)Tj -14.016 -1.398 TD -0.017 Tc -0.06 Tw [(T)59.2(rauma, 10)]TJ /TT2 1 Tf 4.38 0 TD (, 253-265.)Tj -5.58 -1.8 TD -0.0132 Tc -0.0625 Tw [(American Psychiatric )52.8(Association \(2000\). )]TJ /TT5 1 Tf 16.185 0 TD -0.0138 Tc (Diagnostic and sta-)Tj -14.985 -1.401 TD 0.0007 Tc 0.125 Tw (tistical manual of mental disorders )Tj /TT2 1 Tf 14.904 0 TD 0.0015 Tc (\(4th ed., text revi-)Tj -14.904 -1.401 TD -0.0037 Tc -0.0255 Tw [(sion\). W)97.1(ashington )-13.6(DC: )36.1(American )-14.5(Psychiatric)]TJ -1.2 -1.8 TD -0.0052 Tc -0.1105 Tw [(Antonovsky)60.8(, A. )-49(\(1979\). )]TJ /TT5 1 Tf 9.36 0 TD -0.0058 Tc -0.0618 Tw [(Health, str)30.2(ess, and coping)]TJ /TT2 1 Tf 10.11 0 TD -0.0061 Tc -0.0625 Tw (. San Fran-)Tj -18.27 -1.398 TD 0.0005 Tc 0.125 Tw (cisco: Jossey-Bass.)Tj -1.2 -1.8 TD -0.0031 Tc 0.0511 Tw [(Antonovsky)59.9(, A. )-53.8(\(1987\). )]TJ /TT5 1 Tf 9.906 0 TD -0.0039 Tc 0.105 Tw (Unraveling the mystery of health:)Tj -8.706 -1.401 TD -0.004 Tc 0.0009 Tw (How people manage stress and stay well)Tj /TT2 1 Tf 16.134 0 TD -0.0036 Tc 0.0025 Tw (. San Francisco:)Tj -16.134 -1.401 TD 0.0151 Tc 0 Tw (Jossey-Bass.)Tj -1.2 -1.8 TD -0.0032 Tc 0.0607 Tw [(Antonovsky)59.8(, )53.8(A. \(1990\). Personality and health: )14.8(T)73.6(esting the)]TJ 1.2 -1.398 TD -0.0122 Tc -0.0625 Tw (sense of coherence model. In H.S. Friedman \(Ed.\), )Tj /TT5 1 Tf 19.419 0 TD -0.0142 Tc 0 Tw (Person-)Tj -19.419 -1.401 TD -0.0057 Tc -0.06 Tw (ality and disease)Tj /TT2 1 Tf 6.51 0 TD -0.0054 Tc -0.0631 Tw [( \(pp. 155-177\). New )30.5(Y)107.8(ork: )12.5(W)53.4(iley)60.6(.)]TJ -7.71 -1.8 TD -0.0034 Tc 0.05 Tw [( )50.6(Asken, M.J. \(1993\). )]TJ /TT5 1 Tf 8.58 0 TD -0.0041 Tc (PsycheResponse: Psychological skills)Tj -7.38 -1.401 TD 0.0281 Tc 0.125 Tw (for optimal performance by emergency responder)Tj /TT2 1 Tf 21.831 0 TD 0.0298 Tc 0 Tw (s.)Tj -21.831 -1.398 TD -0.0076 Tc -0.0617 Tw (Englewood Cliffs: Regents/Prentice Hall.)Tj -1.2 -1.8 TD -0.0029 Tc -0.0265 Tw [(Bandura, )54(A. \(1977\). Self-ef)18.1(ficacy: )15(T)73.9(oward a unifying theory)]TJ 1.2 -1.401 TD -0.0057 Tc -0.0617 Tw (of behavioral change. )Tj /TT5 1 Tf 8.574 0 TD -0.0066 Tc -0.0601 Tw [(Psychological Review)65.4(, 84)]TJ /TT2 1 Tf 9.966 0 TD -0.0064 Tc -0.065 Tw (, 191-215.)Tj -19.74 -1.8 TD -0.0038 Tc 0.0348 Tw [(Bandura, A. )-50.6(\(1865\). )]TJ /TT5 1 Tf 8.409 0 TD 0.0871 Tw [(Intr)29.2(oduction a letude de la medecine)]TJ -7.209 -1.401 TD -0.007 Tc 0 Tw (experimentale)Tj /TT2 1 Tf 5.58 0 TD -0.0057 Tc -0.0625 Tw (. Paris: Bailliere et Fils.)Tj -6.78 -1.8 TD -0.0033 Tc 0.0033 Tw (Bernard, C. \(1994\). )Tj /TT5 1 Tf 8.001 0 TD -0.0038 Tc 0.0037 Tw (Psychological services for law enforce-)Tj -6.801 -1.398 TD -0.0149 Tc 0 Tw (ment)Tj /TT2 1 Tf 1.89 0 TD -0.0116 Tc -0.0628 Tw [(. New )32.3(Y)101.6(ork: )14.3(W)56.2(iley)63.4(.)]TJ -3.09 -1.8 TD -0.0058 Tc -0.062 Tw [(Bifulco, )48.7(A.T)69.2(., Brown, G)120.2(.)12(W)90.2(.)-1.3( & Harris, )18.7(T)77(.O. \(1987\). Childhood)]TJ 1.2 -1.401 TD -0.0033 Tc 0.1016 Tw (loss of parent, lack of adequate parental care and adult)Tj T* -0.0037 Tc -0.062 Tw [(depression: A)58.5( )-50.7(replication. )]TJ /TT5 1 Tf 10.314 0 TD -0.0039 Tc -0.0116 Tw [(Journal of )17.2(Affective Disor)32.1(ders,)]TJ -10.314 -1.398 TD -0.034 Tc 0 Tw (12)Tj /TT2 1 Tf 0.945 0 TD -0.027 Tc -0.06 Tw (, 115-128.)Tj -2.145 -1.8 TD -0.0034 Tc 0.0624 Tw [(Blau, T)76.4(.H. )-17.6(\(1994\).)]TJ /TT5 1 Tf 7.395 0 TD -0.0039 Tc 0.0811 Tw [( Psychological services for law enfor)29.1(ce-)]TJ -6.195 -1.401 TD -0.0149 Tc 0 Tw (ment)Tj /TT2 1 Tf 1.89 0 TD -0.0116 Tc -0.0628 Tw [(. New )32.3(Y)101.6(ork: )14.3(W)56.2(iley)63.4(.)]TJ -3.09 -1.8 TD -0.0064 Tc -0.0617 Tw (Blum, L.N. \(2000\). )Tj /TT5 1 Tf 7.671 0 TD -0.0068 Tc -0.0625 Tw (Force under pressure: How cops live and)Tj -6.471 -1.401 TD -0.004 Tc -0.035 Tw (why they die)Tj /TT2 1 Tf 4.884 0 TD -0.0039 Tc -0.0349 Tw [(. New )29.2(Y)103.3(ork: Lantern Books.)]TJ -6.084 -1.8 TD -0.0278 Tc -0.0622 Tw [(Bonanno, G)116.2(.A. \(2005\). Resilience in the face of potential trauma.)]TJ /TT5 1 Tf 1.2 -1.398 TD -0.0038 Tc -0.044 Tw (Current Directions in Psycholoical Science, 14)Tj /TT2 1 Tf 18.495 0 TD -0.0037 Tc -0.045 Tw (, 135-138.)Tj -19.695 -1.8 TD -0.0039 Tc -0.055 Tw (Bowman, M. \(1997\). )Tj /TT5 1 Tf 8.43 0 TD (Individual differences in posttraumatic)Tj -7.23 -1.401 TD 0.114 Tw (response: Problems with the adversity-distress connec-)Tj T* -0.0086 Tc 0 Tw (tion)Tj /TT2 1 Tf 1.53 0 TD -0.0072 Tc -0.0617 Tw (. 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Meta-analy-)]TJ 1.2 -1.401 TD 0.0092 Tc 0.125 Tw (sis of risk factors for posttraumatic stress disorder in)Tj 0 -1.398 TD -0.0039 Tc 0.01 Tw (trauma-exposed adults. )Tj /TT5 1 Tf 9.459 0 TD 0.0125 Tw (Journal of Consulting and Clini-)Tj -9.459 -1.401 TD -0.0041 Tc -0.0596 Tw [(cal Psychology)49.9(, 68)]TJ /TT2 1 Tf 7.341 0 TD -0.0038 Tc -0.065 Tw (, 748-766.)Tj -8.541 -1.8 TD -0.0071 Tc -0.0622 Tw [(Bull, S.J., Shambrook, C.J., James, )10.9(W)108.7(.)0( & Brooks, J.E. \(2005\).)]TJ 1.2 -1.401 TD -0.0037 Tc 0.1221 Tw [(T)73.1(owards an understanding of mental toughness in elite)]TJ 0 -1.398 TD -0.0036 Tc 0.01 Tw (English cricketers. )Tj /TT5 1 Tf 7.644 0 TD -0.0041 Tc [(Journal of )16.8(Applied Sport Psychology)49.9(,)]TJ -7.644 -1.401 TD -0.034 Tc 0 Tw (17)Tj /TT2 1 Tf 0.945 0 TD -0.027 Tc -0.06 Tw (, 209-227.)Tj -2.145 -1.8 TD -0.0098 Tc -0.0617 Tw [(Calhoun, L.G)116.2(. & )14.2(T)70(edeschi, R.G)122.2(. \(1999\). )]TJ /TT5 1 Tf 15.345 0 TD -0.0104 Tc -0.065 Tw (Facilitating posttrau-)Tj -14.145 -1.401 TD -0.0047 Tc -0.055 Tw (matic growth)Tj /TT2 1 Tf 5.199 0 TD -0.0038 Tc -0.0584 Tw (. Mahwah, NJ: Erlbaum.)Tj -6.399 -1.8 TD -0.0037 Tc -0.0279 Tw [(Cannon, )14.5(W)106.1(.B. \(1914\). )14.5(The interrelations of emotions as sug-)]TJ 1.2 -1.398 TD 0.0122 Tc 0.125 Tw (gested by recent physiological researchers. )Tj /TT5 1 Tf 18.546 0 TD 0.0095 Tc 0 Tw (American)Tj -18.546 -1.401 TD -0.004 Tc -0.0364 Tw [(Journal of Psychology)53(, 25)]TJ /TT2 1 Tf 10.239 0 TD -0.0036 Tc -0.04 Tw (, 256-282.)Tj -11.439 -1.8 TD -0.0611 Tw [(Cannon, W)106.2(.B. )-14.9(\(1939\). )]TJ /TT5 1 Tf 8.805 0 TD -0.0041 Tc -0.0487 Tw (The wisdom of the body)Tj /TT2 1 Tf 9.219 0 TD -0.0036 Tc -0.05 Tw (. Philadelphia:)Tj -16.824 -1.401 TD -0.0013 Tc 0 Tw (Norton.)Tj -1.2 -1.8 TD -0.0145 Tc -0.0621 Tw [(Carlier)36.5(, I.V)123.5(.E. & Gersons, B.P)105.5(.R. \(1995\). Partial PTSD: )15.6(The is-)]TJ 1.2 -1.398 TD -0.0034 Tc 0.0787 Tw (sue of psychological scars and the occurrence of PTSD)Tj 0 -1.401 TD -0.0029 Tc 0 Tw (symptoms. )Tj /TT5 1 Tf 4.566 0 TD -0.0039 Tc -0.0208 Tw (Journal of Nervous and Mental Disease, 183)Tj /TT2 1 Tf 17.685 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.401 TD -0.0511 Tc (107-109.)Tj -1.2 -1.8 TD -0.0137 Tc -0.0624 Tw [(Carlier)37.3(, I.V)127.3(.E., Lamberts, R.D. & Gersons, B.P)106.3(.R. \(1997\). Risk)]TJ 1.2 -1.398 TD -0.0025 Tc 0.125 Tw (factors for posttraumatic stress symptomatology in po-)Tj 0 -1.401 TD -0.003 Tc 0.0369 Tw [(lice of)18(ficers: )53.9(A)59.2( prospective analysis. )]TJ /TT5 1 Tf 14.769 0 TD -0.0043 Tc 0.0402 Tw (Journal of Nervous)Tj -14.769 -1.401 TD -0.0041 Tc -0.04 Tw (and Mental Disease, 185)Tj /TT2 1 Tf 9.789 0 TD -0.0036 Tc (, 498-506.)Tj -10.989 -1.8 TD -0.0038 Tc -0.0299 Tw [(DeAngelis, )14.3(T)79(.)-0.4( \(1995\). Firefighters)50.2(s PTSD at dangerous lev-)]TJ 1.2 -1.398 TD -0.0035 Tc -0.0623 Tw [(els. )56.2(A)8.8(P)86.5(A)58.7( Monitor)38.5(, February)65.5(, pp. 36-37.)]TJ -1.2 -1.8 TD -0.0034 Tc 0.066 Tw [(Dienstbier)35.6(, R. )53.9(A. \(1989\). )53.9(Arousal and physiological tough-)]TJ 1.2 -1.401 TD -0.0032 Tc 0.1135 Tw (ness: Implications for mental and physical health. )Tj /TT5 1 Tf 20.739 0 TD -0.0053 Tc 0 Tw (Psy-)Tj -20.739 -1.401 TD -0.0038 Tc -0.0094 Tw [(chological Review)71.2(, 96,)]TJ /TT2 1 Tf 8.934 0 TD -0.015 Tw [( 84-100.)]TJ -10.134 -1.8 TD -0.0147 Tc -0.0616 Tw [(Doss, )15.4(W)104.1(.)-0.1( \(2006\). Exercising emotional control. )]TJ /TT5 1 Tf 18.045 0 TD -0.0158 Tc 0 Tw (Police)Tj /TT2 1 Tf 2.466 0 TD -0.0151 Tc -0.065 Tw (, March,)Tj -19.311 -1.398 TD -0.022 Tc -0.06 Tw (pp. 68-73.)Tj -1.2 -1.8 TD -0.0036 Tc -0.0077 Tw [(Doss, W)106.2(.)-0.8( )-15.1(\(2007\). )]TJ /TT5 1 Tf 6.954 0 TD -0.0039 Tc 0.008 Tw (Condition to win: Dynamic techniques for)Tj -5.754 -1.401 TD -0.0055 Tc -0.0617 Tw (performance oriented mental conditioning)Tj /TT2 1 Tf 16.569 0 TD -0.0058 Tc -0.0625 Tw [(. Flushing, NY)84.2(:)]TJ -16.569 -1.401 TD -0.004 Tc -0.0525 Tw (Looseleaf Law Press.)Tj -1.2 -1.8 TD 0.0017 Tc 0.125 Tw (Dunning, C. \(1999\). Postintervention strategies to reduce)Tj 1.2 -1.398 TD -0.0191 Tc -0.0624 Tw [(police trauma: )53(A)58.1( paradigm shift. In J.M. )17(V)61.1(iolanti & D. Paton)]TJ 0 -1.401 TD -0.003 Tc 0 Tw (\(Eds.\), )Tj /TT5 1 Tf 2.955 0 TD -0.0038 Tc 0.062 Tw (Police trauma: Psychological aftermath of civil-)Tj -2.955 -1.401 TD -0.0095 Tc -0.06 Tw (ian combat)Tj /TT2 1 Tf 4.32 0 TD -0.0092 Tc -0.0625 Tw [( \(pp. 269-289\). Springfield: Charles C Thomas.)]TJ -5.52 -1.8 TD -0.0043 Tc -0.0621 Tw [(Durham, )17.1(T)75.5(.)13.5(W)85.7(., McCammon, S.L. & )53.1(Allison, E.J. \(1985\). )14.1(The)]TJ 1.2 -1.398 TD 0.0076 Tc 0.125 Tw (psychological impact of disaster on rescue personnel.)Tj /TT5 1 Tf 0 -1.401 TD -0.004 Tc -0.0349 Tw [(Annals of Emergency Medicine, 14)]TJ /TT2 1 Tf 13.761 0 TD -0.0038 Tc -0.035 Tw (, 664-668.)Tj 10.539 63.999 TD -0.0061 Tc -0.0626 Tw [(Dyregrov)56.9(, )53.8(A. \(1989\). Caring for helpers in disaster situations:)]TJ 1.2 -1.398 TD -0.0032 Tc 0.1025 Tw (Psychological debriefing. )Tj /TT5 1 Tf 10.596 0 TD -0.0042 Tc 0.105 Tw (Disaster Management, 2)Tj /TT2 1 Tf 9.978 0 TD -0.003 Tc (, 25-)Tj -20.574 -1.401 TD -0.0625 Tc 0 Tw (30.)Tj -1.2 -1.8 TD -0.0033 Tc 0.0349 Tw [(Dyregrov)62.7(, )50.6(A. \(1997\). )14.6(The process in psychological debrief-)]TJ 1.2 -1.401 TD -0.0035 Tc 0 Tw (ing. )Tj /TT5 1 Tf 1.734 0 TD -0.0041 Tc -0.0324 Tw [(Journal of T)49.9(raumatic S)31.9(t)2.9(r)28.9(ess, 10)]TJ /TT2 1 Tf 12.327 0 TD -0.0038 Tc -0.035 Tw (, 589-605.)Tj -15.261 -1.8 TD 0.0378 Tw [(Evans, R.W)86.1(. \(1992\). )14(The postconcussion syndrome and the)]TJ 1.2 -1.398 TD -0.0035 Tc -0.061 Tw [(sequelae of mild head injury)62.5(.)-5.5( )]TJ /TT5 1 Tf 11.421 0 TD -0.0044 Tc -0.062 Tw [(Neur)31.6(ologic Clinics, 10)]TJ /TT2 1 Tf 8.835 0 TD -0.0048 Tc -0.065 Tw (, 815-)Tj -20.256 -1.401 TD -0.0583 Tc 0 Tw (847.)Tj -1.2 -1.8 TD -0.0028 Tc -0.0284 Tw [(Everly)63.2(, G)117.2(.S., Flannery)63.2(, R.B. & Mitchell, J.T)72.2(. \(2000\). Critical)]TJ 1.2 -1.401 TD -0.0036 Tc 0.1237 Tw [(incident stress management: )50.5(A)58.6( review of the literature.)]TJ /TT5 1 Tf 0 -1.398 TD -0.0043 Tc 0.0317 Tw [(Aggr)31.7(ession and V)67.7(iolent Behavior)106.7(, 5)]TJ /TT2 1 Tf 14.079 0 TD -0.0031 Tc 0.035 Tw (, 23-40.)Tj -15.279 -1.8 TD -0.0029 Tc 0.0048 Tw [(Everly)63.1(, G)117.1(.S. & Mitchell, J.T)72.1(. \(1997\). )]TJ /TT5 1 Tf 14.694 0 TD -0.0041 Tc 0.0079 Tw [(Critical incident str)28.9(ess)]TJ -13.494 -1.401 TD 0.0083 Tw (management \(CISM\): A new era and standard of care in)Tj T* -0.0038 Tc -0.025 Tw (crisis intervention)Tj /TT2 1 Tf 7.155 0 TD -0.0028 Tc (. Ellicott City: Chevron.)Tj -8.355 -1.8 TD -0.0075 Tc -0.0625 Tw (Everstine, D.S. & Everstine, L. \(1993\). )Tj /TT5 1 Tf 15.216 0 TD -0.0089 Tc (The trauma response:)Tj -14.016 -1.398 TD -0.0039 Tc -0.035 Tw [(T)57.3(r)34.3(eatment for emotional injury)]TJ /TT2 1 Tf 12.105 0 TD -0.0349 Tw [(. New )32.3(Y)103.4(ork: Norton.)]TJ -13.305 -1.8 TD -0.0075 Tc -0.0624 Tw [(Fullerton, C.S., McCarroll, J.E., Ursano, R.J. & )19.6(W)54.3(r)0.4(ight, K.M.)]TJ 1.2 -1.401 TD 0.027 Tc 0.125 Tw (\(1992\). Psychological responses of rescue workers:)Tj T* -0.0036 Tc 0.0384 Tw (Firefighters and trauma. )Tj /TT5 1 Tf 9.915 0 TD -0.0042 Tc 0.04 Tw (American Journal of Orthopsy-)Tj -9.915 -1.398 TD -0.0111 Tc -0.0589 Tw [(chiatr)-5.1(y)57.7(,)-1.1( 62)]TJ /TT2 1 Tf 4.104 0 TD -0.0113 Tc -0.06 Tw (, 371-378.)Tj -5.304 -1.8 TD -0.0031 Tc -0.0307 Tw [(Garmezy)62.9(, N. \(1993\). Children in poverty: Resilience despite)]TJ 1.2 -1.401 TD -0.0088 Tc 0 Tw (risk. )Tj /TT5 1 Tf 1.884 0 TD -0.0111 Tc -0.0589 Tw [(Psychiatr)-5.1(y)57.7(,)-1.1( 56)]TJ /TT2 1 Tf 5.517 0 TD -0.06 Tw (, 127-136.)Tj -8.601 -1.8 TD -0.0163 Tc -0.0623 Tw [(Garmezy)61.7(, N., Masten, )52.9(A.S. & )19.9(T)75.5(ellegen, )52.9(A. \(1984\). )13.9(The study of)]TJ 1.2 -1.401 TD -0.0036 Tc 0.0737 Tw [(stress and competence in children: )53.3(A)58.6( building block for)]TJ 0 -1.398 TD -0.0032 Tc -0.0552 Tw [(developmental psychopathology)59.8(. )]TJ /TT5 1 Tf 13.2 0 TD -0.0041 Tc -0.0575 Tw (Child Development, 55)Tj /TT2 1 Tf 9.051 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.401 TD -0.0513 Tc (97-111.)Tj -1.2 -1.8 TD -0.0032 Tc 0.0113 Tw (Gentz, D. \(1991\). The psychological impact of critical inci-)Tj 1.2 -1.401 TD -0.0073 Tc -0.0622 Tw (dents on police officers. In J. Reese, J. Horn & C. Dunning)Tj 0 -1.398 TD -0.003 Tc 0 Tw (\(Eds.\), )Tj /TT5 1 Tf 2.835 0 TD -0.0042 Tc -0.0617 Tw (Critical incidents in policing)Tj /TT2 1 Tf 11.22 0 TD -0.004 Tc -0.0616 Tw [( \(pp. 1)32(19-121\). )23.1(W)93.9(ash-)]TJ -14.055 -1.401 TD -0.0091 Tc -0.062 Tw [(ington DC: US Government Printing Office.)]TJ -1.2 -1.8 TD -0.0103 Tc -0.1144 Tw [(Goldber)19.7(g, A.S. )-53(\(1998\). )]TJ /TT5 1 Tf 8.976 0 TD -0.0108 Tc -0.0623 Tw (Sports slump busting: 10 steps to men-)Tj -7.776 -1.401 TD -0.0048 Tc -0.0613 Tw (tal toughness and peak performance.)Tj /TT2 1 Tf 14.394 0 TD -0.0051 Tc -0.0633 Tw [( Champaign, IL: Hu-)]TJ -14.394 -1.398 TD -0.0079 Tc -0.0599 Tw (man Kinetics.)Tj -1.2 -1.8 TD -0.0032 Tc -0.0428 Tw (Gould, D., Hodge, K., Peterson, K. & Petlichkoff, L. \(1987\).)Tj 1.2 -1.401 TD -0.0036 Tc 0.067 Tw (Psychological foundations of coaching: Similarities and)Tj T* -0.013 Tw (differences among intercollegiate wrestling coaches. )Tj /TT5 1 Tf 21.015 0 TD -0.0075 Tc 0 Tw (The)Tj -21.015 -1.398 TD -0.0039 Tc -0.04 Tw (Sport Psychologist, 1)Tj /TT2 1 Tf 8.37 0 TD -0.0037 Tc -0.045 Tw (, 293-308.)Tj -9.57 -1.8 TD -0.004 Tc 0 Tw [(Grossman, D. & Christensen, L.W)86(.)-1( \(2007\). )]TJ /TT5 1 Tf 17.256 0 TD -0.0046 Tc 0.0025 Tw (On combat: The)Tj -16.056 -1.401 TD -0.0037 Tc 0.0118 Tw [(psychology and physiology of deadly conflict in war and)]TJ T* -0.0043 Tc -0.005 Tw (in peace)Tj /TT2 1 Tf 3.324 0 TD -0.0039 Tc (. PPCT Research Publications.)Tj -4.524 -1.8 TD -0.003 Tc -0.045 Tw [(Hays, K.F)78(. & Brown, C.H. \(2004\). )]TJ /TT5 1 Tf 13.695 0 TD -0.004 Tc -0.0463 Tw [(Y)93.2(our)29(e on! Consulting for)]TJ -12.495 -1.398 TD -0.003 Tc 0.125 Tw (peak performance.)Tj /TT2 1 Tf 7.575 0 TD -0.0024 Tc 0.1064 Tw [( W)89.5(ashington )-18.3(DC: )36(American )-18.8(Psycho-)]TJ -7.575 -1.401 TD -0.004 Tc 0.007 Tw (logical Association.)Tj ET endstream endobj 204 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 207 0 obj << /Length 11286 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0063 Tc 0.0781 Tw (122 )Tj /TT3 1 Tf 2.3587 0 TD -0.0053 Tc 0.0812 Tw (Miller Stress and Resilience in Law Enforcement)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0057 Tc -0.08 Tw [(Henry)66.3(,)-8.4( V)137.5(.E. )-17.8(\(2004\). )]TJ /TT5 1 Tf 7.74 0 TD -0.007 Tc -0.0625 Tw (Death work: Police, trauma, and the psy-)Tj -6.54 -1.398 TD -0.0038 Tc -0.0351 Tw (chology of survival)Tj /TT2 1 Tf 7.524 0 TD -0.0034 Tc -0.0379 Tw [(. New )29.7(Y)103.8(ork: Oxford University Press.)]TJ -8.724 -1.8 TD -0.0084 Tc -0.0625 Tw [(Hoge, E.A., )51.6(Austin, E.D. & Pollack, M.H. \(2007\). Resilience:)]TJ 1.2 -1.401 TD 0.0138 Tc 0.125 Tw (Research evidence and conceptual considerations for)Tj T* 0.0053 Tc [(posttraumatic stress disorder)50.3(.)-5.7( )]TJ /TT5 1 Tf 12.441 0 TD 0.0047 Tc 0.1259 Tw [(Depr)34.7(ession and )17.6(Anxiety)46.7(,)]TJ -12.441 -1.398 TD -0.034 Tc 0 Tw (24)Tj /TT2 1 Tf 0.945 0 TD -0.027 Tc -0.06 Tw (, 139-152.)Tj -2.145 -1.8 TD -0.0035 Tc 0.0365 Tw [(Higgins, G)116.5(.O. \(1994\). )]TJ /TT5 1 Tf 8.946 0 TD -0.0042 Tc 0.0376 Tw [(Resilient adults: Over)31.8(coming a cr)-7.2(uel)]TJ -7.746 -1.401 TD -0.0045 Tc 0 Tw (past.)Tj /TT2 1 Tf 1.899 0 TD -0.0033 Tc 0.0634 Tw [( San Francisco: Jossey-Bass.)]TJ -3.099 -1.8 TD -0.0035 Tc -0.0578 Tw (Janik, J. \(1991\). What value are cognitive defenses in critical)Tj 1.2 -1.401 TD -0.0031 Tc -0.0375 Tw (incident stress? In J. Reese, J. Horn & C. Dunning \(Eds.\),)Tj /TT5 1 Tf 0 -1.398 TD -0.0037 Tc 0.0333 Tw (Critical incidents in policing)Tj /TT2 1 Tf 11.52 0 TD -0.0039 Tc 0.0357 Tw [( \(pp. 149-158\). )17.8(W)93.9(ashington)]TJ -11.52 -1.401 TD -0.0142 Tc -0.0625 Tw (DC: US Government Printing Office.)Tj -1.2 -1.8 TD -0.0037 Tc 0.0355 Tw [(Jones, J.G)116.3(., Hanton, S. & Connaughton, D. \(2002\). )17.2(What is)]TJ 1.2 -1.401 TD -0.0035 Tc 0.1027 Tw [(this thing called mental toughness? )50.3(An investigation of)]TJ 0 -1.398 TD -0.0008 Tc 0.125 Tw (elite performers. )Tj /TT5 1 Tf 7.095 0 TD -0.0018 Tc [(Journal of )16.2(Applied Spor)-7.8(t Psychology)49.2(,)]TJ -7.095 -1.401 TD -0.034 Tc 0 Tw (14)Tj /TT2 1 Tf 0.945 0 TD -0.027 Tc -0.06 Tw (, 205-218.)Tj -2.145 -1.8 TD -0.0038 Tc 0.0015 Tw [(Kardiner)35.2(, A. )-50.9(\(1941\). )]TJ /TT5 1 Tf 8.436 0 TD -0.0042 Tc 0.0539 Tw [(The traumatic neur)31.8(oses of war)106.8(.)]TJ /TT2 1 Tf 12.483 0 TD -0.0053 Tc 0.0403 Tw [( W)92.5(ash-)]TJ -19.719 -1.401 TD -0.0039 Tc -0.0575 Tw (ington DC: National Research Council.)Tj -1.2 -1.8 TD -0.0077 Tc -0.0621 Tw (Karlsson, I. & Christianson, S.A. \(2003\). the phenomenology)Tj 1.2 -1.398 TD -0.0035 Tc -0.0191 Tw (of traumatic experiences in police work. )Tj /TT5 1 Tf 16.101 0 TD -0.0039 Tc -0.02 Tw (Policing: An In-)Tj -16.101 -1.401 TD 0.005 Tc 0.125 Tw (ternational Journal of Police Strategies and Manage-)Tj T* -0.0136 Tc -0.06 Tw (ment, 26,)Tj /TT2 1 Tf 3.516 0 TD -0.0138 Tc -0.0625 Tw [( 419-438.)]TJ -4.716 -1.8 TD -0.0032 Tc 0.0479 Tw (Kobasa, S.C. \(1979a\). Personality and resistance to illness.)Tj /TT5 1 Tf 1.2 -1.398 TD -0.0042 Tc -0.0529 Tw [(American Journal of Community Psychology)49.8(, 7)]TJ /TT2 1 Tf 18.504 0 TD -0.0036 Tc -0.055 Tw (, 413-423.)Tj -19.704 -1.8 TD -0.0032 Tc 0.0085 Tw [(Kobasa, S.C. \(1979b\). S)14.8(tressful life events, personality)62.8(, and)]TJ 1.2 -1.401 TD 0.0112 Tw [(health: )51(An inquiry into hardiness. )]TJ /TT5 1 Tf 13.56 0 TD -0.004 Tc 0.0125 Tw (Journal of Personality)Tj -13.56 -1.401 TD 0.0335 Tw [(and Social Psychology)49.9(, 37)]TJ /TT2 1 Tf 10.56 0 TD -0.0042 Tc 0.0357 Tw [(, 1-1)28.8(1.)]TJ -11.76 -1.8 TD -0.0034 Tc 0.0066 Tw (Kobassa, S.C., Maddi, S. & Cahn, S. \(1982\). Hardiness and)Tj 1.2 -1.398 TD -0.003 Tc 0.0914 Tw [(health: )54.2(A)59.2( prospective study)60(. )]TJ /TT5 1 Tf 11.574 0 TD -0.0039 Tc 0.0916 Tw (Journal of Personality and)Tj -11.574 -1.401 TD -0.0041 Tc -0.0317 Tw [(Social Psychology)49.9(, 42)]TJ /TT2 1 Tf 8.661 0 TD -0.0038 Tc -0.035 Tw (, 168-177.)Tj -9.861 -1.8 TD -0.0165 Tc -0.0621 Tw [(Locke, E.A., Frederick, E., Lee, C., & Bubko, P)106.5(.)-0.3( \(1984\). Ef)19.5(fect)]TJ 1.2 -1.401 TD -0.0009 Tc 0.125 Tw (of self-efficacy goals and task strategy on task perfor-)Tj 0 -1.398 TD -0.0033 Tc -0.015 Tw (mance. )Tj /TT5 1 Tf 3.306 0 TD -0.0041 Tc -0.0169 Tw [(Journal of )17.5(Applied Psychology)49.9(, 64)]TJ /TT2 1 Tf 13.59 0 TD -0.0038 Tc -0.02 Tw (, 241-251.)Tj -18.096 -1.8 TD -0.0034 Tc 0.0858 Tw [(Loehr)35.6(, J.E. \(1995\). )]TJ /TT5 1 Tf 7.959 0 TD -0.004 Tc 0.087 Tw [(The new toughness training for spor)-7(ts.)]TJ /TT2 1 Tf -6.759 -1.401 TD -0.0114 Tc -0.0901 Tw [(New Y)104.8(ork: )-28.4(Penguin.)]TJ -1.2 -1.8 TD -0.0029 Tc 0.0073 Tw [(Luthar)36.1(, S.S. \(1991\). )18.5(V)65.3(ulnerability and resilience: )54.5(A)59.3( study of)]TJ 1.2 -1.401 TD -0.0036 Tc -0.01 Tw (high-risk adolescents. )Tj /TT5 1 Tf 8.871 0 TD -0.0042 Tc (Child Development, 62)Tj /TT2 1 Tf 9.144 0 TD -0.0037 Tc -0.015 Tw (, 600-616.)Tj -19.215 -1.8 TD -0.0071 Tc -0.0618 Tw [(Luthar)31.9(, S.S., Cicchetti, D. & Becker)34.9(, B. \(2000\). )17.3(The construct)]TJ 1.2 -1.398 TD -0.0034 Tc 0.0393 Tw [(of resilience: )50.5(A)58.8( critical evaluation and guidelines for fu-)]TJ 0 -1.401 TD -0.0036 Tc -0.0575 Tw (ture work. )Tj /TT5 1 Tf 4.209 0 TD -0.0041 Tc (Child Development, 71)Tj /TT2 1 Tf 9.051 0 TD -0.0037 Tc -0.06 Tw (, 543-562.)Tj -14.46 -1.8 TD -0.0108 Tc -0.0625 Tw (Maddi, S.R. & Khoshaba, D.M. \(1994\). Hardiness and mental)Tj 1.2 -1.401 TD -0.0033 Tc 0 Tw (health. )Tj /TT5 1 Tf 2.895 0 TD -0.0039 Tc -0.0262 Tw (Journal of Personality Assessment, 63)Tj /TT2 1 Tf 15.06 0 TD -0.0037 Tc -0.03 Tw (, 265-274.)Tj 6.345 63 TD -0.0035 Tc 0.005 Tw (Maddi, S.R. & Khoshaba, D.M. \(2005\). )Tj /TT5 1 Tf 16.041 0 TD -0.0039 Tc (Resilience at work:)Tj -14.841 -1.398 TD -0.0037 Tc 0.0444 Tw (How to succeed no matter what life throws at you)Tj /TT2 1 Tf 20.085 0 TD -0.0045 Tc 0.045 Tw (. New)Tj -20.085 -1.401 TD -0.0301 Tc -0.1109 Tw [(Y)101.1(ork: Amacom.)]TJ -1.2 -1.8 TD -0.0045 Tc 0.0588 Tw [(Maslow)58.5(,)-5.2( A.H. )-50.5(\(1968\). )]TJ /TT5 1 Tf 9.216 0 TD -0.0042 Tc 0.1095 Tw [(T)93(owar)28.8(d a psychology of being )]TJ /TT2 1 Tf 12.669 0 TD -0.006 Tc 0 Tw (\(2nd)Tj -20.685 -1.401 TD -0.0038 Tc -0.017 Tw [(ed.\). Princeton: )17.7(V)112.4(anNostrand.)]TJ -1.2 -1.8 TD -0.0036 Tc -0.0567 Tw [(Matsakis, A. )-53.8(\(1994\). )]TJ /TT5 1 Tf 8.364 0 TD -0.0042 Tc -0.0051 Tw [(Post-traumatic str)28.8(ess disor)31.8(der: )16.7(A)21.6( com-)]TJ -7.164 -1.398 TD -0.0199 Tw [(plete tr)28.9(eatment guide)]TJ /TT2 1 Tf 8.346 0 TD -0.004 Tc [(. Oakland, CA: New Harbinger)50(.)]TJ -9.546 -1.8 TD -0.0033 Tc -0.045 Tw [(Max, D.J. \(2000\). )17.7(The cop and the therapist. )]TJ /TT5 1 Tf 17.445 0 TD -0.0054 Tc -0.0472 Tw [(New Y)84.6(ork T)51.6(imes)]TJ -16.245 -1.401 TD -0.0084 Tc 0 Tw (Magazine)Tj /TT2 1 Tf 3.885 0 TD -0.0066 Tc -0.0625 Tw (, December 3, pp. 94-98.)Tj -5.085 -1.8 TD -0.0146 Tc -0.0617 Tw (McCann, I.L. & Pearlman, L.A. \(1990\). )Tj /TT5 1 Tf 15.264 0 TD -0.016 Tc -0.065 Tw (Psychological trauma)Tj -14.064 -1.401 TD -0.0038 Tc -0.0065 Tw [(and the adult survivor: Theory)56(,)-0.1( therapy)50.2(, and transforma-)]TJ 0 -1.398 TD -0.0086 Tc 0 Tw (tion)Tj /TT2 1 Tf 1.524 0 TD -0.0081 Tc -0.0616 Tw [(. New )31(Y)105.1(ork: Brunner/Mazel.)]TJ -2.724 -1.8 TD -0.0026 Tc -0.031 Tw [(McNally)60.4(, R.J., Bryant, R.A. & Ehlers, )54.5(A. \(2003\). 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Defining)]TJ 1.2 -1.401 TD -0.004 Tc -0.0125 Tw [(and understanding mental toughness within soccer)53(.)-5.5( )]TJ /TT5 1 Tf 20.376 0 TD -0.006 Tc 0 Tw [(Jour)15(-)]TJ -20.376 -1.401 TD -0.0039 Tc 0.0011 Tw [(nal of )17.2(Applied Sport Psychology)50.1(, 17)]TJ /TT2 1 Tf 14.244 0 TD -0.0036 Tc 0.005 Tw (, 326-332.)Tj -15.444 -1.8 TD -0.0032 Tc -0.0067 Tw [(T)73.6(och, H. \(2002\). )]TJ /TT5 1 Tf 6.801 0 TD -0.0034 Tc -0.0075 Tw [(S)37.6(t)3.6(r)32.6(ess in policing.)]TJ /TT2 1 Tf 7.044 0 TD -0.0047 Tc -0.0263 Tw [( W)93.1(ashington )-18.5(DC: )31.3(Ameri-)]TJ -12.645 -1.398 TD -0.0035 Tc 0.1054 Tw [(can Psychological )53.9(Association.)]TJ -1.2 -1.8 TD 0.04 Tw (Trimble, M.R. \(1981\). )Tj /TT5 1 Tf 9.24 0 TD -0.004 Tc 0.0416 Tw (Post-traumatic neurosis: From rail-)Tj -8.04 -1.401 TD -0.0166 Tw (way spine to whiplash)Tj /TT2 1 Tf 8.73 0 TD -0.0026 Tc -0.0178 Tw [(. New )32.3(Y)104.6(ork: )17.3(W)56.2(iley)60.4(.)]TJ -9.93 -1.8 TD -0.0043 Tc -0.0625 Tw [(V)63.9(iolanti, J.M. \(1999\). Death on duty: Police survivor trauma.)]TJ 1.2 -1.401 TD -0.0119 Tc -0.0621 Tw [(In J.M. )18.1(V)59.3(iolanti & D. Paton \(Eds.\), )]TJ /TT5 1 Tf 13.401 0 TD -0.013 Tc -0.0625 Tw (Police trauma: Psycho-)Tj -13.401 -1.398 TD -0.0121 Tc -0.0612 Tw (logical aftermath of civilian combat)Tj /TT2 1 Tf 13.71 0 TD -0.0634 Tw [( \(pp. 139-158\). Spring-)]TJ -13.71 -1.401 TD -0.0084 Tc -0.0617 Tw (field: Charles C Thomas.)Tj -1.2 -1.8 TD -0.0054 Tc -0.0625 Tw [(V)62.8(iolanti, J.M. \(2000\). Scripting trauma: )15.6(The impact of patho-)]TJ 1.2 -1.401 TD -0.0034 Tc -0.0189 Tw [(genic intervention. In J. )14.6(V)64.8(iolanti, D. Paton & C. Dunning)]TJ 0 -1.398 TD -0.0029 Tc 0 Tw (\(Eds.\), )Tj /TT5 1 Tf 2.886 0 TD -0.0038 Tc -0.015 Tw (Posttraumatic stress intervention: Challenges, is-)Tj -2.886 -1.401 TD -0.0066 Tc -0.0616 Tw (sues, and perspectives )Tj /TT2 1 Tf 8.835 0 TD -0.0068 Tc -0.0617 Tw (\(pp. 153-165\). 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High-risk children in young adulthood: )54.5(A)]TJ 1.2 -1.401 TD -0.0028 Tc -0.0435 Tw (longitudinal study from birth to 32 years. )Tj /TT5 1 Tf 16.299 0 TD -0.0044 Tc -0.045 Tw (American Jour-)Tj -16.299 -1.401 TD -0.0038 Tc -0.0234 Tw [(nal of Orthopsychiatry)56(,)0.4( 59)]TJ /TT2 1 Tf 10.389 0 TD -0.0031 Tc -0.025 Tw (, 72-81.)Tj -11.589 -1.8 TD -0.0208 Tc -0.0617 Tw [(W)92(erner)39.2(, E.E. & Smith, R.S. \(1992\).)]TJ /TT5 1 Tf 13.134 0 TD -0.0218 Tc -0.0626 Tw [( Over)26.2(coming the odds: High)]TJ -11.934 -1.398 TD -0.004 Tc -0.0372 Tw [(risk childr)32(en fr)32(om birth to adulthood)]TJ /TT2 1 Tf 14.361 0 TD -0.0035 Tc -0.0382 Tw [(. Ithaca, NY)89.5(: Cornell)]TJ -14.361 -1.401 TD -0.003 Tc 0.04 Tw (University Press.)Tj -1.2 -1.8 TD -0.0051 Tc -0.0623 Tw [(W)92.7(ester)36.9(, S.R. & L)48.9(yubelsky)60.9(, J. \(2005\). Supporting the thin blue)]TJ 1.2 -1.401 TD -0.0033 Tc 0.0275 Tw (line: Gender-sensitive therapy with male police officers.)Tj /TT5 1 Tf 0 -1.398 TD -0.0039 Tc -0.039 Tw (Professional Psychology: Research and Practice, 36)Tj /TT2 1 Tf 20.721 0 TD -0.0035 Tc -0.04 Tw (, 51-)Tj -20.721 -1.401 TD -0.0625 Tc 0 Tw (58.)Tj -1.2 -1.8 TD -0.0035 Tc 0.0249 Tw [(W)55.3(ilson, J.P)107.5(. \(1994\). )17.4(The historical evolution of PTSD diag-)]TJ 1.2 -1.401 TD -0.004 Tc 0.0175 Tw [(nostic criteria: From Freud to DSM-IV)125(.)-5.5( )]TJ /TT5 1 Tf 15.915 0 TD -0.0046 Tc 0.018 Tw [(Journal of T)49.4(rau-)]TJ -15.915 -1.398 TD -0.0098 Tc -0.06 Tw (matic Stress, 7)Tj /TT2 1 Tf 5.601 0 TD -0.0104 Tc -0.065 Tw (, 681-698.)Tj -6.801 -1.8 TD -0.0042 Tc -0.0614 Tw [(Zimrin, H. \(1986\). )52.8(A)58( profile of survival. )]TJ /TT5 1 Tf 15.645 0 TD -0.0058 Tc -0.0631 Tw [(Child )12.4(Abuse and Ne-)]TJ -14.445 -1.401 TD -0.0112 Tc -0.06 Tw (glect, 10)Tj /TT2 1 Tf 3.285 0 TD -0.012 Tc (, 339-349.)Tj /TT5 1 Tf 9 0 0 9 411 389.01 Tm -0.0047 Tc 0.0056 Tw [(Manuscript received: April 15, 2008)]TJ -1.25 -1.78 TD -0.0334 Tw [(Accepted for Publication: April 27, 2008)]TJ /F1 1 Tf 14 0 0 14 222.66 220.35 Tm 0.0025 Tc 0.1375 Tw (New Editor Appointed)Tj /TT2 1 Tf 10 0 0 10 100.41 205.65 Tm -0.0036 Tc -0.0049 Tw [(The International Journal of Emer)17.4(gency Mental Health is pleased to announce that Laurence Miller)35.4(,)]TJ 0.45 -1.401 TD -0.0032 Tc -0.0509 Tw [(Ph.D. has been appointed as its new Editor for a five-year term \(January)62.8(, 2009 to December)38.8(, 2014\).)]TJ -1.092 -1.398 TD -0.0048 Tc -0.0624 Tw [(D)6.4(r)49.2(. Miller)-40.8()55.2(s)0( tenure will commence with )19.3(V)132.4(olume 1)37.2(1)-0.2( of the Journal. He will begin receiving submissions of)]TJ 1.392 -1.401 TD -0.0035 Tc -0.0235 Tw [(manuscripts from contributing authors as of July)62.5(, 2008. )17.7(The term of the Journal)50.5(s current Editor)38.5(,)]TJ 3.033 -1.401 TD -0.0065 Tc -0.0624 Tw [(Richard L. Levenson, Jr)53.5(., Psy)65.5(.D., CTS, will expire with the last issue of )11.6(V)136.7(olume 10.)]TJ 2.925 -1.398 TD -0.0036 Tc -0.0049 Tw [(He will assume a position as an )50.5(Associate Editor with the Journal.)]TJ ET 2.01 w 1000 M /GS1 gs 85.005 241.995 429.99 -119.99 re S endstream endobj 214 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 216 0 obj << /Length 6129 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (125)Tj /TT3 1 Tf 7 0 0 7 120.66 726.66 Tm -0.0061 Tc 0.021 Tw [(International Journal of Emergency Mental Health, Vol. 10, No. 2, pp. 125-136 2008 Chevron Publishing ISSN 1522-4821)]TJ /TT4 1 Tf 10 0 0 10 102.99 510.36 Tm -0.0042 Tc 0 Tw (Abstract: )Tj /TT5 1 Tf 4.11 0 TD -0.0038 Tc 0.1235 Tw [(Since September 1)71.2(1)-0.5( the envir)32.2(onment of contemporary policing has changed substantially)53.2(. )14.1(A)5.9(t)]TJ -4.11 -1.302 TD -0.0006 Tc 0.125 Tw (the same time, it has become increasingly evident that police officers often demonstrate considerable)Tj 0 -1.299 TD 0.0065 Tc (resilience in the face of the critical incidents they face. This paper examines how resilience can be)Tj T* -0.0037 Tc 0.0096 Tw (developed to promote officer well-being and performance when responding to acts of terrorism. It argues)Tj 0 -1.302 TD -0.0034 Tc -0.0194 Tw (that to achieve this objective, it is necessary to expand the conceptualization of resilience in two important)Tj 0 -1.299 TD -0.0036 Tc 0.0468 Tw (ways. First, terrorism has created an operating environment that differs qualitatively from that in which)Tj T* -0.0022 Tc 0.125 Tw (police agencies had been used to operating. Second, the agency itself plays a more important role in)Tj 0 -1.302 TD -0.0007 Tc 0.1249 Tw [(developing resilience than has hitherto been acknowledged. These new perspectives are integrated to)]TJ 0 -1.299 TD 0.0238 Tc 0.125 Tw (argue that, when developing police resilience, the focus should be on recognizing the reality of)Tj T* -0.0038 Tc 0.0658 Tw (contemporary policing and understanding how agencies and officers can learn from their experience of)Tj 0 -1.302 TD -0.0033 Tc 0.1249 Tw [(challenging events to develop in ways that facilitate their capacity to adapt and cope with challenges)]TJ 0 -1.299 TD -0.0036 Tc -0.0144 Tw (posed by their response to acts of terrorism. The ways in which agency and officer learning can occur and)Tj T* -0.0037 Tc 0.011 Tw (how the lessons learned can be sustained in the form of enhanced resilience are discussed. [International)Tj 0 -1.302 TD -0.0035 Tc 0.0762 Tw (Journal of Emergency Mental Health, 2008, 10\(2\), pp. 125-136].)Tj /TT1 1 Tf 9 0 0 9 209.49 321 Tm -0.0054 Tc 0.0222 Tw (Key words: )Tj /TT5 1 Tf 5.1567 0 TD -0.0051 Tc 0.0243 Tw [(police, terr)37.4(orism, r)34.9(esiliency)51.6(, trauma, or)34.9(ganizations)]TJ ET /GS1 gs 66.99 145.755 m 300 145.755 l S BT 9 0 0 9 66.99 128.01 Tm /GS2 gs -0.0023 Tc 0.1255 Tw [(Douglas Paton, School of Psychology)44.4(, University of T)81(asmania,)]TJ 0 -1.2233 TD -0.0052 Tc 0.078 Tw [(Launceston, T)81.5(asmania, )11.7(Australia; John M. V)68.1(iolanti, Depar)-8.5(tment)]TJ T* 0.0143 Tc 0.125 Tw (of Social and Preventative Medicine, School of Medical and)Tj 0 -1.22 TD -0.0044 Tc -0.0203 Tw [(Biomedical Sciences, S)28.9(tate University of New Y)82.3(ork at Buffalo, NY)85.6(.)]TJ 0 -1.2233 TD -0.0049 Tc 0.0714 Tw (Correspondence concerning this article should be addressed to:)Tj T* -0.0023 Tc 0 Tw (Douglas.Paton@utas.edu.au.)Tj /F1 1 Tf 14 0 0 14 168.9 629.34 Tm 0.0019 Tc 0.1376 Tw [(L)7.5(a)6.2(w Enf)16.9(o)5.5(r)12.6(cement Response to )92(T)57.9(err)12.6(orism:)]TJ -0.7779 -1.1421 TD -0.0048 Tc [(The Role of the Resilient P)31.6(olice Or)5.9(ganization)]TJ /TT2 1 Tf 10 0 0 10 84.99 271.65 Tm -0.0037 Tc 0.0814 Tw (Since September 11, the environment of policing has)Tj -1.8 -1.401 TD -0.0035 Tc 0.0817 Tw [(changed irrevocably)59.5(, with terrorism being an ever)17.5(-present)]TJ 0 -1.398 TD -0.0034 Tc -0.0415 Tw (hazard for police agencies. 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In this)Tj 0 -1.401 TD -0.0019 Tc 0.125 Tw (context, the focus should be on understanding how agen-)Tj T* -0.0034 Tc -0.0489 Tw (cies and officers can learn from their experience of challeng-)Tj 0 -1.398 TD 0.001 Tc 0.125 Tw (ing events and develop a more sophisticated, interpretive)Tj 0 -1.401 TD -0.0032 Tc 0.0045 Tw (schema that facilitates their capacity to adapt and cope with)Tj T* -0.0036 Tc 0.0481 Tw (future challenges. This makes it important to consider how)Tj 0 -1.398 TD -0.003 Tc 0.125 Tw (learning takes place and how the lessons learned are sus-)Tj 0 -1.401 TD -0.0034 Tc -0.0142 Tw (tained in the form of enhanced resilience.)Tj 1.8 -2.001 TD -0.0033 Tc 0.1222 Tw (Given the role of the agency in the development and)Tj -1.8 -1.398 TD 0.0128 Tc 0.125 Tw (maintenance of a schema, any sustained benefit will be)Tj 0 -1.401 TD 0.0012 Tc (strongly influenced by the degree to which new insights,)Tj T* 0.0188 Tc (perspectives, knowledge, and relationships that emerge)Tj 0 -1.398 TD -0.0057 Tc -0.0622 Tw (through operational experience become embedded in the cul-)Tj 0 -1.401 TD -0.0033 Tc -0.0383 Tw (ture of the organization in ways that enhance future adaptive)Tj T* -0.0034 Tc 0.0583 Tw [(capacity)62.6(.)-6.1( )17.6(Thus, it is ar)17.6(gued here that developing a compre-)]TJ 0 -1.398 TD 0.0149 Tc 0.125 Tw (hensive understanding of posttrauma outcomes requires)Tj 0 -1.401 TD 0.0017 Tc [(analysis at the level of both agency and of)16.7(ficer)37.7(, with the)]TJ T* -0.0013 Tc [(interaction between them playing a pivotal role in under-)]TJ 0 -1.398 TD -0.0038 Tc 0.03 Tw (standing and managing resilience.)Tj 1.8 -2.001 TD 0.0063 Tc 0.125 Tw (An important tenet of this paper is the need to give)Tj -1.8 -1.401 TD -0.002 Tc (police agencies a more prominent place in the process of)Tj 25.5 64.8 TD -0.0035 Tc 0 Tw (developing resilience than has hitherto been the norm in the)Tj 0 -1.398 TD -0.006 Tc -0.0625 Tw (literature of traumatic stress. The first argument for including)Tj 0 -1.401 TD -0.0622 Tw (an agency perspective in planning for resilience can be traced)Tj T* -0.0034 Tc 0.0862 Tw (to the recognition that terrorism has resulted in significant)Tj 0 -1.398 TD -0.0016 Tc 0.125 Tw (changes to the environment within which police agencies)Tj 0 -1.401 TD -0.0033 Tc 0.0561 Tw (and their officers work. This environment has not only be-)Tj T* 0.02 Tw (come more challenging, it is also more dynamic than in the)Tj 0 -1.398 TD -0.0071 Tc -0.0625 Tw (past. It is just this kind of circumstance that prompted Berkes,)Tj 0 -1.401 TD -0.0036 Tc 0.0211 Tw (Colding, and Folke \(2003\) to argue for organizations to be-)Tj T* -0.0031 Tc 0.0779 Tw [(come resilient and to develop their capacity to adapt to an)]TJ 0 -1.398 TD -0.0034 Tc 0.1238 Tw (uncertain and riskier future. This paper first discusses the)Tj 0 -1.401 TD -0.0035 Tc 0.0183 Tw (nature of the environmental change that an age of terrorism)Tj T* -0.0086 Tc -0.0621 Tw (has introduced and its implications for organizational change.)Tj 0 -1.398 TD -0.0036 Tc 0.0611 Tw (The second part of the paper discusses how the interaction)Tj 0 -1.401 TD -0.0033 Tc -0.0187 Tw (between agency and officer influences stress risk and strate-)Tj T* -0.0034 Tc -0.0217 Tw (gies for increasing resilience.)Tj /F1 1 Tf 11 0 0 11 309 480 Tm -0.0049 Tc 0.044 Tw [(Acts of )96.1(T)60.6(err)11.5(orism and the En)38.7(vir)11.5(onment of)]TJ 0 -1.0909 TD -0.0056 Tc 0.1074 Tw [(Contemporar)-13.8(y P)35.3(olicing)]TJ /TT2 1 Tf 10 0 0 10 327 444.66 Tm -0.0625 Tw (Despite a long history of responding effectively to emer-)Tj -1.8 -1.401 TD -0.0032 Tc 0.0875 Tw (gency events, the nature of terrorist events presents police)Tj T* -0.0035 Tc -0.0311 Tw [(agencies with a unique set of problems \(Carafano, 2003\). )53.5(A)6.8(s)]TJ 0 -1.398 TD -0.0066 Tc -0.0625 Tw (Carafano points out, events such mass traffic accidents, plane)Tj 0 -1.401 TD -0.0033 Tc 0.0462 Tw (crashes, and even mass shootings present a relatively more)Tj T* -0.0037 Tc 0.0122 Tw [(coherent response environment than do terrorist events. For)]TJ 0 -1.398 TD -0.0078 Tc -0.0622 Tw (example, the former incidents have a clear starting point, tend)Tj 0 -1.401 TD -0.003 Tc 0.1017 Tw (to be localized, have a finite duration, present a relatively)Tj T* -0.0051 Tc -0.0621 Tw (predictable set of demands, and allow established procedures)Tj 0 -1.398 TD -0.0034 Tc 0.0886 Tw [(to be employed to manage the response. However)35.6(, greater)]TJ 0 -1.401 TD -0.003 Tc 0.0867 Tw (unpredictability regarding the nature and complexity \(e.g.,)Tj T* -0.0038 Tc 0.04 Tw (terrorists devote time to developing and implementing new)Tj 0 -1.398 TD -0.015 Tc -0.0625 Tw (ways to deliberately create maximum harm and fear\), location,)Tj 0 -1.401 TD -0.0015 Tc 0.125 Tw (timing, and duration of acts of terrorism has created new)Tj T* -0.0035 Tc 0.0992 Tw [(challenges for agencies and of)17.5(ficers. )14.4(W)55.3(ith terrorist events,)]TJ 0 -1.398 TD -0.0031 Tc 0.125 Tw (the agency context is also rendered more complex by the)Tj 0 -1.401 TD -0.0036 Tc 0.0086 Tw (need to operate under different legislative requirements and)Tj T* -0.0141 Tc -0.062 Tw (in more complex multi-organizational and multi-jurisdictional)Tj 0 -1.398 TD -0.0019 Tc 0.1249 Tw [(contexts. )52(Agencies also have to plan to accommodate the)]TJ 0 -1.401 TD -0.0037 Tc -0.0611 Tw (implications of hazards that can be more complex and endur-)Tj T* -0.003 Tc 0.0511 Tw (ing than those that typify normal incidents. For example, a)Tj 0 -1.398 TD -0.0033 Tc -0.0318 Tw (biohazard attack \(e.g., pollution of water supplies, release of)Tj 0 -1.401 TD -0.0036 Tc -0.0623 Tw (a biohazard such as smallpox\) may have commenced prior to)Tj T* -0.0464 Tw (its existence being identified; present diffuse beginnings and)Tj 0 -1.398 TD -0.0031 Tc -0.0318 Tw (ends; be difficult to detect by those first on the scene; spread)Tj 0 -1.401 TD 0.002 Tc 0.125 Tw (in ways dictated by local conditions \(some of which can)Tj T* -0.0032 Tc -0.0119 Tw [(change over time\) such as building density)59.8(, topography)62.8(, and)]TJ ET endstream endobj 220 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 222 0 obj << /Length 8990 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (127)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0007 Tc 0.125 Tw (prevailing weather; create relatively prolonged periods of)Tj 0 -1.398 TD -0.0085 Tc -0.0625 Tw (impact; and result in a complex social environment character-)Tj 0 -1.401 TD -0.0031 Tc 0.0137 Tw (ized by confusion and uncertainty in the general population)Tj T* -0.0233 Tc -0.0621 Tw [(\(Department of Homeland Security)60.7(, 2003; Fisher)33.7(,)0.2( 2000; Lasker)33.7(,)]TJ 0 -1.398 TD -0.0032 Tc 0.076 Tw [(2004\). Thus, in the case of terrorist actions, the operating)]TJ 0 -1.401 TD -0.0038 Tc -0.0031 Tw (environment in which agencies plan their response and how)Tj T* -0.0027 Tc -0.0087 Tw (they will deploy their officers is qualitatively different from)Tj 0 -1.398 TD -0.0035 Tc -0.0513 Tw (that in which the prevailing organizational culture has devel-)Tj 0 -1.401 TD -0.0037 Tc -0.0072 Tw [(oped. )53.3(A)58.5( similar ar)14.3(gument can be made regarding the experi-)]TJ T* -0.0036 Tc 0.055 Tw (ence of those who respond, with officers facing challenges)Tj 0 -1.398 TD -0.0027 Tc -0.06 Tw (that differ qualitatively from those they are likely to confront)Tj 0 -1.401 TD -0.004 Tc -0.01 Tw (under normal circumstances.)Tj 1.8 -2.001 TD -0.0032 Tc 0.1206 Tw (Although police officers face danger on a daily basis)Tj -1.8 -1.398 TD 0.0062 Tc 0.125 Tw (\(e.g., confrontation with armed offenders\), terrorism can)Tj 0 -1.401 TD -0.0058 Tc -0.0622 Tw [(change the nature of the risk they face. )21.3(W)56(ith regard to sources)]TJ T* -0.0147 Tc (of risk, exposure to hazardous agents \(e.g., highly toxic chemi-)Tj 0 -1.398 TD -0.0081 Tc (cal, biological, or radiation hazards\) that are difficult to detect)Tj 0 -1.401 TD 0.0018 Tc 0.125 Tw (and can create significant acute and chronic health prob-)Tj T* -0.0032 Tc 0.0255 Tw (lems, as well as generate consequences that may persist for)Tj 0 -1.398 TD 0.0562 Tw (long periods of time, contribute substantially to stress risk.)Tj 0 -1.401 TD -0.0022 Tc 0.125 Tw (The need for protective clothing contributes to stress risk)Tj T* -0.0027 Tc 0.0125 Tw (directly \(e.g., its use is necessitated by the use of biological)Tj 0 -1.398 TD -0.0076 Tc -0.0622 Tw (or chemical contaminants\) and indirectly \(e.g., increased heat)Tj 0 -1.401 TD -0.0037 Tc 0.0164 Tw (stress from wearing protective clothing and from additional)Tj T* 0.0471 Tw [(problems with operating equipment \(Carafano, 2003\)\). In-)]TJ 0 -1.398 TD -0.0035 Tc 0.1006 Tw (creased danger also emanates from the fact that, when re-)Tj 0 -1.401 TD 0.0297 Tc 0.125 Tw (sponding to terror events, the scene could become an)Tj T* -0.0122 Tc -0.0622 Tw (intentionally hostile environment for officers \(Dept. of Home-)Tj 0 -1.398 TD -0.0036 Tc 0.042 Tw [(land Security)62.4(, 2003; FEMA, 2004; Maniscalco & Christen,)]TJ 0 -1.401 TD -0.0034 Tc 0.005 Tw (2002\). Officers must attend events knowing that they them-)Tj T* -0.003 Tc -0.0137 Tw (selves may be deliberately targeted and that the perpetrators)Tj 0 -1.398 TD -0.0032 Tc -0.0029 Tw (are willing to die in the pursuit of their goal of inflicting the)Tj 0 -1.401 TD -0.0034 Tc -0.0505 Tw (maximum level of loss and fear when targeting ordinary citi-)Tj T* -0.0035 Tc 0.0395 Tw (zens. The latter point introduces a more insidious aspect of)Tj 0 -1.398 TD -0.0075 Tc -0.0625 Tw [(the environment of terrorism: the creation of a climate of fear)52.5(.)]TJ 1.8 -2.001 TD -0.0031 Tc 0.1225 Tw [(T)73.7(errorist events possess a unique capacity to create a)]TJ -1.8 -1.401 TD 0.0737 Tw [(sustained climate of fear)53.8(. Beliefs about vulnerability have)]TJ 0 -1.398 TD 0.0041 Tc 0.125 Tw (been changed by the fact that the schemas that underpin)Tj 0 -1.401 TD -0.004 Tc 0.015 Tw (how people interpret and comprehend complex experiences)Tj T* -0.0033 Tc 0.0106 Tw (have been rendered less applicable by the growing threat of)Tj 0 -1.398 TD -0.0036 Tc -0.0237 Tw [(terrorism \(Daw)59.4(, 2001\). Zimbardo \(2001\) stated that the fear)]TJ 0 -1.401 TD -0.003 Tc -0.0268 Tw [(generated by terrorism undercuts the sense of trust, stability)60(,)]TJ T* -0.0036 Tc 0.053 Tw [(and confidence in one)53.4(s personal world, thus af)14.4(fecting per)17.4(-)]TJ 0 -1.398 TD -0.0014 Tc 0.125 Tw [(ceived safety and security)58.6(. )16.6(These beliefs are sustained by)]TJ 0 -1.401 TD -0.0085 Tc -0.0625 Tw (knowledge that terrorist incidents are deliberately perpetrated)Tj T* -0.0029 Tc 0.004 Tw (acts that can occur anywhere and at any time. The assump-)Tj 25.5 64.2 TD -0.0117 Tc -0.0625 Tw (tions that had formerly enabled officers and community mem-)Tj 0 -1.398 TD -0.0032 Tc 0.05 Tw (bers alike to function effectively have become less reliable)Tj 0 -1.401 TD -0.0036 Tc 0.0483 Tw [(guides for behavior \(Janof)17.4(f-Bulman, 1992\). Consequently)59.4(,)]TJ T* 0.0146 Tw [(of)17.5(ficers must explore a new way of being \(Daw)59.5(, 2001\), and)]TJ 0 -1.398 TD -0.004 Tc -0.0622 Tw (knowledge of terrorists, their culture, language, and psychol-)Tj 0 -1.401 TD -0.0034 Tc 0.0778 Tw (ogy must be encapsulated in schemas that enhance the ca-)Tj T* -0.0026 Tc 0.0605 Tw (pacity of officers to adapt to the new reality in which they)Tj 0 -1.398 TD -0.0032 Tc 0.0145 Tw (have to respond. The police agency has a significant role to)Tj 0 -1.401 TD -0.0034 Tc -0.0159 Tw (play in developing these new interpretive frameworks.)Tj 1.8 -2.001 TD 0.0046 Tc 0.125 Tw (This brief discussion of the issues that agencies and)Tj -1.8 -1.398 TD -0.0033 Tc 0.0913 Tw (officers may have to contend with illustrates how terrorist)Tj 0 -1.401 TD 0.0221 Tw (events create an environment that differs qualitatively from)Tj T* -0.0034 Tc 0.05 Tw (the operating environment in which agency and officer ex-)Tj 0 -1.398 TD 0.0095 Tc 0.125 Tw (pectations have developed over years or decades. These)Tj 0 -1.401 TD 0.0085 Tc (historical expectations have driven the development and)Tj T* -0.0035 Tc -0.0381 Tw (maintenance of the culture and thus the policies, procedures,)Tj 0 -1.398 TD -0.0032 Tc 0.009 Tw [(and practices that govern present day police work. The im-)]TJ 0 -1.401 TD -0.0013 Tc 0.125 Tw (portance of acknowledging this issue stems from the fact)Tj T* 0.0028 Tc (that the foundation upon which agencies and officers re-)Tj 0 -1.398 TD -0.0131 Tc -0.0622 Tw (spond to contemporary challenges \(i.e., terrorism\) derive from)Tj 0 -1.401 TD -0.0035 Tc 0.0932 Tw (their historical assumptions \(that past experience is an ap-)Tj T* -0.0033 Tc 0.0225 Tw [(propriate predictor of future experience\). Consequently)59.7(, the)]TJ 0 -1.398 TD -0.0055 Tc -0.0622 Tw (issues facing agencies and officers have been underestimated)Tj 0 -1.401 TD -0.0035 Tc 0.125 Tw (because these assumptions and expectations are not accu-)Tj T* -0.0238 Tw (rate predictors of the conditions agencies could encounter in)Tj 0 -1.398 TD -0.0163 Tc -0.0623 Tw (the new era of terrorism \(Brake, 2001; Carafano, 2003; Kendra)Tj 0 -1.401 TD -0.0039 Tc -0.0598 Tw [(& )17.3(W)93.9(a)-0.4(chtendorf, 2003; Paton, 1992\). )14.3(This highlights the need)]TJ T* -0.0031 Tc -0.0368 Tw (for police agencies to consider both their ability to adapt to a)Tj 0 -1.398 TD 0.0338 Tw [(changing, riskier)38.8(, and more uncertain future and to identify)]TJ 0 -1.401 TD -0.0028 Tc -0.0231 Tw [(what they can do to facilitate the capacity of their officers to)]TJ T* -0.0035 Tc -0.0332 Tw (adapt to new demands. Even as it is undeniable that this new)Tj 0 -1.398 TD -0.0034 Tc -0.0412 Tw (environment increases critical incident stress risk, it can also)Tj 0 -1.401 TD -0.0036 Tc -0.0582 Tw (be conceptualized as creating a stimulus for the development)Tj T* -0.0027 Tc -0.0126 Tw [(of agency and of)15.3(ficer capability)63.3(.)]TJ /F1 1 Tf 11 0 0 11 321 222 Tm -0.0046 Tc 0.0352 Tw (Organizational Learning, Change, and Future)Tj 0 -1.0909 TD -0.0007 Tc 0 Tw (Capability)Tj /TT2 1 Tf 10 0 0 10 339 186.66 Tm -0.0027 Tc 0.078 Tw (It is almost a certainty that terrorism will not only in-)Tj -1.8 -1.401 TD -0.0097 Tc -0.0625 Tw (crease over the coming years, it will also become more deadly)Tj T* -0.0034 Tc 0.0024 Tw [(\(Cooper)38.6(, 2001\). Furthermore, the dif)17.6(ficulty of defining who)]TJ 0 -1.398 TD -0.0028 Tc 0.0678 Tw [(would most likely perpetrate such acts, what they may do,)]TJ 0 -1.401 TD -0.0034 Tc -0.0018 Tw (and when and where they could do so adds to this complex-)Tj T* -0.0614 Tw [(i)-5.1(t)-5.1(y)59.6(, making it imperative that agencies progressively develop)]TJ 0 -1.398 TD -0.0032 Tc 0.0093 Tw [(their adaptive capacity)62.8(. Under these circumstances, it is im-)]TJ 0 -1.401 TD -0.0047 Tc -0.0625 Tw (portant that police agencies learn from experience \(theirs and)Tj T* -0.0032 Tc 0.006 Tw (that of others\), to develop new ways of thinking and acting,)Tj ET endstream endobj 223 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 225 0 obj << /Length 8964 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.0813 Tw [(128 )]TJ /TT3 1 Tf 2.7188 0 TD -0.0052 Tc 0.0831 Tw (Paton and Violanti The Resilient Police Organization: Response to Terrorism)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0035 Tc -0.0567 Tw (and commit to developing a capacity to manage the demands)Tj 0 -1.398 TD -0.0048 Tc -0.0623 Tw (associated with acts of terrorism \(Berkes et al., 2003; FEMA,)Tj 0 -1.401 TD -0.0199 Tc -0.0622 Tw [(2004; Jackson, Baker)40.1(, Ridgely)58.1(, Bartis, & Linn, 2003; Kendra &)]TJ T* -0.0039 Tc -0.0618 Tw [(W)93.9(achtendorf, 2003\). )17.2(What does this mean for or)17.1(ganizational)]TJ 0 -1.398 TD -0.0008 Tc 0.125 Tw (learning? Police organizations must confront the assump-)Tj 0 -1.401 TD -0.003 Tc (tions derived from a long history of effective response to)Tj T* -0.0032 Tc 0.0619 Tw (emergency events and accept that they now operate within)Tj 0 -1.398 TD -0.0033 Tc -0.054 Tw (an environment that is different and that may be more hostile)Tj 0 -1.401 TD -0.0031 Tc 0.1093 Tw [(and dynamic. )53.8(Agencies thus have to develop in ways that)]TJ T* -0.0029 Tc 0.0075 Tw (facilitate their capacity to adapt rapidly to whatever occurs.)Tj 1.8 -1.998 TD -0.0139 Tc -0.0623 Tw (The capacity to learn from experience should not be taken)Tj -1.8 -1.401 TD -0.0035 Tc 0.045 Tw (for granted \(Berkes et al., 2003; Harrison & Shirom, 1999;)Tj T* -0.0067 Tc -0.0624 Tw [(Mitrof)14.3(f & )50.4(Anagnos, 2001; Paton & Hill, 2006\). For example,)]TJ 0 -1.398 TD -0.0029 Tc 0.125 Tw (these authors discuss how bureaucratic inertia, vested po-)Tj 0 -1.401 TD -0.0032 Tc -0.0164 Tw [(litical interests, centralized power and authority)62.8(, and operat-)]TJ T* -0.0038 Tc 0.0425 Tw (ing expectations developed to manage historical conditions)Tj 0 -1.398 TD -0.0034 Tc 0.0905 Tw (have all conspired to block the perceived need to adapt to)Tj 0 -1.401 TD -0.0035 Tc 0.0765 Tw [(deal with changes in the environment. Change is also un-)]TJ T* 0.0041 Tc 0.125 Tw (likely if organizations underestimate the potential conse-)Tj 0 -1.398 TD 0.0338 Tc (quences of new challenges by assuming that existing)Tj 0 -1.401 TD -0.0036 Tc -0.0314 Tw (resources, procedures, and competencies will be adequate to)Tj T* -0.0154 Tc -0.0622 Tw (deal with these new challenges \(Berkes et al.; Carafano, 2003\).)Tj 0 -1.398 TD 0.009 Tc 0.125 Tw (That is, agencies fail to consider the possibility that the)Tj 0 -1.401 TD -0.0063 Tc -0.0622 Tw (changes are significant enough to warrant new ways of think-)Tj T* -0.0038 Tc 0.0684 Tw (ing about and responding to environmental events.)Tj 1.8 -1.998 TD -0.0054 Tc -0.062 Tw (Under these circumstances, agencies may underestimate)Tj -1.8 -1.401 TD -0.0035 Tc 0.0829 Tw (or overlook threats or initiate inadequate actions, reducing)Tj T* -0.0041 Tc -0.0623 Tw (their ability to match their capabilities to an environment that)Tj 0 -1.398 TD -0.0034 Tc 0.0493 Tw (now includes highly unpredictable acts of terrorism, which)Tj 0 -1.401 TD -0.0036 Tc 0.1028 Tw (will challenge their response capabilities and provide new)Tj T* -0.0033 Tc 0.0334 Tw [(sources of stress risk for their officers. Organizational cul-)]TJ 0 -1.398 TD -0.0531 Tw (tures that embody these characteristics will attempt to render)Tj 0 -1.401 TD -0.0036 Tc 0.0864 Tw (the consequences of acts of terrorism understandable by)Tj T* -0.055 Tw (interpreting them in the light of previous experience, making)Tj 0 -1.398 TD -0.0033 Tc -0.0084 Tw [(it dif)17.7(ficult for agencies to consider)35.7(, far less confront, the de-)]TJ 0 -1.401 TD -0.0035 Tc 0.0675 Tw (mands associated with unpredictable and dynamic terrorist)Tj T* 0.0027 Tc 0.1249 Tw [(events. )53.6(Assuming that preexisting capabilities and proce-)]TJ 0 -1.398 TD -0.0035 Tc 0.0931 Tw (dures will suffice increases the likelihood that response to)Tj 0 -1.401 TD 0.0111 Tw [(future events will occur in an ad hoc manner)38.4(, with ef)14.4(fective)]TJ T* -0.0033 Tc 0.0138 Tw (response occurring more by chance than by sound planning)Tj 0 -1.398 TD -0.0035 Tc 0.0395 Tw (and good judgment. Given the potential for terrorist acts to)Tj 0 -1.401 TD -0.055 Tw (become more frequent and more unpredictable, it is essential)Tj T* 0.105 Tw (that agencies commit to developing ways of knowing and)Tj 0 -1.398 TD -0.0012 Tc 0.125 Tw (acting designed to enhance resilience and agency and of-)Tj 0 -1.401 TD -0.003 Tc 0.0233 Tw (ficer capacity to adapt to future challenges.)Tj /TT5 1 Tf 11 0 0 11 309 723.36 Tm 0.0231 Tc 0.1273 Tw [(O)8.1(r)31.3(ganizational Change)]TJ /TT2 1 Tf 10 0 0 10 327 703.65 Tm -0.0033 Tc 0.0012 Tw [(T)73.5(o)0( enhance adaptive capacity to deal with complex ter)14.7(-)]TJ -1.8 -1.401 TD -0.0035 Tc 0.0413 Tw [(rorist events, organizations must learn from past failures to)]TJ 0 -1.398 TD -0.0037 Tc 0.1045 Tw (think outside the square \(Berkes et al., 2003; Kendra &)Tj 0 -1.401 TD 0.0907 Tw [(W)94.1(achtendorf, 2003; Paton, 1994; Paton & Jackson, 2002\).)]TJ T* -0.0034 Tc -0.01 Tw (Not only must the organization learn to live with new forms)Tj 0 -1.398 TD -0.0031 Tc -0.034 Tw [(of risk and greater uncertainty)62.9(, it also must develop a culture)]TJ 0 -1.401 TD -0.0091 Tc -0.0625 Tw (appropriate for a contemporary operating environment within)Tj T* -0.0032 Tc -0.01 Tw [(which acts of terrorism are a fact of life. Recognition of the)]TJ 0 -1.398 TD -0.0037 Tc -0.0072 Tw (importance of institutional learning thus becomes an impor-)Tj 0 -1.401 TD -0.0035 Tc 0.0577 Tw [(tant precursor of culture change. )53.4(According to Berkes and)]TJ T* -0.0032 Tc 0.0493 Tw (colleagues this involves, first, ensuring that the memory of)Tj 0 -1.398 TD -0.0037 Tc 0.0061 Tw [(prior terrorism events and the lessons learned \(in one)53.3(s own)]TJ 0 -1.401 TD -0.0034 Tc -0.0106 Tw (and other agencies\), whether positive or negative, are incor-)Tj T* -0.0119 Tw (porated into institutional memory and accepted as an endur-)Tj 0 -1.398 TD -0.003 Tc 0.0005 Tw (ing fact of police agency life. Second, realistic estimates of)Tj 0 -1.401 TD -0.0035 Tc -0.05 Tw (new forms of risk can inform planning for the culture, proce-)Tj T* 0.0121 Tc 0.125 Tw (dures, and competencies required for effective response)Tj 0 -1.398 TD -0.0035 Tc 0.0819 Tw (\(Jackson et al., 2003\). Knowledge of the competencies re-)Tj 0 -1.401 TD 0.05 Tw (quired will be determined through analysis of the demands)Tj T* -0.0032 Tc 0.0293 Tw (officers are likely to encounter and the procedures required)Tj 0 -1.398 TD -0.0034 Tc 0.1164 Tw (to respond effectively \(see discussion of simulation under)Tj 0 -1.401 TD -0.004 Tc 0.0494 Tw [(Response Schemas below\). This process will inform fu-)]TJ T* -0.0034 Tc -0.0264 Tw [(ture of)14.6(ficer and or)17.6(ganizational development. Finally)62.6(, recog-)]TJ 0 -1.398 TD -0.0045 Tc -0.0625 Tw (nition of the risk posed by terrorist events and the importance)Tj 0 -1.401 TD -0.0036 Tc 0.0978 Tw (of learning from them must be consolidated into a culture)Tj T* -0.0009 Tc 0.125 Tw (that espouses the policies, procedures, practices, and atti-)Tj 0 -1.398 TD -0.0032 Tc 0.0432 Tw (tudes required to facilitate a capacity for adaptive response)Tj 0 -1.401 TD -0.0035 Tc 0.0878 Tw (to an uncertain future \(Berkes et al.; Brake, 2001; FEMA,)Tj T* -0.0037 Tc -0.0033 Tw [(2004; Jackson et al.; Kendra & )17.3(W)94.2(achtendorf; Paton & Jack-)]TJ 0 -1.398 TD -0.0033 Tc -0.0432 Tw (son\); that is, to commit to developing a culture that instills in)Tj 0 -1.401 TD -0.0032 Tc 0.0216 Tw (officers, via, for example, induction, socialization, training,)Tj T* -0.004 Tc 0.007 Tw (and performance management procedures, the development)Tj 0 -1.398 TD -0.0032 Tc -0.005 Tw (and maintenance of a capacity to adapt to future challenges.)Tj 0 -1.401 TD -0.0034 Tc 0.0355 Tw (It is also important to recognize that change is required not)Tj T* -0.0032 Tc -0.02 Tw (only to better position police agencies to respond to terrorist)Tj 0 -1.398 TD 0.0051 Tc 0.125 Tw [(events but also to accommodate the fact that the agency)]TJ 0 -1.401 TD -0.0035 Tc -0.0489 Tw (culture and the procedures and expectations that flow from it)Tj T* 0.0007 Tw (have direct implications for officer well-being and response)Tj 0 -1.398 TD 0.0062 Tc 0 Tw (effectiveness.)Tj 1.8 -2.001 TD -0.0029 Tc 0.1248 Tw [(T)37.9(r)-0.5(aditionally)60.1(, traumatic stress reactions have been at-)]TJ -1.8 -1.401 TD -0.003 Tc -0.0475 Tw (tributed predominantly to the interaction between physically)Tj 0 -1.398 TD -0.0031 Tc 0.022 Tw (and psychologically threatening experiences \(e.g., handling)Tj 0 -1.401 TD -0.0038 Tc 0.1014 Tw [(human remains\) and of)17.2(ficer characteristics. )50.2(Although this)]TJ T* 0.0002 Tc 0.125 Tw (remains an important aspect of understanding posttrauma)Tj 0 -1.398 TD -0.0047 Tc -0.062 Tw (reactions, comprehensive understanding of this phenomenon)Tj ET endstream endobj 226 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 228 0 obj << /Length 8874 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (129)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0033 Tc -0.06 Tw [(must include agency characteristics and their role in molding)]TJ 0 -1.398 TD -0.0035 Tc 0.045 Tw (the schemas that influence how officers formulate their ac-)Tj 0 -1.401 TD -0.0034 Tc -0.05 Tw (tions and that determine their well-being. It is to a discussion)Tj T* 0.0386 Tw (of this relationship that this paper now turns.)Tj /F1 1 Tf 11 0 0 11 66 648 Tm -0.0041 Tc 0.0742 Tw (Organizational Influences on Officer)Tj 0 -1.0909 TD -0.0053 Tc 0.0449 Tw [(Thinking,)35.6( )72.1(W)38.7(e)-1.3(ll-Being,)35.6( and P)27.4(erf)11.1(ormance)]TJ /TT2 1 Tf 10 0 0 10 84 612.66 Tm -0.0035 Tc 0.0999 Tw [(Organizational factors have been identified as signifi-)]TJ -1.8 -1.401 TD -0.0034 Tc 0.0243 Tw (cant predictors of traumatic stress risk for officers respond-)Tj T* 0.0191 Tc 0.125 Tw [(ing to terrorist events \(Carafano, 2003; Grant, Hoover)34.1(,)]TJ 0 -1.398 TD -0.0081 Tc -0.0624 Tw [(Scarisbrick-Hauser)33.9(, & Muf)15.9(fet, 2003; Kendra & )13(W)95.7(achtendorf,)]TJ 0 -1.401 TD -0.004 Tc -0.0621 Tw (2003\). Officers perceptions of organizational culture are not)Tj T* -0.0103 Tc (only a significant predictor of posttraumatic risk \(Huddleston,)Tj 0 -1.398 TD -0.0037 Tc 0.0318 Tw [(Paton, & S)14.3(tephens, 2006; Paton, Smith, )17.2(V)64.5(iolanti & Ernen,)]TJ 0 -1.401 TD -0.0032 Tc 0.0406 Tw (2000\), it may even outweigh the influence of other factors.)Tj T* -0.0037 Tc 0.0925 Tw (For example, compared with dispositional \(hardiness\) fac-)Tj 0 -1.398 TD -0.0035 Tc 0.0315 Tw (tors, social support factors, and formal support \(debriefing\))Tj 0 -1.401 TD 0.075 Tw (factors, Paton and colleagues \(2000\) found that perception)Tj T* -0.0078 Tc -0.0622 Tw (of organizational culture was three times more influential as a)Tj 0 -1.398 TD -0.0034 Tc 0.0582 Tw (predictor of traumatic stress outcomes. In this section, fac-)Tj 0 -1.401 TD -0.0032 Tc 0.0693 Tw (tors contributing to the agency-officer relationship are dis-)Tj T* 0.0179 Tc 0.125 Tw (cussed in terms of their implications for understanding)Tj 0 -1.398 TD -0.0106 Tc 0 Tw (resilience.)Tj 1.8 -2.001 TD -0.0034 Tc -0.0072 Tw (One way in which the organizational culture influences)Tj -1.8 -1.401 TD -0.0035 Tc -0.0381 Tw (officers thinking and action is through prescribing the way)Tj 0 -1.398 TD -0.0034 Tc 0.0993 Tw (things are done, that is, through the relationship between)Tj 0 -1.401 TD 0.07 Tw (the culture and its procedures. For officers working in this)Tj T* -0.0036 Tc 0.0315 Tw (context, factors such as inadequate consultation, poor com-)Tj 0 -1.398 TD -0.0586 Tw (munication, a predisposition to protect the organization from)Tj 0 -1.401 TD -0.016 Tc -0.0622 Tw (criticism or blame, and excessive red tape can increase stress)Tj T* -0.0063 Tc -0.0624 Tw [(risk \(Gist & )14.8(W)91.5(oodall, 2000; Huddleston et al., 2006; Burke &)]TJ 0 -1.398 TD -0.0034 Tc -0.0344 Tw [(Paton, 2006\). Furthermore, stress risk is greatest if response)]TJ 0 -1.401 TD -0.0032 Tc -0.0136 Tw [(procedures \(e.g., command structure, level of autocracy)59.8(, de-)]TJ T* -0.0034 Tc 0.0844 Tw (gree of devolved authority\) derived from routine work are)Tj 0 -1.398 TD -0.0036 Tc 0.0515 Tw (assumed to be appropriate for terrorist response \(Carafano,)Tj 0 -1.401 TD -0.0038 Tc -0.0556 Tw [(2003; McKinsey)62.2(, 2002; Kendra & )17.3(W)94(achtendorf, 2003; Paton)]TJ T* -0.0033 Tc 0.1035 Tw [(& Hannan, 2004\). In contrast, a culture that supports au-)]TJ 0 -1.398 TD -0.0034 Tc 0.03 Tw (tonomous response systems, a flexible, consultative leader-)Tj 0 -1.401 TD 0.0237 Tc 0.125 Tw (ship style, and practices that ensure that role and task)Tj T* 0.0022 Tc (assignments reflect incident demands can facilitate stress)Tj 0 -1.398 TD -0.0035 Tc -0.0261 Tw [(resilience \(Gist & )17.7(W)94.3(oodall; McKinsey; Paton & Hill, 2006\).)]TJ 0 -1.401 TD 0.0015 Tc 0.125 Tw (The influence of response procedures on critical incident)Tj T* -0.0033 Tc 0.005 Tw (stress risk can be more specific. This can be illustrated with)Tj 0 -1.398 TD -0.0034 Tc 0.0022 Tw (reference to the unique challenges of deployment, decision-)Tj 0 -1.401 TD -0.0033 Tc 0.035 Tw (making, and inter-agency collaboration that terrorist events)Tj T* -0.0035 Tc 0.0333 Tw (pose for police agencies.)Tj /TT5 1 Tf 11 0 0 11 321 723.36 Tm 0.016 Tc 0.125 Tw (Agency Planning and Officer Deployment)Tj /TT2 1 Tf 10 0 0 10 339 703.65 Tm -0.0102 Tc -0.0621 Tw (Police agency involvement commences when an alarm is)Tj -1.8 -1.401 TD -0.0077 Tc -0.0625 Tw (issued or a terrorist act occurs. During this initial phase, agen-)Tj 0 -1.398 TD -0.011 Tc -0.0624 Tw [(cies are tasked with, for example, accessing intelligence about)]TJ 0 -1.401 TD -0.0036 Tc -0.0549 Tw [(what has happened, differentiating fact from inference, mak-)]TJ T* 0.0046 Tc 0.125 Tw (ing sense of confusing and often ambiguous information)Tj 0 -1.398 TD -0.0042 Tc 0.0438 Tw (\(Brake, 2001; DTRA, FBI, & USJFCOM, 2001; Kendra &)Tj 0 -1.401 TD 0.0018 Tc 0.125 Tw [(W)96.6(achtendorf, 2003\), and negotiating operational arrange-)]TJ T* -0.0036 Tc -0.0206 Tw (ments with other agencies and jurisdictions \(Brake; Dept. of)Tj 0 -1.398 TD -0.013 Tc -0.0621 Tw [(Homeland Security)62(, 2003; Grant et al., 2003\). )17.1(The uncertainty)]TJ 0 -1.401 TD -0.0034 Tc -0.0407 Tw (and complexity inherent in the mobilization phase illustrates)Tj T* 0.1015 Tw (the fact that agencies must adapt plans to deal with unex-)Tj 0 -1.398 TD -0.0036 Tc 0.125 Tw (pected emergent and evolving problems rather than being)Tj 0 -1.401 TD 0.0106 Tc (able to rely on activating standard operating procedures)Tj T* -0.0035 Tc -0.0625 Tw [(\(Brake; Dept. of Homeland Security; Grant et al.; McKinsey)59.5(,)]TJ 0 -1.398 TD -0.0516 Tc 0 Tw (2002\).)Tj 1.8 -2.001 TD -0.0037 Tc 0.1156 Tw (The degree to which agencies can manage the uncer-)Tj -1.8 -1.401 TD -0.0041 Tc -0.0622 Tw (tainty inherent in this task has significant implications for the)Tj 0 -1.398 TD -0.003 Tc 0.0513 Tw (stress risk in officers deployed to respond. The uncertainty)Tj 0 -1.401 TD -0.0032 Tc 0.0716 Tw (means that agencies often have to deploy officers before a)Tj T* -0.0078 Tc -0.0625 Tw (full appreciation of the nature or implications of a terror event)Tj 0 -1.398 TD -0.0033 Tc -0.0262 Tw [(is available. For example, police officers deployed immedi-)]TJ 0 -1.401 TD -0.003 Tc -0.0218 Tw (ately to the site of the Lockerbie disaster found it difficult to)Tj T* 0.0408 Tc 0.125 Tw (comprehend the carnage and death they encountered)Tj 0 -1.398 TD -0.0105 Tc -0.0622 Tw [(\(Mitchell, 1991\). While performing similar duties in a similar)]TJ 0 -1.401 TD -0.0032 Tc 0.0462 Tw (environment, officers deployed after the cause of the event)Tj T* -0.0127 Tc -0.0621 Tw (had been identified \(a terrorist bombing\) demonstrated greater)Tj 0 -1.398 TD 0.0007 Tc 0.125 Tw (stress resilience because clarification of the nature of the)Tj 0 -1.401 TD -0.0036 Tc 0.0793 Tw (incident allowed them to activate their operational schema)Tj T* -0.006 Tw (and plan how to use their skills and knowledge. The organi-)Tj 0 -1.398 TD -0.0032 Tc 0.0106 Tw (zational role is to facilitate this capacity to impose meaning)Tj 0 -1.401 TD -0.0035 Tc 0.0275 Tw (on threatening and challenging demands, to limit the likeli-)Tj T* -0.0444 Tw (hood that officers will be overwhelmed by the demands with)Tj 0 -1.398 TD -0.0034 Tc -0.019 Tw (which they must contend \(Paton, 1994\).)Tj 1.8 -2.001 TD -0.0032 Tc 0.1032 Tw [(T)73.6(o)0.8( enhance of)17.8(ficers)68.8( capacity to adapt, it is important)]TJ -1.8 -1.401 TD -0.0036 Tc 0.0714 Tw (that agencies guard against basing their mobilization plans)Tj 0 -1.398 TD -0.0038 Tc 0.0038 Tw (on assumptions derived from routine emergencies or on un-)Tj 0 -1.401 TD -0.0035 Tc 0.0168 Tw (realistic or untested plans \(Carafano, 2003; Dept. of Home-)Tj T* -0.0034 Tc 0.0105 Tw [(land Security)62.6(, 2003; Lasker)35.6(, 2004\). Plans should be derived)]TJ 0 -1.398 TD -0.0032 Tc -0.0142 Tw (from accurate analyses of community \(e.g., accommodating)Tj 0 -1.401 TD -0.005 Tc -0.0625 Tw (the need to reconcile different actions\) and professional \(e.g.,)Tj T* -0.0033 Tc -0.0505 Tw [(concerns for self and family)62.7(, having to adapt plans to accom-)]TJ 0 -1.398 TD 0.0177 Tc 0.125 Tw (modate emergent issues, multi-agency/jurisdictional re-)Tj 0 -1.401 TD 0.0261 Tc (sponses, etc.\) response needs and expectations and be)Tj T* -0.0036 Tc 0.0543 Tw (designed to accommodate the unique demands \(e.g., a bio-)Tj 0 -1.398 TD -0.0032 Tc -0.0392 Tw [(hazard response\) likely to be encountered. )50.9(Agency influence)]TJ ET endstream endobj 229 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 231 0 obj << /Length 8671 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.0813 Tw [(130 )]TJ /TT3 1 Tf 2.7188 0 TD -0.0052 Tc 0.0831 Tw (Paton and Violanti The Resilient Police Organization: Response to Terrorism)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm 0.0078 Tc 0.125 Tw (does not stop here, but extends in several ways into the)Tj 0 -1.398 TD -0.0034 Tc 0.0808 Tw (response itself, with decision-making and multi-agency is-)Tj 0 -1.401 TD -0.0036 Tc 0.042 Tw (sues proving unique challenges for officers.)Tj /TT5 1 Tf 11 0 0 11 54 661.35 Tm 0.035 Tc 0 Tw (Decision-Making)Tj /TT2 1 Tf 10 0 0 10 72 641.64 Tm -0.0058 Tc -0.0625 Tw (The dynamic and complex nature of terrorist events gen-)Tj -1.8 -1.398 TD -0.0009 Tc 0.125 Tw (erates a need for a level of creative decision-making that)Tj 0 -1.401 TD -0.0038 Tc 0.0021 Tw (exceeds that required for response to routine emergencies)Tj T* -0.0097 Tc -0.0624 Tw [(\(Jackson et al., 2003; Kendra & )14.4(W)94.1(achtendorf, 2003\). Creative)]TJ 0 -1.398 TD -0.062 Tw (decision-making requires deviation from standard procedures)Tj 0 -1.401 TD -0.0033 Tc -0.0204 Tw [(so that decisions may be made in situ. )17.8(T)70.5(o)0.6( promote resilience)]TJ T* -0.0014 Tc 0.125 Tw (in this domain, agencies need to train officers in creative)Tj 0 -1.398 TD -0.0038 Tc 0.1158 Tw (crisis decision-making and develop procedures to devolve)Tj 0 -1.401 TD -0.0035 Tc -0.0532 Tw (decision-making authority to those working in situ who need)Tj T* -0.0038 Tc -0.0031 Tw (to produce contingent solutions to novel problems \(Alper &)Tj 0 -1.398 TD -0.0114 Tc -0.0621 Tw (Kupferman, 2003; Carafano, 2003; Endsley & Garland, 2000;)Tj 0 -1.401 TD -0.0277 Tc -0.0625 Tw [(FEMA, 2004; Grant et al., 2003; Jackson et al., 2003; McKinsey)62.3(,)]TJ T* -0.0035 Tc 0.0345 Tw [(2002; Paton & Hannan, 2004; Paton et al., 1999\). Further-)]TJ 0 -1.398 TD -0.004 Tc -0.0622 Tw (more, agencies must recognize that they may not be respond-)Tj 0 -1.401 TD -0.0028 Tc 0.0145 Tw (ing with the level of autonomy or authority that they would)Tj T* -0.0039 Tc -0.045 Tw (experience under normal circumstances.)Tj /TT5 1 Tf 11 0 0 11 54 398.34 Tm 0.0145 Tc 0.1258 Tw (The Multi-Agency and Multi-Jurisdictional)Tj 0 -1.1809 TD 0.0271 Tc 0 Tw (Context)Tj /TT2 1 Tf 10 0 0 10 72 365.64 Tm -0.0035 Tc 0.0995 Tw (The environment for acts of terrorism is unique in its)Tj -1.8 -1.398 TD 0.0002 Tc 0.125 Tw (need for a multi-agency and multi-jurisdictional response)Tj 0 -1.401 TD -0.0232 Tc -0.0625 Tw [(\(Brake, 2001; Dept. of Homeland Security)60.8(, 2003; FEMA, 2004;)]TJ T* -0.0183 Tc -0.0624 Tw [(Grant et al., 2003; Jackson et al., 2003; Kendra & )17.8(W)94.5(achtendorf,)]TJ 0 -1.398 TD -0.0065 Tc [(2003\). The complex nature of terrorist events brings together)]TJ 0 -1.401 TD -0.0032 Tc 0.0156 Tw (agencies that rarely interact or collaborate with one another)Tj T* -0.0037 Tc 0.0741 Tw (under routine circumstances, which reduces the opportuni-)Tj 0 -1.398 TD -0.0035 Tc 0.0725 Tw (ties to allow shared understanding of their respective roles)Tj 0 -1.401 TD -0.0093 Tc -0.0622 Tw [(to develop. For example, when responding to terrorist events,)]TJ T* -0.0037 Tc 0.1 Tw (police officers could find themselves having to work with)Tj 0 -1.398 TD 0.0015 Tc 0.125 Tw (representatives from hazardous materials response teams,)Tj 0 -1.401 TD -0.0032 Tc 0.0942 Tw (urban search and rescue teams, community emergency re-)Tj T* -0.0036 Tc -0.0078 Tw (sponse teams, anti-terrorism units, special weapons and tac-)Tj 0 -1.398 TD 0.025 Tw (tics teams, bomb squads, emergency management officials,)Tj 0 -1.401 TD -0.0005 Tc 0.125 Tw (municipal agencies, and private organizations responsible)Tj T* -0.0036 Tc -0.06 Tw [(for transportation, communications, medical services, public)]TJ 0 -1.398 TD -0.0022 Tc 0.125 Tw (health, disaster assistance, public works, and construction)Tj 0 -1.401 TD -0.0052 Tc -0.0622 Tw [(workers \(Carafano, 2003\). The potential for role conflict and)]TJ T* -0.0035 Tc -0.025 Tw (ambiguity under these circumstances can make a substantial)Tj 0 -1.398 TD 0.0022 Tc 0.125 Tw [(contribution to critical incident stress risk. Consequently)62.2(,)]TJ 0 -1.401 TD -0.0031 Tc -0.0137 Tw (developing a capacity to adapt to multi-agency and jurisdic-)Tj T* -0.0035 Tc -0.0119 Tw (tional contexts becomes an important component of any po-)Tj 25.5 65.1 TD -0.0032 Tc -0.0625 Tw [(lice resilience strategy)62.8(, with responsibility for doing so being)]TJ 0 -1.398 TD -0.0033 Tc 0.073 Tw (added to the agency planning agenda.)Tj 1.8 -2.001 TD 0.0039 Tc 0.125 Tw (Simply bringing together representatives of agencies)Tj -1.8 -1.401 TD -0.0036 Tc 0.0673 Tw [(who have little contact with one another under normal cir-)]TJ 0 -1.398 TD 0.0232 Tc 0.125 Tw (cumstances will not guarantee a coordinated response.)Tj 0 -1.401 TD -0.0035 Tc 0.0029 Tw [(Rather)35.5(, such ad hoc arrangements can increase inter)17.5(-agency)]TJ T* -0.0033 Tc -0.0311 Tw (conflict, result in a blurring of roles and responsibilities, and)Tj 0 -1.398 TD -0.0034 Tc 0.0065 Tw (fuel frustration and feelings of inadequacy and helplessness)Tj 0 -1.401 TD -0.0031 Tc -0.0405 Tw [(\(McKinsey)62.9(, 2002; Paton, 1994\). )18(This capacity can be devel-)]TJ T* 0.0413 Tw (oped by integrating the respective agency roles through in-)Tj 0 -1.398 TD -0.0035 Tc -0.0607 Tw (ter-agency team development activities \(Brake, 2001; Flin &)Tj 0 -1.401 TD -0.0033 Tc 0.0205 Tw (Arbuthnot, 2002; Grant et al., 2003; Paton et al., 1999\) that)Tj T* -0.0037 Tc 0.0322 Tw (focus on building understanding of the respective contribu-)Tj 0 -1.398 TD -0.0036 Tc 0.1108 Tw (tions of different agencies, develop collaborative manage-)Tj 0 -1.401 TD 0.0595 Tc 0.35 Tw (ment systems, and ensure effective inter-agency)Tj T* -0.0098 Tc -0.0624 Tw [(communication \(Pollock, Paton, Smith, & )14.3(V)67.4(iolanti, 2003\). )50.3(A)6.2(t)]TJ 0 -1.398 TD -0.0032 Tc 0.0516 Tw (one level, this issue reflects the need for structural integra-)Tj 0 -1.401 TD 0.0363 Tw (tion between agencies to facilitate a capacity to collaborate)Tj T* -0.0035 Tc -0.0425 Tw [(during a crisis. However)35.5(, the ef)17.5(fectiveness of this collabora-)]TJ 0 -1.398 TD 0.0096 Tw (tion is a function of the degree to which it is complemented)Tj 0 -1.401 TD -0.0034 Tc 0.0584 Tw (by officers understanding of their respective contributions)Tj T* 0.0062 Tc 0.125 Tw (to the same plan and their shared understanding of each)Tj 0 -1.398 TD -0.004 Tc 0.0403 Tw [(member)-37()53(s)-0.3( role in the response \(Brake, 2001; FEMA, 2004;)]TJ 0 -1.401 TD -0.0095 Tc -0.0623 Tw [(Paton & Flin, 1999\). This means that the schemas or interpre-)]TJ T* -0.0033 Tc 0.0221 Tw (tive frameworks that have traditionally guided officers op-)Tj 0 -1.398 TD -0.0031 Tc -0.0265 Tw (erational decisions and actions and that play a crucial role in)Tj 0 -1.401 TD -0.0011 Tc 0.125 Tw (influencing posttrauma risk \(Janoff-Bulman, 1992; Paton,)Tj T* -0.0039 Tc 0.0557 Tw [(1994; )14.2(T)72.9(e)-0.1(deschi & Calhoun, 2003\) must be expanded to in-)]TJ 0 -1.398 TD -0.0033 Tc -0.0136 Tw (clude multi-agency response characteristics. This can be ac-)Tj 0 -1.401 TD -0.0038 Tc 0.021 Tw (complished through multi-agency training \(FEMA; Pollock)Tj T* -0.0031 Tc 0.0719 Tw [(et al.\). )14.8(This is, however)38.9(, not the only aspect of developing)]TJ 0 -1.398 TD -0.0026 Tc 0.125 Tw (schemas to accommodate the unique demands of terrorist)Tj 0 -1.401 TD 0.0201 Tc 0 Tw (events.)Tj /TT5 1 Tf 11 0 0 11 309 235.35 Tm 0.0216 Tc 0.1273 Tw (Response Schemas)Tj /TT2 1 Tf 10 0 0 10 327 215.64 Tm -0.0035 Tc 0.0517 Tw (The interpretive frameworks used by officers provides)Tj -1.8 -1.398 TD 0.1039 Tw (the basis for rendering events coherent to the point where)Tj 0 -1.401 TD -0.0031 Tc 0.1005 Tw (they can apply plans and competencies to manage the de-)Tj T* -0.0069 Tc -0.062 Tw (mands encountered \(Janoff-Bulman, 1992; Paton, 1994\).)Tj 1.8 -1.998 TD -0.0037 Tc -0.0425 Tw (The schemas or mental models that guide their response)Tj -1.8 -1.401 TD -0.0033 Tc 0.0382 Tw (to terror events reflect officers socialization into their pro-)Tj T* -0.0032 Tc -0.0336 Tw (fession and organization, their training, the experiences they)Tj 0 -1.398 TD -0.0035 Tc 0.055 Tw (accumulate over time, and the operating practices that pre-)Tj 0 -1.401 TD 0.1119 Tw (scribe how they respond to routine emergencies \(Paton &)Tj T* -0.0433 Tw [(Burke, 2007\). These become implicit \(taken for granted\) as-)]TJ 0 -1.398 TD -0.0033 Tc 0.001 Tw (pects of the mental models used by officers to make predic-)Tj ET endstream endobj 232 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 234 0 obj << /Length 8523 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (131)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0036 Tc 0.11 Tw (tions about future events, organize experiences, and make)Tj 0 -1.398 TD 0.0978 Tw (sense of the consequences of events and their reactions to)Tj 0 -1.401 TD -0.0206 Tw [(them. However)38.4(, the importance of these models as determi-)]TJ T* -0.0037 Tc 0.0479 Tw (nants of well-being and performance effectiveness tends to)Tj 0 -1.398 TD -0.0035 Tc (remain unrealized until officers encounter events that chal-)Tj 0 -1.401 TD -0.0171 Tc -0.0621 Tw [(lenge their implicit assumptions \(Paton, 1994\). )18.9(T)68.7(errorist events)]TJ T* -0.0034 Tc 0.0244 Tw (can result in officers having to contend with several factors)Tj 0 -1.398 TD -0.0037 Tc 0.0975 Tw (that could challenge these assumptions.)Tj 1.8 -2.001 TD -0.0034 Tc -0.0412 Tw [(In addition to the issues introduced earlier)38.6(, several other)]TJ -1.8 -1.401 TD -0.0032 Tc 0.09 Tw (aspects of a terrorist response may fall outside the param-)Tj 0 -1.398 TD -0.0039 Tc 0.045 Tw (eters of schemas developed from routine experience. For)Tj 0 -1.401 TD -0.0032 Tc 0.0133 Tw (example, because the causes of acts of terrorism are always)Tj T* 0.0035 Tc 0.125 Tw (attributable to deliberate human action intended to cause)Tj 0 -1.398 TD -0.0101 Tc -0.0624 Tw [(harm, these acts threaten perceived control, a prominent stres-)]TJ 0 -1.401 TD -0.0036 Tc -0.0244 Tw (sor in officers whose training is designed to promote control)Tj T* -0.0117 Tw [(\(MacLeod & Paton, 1999; Myers, 2001\). The magnitude of)]TJ 0 -1.398 TD 0.0013 Tc 0.125 Tw (the death and injury encountered, coupled in many cases)Tj 0 -1.401 TD 0.0018 Tc (with uncertainty regarding the cause of death or whether)Tj T* -0.0032 Tc (those officers have come into contact with infectious dis-)Tj 0 -1.398 TD (ease agents, represents another conceptual departure from)Tj 0 -1.401 TD -0.0038 Tc 0.0792 Tw [(expectations developed from prior experiences \(Jackson et)]TJ T* -0.003 Tc -0.0112 Tw [(al., 2003\). Performing body recovery and identification du-)]TJ 0 -1.398 TD 0.0608 Tw (ties is as great a stress risk for officers \(North et al., 2002;)Tj 0 -1.401 TD -0.0051 Tc -0.0626 Tw [(Simpson & S)15.9(tehr)33.9(, 2003\) as is having insuf)21.9(ficient, inadequate,)]TJ T* 0.0395 Tc 0.125 Tw (or inappropriate resources to perform response tasks)Tj 0 -1.398 TD -0.011 Tc -0.0625 Tw (\(Carafano, 2003; Paton, 1994\) and having to deal with the fact)Tj 0 -1.401 TD -0.0033 Tc 0.0156 Tw (that the terror response environment is simultaneously a di-)Tj T* 0.054 Tw (saster area, a crime scene, and a mass grave. These factors)Tj 0 -1.398 TD 0.0717 Tw (add to the complexity of the role relationships and tasking)Tj 0 -1.401 TD -0.0035 Tc 0.0175 Tw (that officers have to manage.)Tj 1.8 -2.001 TD -0.0032 Tc 0.1043 Tw [(Consequently)62.8(, developing the capability of of)14.8(ficers to)]TJ -1.8 -1.398 TD -0.01 Tw (adapt to the challenges posed by terrorist hazards is of para-)Tj 0 -1.401 TD -0.0037 Tc 0.0966 Tw (mount importance for agencies, officers, and communities)Tj T* -0.0032 Tc 0.1081 Tw (alike. New schemas capable of facilitating the capacity to)Tj 0 -1.398 TD -0.0036 Tc 0.0215 Tw (adapt to these new kinds of demands need to be developed.)Tj 0 -1.401 TD -0.0054 Tw [(T)73.2(o)-0.1( do so, agencies and of)17.4(ficers must confront prior assump-)]TJ T* -0.0386 Tw (tions and facilitate the development of interpretative compe-)Tj 0 -1.398 TD 0.009 Tc 0.125 Tw (tencies to accommodate the new reality of terrorism for)Tj 0 -1.401 TD -0.0034 Tc -0.035 Tw (contemporary policing.)Tj 1.8 -2.001 TD -0.0039 Tc -0.0191 Tw [(The development of these interpretive mechanisms will)]TJ -1.8 -1.398 TD -0.0034 Tc -0.0622 Tw (be particularly important for police officers who may have to)Tj 0 -1.401 TD -0.0037 Tc 0.0863 Tw (confront the consequences of terrorism and respond to the)Tj T* -0.0035 Tc 0.0157 Tw (challenges it poses to themselves and the communities they)Tj 0 -1.398 TD -0.0445 Tw (serve on a regular basis \(Alper & Kupferman, 2003; Grant et)Tj 0 -1.401 TD -0.0037 Tc 0.0781 Tw [(al., 2003; Kendra & )17.3(W)94.1(achtendorf, 2003; Paton & Hannan,)]TJ 25.5 63.399 TD -0.0093 Tc -0.0622 Tw [(2004; Simpson & S)20.7(tehr)35.7(, 2003\). In general, training that devel-)]TJ 0 -1.398 TD -0.0033 Tc -0.0188 Tw (ops the capability of operational mental models \(essential to)Tj 0 -1.401 TD -0.0038 Tc 0.0636 Tw (response planning and organizing action\) to impose coher-)Tj T* -0.0033 Tc 0.0775 Tw (ence upon atypical and challenging experiences and to ac-)Tj 0 -1.398 TD -0.0039 Tc -0.0229 Tw (commodate the demands encountered should be an essential)Tj 0 -1.401 TD -0.0107 Tc -0.0622 Tw (component of stress risk management \(Dunning, 2003; Paton,)Tj T* -0.0083 Tc -0.0625 Tw (1994; Paton & Jackson, 2002\).)Tj 1.8 -1.998 TD -0.0036 Tc -0.0419 Tw (In the past, when dealing with routine events, training)Tj -1.8 -1.401 TD 0.07 Tw (practices and information about officers prior experiences)Tj T* -0.0034 Tc 0.0929 Tw (served as fairly effective mechanisms for transmitting and)Tj 0 -1.398 TD -0.0035 Tc 0.0721 Tw [(sustaining operational schemas. However)38.5(, the qualitatively)]TJ 0 -1.401 TD -0.0024 Tc 0.125 Tw (different nature of the terrorist environment renders these)Tj T* -0.0039 Tc -0.0083 Tw [(existing mechanisms less appropriate. )50.1(Agencies cannot wait)]TJ 0 -1.398 TD -0.0033 Tc 0.0225 Tw (for officers to accumulate experience; they need to develop)Tj 0 -1.401 TD -0.0015 Tc 0.125 Tw [(new schemas as quickly as possible. Consequently)64.5(, agen-)]TJ T* -0.0036 Tc 0.0587 Tw (cies need a more sophisticated approach to confronting as-)Tj 0 -1.398 TD -0.007 Tc -0.0622 Tw (sumptions and reframing schemas in ways that accommodate)Tj 0 -1.401 TD 0 Tc 0.125 Tw (the reality of operating within the context of the terrorist)Tj T* -0.0075 Tc -0.0623 Tw [(threat. )52.4(A)57.7( capacity for reframing can be developed using simu-)]TJ 0 -1.398 TD 0.0012 Tc 0 Tw (lations.)Tj 1.8 -2.001 TD -0.0037 Tc -0.0558 Tw [(Simulations provide opportunities for officers to experi-)]TJ -1.8 -1.401 TD -0.0033 Tc 0.064 Tw (ence the kinds of demands they will have to contend with,)Tj 0 -1.398 TD -0.0036 Tc 0.0833 Tw (develop realistic performance expectations, review and re-)Tj 0 -1.401 TD 0.0031 Tc 0.125 Tw (vise response plans and roles, facilitate adaptation to the)Tj T* -0.0033 Tc 0.0692 Tw (demands associated with body recovery duties, understand)Tj 0 -1.398 TD 0.0002 Tc 0.125 Tw (their stress reactions, and rehearse strategies to deal with)Tj 0 -1.401 TD -0.008 Tc -0.0621 Tw (stressful circumstances and reactions \(Crego & Spinks, 1997;)Tj T* -0.0132 Tc -0.0625 Tw [(Deahl, Gillham, Thomas, Searle, & Srinivasan, 1994; Paton &)]TJ 0 -1.398 TD -0.0036 Tc 0.02 Tw [(Jackson, 2002; Thompson, 1993\). Training is required that)]TJ 0 -1.401 TD -0.0032 Tc -0.0569 Tw (develops expectations of realistic outcomes, an ability to dif-)Tj T* -0.0035 Tc 0.0284 Tw (ferentiate personal and situational constraints, and interpre-)Tj 0 -1.398 TD 0.059 Tc 0.155 Tw (tive processes that review experiences as learning)Tj 0 -1.401 TD -0.0037 Tc 0.0479 Tw (opportunities to enhance future competence and thus offic-)Tj T* -0.0034 Tc 0.1243 Tw (ers capacity to adapt to challenging circumstances \(Dun-)Tj 0 -1.398 TD -0.0128 Tc -0.0616 Tw (ning, 2003; Paton, 1994\).)Tj 1.8 -2.001 TD 0.0177 Tc 0.125 Tw (Developing these more sophisticated psychological)Tj -1.8 -1.401 TD 0.0041 Tc (structures requires that simulations are constructed using)Tj 0 -1.398 TD -0.0036 Tc 0.1189 Tw [(information derived from two sources. One source is the)]TJ 0 -1.401 TD -0.0031 Tc 0.0515 Tw (systematic analysis of the competencies required for effec-)Tj T* -0.0034 Tc 0.1005 Tw [(tive response to terrorist events. The second involves de-)]TJ 0 -1.398 TD 0.0588 Tc 0.316 Tw (signing simulations capable of reconciling event)Tj 0 -1.401 TD -0.0034 Tc 0.0825 Tw (characteristics \(e.g., exposure to biohazards; personal dan-)Tj T* -0.0037 Tc -0.0071 Tw (ger; dealing with human remains; and cross-cultural aspects)Tj 0 -1.398 TD -0.0366 Tw [(of death and loss\) with the competencies required to manage)]TJ 0 -1.401 TD -0.0034 Tc -0.0183 Tw (them \(e.g., hazard identification and interpretation; adaptive)Tj ET endstream endobj 235 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 238 0 obj << /Length 8674 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.0813 Tw [(132 )]TJ /TT3 1 Tf 2.7188 0 TD -0.0052 Tc 0.0831 Tw (Paton and Violanti The Resilient Police Organization: Response to Terrorism)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0082 Tc -0.0625 Tw (planning; team and multi-agency operations; information and)Tj 0 -1.398 TD -0.0036 Tc -0.0407 Tw (decision management\) in ways that promote adaptive capac-)Tj 0 -1.401 TD -0.0043 Tc -0.0625 Tw (ity \(Paton & Hannan, 2004\).)Tj 1.8 -2.001 TD -0.0031 Tc -0.0043 Tw [(By including simulations within a training strategy)62.9(, po-)]TJ -1.8 -1.398 TD 0.01 Tw (lice agencies can proactively enhance officer resilience, de-)Tj 0 -1.401 TD -0.0033 Tc 0.065 Tw (velop their capacity to adapt to challenging circumstances,)Tj T* -0.009 Tc -0.0625 Tw (and protect their well-being. Given the complexity and uncer-)Tj 0 -1.398 TD -0.0044 Tc (tainty inherent within the new environment, this strategy will)Tj 0 -1.401 TD -0.0034 Tc -0.0557 Tw [(not eliminate the risk of posttrauma reactions. Consequently)59.6(,)]TJ T* -0.0038 Tc 0.0007 Tw (post-event support resources will remain an important com-)Tj 0 -1.398 TD -0.0033 Tc 0.0019 Tw (ponent of any critical incident stress risk management strat-)Tj 0 -1.401 TD -0.0139 Tc -0.0626 Tw [(egy)61.1(. )16(The or)16.1(ganizational influence on resilience is not restricted)]TJ T* -0.0034 Tc 0.096 Tw (to the response phase it also extends into the post-event)Tj 0 -1.398 TD -0.0028 Tc 0.015 Tw (recovery period.)Tj /F1 1 Tf 11 0 0 11 54 501.99 Tm -0.0046 Tc 0.0341 Tw (Managing Risk After the Event)Tj /TT2 1 Tf 10 0 0 10 72 478.65 Tm -0.0035 Tc 0.1019 Tw (It is important to remember that the support practices)Tj -1.8 -1.401 TD -0.0169 Tw (and procedures used to reintegrate officers back into routine)Tj 0 -1.398 TD 0.0456 Tw [(work occur within an organizational context. Stress risk is)]TJ 0 -1.401 TD 0.0022 Tc 0.125 Tw (increased if reintegration occurs within an organizational)Tj T* 0.0027 Tc (culture that discourages emotional disclosure, focuses on)Tj 0 -1.398 TD -0.0061 Tc -0.0625 Tw (attributing blame to officers, or minimizes the significance of)Tj 0 -1.401 TD -0.0102 Tc (their reactions or feelings \(Paton & Stephens, 1996; MacLeod)Tj T* -0.0033 Tc 0.0633 Tw [(& Paton, 1999\). In contrast, an organizational culture that)]TJ 0 -1.398 TD -0.0035 Tc 0.0492 Tw (encourages managers to actively promote reintegration can)Tj 0 -1.401 TD -0.0271 Tw [(complement other resilience strategies. Managers can assist)]TJ T* -0.0054 Tc -0.0622 Tw (adaptation by helping officers appreciate that they performed)Tj 0 -1.398 TD -0.0029 Tc -0.028 Tw (to the best of their ability and reducing performance guilt by)Tj 0 -1.401 TD -0.001 Tc 0.125 Tw (realistically reviewing how situational factors constrained)Tj T* -0.0042 Tc -0.045 Tw (performance \(MacLeod & Paton\).)Tj 1.8 -1.998 TD 0.0058 Tc 0.1249 Tw (Managers can also contribute to the development of)Tj -1.8 -1.401 TD 0.0065 Tc 0.125 Tw (stress resilience by working with officers to identify the)Tj T* -0.0033 Tc -0.0119 Tw (strengths that helped them deal with the terrorist emergency)Tj 0 -1.398 TD -0.0035 Tc 0.0446 Tw (and building on this to plan how future events can be dealt)Tj 0 -1.401 TD -0.0264 Tc -0.0624 Tw [(with more ef)15.6(fectively)60.6(. Similarly)57.6(, when reviewing response prob-)]TJ T* -0.0035 Tc -0.0225 Tw (lems, the focus should be on ensuring that the review occurs)Tj 0 -1.398 TD -0.0033 Tc -0.0383 Tw (in a positive climate in which discussion identifies ways that)Tj 0 -1.401 TD 0.0037 Tc 0.125 Tw (issues can be constructively resolved or contained in the)Tj T* -0.0074 Tc -0.0622 Tw (future. The feedback from this process can contribute to iden-)Tj 0 -1.398 TD -0.0033 Tc -0.0444 Tw (tifying future training and support needs as well as organiza-)Tj 0 -1.401 TD 0.0422 Tc 0.125 Tw [(tional practices. If these actions are not taken, risk)]TJ T* -0.0038 Tc -0.0512 Tw (management programs should review the climate of the rela-)Tj 0 -1.398 TD -0.0034 Tc 0.1232 Tw (tionship between managers and staff \(e.g., levels of trust\))Tj 0 -1.401 TD -0.0031 Tc -0.0143 Tw [(and seek ways to build this capacity \(Gist & )18.1(W)94.7(oodall, 2000;)]TJ T* 0.0965 Tw [(Paton et al., 2003\). Such analyses can promote future re-)]TJ 25.5 64.2 TD 0.0154 Tc 0.125 Tw (sponse effectiveness, facilitate the establishment and/or)Tj 0 -1.398 TD -0.0035 Tc 0.0671 Tw (maintenance of a resilient organizational climate, and con-)Tj 0 -1.401 TD -0.0031 Tc -0.032 Tw (tribute to the next iteration of agency and officer change and)Tj T* -0.0014 Tc 0 Tw (development.)Tj /F1 1 Tf 11 0 0 11 309 648 Tm 0.0011 Tc (Conclusion)Tj /TT2 1 Tf 10 0 0 10 327 624.66 Tm -0.0038 Tc 0.0529 Tw [(T)73(errorism adds a new)59.2(, unique, and challenging dimen-)]TJ -1.8 -1.401 TD -0.0034 Tc 0.0394 Tw (sion to the environment of contemporary policing, one that)Tj T* -0.0032 Tc 0.0156 Tw (differs qualitatively from that in which policing has histori-)Tj 0 -1.398 TD -0.005 Tw (cally occurred. It presents agencies and officers alike with a)Tj 0 -1.401 TD -0.0036 Tc -0.0065 Tw [(more complex, dynamic, and threatening environment. )50.3(As a)]TJ T* -0.0034 Tc -0.05 Tw (result, agencies and officers must be able to learn from expe-)Tj 0 -1.398 TD -0.0032 Tc 0.1187 Tw (rience and incorporate into the agency culture and officer)Tj 0 -1.401 TD 0.0072 Tc 0.125 Tw (schemata ways of ensuring a capacity to adapt to future)Tj T* -0.0033 Tc -0.0136 Tw (events. Given the importance of the agency-officer relation-)Tj 0 -1.398 TD -0.0032 Tc -0.0388 Tw (ships in this process, organizational culture \(e.g., attitudes to)Tj 0 -1.401 TD -0.0039 Tc 0.0638 Tw (emotional disclosure, performance expectations, empower-)Tj T* -0.0033 Tc -0.0407 Tw [(ment\) and practices \(e.g., devolving authority)62.7(, incident man-)]TJ 0 -1.398 TD 0.0225 Tc 0.125 Tw (agement protocols, inter-agency collaboration\) play an)Tj 0 -1.401 TD -0.0035 Tc 0.0122 Tw (important role in creating and sustaining a context that sup-)Tj T* -0.0176 Tc -0.0625 Tw (ports officer well-being and effectiveness \(Jackson et al., 2003;)Tj 0 -1.398 TD -0.005 Tc -0.0623 Tw [(Paton & Hill, 2006; Paton & Jackson, 2002\). Cultural change)]TJ 0 -1.401 TD -0.0066 Tc -0.0625 Tw (can be transmitted to officers through, for example, induction)Tj T* -0.0035 Tc 0 Tw (and socialization procedures, training, simulations, and par-)Tj 0 -1.398 TD -0.004 Tc 0.0214 Tw [(ticipative or)14(ganizational development programs. )53.1(Additional)]TJ 0 -1.401 TD -0.0035 Tc -0.0143 Tw [(work is, however)35.5(, required in order to operationalize the de-)]TJ T* -0.0031 Tc -0.0585 Tw (velopment of resilience by identifying the specific indicators)Tj 0 -1.398 TD -0.0029 Tc 0.027 Tw (that reflect how agency culture is enacted in ways that lead)Tj 0 -1.401 TD -0.0034 Tc 0.0788 Tw (to resilience. Once identified, these predictors can be used)Tj T* -0.0006 Tc 0.125 Tw [(by agencies to plan and evaluate their resilience strategy)62.4(.)]TJ 0 -1.398 TD -0.0041 Tc -0.0625 Tw (The dynamic nature of contemporary policing means that the)Tj 0 -1.401 TD -0.0034 Tc 0.0928 Tw (development and maintenance of agency and officer resil-)Tj T* -0.0036 Tc 0.055 Tw (ience should be viewed as an iterative process that encom-)Tj 0 -1.398 TD -0.0037 Tc 0.0563 Tw (passes personal and organizational learning.)Tj /F1 1 Tf 11 0 0 11 388.89 194.01 Tm 0.021 Tc 0 Tw (REFERENCES)Tj /TT2 1 Tf 10 0 0 10 309 176.64 Tm -0.0035 Tc 0.021 Tw [(Alper)38.5(, )50.7(A., & Kupferman, S.L. \(2003\). )]TJ /TT5 1 Tf 15.324 0 TD -0.005 Tc 0.0228 Tw [(Enhancing New Y)85(ork)]TJ -14.124 -1.398 TD -0.0145 Tc -0.0596 Tw [(City)120.5(s emer)30.5(gency pr)30.5(epar)30.5(edness)]TJ /TT2 1 Tf 11.859 0 TD -0.014 Tc -0.094 Tw [(. )-31.6(New Y)96.2(ork: )-30.7(New Y)102.2(ork )-30.9(Eco-)]TJ -11.859 -1.401 TD -0.0074 Tc -0.0625 Tw (nomic Development Corp.)Tj -1.2 -1.8 TD -0.0104 Tc -0.0618 Tw [(Berkes, F)76.6(., Colding, J., & Folke, C. \(2003\). )]TJ /TT5 1 Tf 16.545 0 TD -0.0115 Tc -0.065 Tw (Navigating social-)Tj -15.345 -1.401 TD 0.0046 Tc 0.125 Tw (ecological systems: Building resilience for complexity)Tj 0 -1.398 TD -0.0046 Tc -0.03 Tw (and change)Tj /TT2 1 Tf 4.566 0 TD -0.0036 Tc -0.0312 Tw (. Cambridge: Cambridge University Press.)Tj -5.766 -1.8 TD -0.0031 Tc 0.0433 Tw (Brake, J.D. \(2001\). )Tj /TT5 1 Tf 7.986 0 TD -0.0037 Tc [(T)93.5(e)4.3(rr)34.5(orism and the military)125.3(s r)32.3(ole in do-)]TJ -6.786 -1.401 TD 0.0028 Tc 0.125 Tw (mestic crisis management: Background and issues for)Tj ET endstream endobj 239 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 241 0 obj << /Length 10343 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (133)Tj /TT5 1 Tf 10 0 0 10 78 722.64 Tm -0.0067 Tc [(Congr)26.3(ess)]TJ /TT2 1 Tf 3.705 0 TD -0.0038 Tc -0.0412 Tw [(. )14(W)97(ashington, DC: Congressional Research Ser)14.2(-)]TJ -3.705 -1.398 TD -0.003 Tc -0.04 Tw (vice, Library of Congress.)Tj -1.2 -1.8 TD -0.0039 Tc -0.0622 Tw (Burke, K.J., & Paton, D. \(2006\). Predicting police officer job)Tj 1.2 -1.401 TD -0.0035 Tc 0.067 Tw (satisfaction: Traditional versus contemporary models of)Tj T* -0.0135 Tc -0.0613 Tw (trauma in occupational experience. )Tj /TT5 1 Tf 13.53 0 TD -0.0146 Tc -0.0584 Tw [(T)55.6(raumatology)51.4(, 12)]TJ /TT2 1 Tf 6.771 0 TD -0.0138 Tc -0.065 Tw (, 189-)Tj -20.301 -1.398 TD -0.0583 Tc 0 Tw (197.)Tj -1.2 -1.8 TD -0.0032 Tc -0.0466 Tw (Carafano, J.J. \(2003\). )Tj /TT5 1 Tf 8.649 0 TD -0.0041 Tc -0.0487 Tw (Preparing responders to respond: The)Tj -7.449 -1.401 TD -0.0038 Tc 0.0807 Tw (challenges to emergency preparedness in the 21st Cen-)Tj T* -0.0055 Tc 0 Tw [(tur)-5.5(y )]TJ /TT2 1 Tf 1.869 0 TD -0.0037 Tc 0.0292 Tw [(\(Heritage Lecture No. 812\). )17.3(W)94.1(ashington, DC: Heri-)]TJ -1.869 -1.398 TD -0.0014 Tc 0.125 Tw (tage Foundation.)Tj -1.2 -1.8 TD -0.018 Tc -0.0615 Tw [(Cooper)36(, H. H. )54.7(A. \(2001\). )12.7(T)73.8(errorism: )15.7(The problems of definition)]TJ 1.2 -1.401 TD -0.0032 Tc 0 Tw (revisited. )Tj /TT5 1 Tf 3.906 0 TD -0.0039 Tc -0.0049 Tw (American Behavioral Scientist, 44)Tj /TT2 1 Tf 13.578 0 TD -0.0036 Tc -0.01 Tw (, 881-893.)Tj -18.684 -1.8 TD -0.0549 Tw [(Crego, J., & Spinks, )14.6(T)79.3(.)0.1( \(1997\). Critical incident management)]TJ 1.2 -1.401 TD -0.0234 Tc -0.0623 Tw (simulation. In R. Flin, E. Salas, M. Strub, & L. Martin \(Eds.\),)Tj /TT5 1 Tf 0 -1.398 TD 0.0097 Tc 0.1248 Tw [(Decision making under str)30.7(ess )]TJ /TT2 1 Tf 12.861 0 TD 0.01 Tc 0.1256 Tw [(\(pp. 85-94\). )52.6(Aldershot:)]TJ -12.861 -1.401 TD 0.0212 Tc 0 Tw (Ashgate.)Tj -1.2 -1.8 TD -0.0035 Tc 0.1 Tw [(D)6.1(a)6.1(w)59.5(, J. \(2001\). Responding to the nation)53.5(s sadness, anger)]TJ 1.2 -1.401 TD -0.0041 Tc 0.105 Tw [(and fear)49.9(.)-5.1( )]TJ /TT5 1 Tf 3.876 0 TD 0.1052 Tw [(Monitor on Psychology)52.8(, 32)]TJ /TT2 1 Tf 11.049 0 TD -0.0025 Tc 0.105 Tw (. Retrieved July 3,)Tj -14.925 -1.398 TD -0.0166 Tc -0.0628 Tw [(2002, from www)64.4(.apa.monitor/nov01/)]TJ -1.2 -1.8 TD -0.0031 Tc 0.0354 Tw [(Deahl, M. P)107.9(., Gillham, )53.8(A. B., )14.8(Thomas, J., Searle, M. M., &)]TJ 1.2 -1.401 TD -0.0035 Tc -0.006 Tw (Srinivasan, M. \(1994\). 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Dun-)]TJ 0 -1.401 TD 0.0152 Tc 0.125 Tw (ning \(Eds.\).)Tj /TT5 1 Tf 5.004 0 TD [( Posttraumatic stress intervention: Chal-)]TJ -5.004 -1.401 TD -0.0036 Tc 0.0512 Tw (lenges, issues and perspectives )Tj /TT2 1 Tf 12.729 0 TD -0.0034 Tc 0.0525 Tw (\(pp. 81-96\). Springfield,)Tj -12.729 -1.398 TD -0.011 Tc -0.0616 Tw (IL: Charles C. Thomas.)Tj -1.2 -1.8 TD -0.01 Tc -0.0622 Tw [(Grant, N.K., Hoover)35(, D.A., Scarisbrick-Hauser)32(,)-7.1( )55.9(A., & Muf)14(fet,)]TJ 1.2 -1.401 TD -0.0034 Tc -0.0489 Tw (S.L. \(2003\). The crash of United Flight 93 in Shanksville,)Tj T* -0.0026 Tc 0.069 Tw (Pennsylvania. In J.L. 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306.599 c 450.079 306.599 449.254 305.591 449.254 304.135 c 449.254 302.316 450.302 301.616 451.37 301.616 c 451.724 301.616 453.166 301.695 453.428 303.482 c 452.812 303.482 l 452.596 302.382 451.881 302.184 451.469 302.184 c 450.302 302.184 449.909 303.041 449.909 304.154 c 449.909 305.4 450.597 306.033 451.449 306.033 c 451.901 306.033 452.589 305.881 452.766 305.051 c 453.382 305.051 l f* 454.142 301.741 0.636 4.733 re f* 455.839 301.742 m 457.72 301.742 l 459.266 301.742 459.725 303.113 459.725 304.174 c 459.725 305.538 458.971 306.474 457.746 306.474 c 455.839 306.474 l 455.839 301.742 l h 456.475 305.927 m 457.661 305.927 l 458.526 305.927 459.07 305.327 459.07 304.135 c 459.07 302.942 458.532 302.289 457.707 302.289 c 456.475 302.289 l 456.475 305.927 l f* 463.925 302.309 m 461.088 302.309 l 461.088 303.891 l 463.663 303.891 l 463.663 304.457 l 461.088 304.457 l 461.088 305.907 l 463.879 305.907 l 463.879 306.474 l 460.452 306.474 l 460.452 301.742 l 463.925 301.742 l 463.925 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296.895 446 297.297 c 446 298.015 446.675 298.127 447.075 298.127 c 447.606 298.127 448.208 297.896 448.241 297.165 c 448.837 297.165 l f* 449.231 297.982 m 450.823 297.982 l 450.823 293.816 l 451.458 293.816 l 451.458 297.982 l 453.051 297.982 l 453.051 298.549 l 449.231 298.549 l 449.231 297.982 l f* 454.23 295.847 m 455.77 295.847 l 456.53 295.847 456.609 295.392 456.609 295.003 c 456.609 294.825 456.629 294.107 456.72 293.817 c 457.5 293.817 l 457.5 293.922 l 457.304 294.034 457.271 294.133 457.264 294.397 c 457.225 295.254 l 457.199 295.913 456.93 296.031 456.661 296.143 c 456.963 296.321 457.317 296.578 457.317 297.277 c 457.317 298.278 456.543 298.549 455.77 298.549 c 453.595 298.549 l 453.595 293.817 l 454.23 293.817 l 454.23 295.847 l h 454.23 298.002 m 455.816 298.002 l 456.131 298.002 456.661 297.942 456.661 297.211 c 456.661 296.512 456.17 296.394 455.705 296.394 c 454.23 296.394 l 454.23 298.002 l f* 461.635 294.384 m 458.798 294.384 l 458.798 295.965 l 461.373 295.965 l 461.373 296.532 l 458.798 296.532 l 458.798 297.982 l 461.589 297.982 l 461.589 298.549 l 458.162 298.549 l 458.162 293.817 l 461.635 293.817 l 461.635 294.384 l f* 465.763 297.165 m 465.737 297.685 465.573 298.674 463.928 298.674 c 462.788 298.674 462.31 297.949 462.31 297.211 c 462.31 296.387 463.005 296.17 463.313 296.097 c 464.276 295.873 l 465.049 295.689 465.278 295.53 465.278 295.036 c 465.278 294.357 464.505 294.239 464.046 294.239 c 463.443 294.239 462.749 294.489 462.749 295.346 c 462.153 295.346 l 462.153 294.904 462.231 294.509 462.631 294.146 c 462.841 293.955 463.182 293.691 464.053 293.691 c 464.859 293.691 465.895 294.001 465.895 295.122 c 465.895 295.873 465.436 296.242 464.826 296.387 c 463.483 296.697 l 463.208 296.763 462.926 296.895 462.926 297.297 c 462.926 298.015 463.601 298.127 464.001 298.127 c 464.531 298.127 465.134 297.896 465.167 297.165 c 465.763 297.165 l f* 469.997 297.165 m 469.97 297.685 469.806 298.674 468.162 298.674 c 467.021 298.674 466.543 297.949 466.543 297.211 c 466.543 296.387 467.238 296.17 467.546 296.097 c 468.509 295.873 l 469.282 295.689 469.511 295.53 469.511 295.036 c 469.511 294.357 468.738 294.239 468.28 294.239 c 467.677 294.239 466.982 294.489 466.982 295.346 c 466.386 295.346 l 466.386 294.904 466.465 294.509 466.864 294.146 c 467.074 293.955 467.415 293.691 468.286 293.691 c 469.092 293.691 470.128 294.001 470.128 295.122 c 470.128 295.873 469.669 296.242 469.06 296.387 c 467.716 296.697 l 467.441 296.763 467.159 296.895 467.159 297.297 c 467.159 298.015 467.834 298.127 468.234 298.127 c 468.765 298.127 469.367 297.896 469.4 297.165 c 469.997 297.165 l f* 438.346 288.04 m 440.653 288.04 l 440.653 288.607 l 438.346 288.607 l 438.346 290.056 l 440.968 290.056 l 440.968 290.623 l 437.711 290.623 l 437.711 285.89 l 438.346 285.89 l 438.346 288.04 l f* 445.214 288.257 m 445.214 287.144 444.598 286.333 443.576 286.333 c 442.553 286.333 441.937 287.144 441.937 288.257 c 441.937 289.371 442.553 290.182 443.576 290.182 c 444.598 290.182 445.214 289.371 445.214 288.257 c h 445.869 288.257 m 445.869 289.279 445.332 290.748 443.576 290.748 c 441.819 290.748 441.282 289.279 441.282 288.257 c 441.282 287.236 441.819 285.765 443.576 285.765 c 445.332 285.765 445.869 287.236 445.869 288.257 c f* 449.552 290.623 m 449.552 287.631 l 449.552 286.603 448.896 286.333 448.313 286.333 c 447.743 286.333 447.121 286.616 447.121 287.645 c 447.121 290.623 l 446.485 290.623 l 446.485 287.467 l 446.485 286.583 447.029 285.765 448.294 285.765 c 449.584 285.765 450.187 286.583 450.187 287.552 c 450.187 290.623 l 449.552 290.623 l f* 454.165 286.801 m 454.152 286.801 l 451.799 290.623 l 451.046 290.623 l 451.046 285.892 l 451.662 285.892 l 451.662 289.714 l 451.675 289.714 l 454.067 285.892 l 454.781 285.892 l 454.781 290.623 l 454.165 290.623 l 454.165 286.801 l f* 455.659 285.892 m 457.54 285.892 l 459.086 285.892 459.545 287.262 459.545 288.323 c 459.545 289.687 458.791 290.623 457.566 290.623 c 455.659 290.623 l 455.659 285.892 l h 456.295 290.076 m 457.481 290.076 l 458.345 290.076 458.889 289.477 458.889 288.284 c 458.889 287.091 458.352 286.439 457.526 286.439 c 456.295 286.439 l 456.295 290.076 l f* 462.572 287.269 m 463.037 285.89 l 463.732 285.89 l 462.028 290.623 l 461.308 290.623 l 459.538 285.89 l 460.194 285.89 l 460.685 287.269 l 462.572 287.269 l h 460.882 287.836 m 461.635 289.918 l 461.648 289.918 l 462.343 287.836 l 460.882 287.836 l f* 462.985 290.056 m 464.577 290.056 l 464.577 285.89 l 465.213 285.89 l 465.213 290.056 l 466.805 290.056 l 466.805 290.623 l 462.985 290.623 l 462.985 290.056 l f* 467.369 285.89 0.636 4.733 re f* 472.722 288.257 m 472.722 287.144 472.106 286.333 471.084 286.333 c 470.062 286.333 469.446 287.144 469.446 288.257 c 469.446 289.371 470.062 290.182 471.084 290.182 c 472.106 290.182 472.722 289.371 472.722 288.257 c h 473.377 288.257 m 473.377 289.279 472.84 290.748 471.084 290.748 c 469.328 290.748 468.791 289.279 468.791 288.257 c 468.791 287.236 469.328 285.765 471.084 285.765 c 472.84 285.765 473.377 287.236 473.377 288.257 c f* 477.093 286.801 m 477.08 286.801 l 474.727 290.623 l 473.974 290.623 l 473.974 285.892 l 474.59 285.892 l 474.59 289.714 l 474.603 289.714 l 476.995 285.892 l 477.709 285.892 l 477.709 290.623 l 477.093 290.623 l 477.093 286.801 l f* q 0.9972 0 0 1.0028 0 0 cm 0.333 w 2.613 M 457.228 353.424 m 460.576 353.424 l 460.575 349.99 l 463.346 351.797 l 464.943 349.195 l 461.977 347.468 l 464.965 345.775 l 463.429 343.109 l 460.555 344.776 l 460.555 341.271 l 457.241 341.271 l 457.239 344.698 l 454.306 343.008 l 452.771 345.792 l 455.671 347.445 l 452.716 349.175 l 454.249 351.761 l 457.228 349.989 l 457.228 353.424 l b* Q 0 0 0 0 k 457.971 352.915 m 457.575 353.618 457.23 352.905 y 457.563 343.897 l 457.69 343.644 457.743 343.921 y 457.971 352.915 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.166 w 2.613 M 458.639 349.05 m 458.412 349.192 458.306 349.314 y 457.729 349.931 457.717 350.404 y 457.701 350.818 457.845 351.056 y 457.962 351.312 458.33 351.447 y 458.548 351.532 458.578 351.509 y 458.867 351.504 459.008 351.272 y 459.477 350.936 458.866 350.945 y 458.576 350.988 458.491 351.052 y 458.131 350.956 458.203 350.423 y 458.275 350.108 458.466 349.762 458.618 349.683 c 458.639 349.05 l b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.166 w 2.613 M 458.865 351.249 m 458.818 351.255 458.768 351.234 458.725 351.256 c 458.706 351.266 458.697 351.291 458.705 351.307 c 458.71 351.32 458.742 351.342 458.763 351.334 c 458.808 351.318 458.819 351.263 458.865 351.249 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.166 w 2.613 M 458.835 344.727 m 458.863 344.894 458.943 345.019 v 459.012 345.128 459.071 345.186 459.186 345.307 c 459.249 345.374 459.339 345.5 459.404 345.578 c 459.626 345.858 459.441 346.159 v 459.356 346.288 459.127 346.487 v 459.132 345.873 l 459.129 345.728 458.738 345.283 y 458.64 345.159 458.591 345.1 458.544 344.748 c 458.507 344.345 458.837 343.914 v 458.817 344.565 l 458.823 344.674 458.835 344.727 v b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.166 w 2.613 M 459.195 348.662 m 459.229 348.558 458.688 347.992 y 458.641 347.938 458.587 347.876 458.524 347.808 c 458.185 347.44 458.202 347.136 v 458.22 346.713 458.634 346.314 v 458.686 346.272 458.755 346.197 v 458.737 346.778 l 458.693 346.832 458.641 346.917 458.599 347.045 c 458.554 347.137 458.678 347.333 v 458.895 347.532 459.6 348.367 v 459.804 348.716 459.643 348.945 v 459.487 349.175 459.212 349.356 v 459.195 348.662 l b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.166 w 2.613 M 459.059 343.631 m 459.08 343.557 459.069 343.464 458.978 343.36 c 458.782 343.078 l 459.002 343.172 459.107 343.304 v 459.238 343.433 459.207 343.672 v 459.184 343.785 459.071 343.969 v 459.059 343.631 l b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 459.372 256.758 m 459.528 256.804 459.645 256.711 459.801 256.804 c 460.113 256.943 460.387 257.036 460.66 257.267 c 460.855 257.406 460.972 257.638 461.168 257.823 c 461.246 257.87 461.372 257.873 461.402 257.731 c 461.441 257.545 461.558 257.499 461.675 257.453 c 462.261 257.221 462.847 257.36 463.433 257.453 c 464.097 257.546 464.565 258.148 465.19 258.426 c 465.502 258.612 465.738 258.967 466.049 259.029 c 466.283 259.075 466.557 259.075 466.752 259.26 c 466.869 259.353 466.83 259.492 v 467.259 259.539 467.572 259.863 467.845 260.233 c 467.923 260.28 468.04 260.372 468.157 260.326 c 468.118 260.326 l 471.008 263.986 l 470.968 264.078 l 470.929 264.217 471.007 264.356 470.929 264.495 c 462.221 262.131 l 462.182 261.807 461.831 261.39 461.636 261.112 c 461.671 261.162 460.976 261.565 461.041 261.694 c 461.457 262.526 461.352 263.294 460.922 264.035 c 460.844 264.22 460.766 264.289 460.649 264.452 c 460.351 264.863 459.868 265.1 459.36 265.007 c 459.243 265.007 l 458.735 265.1 458.384 264.869 458.013 264.544 c 457.843 264.396 457.544 264.081 457.466 263.896 c 457.037 263.155 457.214 262.252 457.546 261.527 c 457.606 261.396 456.903 261.167 456.939 261.117 c 456.744 261.395 456.392 261.812 456.353 262.136 c 447.644 264.498 l 447.566 264.359 447.644 264.22 447.605 264.081 c 447.566 263.988 l 450.456 260.329 l 450.417 260.329 l 450.534 260.376 450.651 260.283 450.73 260.237 c 451.003 259.866 451.315 259.542 451.745 259.496 c 451.706 259.357 451.823 259.264 y 452.018 259.079 452.292 259.079 452.526 259.032 c 452.837 258.971 453.073 258.616 453.385 258.43 c 454.01 258.153 454.478 257.55 455.142 257.458 c 455.728 257.365 456.314 257.226 456.9 257.458 c 457.017 257.504 457.134 257.55 457.173 257.735 c 457.203 257.878 457.329 257.875 457.407 257.828 c 457.603 257.643 457.72 257.411 457.915 257.272 c 458.188 257.041 458.462 256.948 458.774 256.809 c 458.93 256.716 459.047 256.809 459.204 256.763 c 459.372 256.758 l b* Q 450.968 263.46 m 454.843 262.511 l 454.823 262.511 454.823 262.534 454.804 262.534 c 454.901 262.232 455.018 261.93 455.096 261.605 c 455.204 261.153 455.096 260.653 455.076 260.188 c 454.882 260.281 454.862 260.421 v 454.784 260.746 454.784 260.978 454.706 261.303 c 454.687 261.326 454.57 261.443 454.551 261.489 c 454.422 261.796 454.258 261.837 453.986 262 c 453.674 262.163 453.363 262.418 453.071 262.557 c 452.448 262.836 451.786 262.882 451.182 263.184 c 451.163 263.208 451.104 263.231 451.085 263.301 c 451.071 263.35 450.91 263.347 450.968 263.46 c f* 451.922 262.673 m 451.961 262.627 452 262.534 452.039 262.511 c 452.214 262.418 452.389 262.441 452.565 262.441 c 452.526 262.464 452.487 262.511 452.448 262.511 c 452.234 262.511 452.097 262.581 451.922 262.673 c f* 452.506 262.07 m 452.681 262.07 452.837 262.093 453.012 262.07 c 453.032 262.046 453.012 262 452.993 261.977 c 452.837 261.93 452.681 261.837 452.526 261.791 c 452.487 261.767 452.428 261.791 y 452.35 261.721 452.149 261.69 452.175 261.767 c 452.214 261.884 452.35 261.954 452.448 262.023 c 452.506 262.07 l f* 452.526 261.28 m 452.584 261.28 452.643 261.257 452.701 261.303 c 452.818 261.396 453.012 261.535 453.149 261.559 c 452.526 261.28 l f* 452.993 260.932 m 453.168 260.932 453.382 260.885 453.519 260.955 c 453.577 261.001 453.655 261.094 453.694 261.21 c 453.441 261.164 453.285 261.001 453.032 261.001 c 452.993 260.932 l f* 454.2 260.769 m 454.161 260.769 454.122 260.792 454.083 260.769 c 453.947 260.676 453.791 260.653 453.694 260.513 c 453.655 260.444 453.655 260.351 453.655 260.281 c 453.694 260.281 453.733 260.258 453.752 260.281 c 453.85 260.467 454.025 260.513 454.122 260.676 c 454.2 260.769 l f* 453.85 259.909 m 453.85 259.886 453.85 259.84 453.85 259.817 c 454.083 259.747 454.239 259.956 454.414 260.119 c 454.551 260.235 454.414 260.328 454.297 260.235 c 454.239 260.188 454.142 260.119 454.064 260.049 c 454.005 259.979 453.908 260.026 453.83 259.956 c 453.85 259.933 453.85 259.909 v f* 454.59 259.724 m 454.687 259.724 454.706 259.84 454.784 259.886 c 454.59 259.724 l f* 455.018 259.701 m 455.018 259.654 455.018 259.631 455.018 259.584 c 455.057 259.584 l 455.057 259.538 455.057 259.468 455.057 259.422 c 455.018 259.701 l f* 447.191 264.23 m 447.307 264.253 447.405 264.206 447.502 264.16 c 447.522 264.16 447.561 264.113 447.599 264.09 c 447.716 264.044 447.833 263.997 447.95 263.951 c 448.32 263.835 448.709 263.858 449.06 263.649 c 449.196 263.579 449.352 263.509 449.488 263.463 c 449.858 263.37 450.189 263.37 450.559 263.301 c 450.617 263.277 450.676 263.208 450.754 263.208 c 450.364 263.231 449.975 263.161 449.566 263.231 c 449.352 263.277 449.138 263.254 448.924 263.324 c 448.865 263.347 448.846 263.417 448.787 263.44 c 448.573 263.509 448.378 263.417 448.184 263.486 c 448.106 263.509 448.008 263.509 447.931 263.556 c 447.658 263.649 447.483 263.904 447.268 264.137 c 447.249 264.16 447.288 264.206 447.249 264.23 c 447.191 264.23 l f* 447.639 263.417 m 447.716 263.324 447.775 263.208 447.892 263.161 c 448.086 263.115 448.262 262.975 448.456 262.929 c 448.69 262.859 448.904 262.813 449.138 262.789 c 449.43 262.743 449.702 262.743 449.994 262.65 c 450.014 262.65 450.074 262.636 450.092 262.627 c 450.54 262.418 451.007 262.511 451.455 262.511 c 451.474 262.65 451.416 262.836 451.279 262.859 c 451.065 262.905 450.871 262.789 450.656 262.766 c 450.384 262.72 450.131 262.72 449.858 262.766 c 449.761 262.789 449.683 262.813 449.605 262.859 c 449.352 262.975 449.099 262.859 448.846 262.975 c 448.748 263.022 448.67 263.045 448.573 263.092 c 448.3 263.161 448.028 263.208 447.775 263.324 c 447.639 263.417 l f* 448.573 262.279 m 449.001 262.255 449.449 262.372 449.878 262.232 c 449.956 262.209 450.014 262.093 450.111 262.07 c 450.267 262.046 450.423 262.093 450.578 262.116 c 450.91 262.186 451.241 262.093 451.571 262.163 c 450.987 261.698 450.228 261.86 449.566 261.907 c 449.41 261.907 449.294 262.046 449.157 262.07 c 449.04 262.07 448.904 262.07 448.787 262.116 c 448.729 262.139 448.69 262.186 448.632 262.209 c 448.573 262.279 l f* 449.702 261.21 m 449.683 261.234 449.722 261.257 449.722 261.28 c 450.072 261.257 450.423 261.373 450.773 261.443 c 451.163 261.512 451.552 261.35 451.941 261.512 c 451.883 261.489 451.823 261.462 451.766 261.443 c 451.085 261.21 450.481 261.257 449.819 261.234 c 449.702 261.21 l f* 450.462 260.56 m 450.676 260.513 450.948 260.56 451.163 260.56 c 451.435 260.606 451.722 260.54 452 260.606 c 452.195 260.653 452.175 260.815 452.409 261.071 c 452.117 261.048 451.98 261.024 451.63 261.048 c 451.408 261.062 451.26 260.908 451.046 260.839 c 450.871 260.792 450.871 260.885 450.734 260.769 c 450.462 260.56 l f* 451.202 260.002 m 451.513 259.979 451.805 260.002 452.117 260.072 c 452.136 260.096 452.175 260.119 452.195 260.142 c 452.311 260.188 452.448 260.142 452.565 260.235 c 452.646 260.299 452.701 260.374 452.798 260.421 c 452.818 260.444 452.857 260.676 452.837 260.676 c 452.759 260.699 452.643 260.56 452.565 260.513 c 452.506 260.513 452.487 260.444 452.428 260.421 c 452.175 260.328 452.156 260.467 451.922 260.305 c 451.786 260.212 451.338 260.235 451.221 260.072 c 451.202 260.002 l f* 452.058 259.492 m 452.273 259.468 452.467 259.561 452.662 259.631 c 452.837 259.701 453.032 259.793 453.188 259.956 c 452.857 260.049 452.565 259.77 452.234 259.677 c 452.195 259.677 452.097 259.608 452.117 259.515 c 452.058 259.492 l f* 452.526 259.213 m 452.565 259.074 452.74 259.097 452.818 259.143 c 452.973 259.259 453.207 259.306 453.246 259.538 c 453.168 259.538 453.11 259.561 453.032 259.515 c 452.973 259.468 452.935 259.422 452.896 259.352 c 452.818 259.236 452.662 259.329 452.584 259.19 c 452.526 259.213 l f* 453.227 258.841 m 453.382 258.841 453.538 258.841 453.694 258.841 c 453.674 259.027 453.733 259.213 453.85 259.352 c 453.85 259.376 453.85 259.422 453.85 259.445 c 453.752 259.492 453.674 259.376 453.597 259.306 c 453.538 259.236 453.538 259.12 453.557 259.027 c 453.46 259.027 453.363 258.981 453.304 258.888 c 453.227 258.841 l f* 454.025 258.725 m 454.2 258.771 454.297 258.957 454.453 259.027 c 454.025 258.725 l f* 454.473 258.748 m 454.59 258.748 454.648 258.934 454.745 259.027 c 454.473 258.748 l f* 454.921 258.725 m 455.062 258.725 455.213 258.655 455.349 258.725 c 455.349 258.795 l 455.252 258.841 455.213 259.027 455.096 258.981 c 455.076 258.981 455.057 258.864 455.018 258.818 c 454.998 258.818 454.979 258.818 454.959 258.818 c 454.921 258.795 454.901 258.725 454.921 258.725 c f* 464.997 263.456 m 461.122 262.506 l 461.142 262.506 461.142 262.529 461.161 262.529 c 461.064 262.227 460.947 261.926 460.87 261.6 c 460.761 261.149 460.87 260.648 460.889 260.184 c 461.084 260.276 461.103 260.416 v 461.181 260.741 461.181 260.973 461.259 261.298 c 461.278 261.322 461.395 261.438 461.415 261.484 c 461.543 261.791 461.707 261.833 461.979 261.995 c 462.291 262.158 462.602 262.414 462.894 262.553 c 463.517 262.832 464.179 262.878 464.783 263.181 c 464.802 263.204 464.861 263.227 464.88 263.297 c 464.894 263.346 465.055 263.343 464.997 263.456 c f* 464.043 262.669 m 464.004 262.623 463.965 262.53 463.926 262.507 c 463.751 262.414 463.576 262.437 463.401 262.437 c 463.44 262.46 463.479 262.507 463.517 262.507 c 463.732 262.507 463.868 262.577 464.043 262.669 c f* 463.459 262.065 m 463.284 262.065 463.128 262.089 462.953 262.065 c 462.933 262.042 462.953 261.996 462.972 261.973 c 463.128 261.926 463.284 261.833 463.44 261.787 c 463.479 261.764 463.537 261.787 y 463.615 261.717 463.816 261.686 463.79 261.764 c 463.751 261.88 463.615 261.949 463.517 262.019 c 463.459 262.065 l f* 463.44 261.276 m 463.381 261.276 463.323 261.252 463.265 261.299 c 463.148 261.392 462.953 261.531 462.817 261.554 c 463.44 261.276 l f* 462.973 260.927 m 462.797 260.927 462.583 260.881 462.447 260.95 c 462.388 260.997 462.31 261.09 462.271 261.206 c 462.525 261.16 462.681 260.997 462.934 260.997 c 462.973 260.927 l f* 461.765 260.764 m 461.804 260.764 461.843 260.788 461.882 260.764 c 462.019 260.672 462.174 260.648 462.271 260.509 c 462.311 260.439 462.311 260.347 462.311 260.277 c 462.272 260.277 462.233 260.254 462.213 260.277 c 462.116 260.463 461.941 260.509 461.843 260.672 c 461.765 260.764 l f* 462.116 259.905 m 462.116 259.882 462.116 259.835 462.116 259.812 c 461.883 259.743 461.727 259.952 461.551 260.114 c 461.415 260.23 461.551 260.323 461.668 260.23 c 461.727 260.184 461.824 260.114 461.902 260.044 c 461.96 259.975 462.058 260.021 462.135 259.952 c 462.116 259.928 462.116 259.905 v f* 461.376 259.719 m 461.279 259.719 461.259 259.835 461.181 259.882 c 461.376 259.719 l f* 460.948 259.696 m 460.948 259.649 460.948 259.626 460.948 259.58 c 460.909 259.58 l 460.909 259.533 460.909 259.464 460.909 259.417 c 460.948 259.696 l f* 468.774 264.227 m 468.657 264.25 468.56 264.203 468.463 264.157 c 468.443 264.157 468.404 264.11 468.365 264.087 c 468.249 264.04 468.132 263.994 468.015 263.948 c 467.645 263.832 467.255 263.855 466.905 263.645 c 466.769 263.576 466.613 263.506 466.477 263.46 c 466.107 263.367 465.776 263.367 465.406 263.297 c 465.347 263.273 465.289 263.204 465.211 263.204 c 465.601 263.227 465.99 263.157 466.399 263.227 c 466.613 263.274 466.827 263.251 467.042 263.32 c 467.1 263.344 467.119 263.413 467.178 263.436 c 467.392 263.506 467.586 263.413 467.781 263.483 c 467.859 263.507 467.957 263.507 468.034 263.553 c 468.307 263.646 468.482 263.901 468.696 264.134 c 468.716 264.157 468.677 264.203 468.716 264.227 c 468.774 264.227 l f* 468.326 263.414 m 468.249 263.321 468.19 263.204 468.073 263.158 c 467.879 263.111 467.703 262.972 467.509 262.926 c 467.275 262.856 467.061 262.81 466.827 262.786 c 466.535 262.74 466.263 262.74 465.971 262.647 c 465.951 262.647 465.891 262.632 465.873 262.623 c 465.426 262.414 464.958 262.507 464.51 262.507 c 464.491 262.646 464.549 262.832 464.686 262.855 c 464.9 262.902 465.095 262.786 465.309 262.763 c 465.581 262.716 465.835 262.716 466.107 262.763 c 466.204 262.786 466.282 262.809 466.36 262.856 c 466.613 262.972 466.866 262.856 467.119 262.972 c 467.217 263.019 467.295 263.042 467.392 263.088 c 467.665 263.158 467.937 263.204 468.19 263.321 c 468.326 263.414 l f* 467.392 262.275 m 466.964 262.252 466.516 262.368 466.088 262.229 c 466.01 262.205 465.951 262.089 465.854 262.066 c 465.698 262.043 465.543 262.089 465.387 262.112 c 465.056 262.182 464.725 262.089 464.394 262.159 c 464.978 261.694 465.737 261.857 466.399 261.904 c 466.555 261.904 466.672 262.043 466.808 262.066 c 466.925 262.066 467.061 262.066 467.178 262.113 c 467.236 262.136 467.275 262.182 467.334 262.206 c 467.392 262.275 l f* 466.263 261.207 m 466.282 261.23 466.244 261.253 466.244 261.277 c 465.893 261.253 465.543 261.369 465.192 261.439 c 464.803 261.508 464.413 261.346 464.024 261.508 c 464.082 261.485 464.143 261.457 464.199 261.439 c 464.881 261.206 465.484 261.253 466.146 261.23 c 466.263 261.207 l f* 465.504 260.556 m 465.29 260.51 465.017 260.556 464.803 260.556 c 464.53 260.602 464.243 260.536 463.966 260.602 c 463.771 260.649 463.79 260.811 463.557 261.067 c 463.849 261.044 463.985 261.02 464.335 261.044 c 464.557 261.059 464.705 260.905 464.92 260.835 c 465.095 260.789 465.095 260.881 465.231 260.765 c 465.504 260.556 l f* 464.764 259.999 m 464.453 259.975 464.16 259.999 463.849 260.068 c 463.829 260.091 463.79 260.115 463.771 260.138 c 463.654 260.184 463.518 260.138 463.401 260.231 c 463.32 260.295 463.265 260.37 463.167 260.416 c 463.148 260.44 463.109 260.672 463.128 260.672 c 463.206 260.695 463.323 260.556 463.401 260.509 c 463.459 260.509 463.479 260.44 463.537 260.417 c 463.79 260.324 463.81 260.463 464.043 260.301 c 464.18 260.208 464.628 260.231 464.745 260.069 c 464.764 259.999 l f* 463.907 259.488 m 463.693 259.464 463.499 259.557 463.304 259.627 c 463.128 259.697 462.934 259.789 462.778 259.952 c 463.109 260.045 463.401 259.766 463.732 259.673 c 463.771 259.673 463.868 259.604 463.849 259.511 c 463.907 259.488 l f* 463.44 259.209 m 463.401 259.069 463.226 259.093 463.148 259.139 c 462.992 259.255 462.759 259.302 462.72 259.534 c 462.798 259.534 462.856 259.557 462.934 259.51 c 462.992 259.464 463.031 259.418 463.07 259.348 c 463.148 259.232 463.304 259.325 463.382 259.185 c 463.44 259.209 l f* 462.739 258.837 m 462.583 258.837 462.428 258.837 462.272 258.837 c 462.291 259.023 462.233 259.209 462.116 259.348 c 462.116 259.371 462.116 259.418 462.116 259.441 c 462.213 259.487 462.291 259.371 462.369 259.302 c 462.428 259.232 462.428 259.116 462.408 259.023 c 462.506 259.023 462.603 258.977 462.661 258.884 c 462.739 258.837 l f* 461.941 258.721 m 461.766 258.767 461.668 258.953 461.513 259.023 c 461.941 258.721 l f* 461.493 258.744 m 461.376 258.744 461.318 258.93 461.221 259.023 c 461.493 258.744 l f* 461.045 258.721 m 460.904 258.721 460.753 258.651 460.617 258.72 c 460.617 258.79 l 460.714 258.837 460.753 259.023 460.87 258.976 c 460.889 258.976 460.909 258.86 460.948 258.814 c 460.968 258.814 460.987 258.814 461.006 258.814 c 461.045 258.79 461.065 258.721 461.045 258.721 c f* 457.404 262.146 m 457.579 262.089 457.768 262.057 457.963 262.057 c 458.921 262.057 459.698 262.807 459.698 263.732 c 459.698 264.657 458.921 265.407 457.963 265.407 c 457.005 265.407 456.229 264.657 456.229 263.732 c 456.229 262.996 456.72 262.371 457.404 262.146 c f* q 0.9972 0 0 1.0028 0 0 cm 1 J 1 j 0.333 w 2.613 M 458.707 261.402 m 458.883 261.344 459.072 261.313 459.268 261.313 c 460.229 261.313 461.007 262.061 461.007 262.983 c 461.007 263.905 460.229 264.653 459.268 264.653 c 458.307 264.653 457.528 263.905 457.528 262.983 c 457.528 262.249 458.021 261.626 458.707 261.402 c S Q q 0.9972 0 0 1.0028 0 0 cm 1 J 1 j 0.166 w 2.613 M 460.625 263.659 m 458.428 261.714 l 458.384 261.696 l 459.263 264.545 l 459.277 264.493 l 460.112 261.644 l 457.979 263.618 l 457.959 263.659 l 460.625 263.659 l S Q 457.47 263.837 m 457.48 263.814 457.518 263.723 457.531 263.703 c 457.57 263.645 457.583 263.647 457.574 263.566 c 457.567 263.507 457.573 263.504 457.615 263.462 c 457.674 263.403 457.671 263.269 457.74 263.211 c 457.769 263.188 457.915 263.368 457.926 263.378 c 458.003 263.45 458.051 263.336 458.206 263.22 c 458.293 263.155 458.3 263.482 458.279 263.628 c 458.275 263.654 458.445 263.814 458.445 263.837 c 458.474 264.081 458.467 263.995 458.32 264.192 c 458.301 264.203 458.136 264.319 458.127 264.343 c 457.99 264.528 457.988 264.456 457.823 264.421 c 457.813 264.421 457.796 264.36 457.802 264.338 c 457.832 264.23 457.633 264.277 457.594 264.254 c 457.526 264.196 457.496 264.184 457.447 264.102 c 457.418 264.033 457.418 263.951 457.408 263.882 c 457.47 263.837 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 1 J 1 j 0.166 w 2.613 M 458.773 263.088 m 458.783 263.065 458.821 262.974 458.835 262.954 c 458.874 262.896 458.887 262.898 458.877 262.817 c 458.87 262.759 458.876 262.756 458.919 262.713 c 458.977 262.655 458.975 262.521 459.044 262.464 c 459.073 262.44 459.22 262.62 459.231 262.63 c 459.308 262.702 459.356 262.588 459.512 262.472 c 459.598 262.408 459.605 262.734 459.584 262.88 c 459.581 262.905 459.751 263.065 459.751 263.088 c 459.78 263.331 459.773 263.245 459.626 263.441 c 459.607 263.453 459.441 263.568 459.432 263.592 c 459.295 263.777 459.293 263.705 459.127 263.67 c 459.117 263.67 459.1 263.609 459.106 263.587 c 459.136 263.479 458.937 263.527 458.898 263.504 c 458.83 263.446 458.799 263.433 458.75 263.352 c 458.721 263.283 458.721 263.202 458.711 263.132 c S Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 0 0 0 0 K 0.333 w 2.613 M 459.378 260.395 m 459.512 260.395 l 459.546 260.358 459.61 260.371 459.663 260.425 c 459.716 260.479 459.767 260.548 459.778 260.583 c 459.895 260.706 460.086 260.654 460.303 260.499 c 460.366 260.417 460.713 260.139 461.145 259.948 c 461.208 259.873 460.938 259.951 460.887 259.969 c 460.97 259.915 460.877 259.869 460.686 259.959 c 460.739 259.872 460.627 259.895 460.497 259.964 c 460.572 259.874 460.447 259.887 460.341 259.956 c 460.386 259.872 460.269 259.877 460.179 259.963 c 460.224 259.883 460.115 259.883 460.036 259.959 c 460.083 259.875 459.93 259.901 459.877 259.963 c 459.919 259.898 459.733 259.934 459.717 260.001 c 459.691 259.911 459.537 259.895 459.5 259.964 c 459.388 259.964 l 459.295 259.87 459.152 259.925 459.137 260.119 c 458.995 259.894 458.791 259.851 458.855 259.971 c 458.743 259.867 458.682 259.903 458.698 259.963 c 458.534 259.822 458.526 259.943 458.542 259.966 c 458.433 259.878 458.34 259.895 458.369 259.954 c 458.268 259.899 458.146 259.889 458.2 259.966 c 458.08 259.896 457.913 259.898 457.985 259.971 c 457.817 259.902 457.634 259.917 457.791 259.982 c 458.264 260.177 458.416 260.362 458.591 260.502 c 458.867 260.721 459.079 260.669 459.127 260.553 c 459.172 260.444 459.32 260.332 459.374 260.388 c 459.378 260.395 l b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 0 0 0 0 K 0.333 w 2.613 M 459.379 257.528 m 459.379 257.496 459.392 257.474 459.435 257.474 c 459.478 257.474 459.491 257.501 459.491 257.529 c 459.516 260.479 l 459.372 260.48 l 459.379 257.528 l b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 0 0 0 0 K 0.333 w 2.613 M 459.436 260.425 m 459.436 260.442 459.495 260.447 459.495 260.428 c 459.474 257.579 l 459.474 257.559 459.463 257.516 459.448 257.516 c 459.438 257.516 459.436 257.556 459.436 257.579 c 459.436 260.425 l b* Q 0 0 0 1 k 458.461 260.964 m 458.426 260.988 458.381 260.981 y 458.437 260.956 458.456 260.935 458.43 260.802 c 458.461 260.964 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.767 260.223 m 459.732 260.246 459.686 260.24 y 459.743 260.215 459.762 260.193 459.736 260.061 c S Q 459.245 261.027 m 459.268 261.009 459.134 260.999 y 459.161 260.977 459.002 260.981 y 459.027 260.952 458.905 260.942 y 458.92 260.919 458.79 260.904 y 458.805 260.883 458.699 260.882 y 458.71 260.86 458.591 260.871 y 458.6 260.843 458.442 260.879 y 459.245 261.027 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.553 260.285 m 460.576 260.268 460.442 260.257 y 460.469 260.235 460.31 260.239 y 460.335 260.211 460.212 260.201 y 460.228 260.178 460.097 260.163 y 460.112 260.142 460.006 260.141 y 460.016 260.119 459.897 260.13 y 459.906 260.102 459.748 260.138 y S Q 459.061 261.183 m 459.06 261.135 458.916 261.175 y 458.913 261.135 458.778 261.16 y 458.787 261.124 458.651 261.129 y 458.661 261.094 458.573 261.103 y 458.6 261.049 458.511 261.025 y 458.532 260.969 458.427 260.978 y 459.061 261.183 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.369 260.441 m 460.367 260.394 460.223 260.433 y 460.22 260.393 460.085 260.418 y 460.094 260.382 459.958 260.387 y 459.967 260.352 459.879 260.362 y 459.907 260.308 459.817 260.284 y 459.838 260.228 459.733 260.237 y S Q 457.818 260.965 m 457.853 260.989 457.898 260.982 y 457.842 260.957 457.823 260.936 457.848 260.804 c 457.818 260.965 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.122 260.224 m 459.157 260.248 459.203 260.241 y 459.146 260.216 459.127 260.195 459.152 260.063 c S Q 457.034 261.03 m 457.011 261.014 457.146 261.002 y 457.118 260.981 457.277 260.984 y 457.252 260.955 457.374 260.945 y 457.358 260.922 457.488 260.906 y 457.474 260.885 457.58 260.884 y 457.569 260.862 457.687 260.872 y 457.679 260.845 457.837 260.88 y 457.034 261.03 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.336 260.289 m 458.313 260.272 458.448 260.261 y 458.42 260.239 458.58 260.243 y 458.554 260.214 458.677 260.204 y 458.661 260.18 458.792 260.165 y 458.777 260.144 458.883 260.143 y 458.872 260.121 458.991 260.131 y 458.982 260.104 459.141 260.139 y S Q 457.219 261.187 m 457.22 261.139 457.364 261.178 y 457.368 261.138 457.502 261.162 y 457.493 261.127 457.629 261.131 y 457.619 261.096 457.707 261.105 y 457.679 261.051 457.768 261.026 y 457.747 260.971 457.852 260.979 y 457.219 261.187 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.522 260.445 m 458.523 260.397 458.667 260.436 y 458.67 260.396 458.805 260.421 y 458.797 260.385 458.932 260.389 y 458.923 260.354 459.011 260.363 y 458.983 260.309 459.072 260.285 y 459.051 260.23 459.156 260.238 y S Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.443 260.467 m 459.346 260.467 459.266 260.53 459.267 260.607 c 459.267 260.684 459.346 260.746 459.444 260.746 c 459.542 260.746 459.621 260.683 459.621 260.606 c 459.621 260.529 459.541 260.467 459.443 260.467 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.427 260.675 m 459.45 260.679 459.436 260.703 459.414 260.703 c 459.352 260.7 459.313 260.652 459.313 260.604 c 459.313 260.581 459.32 260.553 459.335 260.535 c 459.344 260.525 459.366 260.503 459.354 260.508 c 459.31 260.525 459.289 260.567 459.289 260.608 c 459.29 260.675 459.359 260.729 459.445 260.729 c 459.531 260.729 459.6 260.675 459.6 260.607 c 459.6 260.543 459.537 260.489 459.452 260.484 c 459.438 260.483 459.417 260.484 459.41 260.491 c 459.409 260.493 459.438 260.491 459.452 260.493 c 459.517 260.501 459.561 260.543 459.557 260.595 c 459.556 260.608 459.53 260.633 459.533 260.611 c 459.538 260.577 459.495 260.551 459.451 260.55 c 459.416 260.549 459.372 260.577 459.372 260.612 c 459.372 260.647 459.383 260.667 459.427 260.675 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.009 259.642 m 458.982 259.305 460.011 259.644 459.984 259.216 c 459.958 258.808 459.185 259.091 459.21 258.867 c 459.223 258.752 459.889 258.829 459.833 258.562 c 459.781 258.313 459.234 258.436 459.255 258.326 c 459.278 258.204 459.813 258.264 459.713 258.041 c 459.632 257.861 459.216 257.986 459.211 257.789 c 459.059 257.966 459.551 257.95 459.581 258.068 c 459.607 258.168 459.14 258.123 459.094 258.316 c 459.036 258.559 459.613 258.449 459.638 258.586 c 459.66 258.703 459.052 258.604 458.989 258.807 c 458.858 259.232 459.66 258.99 459.712 259.217 c 459.759 259.423 458.897 259.178 458.82 259.579 c 458.79 259.731 458.916 259.776 458.992 259.806 c 459.023 259.818 459.016 259.848 459.086 259.859 c 459.148 259.869 459.198 259.852 459.323 259.728 c 459.34 259.712 459.293 259.682 459.255 259.675 c 459.217 259.669 459.121 259.655 459.081 259.685 c 459.045 259.712 459.012 259.681 459.009 259.642 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.875 259.641 m 459.899 259.304 458.873 259.646 458.897 259.218 c 458.92 258.81 459.695 259.09 459.669 258.866 c 459.655 258.752 458.989 258.831 459.044 258.564 c 459.094 258.315 459.642 258.436 459.62 258.325 c 459.596 258.204 459.062 258.265 459.161 258.043 c 459.241 257.862 459.658 257.985 459.661 257.788 c 459.815 257.965 459.322 257.951 459.293 258.069 c 459.268 258.169 459.734 258.122 459.782 258.315 c 459.841 258.558 459.263 258.45 459.239 258.587 c 459.218 258.703 459.825 258.602 459.889 258.806 c 460.023 259.229 459.219 258.991 459.169 259.218 c 459.123 259.424 459.984 259.176 460.064 259.577 c 460.094 259.729 459.969 259.774 459.892 259.804 c 459.862 259.816 459.869 259.846 459.799 259.858 c 459.738 259.868 459.686 259.851 459.561 259.728 c 459.544 259.711 459.591 259.681 459.629 259.674 c 459.667 259.668 459.762 259.654 459.803 259.684 c 459.839 259.711 459.872 259.679 459.875 259.641 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.711 258.948 m 459.75 258.956 459.852 258.929 459.839 258.863 c 459.795 258.641 459.208 258.747 459.201 258.603 c 459.196 258.518 459.344 258.51 459.277 258.498 c 459.196 258.483 459.081 258.536 459.083 258.601 c 459.09 258.798 459.667 258.743 459.707 258.856 c 459.728 258.916 459.671 258.94 459.711 258.948 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.757 259.29 m 459.803 259.299 459.907 259.265 459.895 259.186 c 459.852 258.9 459.155 259.074 459.138 258.896 c 459.129 258.795 459.307 258.786 459.228 258.771 c 459.133 258.754 459.01 258.822 459.018 258.898 c 459.044 259.157 459.711 259.013 459.752 259.181 c 459.769 259.253 459.71 259.279 459.757 259.29 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.674 258.633 m 459.707 258.639 459.78 258.62 459.769 258.563 c 459.733 258.375 459.251 258.464 459.227 258.343 c 459.213 258.268 459.339 258.263 459.282 258.253 c 459.214 258.24 459.124 258.291 459.126 258.34 c 459.133 258.508 459.629 258.463 459.663 258.559 c 459.682 258.61 459.64 258.625 459.674 258.633 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.65 258.371 m 459.677 258.376 459.737 258.36 459.731 258.311 c 459.713 258.179 459.31 258.193 459.267 258.082 c 459.242 258.021 459.362 258.014 459.314 258.006 c 459.255 257.995 459.186 258.038 459.181 258.08 c 459.162 258.23 459.616 258.205 459.641 258.308 c 459.651 258.352 459.621 258.364 459.65 258.371 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.237 257.88 m 459.265 257.971 459.596 257.955 459.605 258.071 c 459.608 258.11 459.588 258.119 459.613 258.125 c 459.636 258.129 459.683 258.116 459.681 258.074 c 459.676 257.946 459.301 257.939 459.237 257.88 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.818 259.808 m 459.973 259.76 460.002 259.664 459.989 259.594 c 459.927 259.257 459.106 259.454 459.085 259.243 c 459.074 259.124 459.284 259.113 459.191 259.096 c 459.079 259.075 458.939 259.153 458.946 259.245 c 458.97 259.572 459.783 259.334 459.896 259.574 c 459.921 259.626 459.915 259.765 459.79 259.761 c 459.697 259.758 459.652 259.768 459.705 259.808 c 459.745 259.837 459.801 259.83 459.818 259.808 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.894 259.596 m 458.944 259.441 459.149 259.475 459.119 259.485 c 459.049 259.509 459.005 259.533 458.975 259.582 c 458.907 259.693 458.96 259.791 459.087 259.767 c 459.179 259.75 459.232 259.769 459.179 259.809 c 459.14 259.839 459.084 259.831 459.067 259.809 c 458.912 259.763 458.864 259.686 458.894 259.596 c b* Q 458.43 260.802 m 458.415 260.726 458.373 260.661 458.286 260.661 c 458.219 260.661 458.204 260.698 y 458.43 260.802 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.736 260.061 m 459.721 259.985 459.678 259.921 459.591 259.921 c 459.525 259.92 459.509 259.957 y S Q 458.877 260.703 m 458.906 260.684 458.861 260.622 458.804 260.656 c 458.625 260.762 458.591 260.871 y 458.495 260.927 458.461 260.964 y 458.877 260.703 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.184 259.962 m 460.214 259.944 460.169 259.882 460.111 259.916 c 459.931 260.021 459.897 260.13 y 459.802 260.186 459.767 260.223 y S Q 458.724 260.71 m 458.768 260.682 458.725 260.62 458.644 260.663 c 458.523 260.727 458.442 260.879 y 458.724 260.71 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.031 259.969 m 460.075 259.942 460.032 259.879 459.95 259.923 c 459.829 259.986 459.748 260.138 y S Q 458.207 261.141 m 458.279 261.062 458.419 261.213 458.461 261.305 c 458.503 261.394 458.678 261.488 459.003 261.233 c 459.15 261.118 459.26 260.955 459.814 260.706 c 459.882 260.675 459.842 260.652 459.749 260.668 c 459.416 260.723 459.134 260.999 y 459.002 261.062 458.916 261.175 y 458.844 261.245 458.781 261.274 y 458.207 261.141 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.512 260.399 m 459.584 260.321 459.725 260.471 459.767 260.562 c 459.809 260.652 459.984 260.746 460.311 260.491 c 460.458 260.376 460.569 260.214 461.124 259.966 c 461.192 259.935 461.152 259.912 461.058 259.927 c 460.725 259.983 460.442 260.257 y 460.31 260.321 460.223 260.433 y 460.151 260.503 460.088 260.532 y S Q 459.577 260.715 m 459.641 260.681 459.603 260.636 459.507 260.658 c 459.245 260.719 459.002 260.981 y 458.892 261.044 458.778 261.16 y 458.664 261.248 458.616 261.254 y 459.577 260.715 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.886 259.974 m 460.95 259.941 460.912 259.896 460.816 259.917 c 460.553 259.978 460.31 260.239 y 460.199 260.303 460.085 260.418 y 459.971 260.505 459.922 260.512 y S Q 459.37 260.705 m 459.424 260.672 459.384 260.63 459.304 260.657 c 459.073 260.734 458.905 260.942 y 458.746 261.035 458.651 261.129 y 458.607 261.192 458.531 261.211 y 459.37 260.705 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.678 259.965 m 460.733 259.931 460.692 259.89 460.612 259.917 c 460.381 259.994 460.212 260.201 y 460.053 260.293 459.958 260.387 y 459.913 260.45 459.837 260.469 y S Q 459.194 260.704 m 459.24 260.675 459.204 260.624 459.139 260.65 c 458.955 260.724 458.79 260.904 y 458.642 260.99 458.573 261.103 y 458.55 261.142 458.488 261.162 y 459.194 260.704 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.502 259.963 m 460.549 259.935 460.512 259.884 460.447 259.91 c 460.262 259.984 460.097 260.163 y 459.949 260.248 459.879 260.362 y 459.856 260.4 459.794 260.42 y S Q 459.033 260.701 m 459.071 260.678 459.027 260.618 458.969 260.646 c 458.836 260.71 458.699 260.882 y 458.579 260.949 458.511 261.025 y 458.475 261.067 458.41 261.069 y 459.033 260.701 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 460.341 259.96 m 460.378 259.938 460.335 259.878 460.277 259.905 c 460.143 259.969 460.006 260.141 y 459.885 260.208 459.817 260.284 y 459.781 260.325 459.716 260.327 y S Q 457.401 260.706 m 457.371 260.687 457.416 260.625 457.473 260.659 c 457.653 260.764 457.687 260.872 y 457.783 260.928 457.818 260.965 y 457.401 260.706 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.704 259.965 m 458.674 259.947 458.719 259.885 458.776 259.918 c 458.957 260.023 458.991 260.131 y 459.087 260.187 459.122 260.224 y S Q 457.848 260.804 m 457.862 260.727 457.905 260.664 457.991 260.666 c 458.063 260.667 458.083 260.709 y 457.848 260.804 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.152 260.063 m 459.167 259.986 459.209 259.924 459.296 259.926 c 459.368 259.927 459.387 259.969 y S Q 457.554 260.712 m 457.509 260.685 457.552 260.622 457.634 260.665 c 457.755 260.728 457.837 260.88 y 457.554 260.712 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.857 259.971 m 458.813 259.944 458.855 259.882 458.937 259.925 c 459.059 259.988 459.141 260.139 y S Q 458.073 261.141 m 458.001 261.063 457.862 261.214 457.82 261.306 c 457.779 261.396 457.604 261.49 457.278 261.237 c 457.13 261.122 457.019 260.959 456.463 260.712 c 456.396 260.682 456.435 260.659 456.529 260.674 c 456.861 260.728 457.146 261.002 y 457.277 261.066 457.364 261.178 y 457.437 261.248 457.5 261.276 y 458.073 261.141 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.378 260.4 m 459.306 260.321 459.166 260.472 459.124 260.564 c 459.083 260.653 458.908 260.748 458.58 260.494 c 458.432 260.38 458.321 260.218 457.764 259.972 c 457.696 259.942 457.735 259.918 457.829 259.933 c 458.163 259.988 458.448 260.261 y 458.58 260.324 458.667 260.436 y 458.74 260.506 458.803 260.534 y S Q 456.701 260.72 m 456.637 260.687 456.674 260.642 456.77 260.663 c 457.033 260.723 457.277 260.984 y 457.388 261.047 457.502 261.162 y 457.616 261.249 457.665 261.256 y 456.701 260.72 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.001 259.98 m 457.938 259.946 457.975 259.901 458.071 259.923 c 458.335 259.983 458.58 260.243 y 458.691 260.306 458.805 260.421 y 458.92 260.507 458.969 260.514 y S Q 456.908 260.71 m 456.854 260.676 456.894 260.635 456.973 260.661 c 457.204 260.738 457.374 260.945 y 457.533 261.037 457.629 261.131 y 457.674 261.194 457.75 261.212 y 456.908 260.71 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.209 259.969 m 458.155 259.936 458.195 259.894 458.275 259.921 c 458.507 259.997 458.677 260.204 y 458.836 260.296 458.932 260.389 y 458.977 260.452 459.054 260.47 y S Q 457.084 260.708 m 457.037 260.679 457.073 260.628 457.138 260.654 c 457.323 260.727 457.488 260.906 y 457.637 260.991 457.707 261.105 y 457.731 261.144 457.792 261.164 y 457.084 260.708 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.386 259.967 m 458.339 259.939 458.375 259.888 458.441 259.914 c 458.626 259.987 458.792 260.165 y 458.94 260.25 459.011 260.363 y 459.034 260.402 459.096 260.422 y S Q 457.244 260.704 m 457.207 260.682 457.25 260.621 457.308 260.649 c 457.441 260.712 457.58 260.884 y 457.7 260.951 457.768 261.026 y 457.809 261.068 457.87 261.07 y 457.244 260.704 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 458.547 259.964 m 458.509 259.942 458.553 259.881 458.611 259.908 c 458.745 259.972 458.883 260.143 y 459.004 260.209 459.072 260.285 y 459.113 260.327 459.174 260.328 y S Q 458.565 260.717 m 458.603 260.687 458.555 260.66 458.485 260.683 c 458.417 260.706 458.416 260.756 y 458.565 260.717 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.872 259.976 m 459.91 259.946 459.861 259.919 459.791 259.943 c 459.723 259.966 459.722 260.016 y S Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.333 w 2.613 M 459.591 257.92 m 459.577 257.926 459.535 257.918 459.548 257.914 c 459.591 257.899 459.62 257.894 459.636 257.88 c 459.63 257.899 459.618 257.908 459.591 257.92 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 0 K 0.176 w 2.613 M 459.404 261.223 m 458.35 261.223 457.306 261.099 457.074 260.057 c 456.852 259.059 456.908 259.392 457.296 258.227 c S Q 502.413 309.086 m 502.675 309.247 503.477 310.466 503.509 310.416 c 503.989 309.65 504.645 308.877 506.048 308.877 c 507.449 308.877 508.586 309.566 508.586 310.416 c 508.586 309.566 509.68 308.917 511.081 308.917 c 512.484 308.917 513.183 309.569 513.62 310.456 c 513.637 310.533 l 513.896 310.366 515.149 309.534 515.11 309.489 c 511.169 306.667 519.313 300.782 509.776 297.385 c 509.289 297.246 509.068 296.913 v 508.98 297.074 508.279 297.397 y 497.991 299.654 506.659 306.264 502.413 309.086 c f* q 0.9972 0 0 1.0028 0 0 cm 1 J 1 j 0.333 w 2.613 M 503.844 308.208 m 504.107 308.368 504.911 309.584 504.943 309.534 c 505.424 308.77 506.083 307.999 507.489 307.999 c 508.895 307.999 510.035 308.686 510.035 309.534 c 510.035 309.534 l 510.035 308.686 511.132 308.039 512.537 308.039 c 513.943 308.039 514.645 308.69 515.083 309.574 c 515.1 309.651 l 515.359 309.485 516.617 308.655 516.577 308.61 c 516.577 308.61 l 512.625 305.796 520.792 299.928 511.228 296.54 c 510.74 296.402 510.518 296.069 v 510.518 296.069 l 510.43 296.23 509.727 296.552 y 499.409 298.803 508.103 305.394 503.844 308.208 c S Q 0 0 0 0 k 506.105 299.524 m 507.027 303.273 l 504.69 305.353 l 507.621 305.356 l 508.548 308.809 l 509.62 305.342 l 512.781 305.349 l 510.235 303.106 l 511.341 299.524 l 508.769 301.827 l 506.105 299.524 l f* q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 401.625 305.628 m 401.294 305.559 401.119 305.539 400.913 305.123 c 400.839 304.972 400.761 304.802 400.659 304.664 c 400.253 304.068 400.329 303.356 400.38 302.714 c 400.43 302.622 400.481 302.495 400.481 302.392 c 400.481 302.255 400.623 302.166 400.659 302.025 c 400.735 301.727 400.989 301.612 401.142 301.382 c 401.244 301.291 401.599 301.038 401.599 301.084 c 401.599 301.681 401.422 302.314 401.294 302.805 c 401.117 303.494 401.345 304.159 401.498 304.894 c 401.599 305.169 401.574 305.353 401.625 305.628 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 404.496 298.698 m 404.588 298.402 404.603 298.142 405.072 297.976 c 405.242 297.915 405.434 297.853 405.591 297.768 c 406.27 297.429 407.054 297.531 407.762 297.607 c 407.861 297.657 407.999 297.708 408.113 297.713 c 408.265 297.719 408.356 297.851 408.511 297.891 c 408.837 297.973 408.952 298.208 409.199 298.356 c 409.296 298.452 409.558 298.785 409.508 298.783 c 408.848 298.755 408.156 298.565 407.618 298.427 c 406.865 298.235 406.118 298.41 405.298 298.514 c 404.989 298.593 404.804 298.664 404.496 298.698 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 412.273 301.314 m 412.598 301.402 412.771 301.432 412.947 301.859 c 413.011 302.014 413.077 302.188 413.168 302.332 c 413.532 302.95 413.513 303.67 413.417 304.309 c 413.359 304.397 413.309 304.55 413.302 304.653 c 413.277 305.007 413 305.275 413.035 305.169 c 412.938 305.462 412.784 305.397 412.616 305.617 c 412.508 305.703 412.27 305.869 412.273 305.823 c 412.315 305.228 412.378 304.689 412.54 304.205 c 412.766 303.529 412.448 302.796 412.348 302.054 c 412.266 301.773 412.304 301.591 412.273 301.314 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 409.534 308.071 m 409.458 308.37 409.435 308.528 408.976 308.714 c 408.808 308.782 408.62 308.853 408.468 308.944 c 407.807 309.312 407.019 309.244 406.308 309.199 c 406.206 309.153 406.066 309.107 405.952 309.108 c 405.799 309.108 405.702 308.98 405.545 308.947 c 405.215 308.879 405.087 308.65 404.833 308.512 c 404.731 308.42 404.451 308.099 404.502 308.099 c 405.163 308.099 405.864 308.259 406.408 308.373 c 407.171 308.533 407.908 308.325 408.721 308.187 c 409.026 308.095 409.229 308.118 409.534 308.071 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 1.331 w 2.613 M 406.86 299.016 m 409.629 299.016 411.873 301.054 411.873 303.568 c 411.873 306.082 409.629 308.121 406.86 308.121 c 404.091 308.121 401.846 306.082 401.846 303.568 c 401.846 301.054 404.091 299.016 406.86 299.016 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 402.779 306.227 m 400.187 308.223 l 399.959 308.017 400.218 307.752 399.79 306.894 c 399.627 306.569 399.615 305.779 399.463 305.4 c 399.463 305.332 399.501 305.469 399.463 305.4 c 399.425 305.228 399.082 304.471 399.12 304.299 c 399.082 304.299 399.12 304.299 y 399.005 303.817 399.005 303.369 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401.935 310.086 401.977 310.274 402.005 310.122 c 403.931 307.271 l 404.056 307.329 403.794 307.188 403.931 307.271 c 404.429 307.472 405.191 307.903 405.727 307.97 c 406.31 308.079 406.932 308.054 407.507 307.986 c 407.552 307.984 408.446 307.836 408.488 307.823 c 409.033 307.654 408.933 307.602 409.608 307.269 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 404.194 299.655 m 402.21 297.059 l 402.42 296.833 402.684 297.093 403.549 296.674 c 403.877 296.516 404.671 296.511 405.053 296.362 c 405.122 296.363 404.983 296.399 405.053 296.362 c 405.226 296.326 405.99 295.991 406.162 296.03 c 406.163 295.992 406.162 296.03 y 406.648 295.92 407.097 295.924 407.581 295.966 c 407.944 295.987 408.023 296.068 409.24 296.369 c 409.55 296.448 410.357 296.745 410.702 296.824 c 411.013 296.903 411.653 297.064 411.929 297.18 c 411.998 297.218 411.965 297.028 411.929 297.18 c 409.865 299.932 l 409.743 299.868 409.997 300.021 409.865 299.932 c 409.378 299.706 408.638 299.239 408.105 299.146 c 407.528 299.008 406.906 299.003 406.328 299.042 c 406.284 299.042 405.48 299.289 405.437 299.3 c 404.769 299.471 404.875 299.472 404.194 299.655 c b* Q q 0.9972 0 0 1.0028 0 0 cm 0 0 0 1 k 1 j 0.333 w 2.613 M 410.932 301.145 m 414.313 299.09 l 414.52 299.317 414.236 299.556 414.578 300.451 c 414.707 300.79 414.641 301.578 414.756 301.969 c 414.749 302.038 414.725 301.897 414.756 301.969 c 414.777 302.144 415.044 302.932 414.989 303.099 c 415.027 303.103 414.989 303.099 y 415.055 303.59 415.011 304.035 414.926 304.511 c 414.873 304.869 414.785 304.94 414.375 306.119 c 414.268 306.42 413.899 307.193 413.789 307.529 c 413.683 307.829 413.464 308.45 413.323 308.713 c 413.279 308.777 413.472 308.762 413.323 308.713 c 410.754 306.42 l 410.829 306.306 410.652 306.544 410.754 306.42 c 411.023 305.958 411.557 305.266 411.697 304.746 c 411.886 304.187 411.72 303.579 411.732 303.002 c 411.737 302.958 411.606 302.161 411.599 302.118 c 411.487 301.44 411.332 301.72 410.977 301.145 c 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643.693 97.708 643.787 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 97.474 643.756 m 97.474 643.677 97.661 643.693 97.708 643.787 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 97.645 643.709 m 97.645 643.631 97.833 643.646 97.88 643.74 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 97.802 643.677 m 97.802 643.599 97.989 643.615 98.036 643.709 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 97.974 643.631 m 97.974 643.552 98.161 643.568 98.208 643.662 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 98.709 642.322 m 98.785 642.329 98.974 642.427 99.021 642.489 c 99.282 642.837 98.833 642.966 98.63 642.966 c 98.542 642.966 98.259 642.912 97.875 642.959 c 97.492 643.006 97.426 643.114 97.459 643.224 c 97.471 643.263 97.623 643.309 97.656 643.271 c 97.69 643.232 97.755 643.177 97.831 643.192 c 97.908 643.208 98.072 643.24 98.083 643.278 c 98.094 643.318 98.013 643.435 97.958 643.459 c 97.903 643.482 97.654 643.552 97.49 643.473 c 97.428 643.445 96.997 643.177 97.38 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643.646 95.739 643.818 95.802 643.865 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 95.426 643.693 m 95.473 643.584 95.864 643.568 96.052 643.787 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 95.692 643.615 m 95.785 643.473 96.333 643.584 96.348 643.771 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 96.052 643.568 m 96.176 643.459 96.504 643.505 96.567 643.724 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 96.38 643.521 m 96.473 643.38 96.786 643.536 96.833 643.646 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 96.614 643.473 m 96.739 643.364 96.973 643.473 97.021 643.631 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 96.833 643.443 m 96.989 643.318 97.223 643.396 97.239 643.536 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 97.099 643.38 m 97.223 643.24 97.411 643.459 97.474 643.521 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 97.989 643.208 m 98.052 643.13 98.224 643.13 y B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 98.435 643.818 m 98.654 643.802 98.997 643.88 98.989 644.107 c 98.982 644.333 99.177 644.881 99.74 644.646 c 100.302 644.411 99.818 644.474 99.646 644.506 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 99.896 644.474 m 99.911 644.381 99.693 644.381 99.505 644.443 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 99.755 644.396 m 99.74 644.333 99.505 644.349 99.364 644.381 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 99.552 644.349 m 99.505 644.224 99.349 644.349 99.318 644.287 c 99.286 644.224 99.1 644.333 99.068 644.037 c 99.036 643.74 98.49 643.771 98.427 643.74 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 100.021 644.474 m 100.427 644.365 100.849 644.115 100.849 644.021 c 100.849 643.927 100.24 644.271 100.1 644.318 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 100.724 644.006 m 100.724 643.927 100.505 644.006 99.974 644.24 c B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 100.474 644.037 m 100.474 643.959 100.255 643.959 99.724 644.193 c B Q q 1.0111 0 0 0.989 0 0 cm 0 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0.03 w 10 M 98.63 643.208 m 98.567 643.13 98.395 643.13 y B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 98.083 643.505 m 98.036 643.427 l B Q q 1.0111 0 0 0.989 0 0 cm 0 G 2 j 0.03 w 10 M 98.552 643.473 m 98.567 643.427 98.583 643.38 y B Q BT /F32 1 Tf 10 0 0 10.0001 180.96 94.5911 Tm /Cs18 cs 0 scn /GS1 gs -0.0121 Tc -0.061 Tw (3290 Pine Orchard Lane, Suite 106)Tj /F33 1 Tf 13.392 0 TD 0 Tc 0 Tw ( )Tj /G2 1 Tf 0.192 0 TD <0099>Tj /F32 1 Tf 0.84 0 TD -0.0134 Tc -0.062 Tw [( )6.6(Ellicott City)58.6(, MD 21042)]TJ -15.744 -1.488 TD -0.018 Tc 0 Tw (Phone:)Tj /F30 1 Tf 2.688 0 TD 0 Tc ( )Tj /F32 1 Tf 0.168 0 TD -0.0182 Tc -0.06 Tw (\(410\) 750-9600)Tj /F33 1 Tf 5.928 0 TD 0 Tc 0 Tw ( )Tj /G2 1 Tf 0.192 0 TD <0099>Tj /F32 1 Tf 0.792 0 TD -0.0182 Tc -0.0625 Tw [( )-22.7(Fax: \(410\) 750-9601)]TJ /F33 1 Tf 7.992 0 TD 0 Tc 0 Tw ( )Tj /G2 1 Tf 0.168 0 TD <0099>Tj /F32 1 Tf 0.816 0 TD -0.0195 Tc -0.0865 Tw [( W)84.3(e)0.5(b: )-23.6(www)52.5(.icisf.org)]TJ /F34 1 Tf 12 0 0 12.0002 113.52 578.9173 Tm /Cs17 cs 1 scn -0.0211 Tc -0.0104 Tw (August 13-16, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.88 0 TD -0.004 Tc -0.0708 Tw (Orlando, FL)Tj /F31 1 Tf -0.88 -1.2 TD 0.0002 Tc -0.0646 Tw (CISM of Florida)Tj T* -0.0023 Tc -0.0698 Tw (Hospice of Palm Beach County)Tj /F34 1 Tf 0 -2.4 TD -0.0202 Tc 0 Tw [(September 1)59.8(1-14, 2008)]TJ /G2 1 Tf 0 -1.2 TD 0 Tc <0099>Tj /F35 1 Tf 0.9 0 TD 0.0009 Tc -0.0534 Tw [(Phoenix, A)-6.1(Z)]TJ /F31 1 Tf -0.9 -1.2 TD -0.0009 Tc -0.0537 Tw [(Mesa Fire Dept. CISM T)109.9(eam)]TJ /F34 1 Tf 0 -2.4 TD -0.0206 Tc 0.0041 Tw (September 18-21, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.9 0 TD -0.0018 Tc (Jackson, MS)Tj /F31 1 Tf -0.9 -1.2 TD -0.001 Tc -0.0209 Tw (Mississippi Crisis Response Network)Tj /F34 1 Tf 0 -2.4 TD -0.0206 Tc 0.0041 Tw (September 25-28, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.9 0 TD 0.001 Tc 0.0209 Tw (Honolulu, HI)Tj /F31 1 Tf -0.9 -1.2 TD -0.005 Tc -0.0687 Tw (U.S. Coast Guard)Tj T* -0.0048 Tc -0.0695 Tw (Honolulu Police, Fire, EMS)Tj T* -0.001 Tc -0.037 Tw [(V)26(isitor )39.5(Aloha Society of Hawaii \(V)79(ASH\))]TJ /F34 1 Tf 18.16 20.4 TD -0.0207 Tc -0.0208 Tw (October 9-12, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.88 0 TD -0.0036 Tc -0.0708 Tw (Louisville, KY)Tj /F31 1 Tf -0.88 -1.2 TD -0.0048 Tc -0.0695 Tw (Kentucky Dept. of Corrections)Tj /F34 1 Tf 0 -2.4 TD -0.0206 Tc -0.0396 Tw (October 15-19, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.88 0 TD -0.0058 Tc -0.0708 Tw (Buffalo, NY)Tj /F31 1 Tf -0.88 -1.2 TD -0.0047 Tc -0.07 Tw [(W)19.1(estern NY)15.3( )-9.9(S)55.3(tress Reduction Program &)]TJ T* -0.0055 Tc -0.0687 Tw (The Police Helpline)Tj /F34 1 Tf 0 -2.4 TD -0.0211 Tc 0.0125 Tw (November 6-9, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.88 0 TD -0.0051 Tc -0.0687 Tw [(V)41.9(ictoria, BC, Canada)]TJ /F31 1 Tf -0.88 -1.2 TD -0.0017 Tc (Archipelago CISM Society)Tj /F34 1 Tf 0 -2.4 TD -0.0212 Tc 0.0083 Tw (November 12-16, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.9 0 TD -0.0437 Tw (Regina, SK, Canada)Tj /F31 1 Tf -0.9 -1.2 TD -0.0051 Tc -0.07 Tw [(Prarie Region Crisis Intervention )14.7(T)105.7(eam)]TJ /F35 1 Tf 0 -2.4 TD -0.0017 Tc -0.0354 Tw (December 3-7, 2008)Tj /G2 1 Tf 0 -1.2 TD 0 Tc 0 Tw <0099>Tj /F35 1 Tf 0.9 0 TD 0.0003 Tc -0.0167 Tw (San Diego, CA)Tj /F31 1 Tf -0.9 -1.2 TD -0.0025 Tc -0.0698 Tw [(San Diego County CISM )17.5(T)108.3(eam)]TJ ET q 6 789 600 -776.01 re W n 1 J 2.88 w 124.879 243.554 m 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[]0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (137)Tj /TT3 1 Tf 7 0 0 7 120.66 726.66 Tm -0.0061 Tc 0.021 Tw [(International Journal of Emergency Mental Health, Vol. 10, No. 2, pp. 137-148 2008 Chevron Publishing ISSN 1522-4821)]TJ /TT4 1 Tf 10 0 0 10 65.49 445.35 Tm -0.0043 Tc 0 Tw (Abstract: )Tj /TT5 1 Tf 4.107 0 TD -0.0035 Tc 0.118 Tw (Since police officers are frequently exposed to high stress situations, individual differences in the response to)Tj -4.107 -1.299 TD -0.004 Tc -0.0318 Tw [(str)29(ess and trauma ar)29(e of inter)32(est. W)86(e)-0.3( examined the association of har)32(diness components \(commitment, contr)29(ol and challenge\))]TJ 0 -1.302 TD -0.0039 Tc 0.0197 Tw (with depression, posttraumatic stress disorder \(PTSD\) symptoms, and symptoms of general psychological distress in police)Tj 0 -1.299 TD -0.0067 Tw (officers. The random sample included 105 officers \(40 women and 65 men\) from the Buffalo Cardio-Metabolic Police Stress)Tj T* 0.0052 Tc 0.125 Tw [(\(BCOPS\) study baseline visit. Components of hardiness were measured using a 15-item hardiness scale. Depressive)]TJ 0 -1.302 TD -0.0041 Tc 0.0689 Tw (symptoms were measured using the Center for Epidemiological Studies Depression scale \(CES-D\), PTSD symptoms were)Tj 0 -1.299 TD -0.0038 Tc 0.0353 Tw (measured using the impact of events scale \(IES\), and symptoms of general psychological distress were measured using the)Tj T* 0.0753 Tw [(Brief Symptoms Inventory \(BSI\). Associations were assessed using linear regression analysis. Models were adjusted for)]TJ 0 -1.302 TD 0.0038 Tc 0.1249 Tw [(age, education and marital status. Because of significant gender interactions, analyses wer)27.8(e stratified by gender)108.8(. The)]TJ 0 -1.299 TD -0.0038 Tc -0.035 Tw (hardiness control dimension was significantly and negatively associated with CES-D for both genders but was not associated)Tj T* -0.0142 Tw [(with IES. Hardiness commitment was significantly and negatively associated with both CES-D and IES in women. Men had)]TJ 0 -1.302 TD -0.0016 Tc 0.125 Tw [(negative but non-significant associations for commitment with CES-D and IES. Hardiness commitment was negatively)]TJ 0 -1.299 TD -0.0036 Tc 0.0222 Tw (associated with the overall BSI score for both men and women but the association was only significant for men, though the)Tj T* -0.0239 Tw (strength of the association was stronger for women. This is likely a result of the impact of the smaller sample size for women.)Tj 0 -1.302 TD -0.0038 Tc 0.0387 Tw (The magnitude of gender differences in these associations shows that for depressive and PTSD symptoms, the commitment)Tj 0 -1.299 TD -0.0036 Tc 0.0658 Tw [(dimension of hardiness may be more protective in female police officers than in male officers. [International Journal of)]TJ T* 0.0892 Tw (Emergency Mental Health, 2008, 10\(2\), pp. 137-148].)Tj /TT1 1 Tf 9 0 0 9 223.74 201.99 Tm -0.0054 Tc 0.0222 Tw (Key words: )Tj /TT5 1 Tf 5.1567 0 TD -0.0046 Tc 0.0236 Tw (Stress, depression, PTSD, hardiness, police)Tj ET /GS1 gs 66.51 179.265 m 557.01 179.265 l S BT /TT2 1 Tf 9 0 0 9 66.51 161.49 Tm /GS2 gs -0.0045 Tc 0.0834 Tw [(Michael E. )52.2(Andrew)65.5(, PhD and Desta Fekedulegn, PhD are S)12.2(tatisticians, and Cecil M. Burchfiel, PhD, MPH, Erin C. McCanlies, PhD,)]TJ 0 -1.22 TD -0.0046 Tc 0.0302 Tw [(Luenda E. Charles, PhD, MPH, and )15.3(T)66.2(ara )52(A. Hartley)62.1(, MP)85.4(A, MPH are Epidemiologists at the Centers for Disease Control and Preventio)]TJ 53.7549 0 TD -0.0049 Tc 0 Tw (n,)Tj -53.7549 -1.2233 TD -0.0017 Tc 0.1251 Tw [(National Institute of Occupational Safety and Health, Health Effects Laboratory Division, Biostatistics and Epidemiology Branch)]TJ 53.3505 0 TD [( in)]TJ -53.3505 -1.2233 TD -0.0049 Tc -0.0077 Tw [(M)6.2(o)6.2(r)11.8(gantown, )12.1(V)17.8(W)85.1(. John M. )12.1(V)60.6(iolanti, PhD is Research )52.1(Associate Professor)35.1(, School of Public Health & Health Professions, Departme)]TJ 52.6679 0 TD -0.0052 Tc -0.008 Tw (nt of)Tj -52.6679 -1.22 TD -0.0049 Tc 0.0053 Tw [(Social & Preventive Medicine, S)15.1(tate University of NY)31.8( at Buf)11.8(falo, NY)125.1(. )11.8(The findings and conclusions in this report are those of t)]TJ 50.3967 0 TD (he authors)Tj -50.3967 -1.2233 TD -0.0046 Tc -0.0148 Tw [(and do not necessarily represent the views of the National Institute for Occupational Safety and Health. )52.1(Address correspondence)]TJ 50.4765 0 TD -0.0052 Tc [( regarding)]TJ -50.4765 -1.2233 TD -0.0048 Tc 0.0461 Tw [(the article to Michael E. )51.9(Andrew)61.9(, PhD, Epidemiologist, National Institute of Occupational Safety and Health, Health Ef)11.9(fects Lab)]TJ 51.6428 0 TD -0.0051 Tc 0 Tw (oratory)Tj -51.6428 -1.22 TD -0.0117 Tw [(Division, 1095 Willowdale Drive, Morgantown , WV 26505. Email: mta6@cdc.gov)]TJ /F1 1 Tf 14 0 0 14 81.24 672.84 Tm -0.004 Tc 0.1376 Tw [(Har)17.4(diness and Psyc)6.7(hological Distress in a Cohor)-25.4(t of P)32.4(olice Officer)8.9(s)]TJ /TT2 1 Tf 12 0 0 12 268.65 630.66 Tm -0.0237 Tc -0.0596 Tw [(Michael E. )47.1(Andrew)]TJ 10 0 0 10 206.76 618 Tm 0.0015 Tc 0.0042 Tw (National Institute of Occupational Safety and Health)Tj 12 0 0 12 141.51 585.66 Tm -0.0219 Tc -0.0604 Tw (Erin C. McCanlies)Tj 10 0 0 10 76.26 573 Tm 0.0015 Tc -0.0017 Tw (National Institute for Occupational Safety and Health)Tj 12 0 0 12 397.26 585.66 Tm -0.0312 Tc -0.0604 Tw (Cecil M. Burchfiel)Tj 10 0 0 10 331.26 573 Tm 0.0015 Tc -0.0017 Tw (National Institute for Occupational Safety and Health)Tj 12 0 0 12 142.5 536.64 Tm -0.0183 Tc -0.0604 Tw (Luenda E. Charles)Tj 10 0 0 10 77.25 524.01 Tm 0.0015 Tc -0.0017 Tw (National Institute for Occupational Safety and Health)Tj 12 0 0 12 403.65 536.64 Tm -0.0176 Tc -0.1103 Tw [(T)73.2(ara A. )-50.2(Hartley)]TJ 10 0 0 10 331.26 524.01 Tm 0.0015 Tc -0.0017 Tw (National Institute for Occupational Safety and Health)Tj 12 0 0 12 142.65 490.65 Tm -0.0212 Tc -0.0625 Tw (Desta Fekedulegn)Tj 10 0 0 10 76.26 477.99 Tm 0.0015 Tc -0.0017 Tw (National Institute for Occupational Safety and Health)Tj 12 0 0 12 401.4 490.65 Tm -0.0279 Tc -0.0611 Tw [(John M. )11.4(V)66.8(iolanti)]TJ 10 0 0 10 349.26 477.99 Tm -0.0002 Tc -0.0622 Tw [(S)22(t)-0.4(ate University of New )35.7(Y)101(ork, at Buf)17.8(falo, NY)]TJ ET endstream endobj 278 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 280 0 obj << /Length 8773 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.1187 Tw [(138 )]TJ /TT3 1 Tf 2.8312 0 TD -0.0053 Tc 0.1208 Tw (Andrew, McCanlies, Burchfiel, Charles, Hartley, Fekedulegn, & Violanti Hardiness and Psychological Distress)Tj /TT2 1 Tf 10 0 0 10 72.99 721.65 Tm -0.0029 Tc 0.0234 Tw (Resiliency is often used to imply an ability to bounce)Tj -1.8 -1.401 TD -0.0033 Tc -0.01 Tw (back. Being able to bounce back is an important capability)Tj 0 -1.398 TD 0.0338 Tw [(in situations that are dif)14.7(ficult and stressful. Paton, )17.8(V)64.9(iolanti,)]TJ 0 -1.401 TD -0.0029 Tc 0.0115 Tw (and Smith \(2003\) refer to resiliency as the capacity of indi-)Tj T* -0.0037 Tc 0.1012 Tw (viduals to draw upon resources and competencies to cope)Tj 0 -1.398 TD -0.0035 Tc 0.0656 Tw (with, adapt to, and develop from the demands, challenges,)Tj 0 -1.401 TD -0.0034 Tc -0.04 Tw [(and changes encountered during and after a critical incident,)]TJ T* -0.0031 Tc 0.0419 Tw [(mass emer)17.9(gency or disaster)50.9(. )18.1(The concept of resiliency has)]TJ 0 -1.398 TD 0.0185 Tc 0.125 Tw (been operationalized and studied in depth as hardiness)Tj 0 -1.401 TD -0.0205 Tc -0.06 Tw (\(Maddi, 2005\).)Tj /F1 1 Tf 11 0 0 11 54.99 563.01 Tm -0.005 Tc 0.0228 Tw (Hardiness as Resiliency)Tj /TT2 1 Tf 10 0 0 10 72.99 539.64 Tm -0.0031 Tc 0.0188 Tw (Hardiness refers to a personality trait that indicates the)Tj -1.8 -1.398 TD -0.0034 Tc -0.0206 Tw (manner in which a person might interpret a critical incident,)Tj 0 -1.401 TD -0.0033 Tc 0.0494 Tw (life stress, or traumatic event. Hardiness is thought to con-)Tj T* -0.0029 Tc -0.0095 Tw (sist of three sets of cognitive style \(Maddi, 1990\). )Tj /TT5 1 Tf 20.136 0 TD -0.0058 Tc 0 Tw (Commit-)Tj -20.136 -1.398 TD -0.0059 Tc (ment)Tj /TT2 1 Tf 1.926 0 TD -0.0032 Tc 0.0666 Tw [( reflects the tendency to find meaning and purpose in)]TJ -1.926 -1.401 TD -0.003 Tc 0.115 Tw (potentially stressful events; )Tj /TT5 1 Tf 11.451 0 TD -0.0049 Tc 0 Tw (control)Tj /TT2 1 Tf 2.859 0 TD -0.0027 Tc 0.1163 Tw [( refers to the tendency)]TJ -14.31 -1.401 TD -0.0061 Tc -0.0625 Tw (to believe that one is capable of managing the stressful event;)Tj 0 -1.398 TD -0.0049 Tc 0 Tw (and )Tj /TT5 1 Tf 1.752 0 TD (challenge)Tj /TT2 1 Tf 3.849 0 TD -0.0029 Tc 0.0738 Tw [( is the tendency to see stressful events as an)]TJ -5.601 -1.401 TD -0.003 Tc 0.1243 Tw [(opportunity for personal growth. 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Evidence exists that factors such as hardiness,)]TJ 0 -1.398 TD -0.016 Tw [(emotional stability)62.9(, self-awareness, tolerance for ambiguity)59.9(,)]TJ 0 -1.401 TD -0.0114 Tc -0.0625 Tw (and self-efficacy can enhance resilience \(Flin, 1996; Linley &)Tj T* -0.0038 Tc 0.0481 Tw [(Joseph, 2004; MacLeod & Paton, 1999; Paton, )17.2(V)61.4(iolanti, &)]TJ 0 -1.398 TD -0.0323 Tc -0.06 Tw (Smith, 2003\).)Tj /F1 1 Tf 11 0 0 11 54.99 282.99 Tm -0.0055 Tc 0.0251 Tw [( )95.8(The P)35.4(olice and Har)13.6(diness)]TJ /TT2 1 Tf 10 0 0 10 72.99 259.65 Tm -0.0058 Tc -0.0622 Tw (Police officers are regularly exposed to critical incidents)Tj -1.8 -1.401 TD -0.0034 Tc 0.035 Tw (\(emergencies and disasters\). While this type of exposure is)Tj 0 -1.398 TD -0.0036 Tc 0.0012 Tw (often viewed as a precursor to the development of posttrau-)Tj 0 -1.401 TD -0.0037 Tc -0.0257 Tw (matic stress disorder \(PTSD\) and depression, evidence indi-)Tj T* -0.0033 Tc 0.125 Tw (cates that positive outcomes occur as well, and that most)Tj 0 -1.398 TD -0.0034 Tc 0.0864 Tw (officers do not develop psychological anomalies \(Paton et)Tj 0 -1.401 TD -0.0135 Tc -0.0622 Tw [(al., 2003; Moran & Colless, 1995\). Positive outcomes include)]TJ T* -0.0034 Tc 0.0416 Tw (exercising professional skills to achieve highly meaningful)Tj 0 -1.398 TD -0.0038 Tc 0.014 Tw (outcomes, posttraumatic growth, enhanced professional ca-)Tj 0 -1.401 TD -0.003 Tc 0.0304 Tw [(pability)60(, a greater appreciation for family)60(, and an enhanced)]TJ T* -0.0035 Tc 0.0675 Tw (sense of control over significant adverse events.)Tj 1.8 -1.998 TD -0.0039 Tc 0.0834 Tw (Evidence suggests that positive outcomes occur when)Tj -1.8 -1.401 TD -0.0034 Tc -0.0078 Tw (police officers use psychological competencies such as har-)Tj T* -0.0035 Tc 0.0737 Tw (diness to allow themselves to render traumatic or stressful)Tj 25.401 65.001 TD -0.0037 Tc -0.006 Tw [(events coherent, manageable, and meaningful \(Antonovsky)59.3(,)]TJ 0 -1.401 TD -0.0055 Tc -0.0625 Tw [(1990\). In police work, traumatic work incidents may create a)]TJ 0 -1.398 TD 0.0002 Tc 0.125 Tw (sense of psychological disequilibrium that represents that)Tj 0 -1.401 TD -0.0037 Tc -0.0071 Tw (period when the existing interpretive framework that guides)Tj T* -0.0033 Tc -0.0338 Tw [(the of)17.7(ficer)-39.3()53.7(s)-0.2( expectations and actions has lost the capacity to)]TJ 0 -1.398 TD -0.0038 Tc -0.0591 Tw (make sense of traumatic experiences. \(Janoff-Bulman, 1992;)Tj 0 -1.401 TD -0.0167 Tc -0.06 Tw (Paton, 1994\).)Tj 1.8 -2.001 TD -0.0034 Tc -0.0082 Tw (Hardiness has been identified as a protective factor that)Tj -1.8 -1.398 TD -0.0032 Tc -0.0193 Tw (reduces the probability of pathogenic traumatic and psycho-)Tj 0 -1.401 TD -0.0202 Tc -0.0625 Tw (logical reactions \(Frederickson et al., 2003; Paton, 1994; 2006\).)Tj T* -0.0032 Tc -0.0075 Tw (Thus, the objective of the present study is to examine hardi-)Tj 0 -1.398 TD -0.0035 Tc 0.0761 Tw (ness in police officers and its associations with PTSD, de-)Tj 0 -1.401 TD -0.0029 Tc -0.0007 Tw (pression, and psychological distress. It is hypothesized that)Tj T* -0.0094 Tc -0.0622 Tw (officers higher in hardiness will be more resistant to increased)Tj 0 -1.398 TD -0.0009 Tc 0.125 Tw (levels of PTSD symptoms, depression, and psychological)Tj 0 -1.401 TD 0.0156 Tc 0 Tw (distress.)Tj /F1 1 Tf 11 0 0 11 399.39 473.01 Tm 0.0189 Tc (METHODS)Tj -8.2173 -1.4564 TD -0.006 Tc 0.0891 Tw [(Stud)7.6(y P)34.9(opulation)]TJ /TT2 1 Tf 10 0 0 10 327 433.65 Tm -0.0029 Tc 0.034 Tw (The data for this study was collected by the Center for)Tj -1.8 -1.401 TD -0.0035 Tc 0.1 Tw [(Preventive Medicine at the S)17.5(tate University of New )29.5(Y)103.7(ork,)]TJ 0 -1.398 TD -0.0092 Tc -0.062 Tw [(Buf)17.8(falo, New )30.1(Y)101(ork during 1999 and 2000. )18.1(The study popula-)]TJ 0 -1.401 TD -0.0034 Tc 0.0533 Tw (tion was made up of 115 randomly selected police officers)Tj T* -0.0035 Tc 0.0144 Tw [(from the Buf)17.5(falo, New )32.4(Y)103.7(ork police department. Of these, a)]TJ 0 -1.398 TD -0.0074 Tc -0.0625 Tw (total of 105 \(40 women and 65 men\) had complete data on the)Tj 0 -1.401 TD -0.0027 Tc 0.0625 Tw [(psychosocial variables of interest in this study)63.3(. )18.6(This study)]TJ T* -0.0055 Tc -0.0621 Tw (was cross-sectional and included self-report measures of har-)Tj 0 -1.398 TD -0.0033 Tc 0.0838 Tw (diness, the impact of events \(IES\) scale, depressive symp-)Tj 0 -1.401 TD -0.004 Tc -0.0622 Tw (toms \(CES-D\), and the brief symptoms inventory \(BSI\).)Tj /F1 1 Tf 11 0 0 11 309 275.01 Tm -0.0057 Tc 0.041 Tw (Study Measures)Tj /TT5 1 Tf 0 -1.5136 TD 0.0265 Tc 0 Tw [(Har)29.2(diness)]TJ /TT2 1 Tf 10 0 0 10 327 238.65 Tm -0.0038 Tc -0.005 Tw (Hardiness was measured using the 15-item scale devel-)Tj -1.8 -1.401 TD -0.0035 Tc 0.0707 Tw (oped by Bartone \(1995\) consisting of three dimensions in-)Tj 0 -1.398 TD 0.0256 Tc 0.125 Tw [(cluding control, commitment, and challenge. For this)]TJ 0 -1.401 TD -0.0036 Tc -0.0386 Tw (instrument participants respond on a 4-point scale indicating)Tj T* -0.0032 Tc 0.0982 Tw (the level at which each of 15 statements apply to them as)Tj 0 -1.398 TD -0.003 Tc 0.0458 Tw (follows: 0 \(not at all true\); 1 \(a little true\); 2 \(quite true\); 3)Tj 0 -1.401 TD -0.0494 Tw [(\(completely true\). Scores are obtained by reverse coding the)]TJ T* -0.0038 Tc 0.0985 Tw (appropriate items and summing items for each dimension.)Tj 0 -1.398 TD -0.0034 Tc 0.0656 Tw (The overall hardiness score is obtained by summing all 15)Tj 0 -1.401 TD -0.0036 Tc -0.0436 Tw [(items. Hardiness control, commitment, and challenge repre-)]TJ T* 0.0211 Tw [(sent three related dimensions. The control dimension con-)]TJ 0 -1.398 TD -0.0034 Tc 0.1138 Tw (sists of items that represent the characteristic of believing)Tj 0 -1.401 TD -0.0033 Tc 0.0362 Tw (that one is capable of managing potentially stressful events)Tj ET endstream endobj 281 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 283 0 obj << /Length 8425 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (139)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0035 Tc 0.0094 Tw (\(e.g., planning ahead can help avoid most future problems\).)Tj 0 -1.398 TD -0.0039 Tc 0.0086 Tw (The commitment dimension consists of items that represent)Tj 0 -1.401 TD -0.0045 Tc -0.0623 Tw (an ability to find meaning in potentially stressful events \(e.g.,)Tj T* -0.0033 Tc -0.0295 Tw (most of my life gets spent doing things that are worthwhile\).)Tj 0 -1.398 TD 0.0595 Tw (The challenge dimension has items related to the ability to)Tj 0 -1.401 TD -0.0031 Tc 0.1167 Tw (interpret potentially stressful events as opportunities \(e.g.,)Tj T* -0.0034 Tc 0.01 Tw (changes in routine are interesting to me\).)Tj 1.8 -1.998 TD -0.003 Tc 0.0044 Tw (It has been suggested that analysis of hardiness may be)Tj -1.8 -1.401 TD -0.0033 Tc 0.1188 Tw (done using either the three dimensions \(separately\) or the)Tj T* -0.0036 Tc -0.0195 Tw (composite score as long as the composite score is more con-)Tj 0 -1.398 TD -0.003 Tc 0.0688 Tw (sistently and strongly related to the dependent variables of)Tj 0 -1.401 TD 0.0019 Tc 0.125 Tw [(interest than the separate dimensions \(Funk, 1992\). It is)]TJ T* -0.0018 Tc (straightforward to evaluate this empirically by comparing)Tj 0 -1.398 TD 0.0055 Tc (associations between the composite score and dependent)Tj 0 -1.401 TD 0.0024 Tc (variables of interest with associations between the hardi-)Tj T* -0.0038 Tc -0.0513 Tw (ness dimensions and dependent variables and using the com-)Tj 0 -1.398 TD 0.0084 Tc 0.125 Tw (posite score only when it is as strong a predictor as the)Tj 0 -1.401 TD -0.0035 Tc 0.0525 Tw [(dimensions taken separately)59.5(.)]TJ /TT5 1 Tf 11 0 0 11 66 445.35 Tm 0.0124 Tc 0.1278 Tw [(Depr)31.5(essive Symptoms)]TJ /TT2 1 Tf 10 0 0 10 84 425.64 Tm -0.0036 Tc -0.0375 Tw [( Depressive symptoms were measured using the Center)]TJ -1.8 -1.398 TD -0.0059 Tc -0.0625 Tw [(for Epidemiological Studies-Depression scale \(CES-D\). The)]TJ 0 -1.401 TD -0.0034 Tc 0.0175 Tw (CES-D is a short scale that was designed to measure symp-)Tj T* -0.0049 Tc -0.0625 Tw (toms of depression in the general population \(Radloff, 1977\).)Tj 0 -1.398 TD -0.0033 Tc 0.125 Tw (The CES-D measures symptoms of depression \(e.g., poor)Tj 0 -1.401 TD -0.0034 Tc -0.0067 Tw (appetite, restless sleep, sadness\) using 20 items on a 4-point)Tj T* -0.0477 Tw [(scale. The 4-point scale represents how often each symptom)]TJ 0 -1.398 TD -0.0029 Tc -0.0182 Tw (occurred during the past 7 days as follows: 0 \(rarely or none)Tj 0 -1.401 TD -0.0357 Tw (of the time, less than 1 day\); 1 \(some or little of the time, 1-2)Tj T* -0.0025 Tc 0.125 Tw (days\); 2 \(occasionally or a moderate amount of time, 3-4)Tj 0 -1.398 TD -0.0059 Tc -0.0625 Tw [(days\); and 3 \(most or all of the time, 5-7 days\). The CES-D is)]TJ 0 -1.401 TD -0.0035 Tc -0.0532 Tw (scored by reverse coding the appropriate items and summing)Tj T* -0.0033 Tc 0.0408 Tw (the scores to obtain an overall score.)Tj /TT5 1 Tf 11 0 0 11 66 224.34 Tm 0.0054 Tc 0.1273 Tw (PTSD Symptoms)Tj /TT2 1 Tf 10 0 0 10 84 204.66 Tm -0.0037 Tc -0.0217 Tw (Symptoms of posttraumatic stress were measured using)Tj -1.8 -1.401 TD -0.0149 Tc -0.062 Tw [(the impact of events scale \(IES\) \(Horowitz, )18.3(W)55.9(ilner)33.1(, & )51.3(Alvarez,)]TJ T* -0.0039 Tc -0.0625 Tw (1979; Sundin & Horowitz, 2002; Sundin & Horowitz, 2003\).)Tj 0 -1.398 TD -0.0062 Tc -0.0622 Tw (The IES consists of 15 items describing the subjective impact)Tj 0 -1.401 TD -0.0032 Tc 0.0915 Tw [(or symptom related to a traumatic event. These items are)]TJ T* -0.0036 Tc -0.0031 Tw (related to two response sets or subscales including intrusion)Tj 0 -1.398 TD -0.0033 Tc -0.001 Tw (\(e.g., I had waves of strong feelings about it\) and avoidance)Tj 0 -1.401 TD -0.0026 Tc -0.0547 Tw [(\(e.g., I stayed away from reminders of it\). Each item has a 4-)]TJ T* -0.0033 Tc 0.0829 Tw (point response describing the frequency of symptoms dur-)Tj 0 -1.398 TD -0.0026 Tc 0.1027 Tw (ing the past 7 days as follows: 0 \(not at all\); 1 \(rarely\); 3)Tj 25.5 64.398 TD -0.0036 Tc 0.0619 Tw [(\(sometimes\); and 5 \(often\). Subscales for intrusion \(seven)]TJ 0 -1.398 TD -0.0394 Tw (items\) and avoidance \(eight items\) are obtained by summing)Tj 0 -1.401 TD -0.0034 Tc -0.0078 Tw (the appropriate items and the overall IES score by summing)Tj T* -0.018 Tc -0.0625 Tw (all 15 items.)Tj /TT5 1 Tf 11 0 0 11 321 647.34 Tm 0.0119 Tc 0.125 Tw (Brief Symptoms Inventory)Tj /TT2 1 Tf 10 0 0 10 339 627.66 Tm -0.0069 Tc -0.062 Tw (Self-reported psychological symptoms and distress were)Tj -1.8 -1.401 TD -0.0034 Tc 0.0943 Tw (measured using the Brief Symptoms Inventory \(BSI\). The)Tj T* -0.0058 Tc -0.0625 Tw (BSI is a shortened \(54 item\) version of the Symptoms Check-)Tj 0 -1.398 TD -0.0118 Tc -0.0622 Tw [(list-90-Revised \(SCL-90-R\). It was developed as a brief alter-)]TJ 0 -1.401 TD -0.0067 Tc -0.0625 Tw (native to the complete scale \(Derogatis & Melisaratos, 1983\).)Tj T* -0.0034 Tc -0.0356 Tw (The BSI consists of nine primary dimensions, each with five)Tj 0 -1.398 TD -0.0093 Tc -0.0625 Tw (to seven items measured on a 5-point scale \(0-4\) ranging from)Tj 0 -1.401 TD -0.0037 Tc -0.061 Tw [(not-at-all to extremely)62.3(. )17.7(These dimensions are quantified)]TJ T* -0.0033 Tc 0.0585 Tw [(by computing the means score for subscale items. The di-)]TJ 0 -1.398 TD -0.0036 Tc 0.0207 Tw [(mensions of this scale include the following: somatization,)]TJ 0 -1.401 TD 0.0284 Tw [(obsessive-compulsive, interpersonal sensitivity)62.5(, depression,)]TJ T* 0.0103 Tc 0.1248 Tw [(anxiety)64.3(, hostility)58.3(, phobic anxiety)61.3(, paranoid ideation, and)]TJ 0 -1.398 TD -0.0033 Tc -0.0539 Tw [(psychoticism. The instrument also includes a general sever-)]TJ 0 -1.401 TD -0.0031 Tc 0.0455 Tw (ity index \(GSI\) that consists of the average of all 54 items.)Tj T* -0.0036 Tc 0.1005 Tw [(This instrument has shown good conver)14.4(gent validity)62.4(, con-)]TJ 0 -1.398 TD -0.0031 Tc -0.0622 Tw [(struct validity)59.9(, test re-test reliability)62.9(, and internal consistency)]TJ 0 -1.401 TD -0.0052 Tc -0.0617 Tw (\(Derogatis & Melisaratos, 1983\).)Tj /F1 1 Tf 11 0 0 11 321 371.01 Tm -0.0043 Tc 0.0319 Tw (Statistical Methods)Tj /TT2 1 Tf 10 0 0 10 339 347.64 Tm 0.0039 Tc 0.125 Tw (Descriptive statistics were obtained for demographic)Tj -1.8 -1.398 TD -0.0031 Tc 0.0957 Tw (variables including age, education, marital status, years of)Tj 0 -1.401 TD -0.0034 Tc 0.1094 Tw [(police service, and police rank. For descriptive purposes,)]TJ T* -0.0019 Tw (continuous demographic variables, such as age and years of)Tj 0 -1.398 TD -0.0036 Tc 0.01 Tw [(service, were broken into meaningful descriptive categories)]TJ 0 -1.401 TD 0.0381 Tw (and reported as frequencies and percentages along with the)Tj T* -0.0132 Tc -0.0624 Tw [(other categorical demographic variables. )49.9(Age-adjusted means)]TJ 0 -1.398 TD -0.0038 Tc -0.0095 Tw (and comparisons across gender for the CES-D, IES and BSI)Tj 0 -1.401 TD 0.0468 Tc 0.125 Tw (scores were completed using analysis of covariance)Tj T* -0.0047 Tc 0.0448 Tw [(\(ANCOV)124.3(A\). Dichotomous variables )]TJ 14.8027 0 TD -0.0039 Tc 0.044 Tw (were compared across)Tj -14.8027 -1.398 TD -0.0029 Tc 0.125 Tw [(groups by means of chi-square statistics or Fisher)-38.9()57.1(s)0( exact)]TJ 0 -1.401 TD -0.0079 Tc -0.0622 Tw (tests where expected frequencies were too small for valid chi-)Tj T* 0.0031 Tc 0.125 Tw [(square tests. )54.1(All significance tests were performed at the)]TJ 0 -1.398 TD -0.0104 Tc -0.0617 Tw (alpha = 0.05 level.)Tj 1.8 -2.001 TD -0.0033 Tc 0.1185 Tw [(Linear regression analysis was used to estimate asso-)]TJ -1.8 -1.401 TD -0.0037 Tc 0.0871 Tw (ciations between hardiness as an independent variable and)Tj 0 -1.398 TD -0.0067 Tc -0.0625 Tw (CES-D score, the two IES subscales and total IES, along with)Tj 0 -1.401 TD -0.0055 Tc -0.0622 Tw [(the nine BSI dimensions and total GSI. )15.6(W)92.3(e)-0.3( tested for interac-)]TJ T* 0.0015 Tc 0.125 Tw (tions between gender and hardiness dimensions to assess)Tj 0 -1.398 TD -0.0035 Tc 0.0587 Tw (the observed differences in the strength of associations be-)Tj ET endstream endobj 284 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 286 0 obj << /Length 8084 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.1187 Tw [(140 )]TJ /TT3 1 Tf 2.8312 0 TD -0.0053 Tc 0.1208 Tw (Andrew, McCanlies, Burchfiel, Charles, Hartley, Fekedulegn, & Violanti Hardiness and Psychological Distress)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0036 Tc 0.0382 Tw (tween hardiness and the dependent variables of interest be-)Tj 0 -1.398 TD 0.0588 Tc 0.1569 Tw [(tween men and women. Results were reported as)]TJ 0 -1.401 TD -0.0097 Tc -0.062 Tw (unstandardized and standardized regression coefficients \(e.g.,)Tj T* -0.0039 Tc 0.0609 Tw (regression slopes with hardiness dimension as independent)Tj 0 -1.398 TD -0.0036 Tc -0.053 Tw [(variable and CES-D, IES or GSI as dependent variable\). Re-)]TJ 0 -1.401 TD -0.0034 Tc -0.0093 Tw (gression analyses were adjusted for important covariates in-)Tj T* -0.0032 Tc -0.0267 Tw [(cluding age, education and marital status. )50.8(All analyses were)]TJ 0 -1.398 TD -0.005 Tc -0.0625 Tw (performed using the SAS system for statistical analysis \(SAS)Tj 0 -1.401 TD -0.0069 Tc -0.0617 Tw [(S)11.1(T)71.1(A)115.3(T)18.9( Procedures Guide, 2006\).)]TJ /F1 1 Tf 11 0 0 11 145.14 578.01 Tm -0.0023 Tc 0.1409 Tw [( RESUL)85(T)7.5(S)]TJ -8.2855 -1.4564 TD 0.0008 Tc 0 Tw (Demographics)Tj /TT2 1 Tf 10 0 0 10 72 538.65 Tm -0.0037 Tc 0.1123 Tw [(Demographic statistics are presented in )17.7(T)73.1(able 1. )14.7(The)]TJ -1.8 -1.401 TD -0.0036 Tc 0.0615 Tw (study population had 40 women and 65 men with a higher)Tj 0 -1.398 TD -0.0033 Tc 0.083 Tw (percentage of men aged 50 years or older \(13.8% men vs.)Tj 0 -1.401 TD -0.0042 Tc -0.0622 Tw [(2.5 % women\). More than half of the participants had educa-)]TJ T* -0.0031 Tc -0.013 Tw [(tion including at least four years of college. The percentage)]TJ 0 -1.398 TD -0.005 Tc -0.0625 Tw (of women who were divorced was nearly double that for men)Tj 25.5 25.299 TD -0.0063 Tc (\(17.5% women vs. 9.2% men\) with a similar pattern for those)Tj 0 -1.401 TD -0.0032 Tc 0.0056 Tw [(who were single. There were approximately twice as many)]TJ 0 -1.398 TD 0.0355 Tw (men with at least 15 years of police service as women, and)Tj 0 -1.401 TD -0.0035 Tc -0.0304 Tw (women had a higher percentage of rank at the level of police)Tj T* 0.074 Tw (officer with men having a higher proportion at the rank of)Tj 0 -1.398 TD 0.0046 Tc 0 Tw (detective.)Tj /F1 1 Tf 11 0 0 11 309 618.99 Tm 0.0007 Tc (Hardiness)Tj /TT2 1 Tf 10 0 0 10 327 595.65 Tm -0.0038 Tc -0.0364 Tw (Since the three hardiness dimensions were more consis-)Tj -1.8 -1.401 TD -0.0031 Tc 0.0435 Tw (tently and strongly associated with the dependent variables)Tj 0 -1.398 TD 0.0063 Tc 0.125 Tw (of interest than the composite scale, analyses were done)Tj 0 -1.401 TD -0.0035 Tc 0.0943 Tw [(using the separate dimensions. Therefore, descriptive sta-)]TJ T* 0.0002 Tc 0.125 Tw (tistics for the composite hardiness scale are not reported.)Tj 0 -1.398 TD -0.0037 Tc 0.0557 Tw (Higher values for the hardiness dimensions indicate higher)Tj 0 -1.401 TD -0.0035 Tc 0.0048 Tw (levels of hardiness. Men and women had similar mean val-)Tj T* 0.0505 Tw (ues for the hardiness challenge dimension \(p = 0.83\) while)Tj 0 -1.398 TD -0.0038 Tc 0.0366 Tw (men had higher levels than women on both hardiness com-)Tj 0 -1.401 TD -0.0475 Tw (mitment and hardiness control \()Tj /TT5 1 Tf 12.414 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0029 Tc -0.0475 Tw [( = 0.01 and )]TJ /TT5 1 Tf 4.536 0 TD -0.006 Tc 0 Tw (p )Tj /TT2 1 Tf 0.699 0 TD -0.0034 Tc -0.05 Tw (= 0.04 respec-)Tj -18.144 -1.401 TD -0.0032 Tc -0.0773 Tw [(tively; T)73.6(able )-14.3(2\).)]TJ /TT3 1 Tf -8.55 -7.014 TD -0.0057 Tc 0.0158 Tw [( )18.4( )18.4( )18.4( )18.4(Women)-6305.7( Men)-7430.7( )-5.8( )-5.8( )-5.8( )-5.8( )-5.8(Total)]TJ -13.2 -1.359 TD -0.0087 Tc 0.0099 Tw [(Characteristic)-7208.7( \()]TJ /F24 1 Tf 10 0 2.1256 10 237.99 371.91 Tm -0.008 Tc 0 Tw (n )Tj /TT3 1 Tf 10 0 0 10 246.3 371.91 Tm -0.0041 Tc 0.0023 Tw [(= )-6.3(40\))-6229.1( \()]TJ /F24 1 Tf 10 0 2.1256 10 343.11 371.91 Tm -0.009 Tc 0 Tw (n )Tj /TT3 1 Tf 10 0 0 10 351.36 371.91 Tm -0.0069 Tc -0.0019 Tw [(= )-8(65\))-6531.9( \()]TJ /F24 1 Tf 10 0 2.1256 10 450.9 371.91 Tm -0.011 Tc 0 Tw (N )Tj /TT3 1 Tf 10 0 0 10 460.74 371.91 Tm -0.0055 Tc -0.01 Tw (= 105\))Tj /TT2 1 Tf -23.724 -1.44 TD 0 Tc 0 Tw ( )Tj /TT3 1 Tf 0.255 0 TD -0.0046 Tc 0.0157 Tw [(Freq )4.2( )4.2( )4.2( )4.2( )4.2( )4.2( )4.2(%)-5629.6( Freq %)-6154.6( Freq %)]TJ -13.506 -1.401 TD -0.0146 Tc -0.07 Tw (Age Group)Tj 0 -1.2 TD -0.0046 Tc 0.015 Tw [( < 40 years)-7804.6(2)57.7(3)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(57.5)-5348.8(3)38.5(5)-1973.8(53.8)-5948.8(5)38.5(8)-2573.8(55.2)]TJ -16.95 -1.2 TD -0.0049 Tc -0.0125 Tw [( 40-49 years)-7354.9(1)57.4(6)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(40.0)-5348.8(2)38.5(1)-1973.8(32.3)-5948.8(3)38.5(7)-2573.8(35.2)]TJ -16.95 -1.2 TD -0.0046 Tc 0.015 Tw [( 50 + years)-8329.6(1)-3048.4(2)15.5(.)15.5(5)-5854.6(9)]TJ 27.15 0 TD -0.0222 Tc 0 Tw [(13.8)-5947.2(1)40.1(0)-3097.2(9.5)]TJ -27.15 -1.2 TD -0.0122 Tc (Education)Tj T* -0.0053 Tc -0.0075 Tw [( High School/GED)-5330.3(5)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(12.5)-5348.8(1)38.5(4)-1973.8(21.5)-5948.8(1)38.5(9)-2573.8(18.1)]TJ -16.95 -1.2 TD -0.0048 Tc -0.0007 Tw [( College < 4 years)-4804.8(1)57.5(4)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(35.0)-5348.8(1)38.5(8)-1973.8(27.7)-5948.8(3)38.5(2)-2573.8(30.5)]TJ -16.95 -1.2 TD -0.0048 Tc -0.0007 Tw [( College 4 + years)-4804.8(2)57.5(1)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(52.5)-5348.8(3)38.5(3)-1973.8(50.8)-5948.8(5)38.5(4)-2573.8(51.4)]TJ -16.95 -1.2 TD -0.0049 Tc 0.025 Tw (Marital Status)Tj T* 0.0083 Tw [( Single)-9754.8(1)57.5(3)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(32.5)-5348.8(1)38.5(1)-1973.8(16.9)-5948.8(2)38.5(4)-2573.8(22.8)]TJ -16.95 -1.2 TD -0.0048 Tc -0.0183 Tw [( Married)-9229.8(2)57.5(0)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(50.0)-5348.8(4)38.5(8)-1973.8(73.8)-5948.8(6)38.5(8)-2573.8(64.8)]TJ -16.95 -1.2 TD -0.0054 Tc -0.0012 Tw [( Divorced)-9155.4(7)]TJ 16.95 0 TD -0.0228 Tc 0 Tw [(17.5)-5872.8(6)-2466.6(9.2)-5947.8(1)39.5(3)-2572.8(12.4)]TJ -16.95 -1.2 TD -0.0058 Tc -0.07 Tw (Years Served)Tj T* -0.0047 Tc 0 Tw [( 1-5 years)-8404.7(1)57.6(1)]TJ 16.95 0 TD -0.0238 Tc [(27.5)-5348.8(1)38.5(1)-1973.8(16.9)-5948.8(2)38.5(2)-2573.8(21.0)]TJ -16.95 -1.2 TD -0.0048 Tc -0.0063 Tw [( 6-10 years)-8404.8(9)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(22.5)-5873.8(7)-1942.6(10.8)-5948.8(1)38.5(6)-2573.8(15.2)]TJ -16.95 -1.2 TD -0.0049 Tc -0.0125 Tw [( 11-15 years)-7354.9(1)57.4(1)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(27.5)-5348.8(1)38.5(8)-1973.8(27.7)-5948.8(2)38.5(9)-2573.8(27.6)]TJ -16.95 -1.2 TD -0.0048 Tc 0.0125 Tw [( 15+ years)-8629.8(9)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(22.5)-5348.8(2)38.5(9)-1973.8(44.6)-5948.8(3)38.5(8)-2573.8(36.2)]TJ -16.95 -1.2 TD -0.0282 Tc (Rank)Tj T* -0.0044 Tc 0.0288 Tw [( Police Officer)-6529.4(3)57.9(0)]TJ 16.95 0 TD -0.0238 Tc 0 Tw [(75.0)-5348.8(3)38.5(8)-1973.8(58.5)-5948.8(6)38.5(8)-2573.8(64.8)]TJ -16.95 -1.2 TD -0.0049 Tc -0.0275 Tw [( Sergeant/ Lieutenant)-3979.9(6)]TJ 16.95 0 TD -0.0238 Tc 0 Tw 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TD -0.0266 Tc 0 Tw [(\(0.47\))-5651.6(8)-6.5(.)-6.5(5)-1976.6(\(0.37\))-5951.6(0.83)]TJ -17.775 -1.2 TD -0.0065 Tc -0.0042 Tw [( Commitment)-7731.5(9)13.6(.)13.6(2)]TJ 17.775 0 TD -0.026 Tc 0 Tw [(\(0.34\))-5126(10.4)-1976(\(0.27\))-5951(0.01)]TJ -17.775 -1.2 TD -0.0049 Tc -0.0325 Tw [( Control)-10204.9(9)15.2(.)15.2(2)]TJ 17.775 0 TD -0.026 Tc 0 Tw [(\(0.30\))-5126(10.0)-1976(\(2.00\))-5951(0.04)]TJ -17.775 -1.2 TD -0.0269 Tc [(CES-D)-10901.9(8)-6.8(.)-6.8(4)-2576.9(\(1.07\))-5651.9(6)-6.8(.)-6.8(7)-1976.9(\(0.84\))-5951.9(0.21)]TJ T* -0.0053 Tc -0.0375 Tw [( Depression)]TJ 5.8 0 0 5.8 163.8 573.36 Tm 0 Tc 0 Tw (a)Tj 10 0 0 10 167.01 570 Tm -0.0065 Tc -0.0392 Tw [( \(%\))-5778.5(12.3 )-34(%)-9456.5(6.3 )-58.9(%)]TJ 31.773 0 TD -0.0238 Tc 0 Tw (0.31)Tj -37.575 -1.2 TD -0.0049 Tc 0.045 Tw (IES total score)Tj 13.35 0 TD -0.0257 Tc 0 Tw [(14.1)-2575.7(\(2.68\))-5125.7(15.9)-1975.7(\(2.10\))-5950.7(0.61)]TJ -13.35 -1.2 TD -0.0045 Tc 0.03 Tw [( Intrusive)-9529.5(6)15.6(.)15.6(8)]TJ 17.775 0 TD -0.0266 Tc 0 Tw [(\(1.33\))-5651.6(7)-6.5(.)-6.5(0)-1976.6(\(1.04\))-5951.6(0.89)]TJ -17.775 -1.2 TD -0.0053 Tc 0.0125 Tw [( Avoidant)-9455.3(7)14.8(.)14.8(3)]TJ 17.775 0 TD -0.0266 Tc 0 Tw [(\(1.46\))-5651.6(8)-6.5(.)-6.5(9)-1976.6(\(1.15\))-5951.6(0.43)]TJ -17.775 -1.2 TD -0.0067 Tc ( PTSD)Tj 5.8 0 0 5.8 140.91 525.36 Tm 0 Tc (b)Tj 10 0 0 10 144.09 522 Tm -0.0065 Tc -0.0052 Tw [( )-5.7(\(%\))-8031.5(28.5 %)-8931.5(31.7 %)]TJ 34.065 0 TD -0.0238 Tc 0 Tw (0.72)Tj -37.575 -1.2 TD -0.0257 Tc [(G)-26.9(S)-26.9(I)-12175.7(0.48)-2050.7(\(0.06\))-5650.7(0.36)-1450.7(\(0.05\))-5950.7(0.13)]TJ 5.8 0 0 5.8 66.99 487.35 Tm 0 Tc (a)Tj 10 0 0 10 70.2 483.99 Tm -0.0048 Tc -0.0118 Tw (Depression defined as CES-D total score of 16 or more. )Tj 5.8 0 0 5.8 319.14 487.35 Tm 0 Tc 0 Tw (b)Tj 10 0 0 10 322.35 483.99 Tm -0.005 Tc -0.0116 Tw (PTSD defined as IES total score of 26 or more.)Tj ET 0.99 w /GS1 gs 243.51 651.495 m 311.01 651.495 l 365.49 651.495 m 431.79 651.495 l S 1000 M 66.495 732.505 492.51 -234.01 re S 10 M 66 638.505 m 558 638.505 l 66.51 678.285 m 558 678.285 l S BT /F1 1 Tf 11 0 0 11 66 426.99 Tm /GS2 gs -0.0057 Tc 0.0818 Tw (Depressive Symptoms)Tj /TT2 1 Tf 10 0 0 10 84 403.65 Tm -0.0038 Tc 0.0445 Tw (The CES-D scores had values ranging from zero to 38)Tj -1.8 -1.401 TD -0.0239 Tw [(\(T)68.1(able 2\). Men had lower mean CES-D scores than women,)]TJ 0 -1.398 TD -0.0031 Tc -0.0271 Tw (but the difference was not statistically significant \()Tj /TT5 1 Tf 19.89 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0027 Tc -0.03 Tw [( = 0.21\).)]TJ -20.385 -1.401 TD -0.0037 Tc 0.125 Tw [(W)94.1(e)0( also computed the percentage of individuals with and)]TJ T* -0.0405 Tw (without depression based on a CES-D score of 16 or more as)Tj 0 -1.398 TD 0.0029 Tc 0.125 Tw (an indicator of the presence of depression \(McDowell &)Tj 0 -1.401 TD -0.0043 Tc -0.0622 Tw [(Newell, 1996\). This resulted in age-adjusted estimates of the)]TJ T* -0.0038 Tc -0.0189 Tw (prevalence of depression with 12.3% in women and 6.3% in)Tj 0 -1.398 TD -0.0032 Tc -0.0214 Tw [(men. While this is an apparently large difference, it was not)]TJ 0 -1.401 TD -0.0036 Tc -0.0625 Tw (statistically significant \()Tj /TT5 1 Tf 9.39 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.004 Tc -0.0625 Tw [( = 0.31\).)]TJ /F1 1 Tf 11 0 0 11 66 245.01 Tm -0.0066 Tc 0.1363 Tw (PTSD Symptoms)Tj /TT2 1 Tf 10 0 0 10 84 221.64 Tm -0.0037 Tc -0.0129 Tw (There were no significant differences between men and)Tj -1.8 -1.398 TD -0.0053 Tc -0.0621 Tw [(women for the IES composite score or subscale scores \(T)63.7(able)]TJ 0 -1.401 TD -0.0035 Tc -0.0521 Tw [(2\). )17.6(W)94.3(e)0.1( estimated the age-adjusted prevalence of moderate to)]TJ T* -0.0265 Tw (severe PTSD symptoms using the cutoff point of 26 or more)Tj 0 -1.398 TD -0.0033 Tc -0.0567 Tw [(for the IES total score \(Corneil, Beaton, Murphy)59.7(, Johnson, &)]TJ 0 -1.401 TD -0.0116 Tc -0.0622 Tw [(Pike, 1999\). This resulted in moderate to severe PTSD symp-)]TJ T* -0.021 Tc -0.0625 Tw (tom prevalence of 28.5% for women and 31.7% for men, which)Tj 0 -1.398 TD -0.0039 Tc (were not significantly different \()Tj /TT5 1 Tf 12.615 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.004 Tc -0.0625 Tw [( = 0.67\).)]TJ /F1 1 Tf 11 0 0 11 321.99 426.99 Tm -0.005 Tc 0.0525 Tw [(Brief Symptoms In)35.9(ventor)-15.9(y)]TJ /TT2 1 Tf 10 0 0 10 339.99 403.65 Tm -0.0047 Tc -0.0625 Tw (The overall mean level of psychological distress as mea-)Tj -1.8 -1.401 TD -0.0146 Tc -0.0622 Tw (sured by the GSI was higher for women \(0.48\) than men \(0.36\))Tj 0 -1.398 TD -0.0031 Tc -0.0271 Tw (but the difference was not statistically significant \()Tj /TT5 1 Tf 19.89 0 TD -0.006 Tc 0 Tw (p )Tj /TT2 1 Tf 0.717 0 TD -0.003 Tc -0.03 Tw (= 0.13\).)Tj -20.607 -1.401 TD -0.0165 Tc -0.0625 Tw (Norms for the GSI are published in terms of mean GSI with the)Tj T* -0.0037 Tc 0.0481 Tw (mean for normal non-patients being 0.30 with standard de-)Tj 0 -1.398 TD -0.006 Tc -0.0622 Tw [(viation 0.31 \(Derogatis & Melisaratos, 1983\). The mean GSI)]TJ 0 -1.401 TD -0.0034 Tc -0.015 Tw [(for our sample was 0.42, with standard deviation 0.39. This)]TJ T* -0.0033 Tc 0.0087 Tw [(implies a higher than normal level of psychological distress)]TJ 0 -1.398 TD -0.0035 Tc -0.0339 Tw [(for our sample of police officers, with women being particu-)]TJ 0 -1.401 TD -0.0075 Tc -0.06 Tw (larly high.)Tj /F1 1 Tf 11 0 0 11 321.99 245.01 Tm -0.0054 Tc 0.047 Tw (Hardiness and Depressive Symptoms)Tj /TT2 1 Tf 10 0 0 10 339.99 221.64 Tm -0.0035 Tc 0.0425 Tw (The hardiness control dimension was significantly and)Tj -1.8 -1.398 TD 0.0044 Tc 0.125 Tw (negatively associated with depressive symptoms as mea-)Tj 0 -1.401 TD -0.0037 Tc -0.0054 Tw [(sured by the CES-D for both men and women \(T)65.3(ables 3 and)]TJ T* -0.0034 Tc -0.0481 Tw [(4\). The standardized regression coefficients for this associa-)]TJ 0 -1.464 TD -0.013 Tc -0.0615 Tw (tion were nearly the same for men \()Tj /F36 1 Tf 13.362 0 TD 0 Tw ( )Tj /TT2 1 Tf 0.714 0 TD -0.0136 Tc -0.062 Tw [(= -0.36\) and women )]TJ /F36 1 Tf 8.04 0 TD -0.013 Tc 0 Tw (\( )Tj /TT2 1 Tf 1.026 0 TD 0 Tc (=)Tj -23.142 -1.434 TD -0.01 Tc -0.0625 Tw [(-0.37\) indicating similar relationships between hardiness con-)]TJ 0 -1.401 TD -0.0035 Tc 0.0462 Tw [(trol and depressive symptoms. The control dimension was)]TJ T* 0.095 Tw (not significantly associated with the depression dimension)Tj 0 -1.398 TD -0.0123 Tc -0.0625 Tw [(of the BSI. Depressive symptoms \(CES-D\) were significantly)]TJ ET endstream endobj 290 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F24 134 0 R /F36 291 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 294 0 obj << /Length 9496 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.1187 Tw [(142 )]TJ /TT3 1 Tf 2.8312 0 TD -0.0053 Tc 0.1208 Tw (Andrew, McCanlies, Burchfiel, Charles, Hartley, Fekedulegn, & Violanti Hardiness and Psychological Distress)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0064 Tc -0.0625 Tw (negatively associated with the hardiness commitment dimen-)Tj 0 -1.464 TD -0.004 Tc -0.0117 Tw (sion for women \()Tj /TT5 1 Tf 6.765 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0033 Tc -0.0133 Tw [( < 0.0001; )]TJ /F36 1 Tf 4.269 0 TD -0.004 Tc 0 Tw ( )Tj /TT2 1 Tf 0.78 0 TD -0.0032 Tc -0.0125 Tw (= -0.69\) but not for men \()Tj /TT5 1 Tf 10.101 0 TD -0.006 Tc 0 Tw (p )Tj /TT2 1 Tf 0.729 0 TD 0 Tc (=)Tj -23.139 -1.5 TD -0.004 Tc (0.139; )Tj /F36 1 Tf 2.784 0 TD ( )Tj /TT2 1 Tf 0.825 0 TD -0.0033 Tc 0.0312 Tw [(= -0.19\). The test for interaction between sex and)]TJ -3.609 -1.434 TD -0.0039 Tc -0.0621 Tw (hardiness commitment in predicting CES-D score was statis-)Tj 0 -1.401 TD -0.0031 Tc -0.0275 Tw (tically significant \(p = 0.004\), indicating that the association)Tj T* -0.0034 Tc 0.0087 Tw (reported above for women was significantly higher than for)Tj 0 -1.398 TD -0.0036 Tc 0.1122 Tw (men. There was no association between depressive symp-)Tj 0 -1.401 TD -0.0037 Tc 0.045 Tw (toms and the hardiness challenge dimension for either men)Tj T* -0.0115 Tc -0.06 Tw (or women.)Tj /F1 1 Tf 11 0 0 11 54 576 Tm -0.0057 Tc 0.0651 Tw (Hardiness and PTSD Symptoms)Tj /TT2 1 Tf 10 0 0 10 72 552.66 Tm -0.0036 Tc -0.0235 Tw (The total IES score and the two IES subscales were sig-)Tj -1.8 -1.401 TD -0.0032 Tc -0.035 Tw (nificantly and negatively associated with the hardiness com-)Tj T* -0.0037 Tc 0.0513 Tw [(mitment dimension for women only \(T)68.3(ables 3 and 4\). )14.6(The)]TJ 0 -1.398 TD -0.0036 Tc -0.0031 Tw (intrusive subscale seemed to have a stronger contribution to)Tj 0 -1.401 TD -0.0037 Tc -0.0014 Tw (the overall association between PTSD symptoms and hardi-)Tj T* -0.0062 Tc -0.0625 Tw (ness commitment with higher standardized regression coeffi-)Tj 0 -1.464 TD -0.0034 Tc 0.02 Tw (cient \()Tj /F36 1 Tf 2.526 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 0.543 0 TD -0.0033 Tc 0.0211 Tw [( = -0.54\) relative to the contribution of the avoidant)]TJ -3.069 -1.5 TD -0.004 Tc -0.05 Tw (subscale \()Tj /F36 1 Tf 3.885 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 0.546 0 TD -0.0033 Tc -0.0539 Tw [( = -0.37\). The test for interaction between gender)]TJ -4.431 -1.434 TD -0.0038 Tc 0.045 Tw (and hardiness commitment in predicting IES score was not)Tj 0 -1.401 TD 0.05 Tw (significant \()Tj /TT5 1 Tf 4.809 0 TD -0.005 Tc 0 Tw (p )Tj /TT2 1 Tf 0.795 0 TD -0.0033 Tc 0.0507 Tw (= 0.08\); but the interaction for predicting the)Tj -5.604 -1.401 TD -0.0104 Tc -0.0613 Tw (intrusive subscale was significant \()Tj /TT5 1 Tf 13.38 0 TD -0.009 Tc 0 Tw (p )Tj /TT2 1 Tf 0.669 0 TD -0.0104 Tc -0.0633 Tw (= 0.020\), confirming that)Tj -14.049 -1.398 TD -0.0034 Tc -0.025 Tw (women had a stronger statistically significant negative asso-)Tj 0 -1.401 TD -0.0035 Tc 0.0822 Tw (ciation than men for this subscale. There were no associa-)Tj T* 0.008 Tc 0.125 Tw (tions between the IES scales and hardiness challenge or)Tj 0 -1.398 TD -0.002 Tc (hardiness control.)Tj /F1 1 Tf 11 0 0 11 54 321.99 Tm -0.0052 Tc 0.0459 Tw [(Har)13.9(diness and Brief Symptoms In)35.7(ventor)-13.4(y)]TJ /TT2 1 Tf 10 0 0 10 72 298.65 Tm -0.0115 Tc -0.0621 Tw (The GSI was significantly and negatively associated with)Tj -1.8 -1.464 TD -0.0035 Tc -0.051 Tw (hardiness commitment for men only )Tj /F36 1 Tf 14.376 0 TD -0.006 Tc 0 Tw (\()Tj /TT2 1 Tf 0.873 0 TD -0.0023 Tc -0.0517 Tw [( = -0.26, )]TJ /TT5 1 Tf 3.471 0 TD -0.004 Tc 0 Tw (p )Tj /TT2 1 Tf 0.696 0 TD -0.0036 Tc -0.0525 Tw (= 0.04\) but)Tj -19.416 -1.437 TD -0.0034 Tc 0.0717 Tw (the association for women was of roughly similar order of)Tj 0 -1.464 TD -0.0043 Tc -0.03 Tw (magnitude \()Tj /F36 1 Tf 4.731 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 0.543 0 TD -0.0027 Tc -0.0315 Tw [( = -0.31, p = 0.08\) and was not statistically sig-)]TJ -5.274 -1.434 TD -0.0031 Tc 0.0255 Tw [(nificant. This was likely due to the smaller sample size for)]TJ 0 -1.401 TD -0.0038 Tc 0.0122 Tw (women. The test for interaction between hardiness commit-)Tj T* -0.0036 Tc 0.0855 Tw (ment and gender in predicting the GSI was not significant)Tj 0 -1.398 TD 0 Tc 0 Tw (\()Tj /TT5 1 Tf 0.315 0 TD -0.021 Tc (p )Tj /TT2 1 Tf 0.651 0 TD -0.0219 Tc -0.06 Tw (= 0.15\).)Tj /F1 1 Tf 11 0 0 11 137.25 165.99 Tm 0.0207 Tc 0 Tw (DISCUSSION)Tj /TT2 1 Tf 10 0 0 10 72 142.65 Tm -0.0039 Tc -0.0079 Tw [(W)93.9(e)0( have shown that hardiness control and commitment)]TJ -1.8 -1.401 TD -0.0034 Tc -0.0609 Tw (dimensions have significant and potentially protective cross-)Tj 0 -1.398 TD -0.0035 Tc 0.1042 Tw (sectional associations with measures of psychological dis-)Tj 0 -1.401 TD -0.0456 Tw [(tress. )53.5(Also evident are significant gender dif)17.5(ferences in these)]TJ T* -0.0316 Tw (associations for depressive symptoms and PTSD symptoms,)Tj 25.5 63.402 TD -0.0039 Tc 0.0115 Tw (with significant associations among women but not men.)Tj 1.8 -2.001 TD -0.0116 Tc -0.0625 Tw (Overall, our sample of officers had a higher mean level of)Tj -1.8 -1.401 TD -0.0035 Tc -0.0171 Tw (psychological distress than did the non-patient norm sample)Tj 0 -1.398 TD -0.0104 Tc -0.0623 Tw [(from the Brief Symptom Inventory GSI police = 0.48, GSI)]TJ 0 -1.401 TD -0.0096 Tc [(norm population = 0.36 \(Derogatis & Melisaratos, 1983\). The)]TJ T* -0.0031 Tc -0.0069 Tw (overall mean level of psychological distress as measured by)Tj 0 -1.398 TD -0.0036 Tc -0.0609 Tw (the GSI was higher for women \(0.48\) than men \(0.36\) but the)Tj 0 -1.401 TD -0.0031 Tc -0.039 Tw (difference was not statistically significant \()Tj /TT5 1 Tf 16.911 0 TD -0.005 Tc 0 Tw (p )Tj /TT2 1 Tf 0.705 0 TD -0.0033 Tc -0.04 Tw (= 0.13\).)Tj -15.816 -2.001 TD -0.0035 Tc -0.031 Tw (Additional evidence of increased psychological distress)Tj -1.8 -1.398 TD 0.0096 Tc 0.125 Tw (among the police was found with depression and PTSD)Tj 0 -1.401 TD -0.0034 Tc -0.0106 Tw (scores. In this regard, the age-adjusted prevalence of female)Tj T* -0.0098 Tc -0.0621 Tw (officers who met CES-D criteria \(score of )Tj ET 500 w 476.28 -445.36 m 470.76 -445.36 l S BT 10 0 0 10 470.76 554.64 Tm -0.0105 Tc -0.0623 Tw (>16\) for depression)Tj -16.176 -1.398 TD -0.0032 Tc 0.028 Tw (was nearly twice that of male officers \(12.3% and 6.3% re-)Tj 0 -1.401 TD -0.0539 Tw [(spectively\). This result is similar to the United States general)]TJ T* -0.0033 Tc 0.125 Tw [(population studies \(Kessler)35.7(, Sonnega, Bromet, Hughes, &)]TJ 0 -1.398 TD -0.0035 Tc 0.0581 Tw (Nelson, 1995\). This gender difference in prevalence of de-)Tj 0 -1.401 TD 0.0017 Tc 0.125 Tw (pression has been reported and discussed for the Buffalo)Tj T* -0.0031 Tc -0.0239 Tw (police officers in a previous study \(Darensburg et al., 2006\).)Tj 0 -1.398 TD 0.0026 Tc 0.125 Tw [(W)97.4(omen having higher levels of depression than men has)]TJ 0 -1.401 TD -0.0074 Tc -0.0625 Tw [(been a common finding in epidemiological studies \(W)31.6(ulsin et)]TJ T* -0.0031 Tc 0.0038 Tw [(al., 2005; )17.7(W)94.7(eissman et al., 1996\). Several studies have also)]TJ 0 -1.398 TD -0.0034 Tc 0.023 Tw (reported that women with PTSD are twice as likely to have)Tj 0 -1.401 TD -0.0037 Tc 0.0216 Tw (comorbid depression and anxiety disorders when compared)Tj T* -0.0094 Tc -0.0625 Tw [(to men \(Kessler)35.6(, Sonnega, Bromet, Hughes, & Nelson, 1995\).)]TJ 1.8 -1.998 TD -0.007 Tc -0.0622 Tw (The higher prevalence of depression among women may)Tj -1.8 -1.401 TD -0.0623 Tw (be due to comorbidity with PTSD and the influence of type of)Tj T* -0.0036 Tc 0.0273 Tw [(traumatic event exposure. It has been reported that women)]TJ 0 -1.398 TD 0.0037 Tw (have differential exposure to work trauma and higher levels)Tj 0 -1.401 TD -0.0061 Tw (of stress from dealing with violent persons and dealing with)Tj T* -0.0116 Tc -0.0625 Tw (exposure to sex discrimination and prejudice \(Brown & Field-)Tj 0 -1.398 TD -0.0251 Tc -0.06 Tw (ing, 1993\).)Tj 1.8 -2.001 TD -0.0002 Tc 0.125 Tw (It has been argued that social isolation, conflict with)Tj -1.8 -1.401 TD -0.0033 Tc 0.01 Tw (colleagues, and negative group climate are relatively strong)Tj 0 -1.398 TD -0.0037 Tc 0.0357 Tw (predictors of depression in policewomen, and that manage-)Tj 0 -1.401 TD -0.0036 Tc 0.0312 Tw (ment stressors impacted female officers more than the dan-)Tj T* -0.0025 Tc 0.125 Tw (gers of police work \(Dormann & Zapf, 2002; Thompson,)Tj 0 -1.398 TD -0.0069 Tc -0.0625 Tw [(Kirk-Brown, & Brown, 2000\). Since management and social)]TJ 0 -1.401 TD 0.0049 Tc 0.125 Tw (support have been identified by women as important for)Tj T* 0.0146 Tc (achieving job satisfaction \(Harris, Moritzen, Robitshek,)Tj 0 -1.398 TD -0.0056 Tc -0.0619 Tw [(Imhof)12.4(f, & L)54.4(ynch, 2001\), these sources of stress are important)]TJ 0 -1.401 TD -0.0039 Tc -0.0625 Tw (in explaining findings that female police officers have higher)Tj T* -0.0033 Tc 0.0834 Tw (prevalence of psychological distress.)Tj 1.8 -1.998 TD -0.0091 Tc -0.0625 Tw (Managing multiple roles and dealing with work and fam-)Tj -1.8 -1.401 TD -0.0033 Tc 0.0106 Tw (ily conflict is a more common challenge for female officers)Tj T* -0.0034 Tc 0.0333 Tw (than for male officers. These stressors could lead to female)Tj ET endstream endobj 295 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 297 0 obj << /Length 7954 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (143)Tj /TT3 1 Tf 0 9.9998 -9.9998 0 80.5092 393.0354 Tm -0.0055 Tc -0.05 Tw (Table 3.)Tj -25.2 -1.2 TD -0.0049 Tc -0.0057 Tw (Associations between hardiness dimensions and psychological distress defined by CES-D, IES, and BSI scores for women.)Tj 16.65 -1.2 TD -0.0047 Tc -0.0092 Tw (Adjusted for age, education, and marital status.)Tj /F1 1 Tf 6.825 -2.598 TD -0.0056 Tc -0.0316 Tw [( Hardiness Dimension)]TJ /TT3 1 Tf -16.989 -1.5 TD -0.0047 Tc 0.0178 Tw [( )18.4( )18.4( )18.4( )18.4( )18.4( )18.4( )18.4(Challenge)-11629.7( )5.2( )5.2( )5.2( )5.2( )5.2(Commitment)-10954.7( Control)]TJ -10.8 -1.5 TD -0.0206 Tc 0.0404 Tw [(Variable)-3695.6( B)-16.7( )]TJ 11.1366 0 TD -0.0039 Tc 0.0176 Tw [(\(SE\))-1278.9( )]TJ /F24 1 Tf 0 9.9999 -9.9999 2.1255 160.488 253.5975 Tm 0 Tc 0 Tw (p)Tj /TT3 1 Tf 0 9.9998 -9.9998 0 160.488 259.0874 Tm -0.0039 Tc 0.0189 Tw [( value )]TJ /F36 1 Tf 5.01 0 TD 0 Tc 0 Tw ()Tj /TT3 1 Tf 4.071 0 TD -0.0038 Tc 0.0237 Tw [( B \(SE\))-978.8( )12.1( )12.1( )12.1( )]TJ /F24 1 Tf 0 9.9999 -9.9999 2.1255 160.488 433.3548 Tm 0 Tc 0 Tw (p)Tj /TT3 1 Tf 0 9.9998 -9.9998 0 160.488 438.8447 Tm -0.0057 Tc 0.015 Tw [( value)]TJ /F36 1 Tf 5.505 0 TD 0 Tc 0 Tw ()Tj /TT3 1 Tf 3.6 0 TD -0.0037 Tc 0.0239 Tw [( B \(SE\))-378.7( )8.6( )8.6( )8.6( )8.6( )8.6( )]TJ /F24 1 Tf 0 9.9999 -9.9999 2.1255 160.488 619.2921 Tm 0 Tc 0 Tw (p)Tj /TT3 1 Tf 0 9.9998 -9.9998 0 160.488 624.7819 Tm -0.0055 Tc 0.02 Tw [( value)-2255.5( )]TJ /F36 1 Tf 5.19 0 TD 0 Tc 0 Tw ()Tj /TT3 1 Tf -57.774 -2.2001 TD -0.0278 Tc (CES-D)Tj 9.3 0 TD -0.0116 Tc -0.07 Tw (0.39 \(0.45\))Tj 6.6 0 TD -0.0248 Tc 0 Tw [(0.388)-2385.8(0.16)]TJ /F1 1 Tf 11.325 0 TD -0.0147 Tc -0.0688 Tw [(-2.60 \(0.55\))-1439.7(<.0001)]TJ 11.286 0 TD -0.026 Tc 0 Tw (-0.69)Tj 7.164 0 TD -0.0135 Tc -0.07 Tw (-1.80 \(0.80\))Tj 6.9 0 TD -0.0258 Tc 0 Tw [(0.029)-2011.8(-0.37)]TJ /TT3 1 Tf -52.575 -2.4 TD -0.0049 Tc 0.045 Tw (IES total score)Tj 9.3 0 TD -0.0116 Tc -0.07 Tw (0.04 \(0.86\))Tj 6.6 0 TD -0.0248 Tc 0 Tw [(0.968)-2385.8(0.01)]TJ /F1 1 Tf 11.325 0 TD -0.0135 Tc -0.07 Tw (-3.59 \(1.22\))Tj 6.675 0 TD -0.0258 Tc 0 Tw [(0.006)-2236.8(-0.47)]TJ /TT3 1 Tf 11.775 0 TD -0.0136 Tc -0.07 Tw (-1.33 \(1.62\))Tj 6.9 0 TD -0.0259 Tc 0 Tw [(0.418)-2011.9(-0.14)]TJ -52.575 -1.2 TD 0 Tc 0.024 Tw [( )]TJ 0.9055 0 TD -0.0043 Tc (Intrusive)Tj 8.0945 0 TD -0.0136 Tc -0.07 Tw (-0.03 \(0.45\))Tj 6.9 0 TD -0.0259 Tc 0 Tw [(0.956)-2236.9(-0.01)]TJ /F1 1 Tf 11.325 0 TD -0.0135 Tc -0.07 Tw (-2.13 \(0.61\))Tj 6.675 0 TD -0.0258 Tc 0 Tw [(0.001)-2236.8(-0.54)]TJ /TT3 1 Tf 11.775 0 TD -0.0136 Tc -0.07 Tw (-0.73 \(0.84\))Tj 6.9 0 TD -0.0259 Tc 0 Tw [(0.392)-2011.9(-0.15)]TJ -52.575 -1.2 TD -0.0116 Tc 0.0188 Tw [( A)-6.3(v)-6.3(o)-6.4(i)-6.3(d)-6.4(a)-6.3(n)-6.4(t)-4886.6(0.06 )88.8(\(0.44\))]TJ 15.9 0 TD -0.0248 Tc 0 Tw [(0.892)-2385.8(0.02)]TJ /F1 1 Tf 11.325 0 TD -0.0135 Tc -0.07 Tw (-1.46 \(0.65\))Tj 6.675 0 TD -0.0258 Tc 0 Tw [(0.031)-2236.8(-0.37)]TJ /TT3 1 Tf 11.775 0 TD -0.0136 Tc -0.07 Tw (-0.60 \(0.82\))Tj 6.9 0 TD -0.0259 Tc 0 Tw [(0.474)-2011.9(-0.12)]TJ -52.575 -2.4 TD -0.0037 Tc 0.0186 Tw [(GSI 0.005 \(0.02\))]TJ 15.9 0 TD -0.0248 Tc 0 Tw [(0.830)-2385.8(0.04)]TJ 11.325 0 TD -0.0136 Tc -0.07 Tw (-0.07 \(0.04\))Tj 6.675 0 TD -0.0259 Tc 0 Tw [(0.077)-2236.9(-0.31)]TJ 11.775 0 TD -0.0136 Tc -0.07 Tw (-0.05 \(0.05\))Tj 6.9 0 TD -0.0259 Tc 0 Tw [(0.284)-2011.9(-0.18)]TJ -52.575 -2.535 TD -0.0046 Tc -0.0114 Tw [(Note. 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Since)]TJ 0 -1.401 TD -0.0088 Tc -0.0622 Tw (the number of female-headed, single-parent families has been)Tj 0 -1.398 TD 0.0016 Tc 0.125 Tw (increasing in recent years, it is possible that some of the)Tj 0 -1.401 TD -0.0035 Tc (female officers are heads of single-parent households and)Tj T* -0.0067 Tc -0.0621 Tw [(therefore have sole responsibility for raising children \(Kasen,)]TJ 0 -1.398 TD -0.0034 Tc -0.0291 Tw [(Cohen, Chen, & Castille, 2003\). )50.6(Added to this is shift work,)]TJ 0 -1.401 TD -0.0031 Tc 0.0822 Tw (which may place a strain upon family schedules and child)Tj T* -0.0099 Tc 0 Tw (care.)Tj 1.8 -1.998 TD -0.0035 Tc 0.0685 Tw [(Secondly)59.5(, the present results suggest that both women)]TJ -1.8 -1.401 TD -0.0032 Tc -0.0095 Tw (and men officers have equally higher levels of PTSD symp-)Tj T* -0.035 Tw (tomatology \(28.5% and 31.7% respectively\) than seen in the)Tj 0 -1.398 TD -0.0083 Tc -0.0621 Tw [(general population. )15.7(W)89.5(omen from the general population were)]TJ 0 -1.401 TD -0.008 Tc -0.0625 Tw (found to have higher PTSD rates than men \(18.3% and 10.2%)Tj T* -0.0104 Tc -0.0621 Tw [(respectively; Kessler)40.6(, 1995\). )55.6(Additionally)61.6(, the present sample)]TJ 0 -1.398 TD -0.0065 Tc -0.0623 Tw (suggests higher rates of PTSD when compared to other emer-)Tj 0 -1.401 TD -0.001 Tc 0.125 Tw (gency responders and cohorts of police officers \(Bennett,)Tj T* -0.0055 Tc -0.0622 Tw [(W)53.3(illiams, Page, Hood, & )18.5(W)95.3(oollard, 2004; Chang et al., 2003;)]TJ 0 -1.398 TD -0.0039 Tc 0.0659 Tw [(Robinson, Sigman, & )17.3(W)54.9(ilson, 1997; )14.3(W)96.9(agner)35.1(, Heinrichs, &)]TJ 0 -1.401 TD -0.0194 Tc -0.0622 Tw (Ehlert, 1998\). There are likely many factors which explain both)Tj T* -0.0032 Tc 0.015 Tw (high rates and similarity of PTSD symptom levels in police)Tj 0 -1.398 TD -0.0215 Tw (officers. First, we presently do not have data on such factors)Tj 0 -1.401 TD -0.0355 Tw (as the degree of identification with victims, frequency of ex-)Tj T* -0.003 Tc -0.0149 Tw [(posure, and coping styles. )51.1(Also, the type of traumatic expo-)]TJ 0 -1.398 TD -0.0106 Tc -0.0625 Tw (sure may explain the increased levels of PTSD in both women)Tj 0 -1.401 TD -0.0037 Tc 0.0857 Tw [(and men \(Breslau, 1998\). Other studies which considered)]TJ T* -0.003 Tc -0.0583 Tw [(these factors had contrary results. In one study)63(, female of)15(fic-)]TJ 0 -1.398 TD -0.0035 Tc 0.0825 Tw (ers reported exposure to more traumatic incidents, such as)Tj 0 -1.401 TD -0.0034 Tc -0.035 Tw (natural disasters, suicide, child and spousal abuse, than male)Tj T* -0.0093 Tc -0.0623 Tw [(of)14.7(ficers \(Martin, McKean, & )14.9(V)112.9(eltkamp, 1986\). )53.9(Also, )14.9(V)64.9(iolanti)]TJ 0 -1.398 TD -0.0226 Tc -0.0625 Tw (and Gehrke \(2004\) found a 33-fold higher risk for PTSD among)Tj 0 -1.401 TD -0.0037 Tc -0.01 Tw (female police officers who were exposed to abused children)Tj T* -0.0035 Tc 0.0117 Tw (than female officers who were not, and a 4.3-fold increased)Tj 0 -1.398 TD -0.0032 Tc -0.0475 Tw [(likelihood of PTSD when they witnessed someone dying. It)]TJ 0 -1.401 TD -0.0035 Tc -0.0137 Tw (may also be possible that PTSD symptoms mask depression)Tj T* -0.0103 Tc -0.0624 Tw [(as well \(Kessler)34.7(, Sonnega, Bromet, Hughes, & Nelson, 1995\).)]TJ /F1 1 Tf 11 0 0 11 54 207 Tm -0.0048 Tc 0.0454 Tw [(Har)14.3(diness as a Pr)11.6(otective )96.1(T)79.8(rait)]TJ /TT2 1 Tf 10 0 0 10 72 183.66 Tm -0.0032 Tc 0.1138 Tw (Of considerable interest in the present study were re-)Tj -1.8 -1.401 TD 0.006 Tc 0.125 Tw (sults concerning associations between psychological dis-)Tj T* -0.0035 Tc 0.0617 Tw [(tress and hardiness. Results in )17.5(T)70.3(able 3 indicate that female)]TJ 0 -1.398 TD -0.0038 Tc -0.0513 Tw (officers high on the commitment dimension of hardiness had)Tj 0 -1.401 TD -0.0207 Tc -0.0625 Tw (significantly lower levels of depression and PTSD. For women,)Tj T* -0.0038 Tc -0.0228 Tw (there was a negative association between hardiness commit-)Tj 0 -1.398 TD -0.0104 Tc -0.0625 Tw (ment and the overall psychological distress score \(GSI\) which)Tj 0 -1.401 TD -0.0049 Tc -0.06 Tw (approached significance \()Tj /TT5 1 Tf 10.035 0 TD -0.004 Tc 0 Tw (p )Tj /TT2 1 Tf 0.675 0 TD -0.0049 Tc -0.0624 Tw [(= 0.077\). )49.2(Also, in women the har)16.1(-)]TJ -10.71 -1.401 TD -0.0033 Tc 0.12 Tw (diness control dimension was significantly and negatively)Tj 25.5 65.1 TD -0.0121 Tc -0.0617 Tw [(associated with depression \()]TJ /TT5 1 Tf 10.725 0 TD -0.009 Tc 0 Tw (p )Tj /TT2 1 Tf 0.669 0 TD -0.0122 Tc -0.0618 Tw [(= 0.029\). In male of)11.8(ficers \(T)68.8(able)]TJ -11.394 -1.398 TD -0.0038 Tc 0.0829 Tw (4\), hardiness commitment was not associated with depres-)Tj 0 -1.401 TD -0.0035 Tc 0.0944 Tw (sion or PTSD scores, but did have a significant protective)Tj T* -0.0034 Tc -0.0486 Tw (association with the overall GSI psychological distress score)Tj 0 -1.398 TD 0 Tc 0 Tw (\()Tj /TT5 1 Tf 0.33 0 TD (p)Tj /TT2 1 Tf 0.495 0 TD -0.0033 Tc -0.0172 Tw [( = 0.041\). Similar to female officers, the hardiness control)]TJ -0.825 -1.401 TD -0.0036 Tc 0.0557 Tw [(dimension had a significant protective association with de-)]TJ T* -0.004 Tc -0.062 Tw (pressive symptoms in male officers \()Tj /TT5 1 Tf 14.295 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0041 Tc -0.0625 Tw [( = 0.006\).)]TJ -12.99 -1.998 TD -0.0033 Tc 0.0187 Tw (These results suggest that hardiness, as an overall trait,)Tj -1.8 -1.401 TD -0.0052 Tc -0.0623 Tw (may be less effective in police work for ameliorating psycho-)Tj T* -0.0036 Tc 0.0656 Tw (logical distress than are the individual dimensions of com-)Tj 0 -1.398 TD -0.0029 Tc 0.125 Tw [(mitment and control. This was especially evident among)]TJ 0 -1.401 TD -0.01 Tc -0.0625 Tw (policewomen, where only hardiness commitment was signifi-)Tj T* -0.0031 Tc 0.0669 Tw [(cantly associated with psychological distress \(T)65.9(able 3\). In)]TJ 0 -1.398 TD -0.0034 Tc -0.0522 Tw (light of these findings, it is therefore important to understand)Tj 0 -1.401 TD -0.0035 Tc 0.0244 Tw (the nature of these significant components in the context of)Tj T* -0.0126 Tc -0.06 Tw (police work.)Tj 1.8 -1.998 TD -0.0036 Tc 0.0085 Tw [(Such findings appear contrary to Maddi)53.4(s \(2002; 2004\))]TJ -1.8 -1.401 TD 0.0032 Tc 0.125 Tw (suggestion that individual hardiness components of chal-)Tj T* -0.0118 Tc -0.0625 Tw (lenge, commitment, and control by themselves are not enough)Tj 0 -1.398 TD -0.0037 Tc 0.0413 Tw [(to turn stressful changes to advantage. )53.4(According to Maddi)]TJ 0 -1.401 TD -0.0032 Tc 0.0335 Tw (\(2004\), if one is strong in commitment, she/he will stay in-)Tj T* 0.0105 Tw (volved, as that seems the best way to find what is experien-)Tj 0 -1.398 TD -0.0144 Tc -0.0625 Tw (tially interesting and meaningful. They do not become isolated)Tj 0 -1.401 TD -0.0047 Tc -0.0622 Tw (or alienated. If one is strong in control, she/he will seek influ-)Tj T* -0.0034 Tc 0.0955 Tw (ence on outcomes around them, even if difficult. If one is)Tj 0 -1.398 TD -0.0035 Tc 0.0028 Tw (strong in challenge, she/he will continue to learn from posi-)Tj 0 -1.401 TD -0.0031 Tc 0.0684 Tw (tive or negative experiences, and will be less likely threat-)Tj T* 0.0101 Tc 0.125 Tw (ened by change. Maddi \(2004\) adds that people high in)Tj 0 -1.398 TD -0.0039 Tc -0.0031 Tw (commitment but low in control and challenge are enmeshed)Tj 0 -1.401 TD -0.0622 Tw (with the people, things, and events around them, never think-)Tj T* -0.0033 Tc -0.0355 Tw (ing to have an influence through or to reflect on their experi-)Tj 0 -1.398 TD -0.003 Tc -0.0519 Tw [(ence in the interactions. )18(They would have little individuality)60(,)]TJ 0 -1.401 TD -0.0035 Tc -0.0325 Tw (and their sense of meaning would be contributed completely)Tj T* -0.003 Tc 0.0244 Tw (by the social institutions in which they are enmeshed.)Tj 1.8 -1.998 TD -0.0036 Tc -0.0322 Tw (In the context of police work, a strong enmeshment into)Tj -1.8 -1.401 TD -0.0029 Tc 0.0032 Tw (the social institution may actually be beneficial for officers,)Tj T* 0.0073 Tc 0.125 Tw (especially women. The sense of cohesiveness evident in)Tj 0 -1.398 TD -0.0032 Tc -0.002 Tw [(police work may be a factor \(V)56.8(iolanti, 1996\). )53.9(As such, this)]TJ 0 -1.401 TD -0.003 Tc 0.0488 Tw [(protection may)63(, by itself, supersede the need for individual)]TJ T* -0.0034 Tc 0.0355 Tw (officers to be high in such hardiness traits as challenge and)Tj 0 -1.398 TD -0.0126 Tc -0.0624 Tw [(control. Following )53.5(Antonovsky)44.4(s \(1990\) definition, resilience)]TJ 0 -1.401 TD -0.0035 Tc 0.0428 Tw (reflects the extent to which individuals and groups can call)Tj T* -0.0034 Tc 0.105 Tw (upon their resources and competencies in ways that allow)Tj 0 -1.398 TD -0.0056 Tc -0.0622 Tw (them to render challenging events coherent, manageable, and)Tj 0 -1.401 TD -0.0624 Tw [(meaningful. )54.5(A)56.6( police of)18.4(ficer)-35.6()51.4(s)-0.2( capacity to render challenging)]TJ T* -0.0037 Tc 0.056 Tw (experiences meaningful, coherent, and manageable reflects)Tj ET endstream endobj 301 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 303 0 obj << /Length 9085 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (145)Tj /TT2 1 Tf 10 0 0 10 66 721.65 Tm -0.0035 Tc 0.0413 Tw (the interaction of person and organizational factors. Such a)Tj 0 -1.401 TD -0.0385 Tw (model of resilience integrates person and organizational fac-)Tj 0 -1.398 TD -0.0037 Tc 0.1207 Tw (tors to provide a proactive framework for developing and)Tj 0 -1.401 TD -0.0052 Tc -0.0621 Tw [(sustaining police of)15.8(ficer resilience \(Paton, )12.8(V)63(iolanti, & Smith,)]TJ T* -0.0038 Tc 0.0027 Tw [(2003\). )53.4(Another issue to be addressed is dif)14.2(ferences between)]TJ 0 -1.398 TD -0.0055 Tc -0.0625 Tw (male and female officers in terms of the influence of commit-)Tj 0 -1.401 TD -0.0038 Tc 0.01 Tw (ment on reducing distress. Commitment, as a component of)Tj T* -0.0008 Tc 0.125 Tw (hardiness, reflects the tendency to find meaning and pur-)Tj 0 -1.398 TD -0.0031 Tc 0.0317 Tw (pose in potentially stressful events. It is speculated that po-)Tj 0 -1.401 TD 0.0154 Tc 0.125 Tw (licewomen high in commitment, despite the difficulties)Tj T* -0.0037 Tc 0.0435 Tw (experienced in a male dominated environment, recognize a)Tj 0 -1.398 TD -0.0054 Tc -0.0622 Tw [(positive side to policing and are more secure being enmeshed)]TJ 0 -1.401 TD -0.003 Tc 0.0034 Tw (in a cohesive network. The very situations that lead police-)Tj T* -0.0033 Tc 0.023 Tw (men to assume the job is stressful may in essence stimulate)Tj 0 -1.398 TD -0.0036 Tc -0.0338 Tw (the female officers with high commitment to do battle \(Hart,)Tj 0 -1.401 TD -0.0034 Tc -0.0471 Tw [(W)94.4(earing, & Headley)62.6(, 1995\). )17.7(The question then becomes one)]TJ T* -0.0035 Tc 0.1029 Tw (of individual differences and officers perceptions of their)Tj 0 -1.398 TD -0.0034 Tc 0.013 Tw (work, their status outside of work, and the amount of social)Tj 0 -1.401 TD -0.0179 Tc -0.0621 Tw (support they perceive. For the highly committed policewoman,)Tj T* 0.0088 Tc 0.125 Tw (distress can act as a catalyst for positive adaptation and)Tj 0 -1.398 TD -0.0041 Tc -0.0625 Tw [(growth \(T)64.9(edeschi & Calhoun, 1995\).)]TJ 1.8 -2.001 TD -0.0036 Tc 0.0263 Tw (The present results suggest that we should further con-)Tj -1.8 -1.401 TD 0.0432 Tw (sider the implications of elevated PTSD symptoms and de-)Tj 0 -1.398 TD 0.0367 Tc 0.125 Tw (pression in police work and the protective impact of)Tj 0 -1.401 TD -0.0033 Tc -0.061 Tw [(hardiness. )53.7(A)58.9( defining characteristic of police work is the risk)]TJ T* -0.0031 Tc 0.0593 Tw (of exposure to highly challenging and potentially threaten-)Tj 0 -1.398 TD -0.0035 Tc 0.0862 Tw (ing events capable of eliciting acute stress and posttrauma)Tj 0 -1.401 TD 0.0043 Tc 0.125 Tw [(reactions. It is important to understand that exposure to)]TJ T* -0.0035 Tc -0.0069 Tw (stress is unpredictable. Recent acts of terrorism present new)Tj 0 -1.398 TD -0.0034 Tc 0.0728 Tw (challenges and introduce new sources of risk \(Paton et al.,)Tj 0 -1.401 TD -0.0032 Tc 0.0145 Tw (2003\). In order to more effectively deal with these new and)Tj T* -0.0033 Tc 0.1081 Tw (uncertain risks in policing, better ways of promoting both)Tj 0 -1.398 TD -0.0035 Tc 0.04 Tw (personal and organization networks that enhance resiliency)Tj 0 -1.401 TD -0.0034 Tc -0.0425 Tw (become increasingly important.)Tj /F1 1 Tf 11 0 0 11 119.64 165 Tm 0.0187 Tc 0 Tw [(ACKNO)40.5(WLEDGEMENTS)]TJ /TT2 1 Tf 10 0 0 10 84 141.66 Tm -0.0034 Tc 0.0794 Tw (This work was supported by the National Institute for)Tj -1.8 -1.401 TD 0.0454 Tc 0.125 Tw (Occupational Safety and Health \(NIOSH\), grant no.)Tj T* 0.0061 Tc 0.1253 Tw [(IR03OH003772-01. )15.4(The authors would like to thank Dr)51.1(.)]TJ 0 -1.398 TD -0.0036 Tc -0.0163 Tw (Michael Kashon for his careful review of this manuscript.)Tj /F1 1 Tf 11 0 0 11 391.14 719.01 Tm 0.0033 Tc 0.1409 Tw (REFERENCE LIST)Tj /TT2 1 Tf 10 0 0 10 321 701.64 Tm -0.0032 Tc 0.0607 Tw [(Antonovsky)59.8(, )53.8(A. \(1990\). 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Qualitative dif)17.2(ferences in men)]TJ 1.2 -1.401 TD -0.0017 Tc 0.125 Tw (and women police officers' experience of occupational)Tj 0 -1.398 TD -0.003 Tc 0 Tw (stress. )Tj /TT5 1 Tf 2.691 0 TD -0.0038 Tc -0.01 Tw [(W)94.2(ork and S)32.2(t)3.2(r)32.2(ess, 7)]TJ /TT2 1 Tf 7.299 0 TD -0.0037 Tc -0.015 Tw (, 327-340.)Tj -11.19 -1.8 TD -0.0029 Tc 0.0645 Tw [(Chang, C. M., Lee, L. C., Connor)39.1(, K. M., Davidson, J. R.,)]TJ 1.2 -1.401 TD -0.0036 Tc -0.0621 Tw [(Jef)17.4(fries, K., & Lai, )14.5(T)76.2(.)0.2( J. \(2003\). Posttraumatic distress and)]TJ T* 0.12 Tw (coping strategies among rescue workers after an earth-)Tj 0 -1.398 TD -0.0043 Tc 0 Tw (quake.)Tj /TT5 1 Tf 2.616 0 TD -0.0037 Tc -0.0456 Tw [( The Journal of Nervous and Mental Disease, 191)]TJ /TT2 1 Tf 19.635 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.401 TD -0.0511 Tc (391-398.)Tj -1.2 -1.8 TD -0.0029 Tc -0.0388 Tw [(Corneil, )15.3(W)106.9(., Beaton, R., Murphy)63.1(, S., Johnson, C., & Pike, K.)]TJ 1.2 -1.401 TD -0.005 Tc -0.0621 Tw (\(1999\). Exposure to traumatic incidents and prevalence of)Tj 0 -1.398 TD -0.0058 Tc -0.062 Tw (posttraumatic stress symptomatology in urban firefighters)Tj 0 -1.401 TD -0.0026 Tc 0.125 Tw [(in two countries. )]TJ /TT5 1 Tf 7.275 0 TD -0.0031 Tc (Journal of Occupational Health Psy-)Tj -7.275 -1.401 TD -0.0111 Tc -0.0584 Tw [(chology)48.9(, 4)]TJ /TT2 1 Tf 3.951 0 TD -0.06 Tw (, 131-141.)Tj -5.151 -1.8 TD -0.0032 Tc 0.0057 Tw [(Darensbur)17.8(g, )15.5(T)76.6(., )54.5(Andrew)59.8(, M. E., Hartley)62.8(, )15.5(T)76.6(.)-2.2( )51.5(A., Burchfiel, C.)]TJ 1.2 -1.398 TD -0.0034 Tc -0.0443 Tw [(M., Fekedulegn, D., & )14.7(V)64.8(iolanti, J. M. \(2006\). Gender and)]TJ 0 -1.401 TD -0.0035 Tc 0.0964 Tw (age differences in posttraumatic stress disorder and de-)Tj T* -0.0091 Tc -0.0612 Tw [(pression among Buf)14.9(falo police of)17.9(ficers. )]TJ /TT5 1 Tf 15.411 0 TD -0.0101 Tc -0.0632 Tw [(T)57.1(raumatology)49.9(, 12)]TJ /TT2 1 Tf 6.84 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.398 TD -0.0511 Tc (220-228.)Tj -1.2 -1.8 TD -0.0149 Tc -0.0625 Tw [(Derogatis, L. R. & Melisaratos, N. \(1983\). The Brief Sympton)]TJ 1.2 -1.401 TD -0.0028 Tc 0.0339 Tw [(Inventory: )51.1(An introductory report. )]TJ /TT5 1 Tf 14.241 0 TD -0.0044 Tc 0.035 Tw (Psychological Medi-)Tj -14.241 -1.401 TD -0.0034 Tc 0.08 Tw (cine, 13, 595-605.)Tj /TT2 1 Tf -1.2 -1.8 TD -0.011 Tc -0.0625 Tw (Dormann C. & Zapf D. \(2002\). Social stressors at work, irrita-)Tj 1.2 -1.398 TD -0.0027 Tc 0.1253 Tw [(tion and depressive symptoms: )54.6(Accounting for unmea-)]TJ 0 -1.401 TD -0.0032 Tc 0.1242 Tw [(sured third variables in a multi-wave study)62.8(. )]TJ /TT5 1 Tf 18.276 0 TD -0.0044 Tc 0.125 Tw (Journal of)Tj -18.276 -1.401 TD 0.004 Tc 0.1249 Tw [(Occupational and Or)34(ganizational Psychology)52(,)]TJ /TT2 1 Tf 19.131 0 TD 0 Tc 0 Tw ( )Tj /TT5 1 Tf 0.384 0 TD -0.004 Tc (75)Tj /TT2 1 Tf 1.005 0 TD 0.0055 Tc 0.125 Tw (, 33-)Tj -20.52 -1.398 TD -0.0625 Tc 0 Tw (58.)Tj -1.2 -1.8 TD -0.0031 Tc -0.0449 Tw (Flin, R. \(1996\). )Tj /TT5 1 Tf 6.261 0 TD -0.0035 Tc -0.0469 Tw (Sitting in the hot seat. Leaders and teams for)Tj -5.061 -1.401 TD -0.0042 Tc 0.055 Tw (Critical Incident Management)Tj /TT2 1 Tf 12.105 0 TD -0.0026 Tc 0.0542 Tw [(. Chichester: )17.6(W)56.2(iley)60.4(.)]TJ ET endstream endobj 304 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 306 0 obj << /Length 11003 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.1187 Tw [(146 )]TJ /TT3 1 Tf 2.8312 0 TD -0.0053 Tc 0.1208 Tw (Andrew, McCanlies, Burchfiel, Charles, Hartley, Fekedulegn, & Violanti Hardiness and Psychological Distress)Tj /TT2 1 Tf 10 0 0 10 54 722.64 Tm -0.0157 Tc -0.0625 Tw (Funk, S. C. \(1992\). Hardiness: a review of theory and research.)Tj /TT5 1 Tf 1.2 -1.398 TD -0.0043 Tc -0.0544 Tw [(Health Psychology)49.7(, 1)70.7(1)]TJ /TT2 1 Tf 8.76 0 TD -0.0037 Tc -0.06 Tw (, 335-345.)Tj -9.96 -1.8 TD -0.0259 Tc -0.0626 Tw [(Harris, J. I., Moritzen, S. K., Robitshek, C., Imhof)13.1(f, )54.8(A., & L)55.1(ynch,)]TJ 1.2 -1.401 TD -0.0036 Tc -0.0417 Tw [(J. L. )50.6(A. \(2001\). )17.6(The comparative contributions of congru-)]TJ T* 0.0558 Tw (ence and social support in career outcomes. )Tj /TT5 1 Tf 17.901 0 TD -0.0049 Tc 0.06 Tw (The Career)Tj -17.901 -1.398 TD -0.0061 Tc -0.0596 Tw [(Development Quar)-6.1(terly)50.9(, 49)]TJ /TT2 1 Tf 10.656 0 TD -0.0054 Tc -0.065 Tw (, 314-324.)Tj -11.856 -1.8 TD -0.0115 Tc -0.0621 Tw [(Hart, P)108.5(.)-0.4( M., )12.7(W)98.3(earing, )54.7(A. J., & Headley)60.5(, B. \(1995\). Police stress)]TJ 1.2 -1.401 TD -0.0031 Tc -0.0285 Tw [(and well-being: integrating personality)62.9(, coping and daily)]TJ T* -0.0038 Tc 0.02 Tw (work experiences. )Tj /TT5 1 Tf 7.5 0 TD -0.0041 Tc 0.0213 Tw (Journal of Occupational and Organi-)Tj -7.5 -1.398 TD -0.0197 Tw [(zational Psychology)53(, 68)]TJ /TT2 1 Tf 9.399 0 TD -0.0036 Tc -0.025 Tw (, 133-256.)Tj -10.599 -1.8 TD -0.0034 Tc 0.0386 Tw [(Horowitz, M., )17.9(W)55.4(ilner)35.6(, N., & )50.9(Alvarez, )17.9(W)106.4(.)-0.1( \(1979\). Impact of)]TJ 1.2 -1.401 TD -0.0026 Tc 0.125 Tw (Event Scale: a measure of subjective stress. )Tj /TT5 1 Tf 18.42 0 TD -0.0037 Tc 0 Tw (Psychoso-)Tj -18.42 -1.401 TD -0.0106 Tc -0.06 Tw (matic Medicine)Tj /TT2 1 Tf 5.991 0 TD -0.0095 Tc -0.0625 Tw (, 41, 209-218.)Tj -7.191 -1.8 TD -0.0099 Tc -0.0613 Tw [(Janof)17.1(f-Bulman, R. \(1992\). )]TJ /TT5 1 Tf 10.38 0 TD -0.0106 Tc -0.0601 Tw [(Shatter)34.4(ed assumptions)]TJ /TT2 1 Tf 8.715 0 TD -0.0104 Tc -0.0615 Tw [(. New )35.6(Y)102.8(ork:)]TJ -17.895 -1.398 TD -0.0038 Tc 0 Tw (Free Press.)Tj -1.2 -1.8 TD -0.0083 Tc -0.0625 Tw [(Kasen, S., Cohen, P)108.7(., Chen, H., & Castille, D. \(2003\). Depres-)]TJ 1.2 -1.401 TD 0.0061 Tc 0.125 Tw (sion in adult women: age changes and cohort effects.)Tj /TT5 1 Tf T* -0.0037 Tc -0.03 Tw (American Journal of Public Health, 93,)Tj /TT2 1 Tf 15.57 0 TD -0.0043 Tc -0.035 Tw [( 2061-2066.)]TJ -16.77 -1.8 TD -0.0205 Tc -0.0622 Tw [(Kessler)33.5(, R. C., Sonnega, )57.8(A., Bromet, E., Hughes, M., & Nelson,)]TJ 1.2 -1.398 TD -0.0117 Tc -0.0625 Tw (C. B. \(1995b\). Posttraumatic stress disorder in the National)Tj 0 -1.401 TD -0.0031 Tc -0.0325 Tw [(Comorbidity Survey)59.9(.)-6.6( )]TJ /TT5 1 Tf 8.514 0 TD -0.0037 Tc -0.0323 Tw [(A)6.3(r)29.3(chives of General Psychiatry)56.1(,)-1.5( 52)]TJ /TT2 1 Tf 13.737 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.401 TD -0.0509 Tc (1048-1060.)Tj -1.2 -1.8 TD -0.0034 Tc -0.0206 Tw [(Linley)62.6(, P)104.6(.)-4( )53.6(A. & Joseph, S. \(2004\). Positive change following)]TJ 1.2 -1.398 TD 0.0075 Tc 0.1248 Tw [(trauma and adversity: a review)64.5(. )]TJ /TT5 1 Tf 13.629 0 TD 0.0061 Tc 0.1253 Tw [(Journal of T)51.1(raumatic)]TJ -13.629 -1.401 TD -0.0111 Tc -0.06 Tw (Stress, 17)Tj /TT2 1 Tf 3.726 0 TD -0.0106 Tc (, 11-21.)Tj -4.926 -1.8 TD -0.009 Tc -0.0624 Tw [(MacLeod, M. D. & Paton, D. \(1999\). Police Of)15(ficers and )18.1(V)62.2(io-)]TJ 1.2 -1.401 TD -0.0035 Tc 0.0325 Tw (lent Crime: Social psychological perspectives on impact)Tj 0 -1.398 TD -0.0032 Tc 0.058 Tw [(and recovery)62.8(. In J.M.V)56.8(iolanti & D. Paton \(Eds.\), )]TJ /TT5 1 Tf 19.971 0 TD -0.005 Tc 0 Tw (Police)Tj -19.971 -1.401 TD 0.0176 Tc 0.125 Tw (trauma: Psychological aftermath of civilian combat.)Tj /TT2 1 Tf T* -0.0114 Tc -0.0625 Tw (Springfield, Ill.: Charles C. Thomas.)Tj -1.2 -1.8 TD -0.0122 Tc [(Maddi, S. R. \(2004\). Hardiness: )47.8(An operationalization of exis-)]TJ 1.2 -1.398 TD -0.0033 Tc 0.12 Tw (tential courage. )Tj /TT5 1 Tf 6.6 0 TD -0.0041 Tc 0.1213 Tw [(Journal of Humanistic Psychology)49.9(, 44)]TJ /TT2 1 Tf 15.651 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.401 TD -0.0511 Tc (279-298.)Tj -1.2 -1.8 TD -0.0034 Tc 0.0111 Tw (Maddi, S. R. \(1990\). Issues and interventions in stress mas-)Tj 1.2 -1.401 TD -0.0028 Tc -0.0554 Tw [(tery)60.2(. In H.S.Friedman \(Ed.\), )]TJ /TT5 1 Tf 11.166 0 TD -0.0041 Tc -0.055 Tw (Personality and Disease)Tj /TT2 1 Tf 9.573 0 TD -0.003 Tc -0.06 Tw [( \(pp.)]TJ -20.739 -1.398 TD -0.0103 Tc -0.0622 Tw [(121-154\). New )32(Y)105.9(ork: John )14(W)60.5(iley & Sons.)]TJ -1.2 -1.8 TD -0.0112 Tc -0.0625 Tw (Maddi, S. R. \(2005\). Hardiness: The courage to be resilient. In)Tj 1.2 -1.401 TD -0.0135 Tc (J.C.Thomas, D. L. Segal, & M. Hersen \(Eds.\), )Tj /TT5 1 Tf 17.646 0 TD -0.0161 Tc 0 Tw (Comprehen-)Tj -17.646 -1.401 TD -0.004 Tc 0.094 Tw (sive handbook of personality and psychopathology)Tj /TT2 1 Tf 20.586 0 TD -0.0035 Tc 0.095 Tw [( \(pp.)]TJ -20.586 -1.398 TD -0.0041 Tc -0.0621 Tw [(306-321\). Hoboken, New Jersey: John )13.9(W)54.7(iley & Sons.)]TJ -1.2 -1.8 TD -0.0103 Tc -0.0623 Tw [(Maddi, S. R., Khoshaba, D. M., Persico, M., Lu, J. L., Harvey)64.7(,)]TJ 1.2 -1.401 TD -0.0106 Tc -0.0621 Tw [(R., & Bleecker)34.4(, F)73.4(.)0.2( \(2002\). )13.5(The personality construct of har)16.4(-)]TJ T* -0.0036 Tc -0.0336 Tw (diness, II: Relationships with comprehensive tests of per-)Tj 25.5 63.6 TD 0.0056 Tc 0.125 Tw [(sonality and psychopathology)59.6(.)-5.4( )]TJ /TT5 1 Tf 12.93 0 TD 0.0044 Tc [(Journal of Resear)34.4(ch in)]TJ -12.93 -1.398 TD -0.0041 Tc -0.0042 Tw [(Personality)52.9(, 36)]TJ /TT2 1 Tf 5.994 0 TD -0.0023 Tc -0.01 Tw (, 85.)Tj -7.194 -1.8 TD -0.0085 Tc -0.0622 Tw [(Martin, C. )51.6(A., McKean, H. E., & )18.6(V)113.7(eltkamp, L. J. \(1986\). Post-)]TJ 1.2 -1.401 TD -0.0625 Tw [(traumatic stress disorder in police working with victims: )51.5(A)]TJ T* -0.0005 Tc 0.125 Tw [(pilot study)65.5(.)0.5( )]TJ /TT5 1 Tf 4.935 0 TD -0.0016 Tc 0.1252 Tw [(Journal of Police Science and )19.6(Administra-)]TJ -4.935 -1.398 TD -0.0092 Tc -0.06 Tw (tion, 14)Tj /TT2 1 Tf 2.925 0 TD (, 98-101.)Tj -4.125 -1.8 TD -0.0132 Tc -0.0617 Tw (McDowell, I. & Newell, C. \(1996\). Depression)Tj /TT5 1 Tf 17.91 0 TD -0.009 Tc 0 Tw (. )Tj /TT2 1 Tf 0.414 0 TD -0.017 Tc (In)Tj /TT5 1 Tf 0.81 0 TD -0.0142 Tc -0.0625 Tw [( Measuring)]TJ -17.934 -1.401 TD -0.001 Tc 0.125 Tw (health: A guide to rating scales and questionnaires )Tj /TT2 1 Tf 21.669 0 TD -0.002 Tc 0 Tw (\(2)Tj -21.669 -1.401 TD -0.0114 Tc -0.0625 Tw (ed., pp. 238-286\). Oxford: Oxford University Press.)Tj -1.2 -1.8 TD -0.0035 Tc -0.0494 Tw (Moran, C. & Colless, E. \(1995\). Positive reactions following)Tj 1.2 -1.398 TD -0.0031 Tc 0.125 Tw (emergency and disaster responses. )Tj /TT5 1 Tf 14.421 0 TD -0.004 Tc (Disaster Prevention)Tj -14.421 -1.401 TD -0.0044 Tc -0.0275 Tw (and Management, 4)Tj /TT2 1 Tf 7.845 0 TD -0.0033 Tc -0.03 Tw (, 55-61.)Tj -9.045 -1.8 TD -0.0083 Tc -0.0622 Tw [(Paton, D. \(1994\). Disaster relief work: an assessment of train-)]TJ 1.2 -1.401 TD -0.0002 Tc 0.1241 Tw [(ing ef)14.8(fectiveness. )]TJ /TT5 1 Tf 7.479 0 TD -0.0009 Tc 0.125 Tw [(Journal of T)47.1(raumatic S)29.1(t)6.1(r)29.1(ess, 7)]TJ /TT2 1 Tf 12.561 0 TD 0.0004 Tc (, 275-)Tj -20.04 -1.398 TD -0.0583 Tc 0 Tw (288.)Tj -1.2 -1.8 TD -0.003 Tc -0.0409 Tw [(Paton, D., )18.1(V)62.2(iolanti, J. M., & Smith, L. 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Duty-)]TJ 1.2 -1.401 TD -0.0036 Tc -0.0157 Tw (related stressors and PTSD symptoms in suburban police)Tj 0 -1.398 TD -0.0033 Tc 0 Tw (officers. )Tj /TT5 1 Tf 3.489 0 TD -0.004 Tc -0.04 Tw (Psychological Reports, 81)Tj /TT2 1 Tf 10.35 0 TD -0.0036 Tc (, 835-845.)Tj /TT5 1 Tf -15.039 -1.8 TD -0.0152 Tc -0.0617 Tw [(SAS ST)68.8(A)37.6(T)25( User's Guide)]TJ /TT2 1 Tf 8.946 0 TD -0.0144 Tc -0.0623 Tw [(, )18.4(V)110.8(ersion 8 \(1999\). Cary)60.6(, NC: Sas Insti-)]TJ -7.746 -1.401 TD 0.0126 Tc 0 Tw (tute.)Tj -1.2 -1.8 TD -0.0182 Tc -0.0623 Tw (Sundin, E. C. & Horowitz, M. J. \(2002\). Impact of Event Scale:)Tj 1.2 -1.401 TD -0.0016 Tc 0.125 Tw (psychometric properties.)Tj /TT5 1 Tf 9.975 0 TD -0.0021 Tc [( British Journal of Psychiatr)-5.1(y)54.7(,)]TJ -9.975 -1.398 TD -0.0233 Tc 0 Tw (180,)Tj /TT2 1 Tf 1.659 0 TD -0.0228 Tc -0.06 Tw [( 205-209.)]TJ -2.859 -1.8 TD -0.0083 Tc -0.0625 Tw (Sundin, E. C. & Horowitz, M. J. \(2003\). 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Mitchell, PhD)Tj /F38 1 Tf 10 0 0 10 251.49 252 Tm -0.0018 Tc 0.11 Tw (Group Crisis Support )Tj /F39 1 Tf 7.41 0 TD 0.095 Tw (is a straightforward, practical guidebook for anyone providing either)Tj -7.41 -1.2 TD -0.0035 Tc 0.0167 Tw [(crucial information or crisis support services to distressed groups. More than a hundred years)]TJ T* -0.0034 Tc -0.0046 Tw (of sound crisis intervention theory and positive-outcome research back up the guidelines in the)Tj T* -0.0048 Tc 0 Tw (book. )Tj /F38 1 Tf 2.112 0 TD -0.0036 Tc (Group Crisis Support)Tj /F39 1 Tf 6.819 0 TD -0.0034 Tc -0.0004 Tw ( provides valuable information for those recently trained as well as)Tj -8.931 -1.2 TD 0.0225 Tw [(the more experienced peer support personnel and crisis intervention professionals. 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Mitchell)]TJ ET q 83.55 372 151.75 -232 re W n /Fm10 Do Q 0 0 0 0.2 k 0.99 w 1000 M 82.995 127.005 468.01 -49.01 re B* BT /TT3 1 Tf 11 0 0 11 159.9 111.51 Tm 0 0 0 1 k /GS2 gs -0.004 Tc 0.0359 Tw (Get your copy of this important new resource by ordering NOW!)Tj 2.4191 -1.0909 TD -0.0047 Tc 0.0197 Tw (Order by calling Chevron Publishing at 410-418-8002)Tj 3.2045 -1.0909 TD 0.0303 Tw (Order online at chevronpublishing.com)Tj ET /GS1 gs 66.995 456.505 491.51 -386.01 re S endstream endobj 310 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F8 36 0 R /F37 311 0 R /F38 312 0 R /F39 313 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R /TT15 314 0 R /TT16 315 0 R >> /XObject << /Fm8 316 0 R /Fm10 317 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 319 0 obj << /Length 11808 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0054 Tc 0.1187 Tw [(148 )]TJ /TT3 1 Tf 2.8312 0 TD -0.0053 Tc 0.1208 Tw (Andrew, McCanlies, Burchfiel, Charles, Hartley, Fekedulegn, & Violanti Hardiness and Psychological Distress)Tj ET /Cs9 cs 0 scn /GS1 gs 44 65 516 -36 re f 0.99 w 395.055 731.01 m 395.055 47.01 l S BT /F40 1 Tf 16 0 0 16 427.71 587.01 Tm 0 0 0 1 k /GS2 gs -0.0083 Tc -0.0625 Tw (Association of)Tj 0.7031 -1.0631 TD -0.0079 Tc 0 Tw [(T)130.4(raumatic)]TJ -1.2188 -1.0631 TD -0.0055 Tc -0.0072 Tw [(S)27.9(t)4.5(r)13.2(ess S)18.9(pecialists)]TJ /F41 1 Tf 9 0 0 9 420.21 538.71 Tm -0.0049 Tc -0.0611 Tw (An International Organization)Tj -0.9567 -1.1133 TD -0.0047 Tc 0.0426 Tw (Recognizing Standards of Excellence)Tj 0.4167 -1.11 TD -0.0043 Tc -0.0125 Tw [(I)20(n)5.3( )5.3(R)5.7(esponse, )45.7(T)113(r)20(eatment & S)9(e)-0.6(r)-21(vices)]TJ /F40 1 Tf 10 0 0 10 444.96 480.36 Tm -0.0067 Tc -0.03 Tw [(P)182.3(.O. 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The majority were cur-)]TJ T* -0.0022 Tw (rently unmarried: single \(54.0%\) and divorced or sepa-)Tj 0 -1.398 TD -0.0035 Tc 0.0919 Tw [(rated \(19.3%\). The sample was diverse in education,)]TJ 0 -1.401 TD 0.1031 Tw [(ranging from high school drop outs to college gradu-)]TJ T* -0.0073 Tc -0.0618 Tw [(ates. The mean IQ score for the sample was 89.82 \()]TJ /TT5 1 Tf 19.752 0 TD -0.011 Tc -0.065 Tw (SD =)Tj /TT2 1 Tf -19.752 -1.398 TD -0.0049 Tc -0.0625 Tw (13.48\), and the mean age was 37.49 years \()Tj /TT5 1 Tf 16.602 0 TD -0.0055 Tc (SD = )Tj /TT2 1 Tf 2.244 0 TD -0.0058 Tc 0 Tw (6.47\).)Tj /F36 1 Tf -20.646 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc -0.008 Tw (In the sample, 88 women \(50.0%\) had a history of sub-)Tj 0 -1.398 TD -0.0035 Tc -0.0418 Tw (stance use disorders, with 67 \(38.1%\) meeting the crite-)Tj 0 -1.401 TD -0.0244 Tw (ria for dependence on at least one substance. Seventeen)Tj T* 0.0392 Tw (women \(9.7%\) met the criteria for current dependence)Tj 0 -1.398 TD -0.0033 Tc -0.0394 Tw (and 3 \(1.8%\) met the criteria for current abuse.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0103 Tc -0.0625 Tw (In all, 52 women \(30.1%\) had a history of depression and)Tj 0 -1.398 TD -0.0073 Tc [(35 \(20.2%\) met criteria for a current depressive disorder)49.7(.)]TJ /F44 1 Tf 12 0 0 12 150.9 712.41 Tm /Cs19 cs 1 scn /GS1 gs -0.0058 Tc -0.0172 Tw (Emergency Mental Health Updates Jeffrey M. Lating, Editor)Tj ET 1000 M 65.995 731.505 490.51 -28.81 re S BT /TT3 1 Tf 20 0 0 20 138.15 636 Tm -0.0134 Tc 0.1375 Tw (Selected Annotated Journal Resources)Tj /TT2 1 Tf 12 0 0 12 179.4 613.65 Tm 0 0 0 1 k /GS2 gs -0.0112 Tc -0.0615 Tw (Karina E. Chapman, M.S. and Kristina Perry Lloyd, M.S.)Tj 10 0 0 10 339 547.65 Tm -0.0096 Tc -0.0625 Tw (Thirty women \(17.0%\) met criteria for current PTSD and)Tj 0 -1.401 TD -0.0109 Tc (18 \(10.2%\) met criteria for past PTSD.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0055 Tc -0.0625 Tw (One hundred and forty five women \(71.6%\) reported ex-)Tj 0 -1.401 TD -0.013 Tc -0.0621 Tw (periencing interpersonal trauma during the course of their)Tj 0 -1.398 TD -0.0153 Tc -0.0625 Tw [(lifetime. Of these, 72 women \(40.9%\) reported childhood)]TJ 0 -1.401 TD -0.0034 Tc 0.0967 Tw (sexual abuse, 62 \(35.2%\) reported childhood physical)Tj T* -0.0036 Tc -0.05 Tw (abuse, and 30 \(17.0%\) reported witnessing violence as a)Tj 0 -1.398 TD -0.0572 Tw [(child. In terms of adulthood trauma, 45 women \(31.9%\))]TJ 0 -1.401 TD -0.0099 Tc -0.0621 Tw (reported partner violence and 28 \(15.9%\) reported sexual)Tj T* 0.0148 Tc 0 Tw (assault.)Tj /TT1 1 Tf 11 0 0 11 321 389.25 Tm 0.0233 Tc (Materials)Tj /F36 1 Tf 10 0 0 10 321 373.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0052 Tc -0.0621 Tw [(The SCID-SAC )12.7(V)114(ersion \(SCID-SAC; Spitzer)39.8(,)-8.2( )15.7(W)53.7(illiams,)]TJ 0 -1.401 TD -0.0036 Tc 0.0309 Tw [(Gibbon, & First, 1992\) was used to assess )50.3(Axis I diag-)]TJ T* -0.0425 Tw [(noses according to the )]TJ /TT5 1 Tf 8.916 0 TD -0.0064 Tc 0 Tw (DSM-IV)Tj /TT2 1 Tf 3.3 0 TD -0.0032 Tc -0.0433 Tw [(. It is a modified version)]TJ -12.216 -1.398 TD -0.0037 Tc -0.0105 Tw [(of the SCID developed for detection of )50.4(Axis I disorders)]TJ 0 -1.401 TD 0.0035 Tc 0.1255 Tw [(among substance abusers based on life history)63.5(. )16(The)]TJ T* -0.0057 Tc -0.0625 Tw [(current study administered: )51.3(Alcohol Use Disorders, Psy-)]TJ 0 -1.398 TD -0.0085 Tc -0.062 Tw [(choactive Substance Use Disorders, )51.5(A)5.7(f)18.5(fective Disorders,)]TJ 0 -1.401 TD -0.0035 Tc 0.04 Tw [(Posttraumatic Stress Disorders, and Psychotic Screen.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0046 Tc -0.0618 Tw [(The Life Events Checklist of the Clinician )49.7(Administered)]TJ 0 -1.401 TD -0.0032 Tc -0.056 Tw (PTSD Scale \(Blake et al., 1990\) was used to assess type,)Tj T* -0.0053 Tc -0.0625 Tw [(frequency)60.7(, and ages of traumatic exposure. )15.7(The Conflict)]TJ 0 -1.398 TD -0.0032 Tc -0.0551 Tw [(T)73.6(actics Scale-2 \(CTS-2; S)17.8(traus, Hamby)62.8(, Boney-McCoy)59.8(,)]TJ 0 -1.401 TD -0.0037 Tc -0.0188 Tw (& Sugarman, 1996\) was used to assess partner violence)Tj T* -0.0035 Tc -0.0137 Tw [(using the Physical )50.6(Assault subscale. )53.5(A)58.7( trauma compos-)]TJ 0 -1.398 TD 0.0004 Tc 0.125 Tw (ite was created by coding five types of interpersonal)Tj 0 -1.401 TD -0.0037 Tc -0.0425 Tw (trauma \(childhood traumas, events occurring before age)Tj T* -0.0031 Tc 0.0406 Tw (18, physical abuse, adult experiences after age 18, and)Tj 0 -1.398 TD -0.0036 Tc 0.1225 Tw [(sexual assault\) as present or absent and summing the)]TJ 0 -1.401 TD -0.0034 Tc -0.0287 Tw (number of trauma types experienced.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc 0.0855 Tw [(The Child )50(Abuse Potential Inventory Form, )17(VI \(CAP;)]TJ 0 -1.401 TD -0.008 Tc -0.062 Tw [(Milner)37(, 1994\) is a 160-item self-report questionnaire that)]TJ T* -0.0047 Tc -0.0624 Tw [(assesses risk for child physical abuse. 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Elevated)]TJ 0 -1.398 TD -0.0033 Tc 0.1029 Tw (scores on this scale have consistently been associated)Tj 0 -1.401 TD -0.0036 Tc 0.0579 Tw (with problems in parent-child interactions and are risk)Tj T* 0.0045 Tc 0.125 Tw (factors of both concurrent and future physical abuse)Tj 0 -1.398 TD -0.0297 Tc -0.0593 Tw [(\(Milner)36.3(, 1994\).)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0079 Tw [(The Parental Punitiveness Scale \(PPS; Blane, Miller)35.2(, &)]TJ 0 -1.398 TD -0.0035 Tc -0.0256 Tw (Leonard, 1988\) is a 21-item self-report measure that as-)Tj 0 -1.401 TD -0.0029 Tc 0.0928 Tw (sesses parental disciplinary style and potential for pa-)Tj T* -0.0004 Tc 0.125 Tw [(rental violence. Parents estimate their most frequent)]TJ 0 -1.398 TD -0.0033 Tc 0.0794 Tw (and likely response to scenarios in which children are)Tj 0 -1.401 TD 0.0067 Tc 0.125 Tw [(misbehaving or acting aggressively)60.7(. Discipline tech-)]TJ T* -0.0037 Tc 0.0578 Tw [(niques ranging in degree of punitiveness from nothing)]TJ 0 -1.398 TD -0.0048 Tc -0.0625 Tw (to severe punishment with a lower score indicating more)Tj 0 -1.401 TD 0.0125 Tc 0 Tw (punitiveness.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0071 Tc -0.0622 Tw [(The Parent Child Conflict )16.8(T)75.7(actics Scale \(CTSPC; S)16.9(traus,)]TJ 0 -1.401 TD -0.0076 Tc -0.0624 Tw [(Hamby)64.4(, Finkelhor)31.4(, Moore, & Runyan, 1998\) was used to)]TJ T* -0.0034 Tc -0.0033 Tw (measure parental discipline practices using the Psycho-)Tj 0 -1.398 TD 0.0203 Tc 0.125 Tw [(logical )56.3(Aggression and Physical )50.3(Assault subscales.)]TJ 0 -1.401 TD -0.0033 Tc 0.0871 Tw (Prevalence scores are derived by coding all responses)Tj T* -0.0082 Tc -0.0625 Tw (with a 0 or 1 dichotomy to indicate whether the disciplin-)Tj 0 -1.398 TD -0.0043 Tc (ary tactic was ever used. 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Ex-)]TJ 0 -1.401 TD -0.0029 Tc -0.0138 Tw (clusion criteria were a\) a clear history of organic symp-)Tj T* -0.0031 Tc -0.056 Tw [(tomatology)59.9(, b\) active )54(AIDS, c\) history of head trauma to)]TJ 0 -1.398 TD 0.0142 Tc 0.125 Tw (mother or child, d\) any serious physical ailment or)Tj 0 -1.401 TD 0.002 Tc (chronic disease which would present participation in)Tj T* -0.0033 Tc 0.0313 Tw (interviewing and e\) diagnosis of a psychotic or bipolar)Tj 0 -1.398 TD -0.0031 Tc 0 Tw [(disorder)50.9(.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.003 Tc 0.0806 Tw (During the 5-year study period, a total of 506 women)Tj 0 -1.398 TD 0.0035 Tc 0.125 Tw (presenting for treatment in the OB/GYN clinic were)Tj 0 -1.401 TD -0.0031 Tc 0.002 Tw (screened for study inclusion. In all, 314 \(62%\) met the)Tj T* -0.003 Tc -0.0583 Tw (eligibility criteria and were invited to participate.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.0893 Tw (The mother completed an initial 3-hour interview and)Tj 0 -1.401 TD -0.0035 Tc 0.0337 Tw (then returned on a second occasion with her child.)Tj /F36 1 Tf 23.7 64.44 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0102 Tc -0.0625 Tw (Participant reimbursement was $100 and roundtrip travel)Tj 0 -1.398 TD 0.005 Tc 0 Tw (expenses.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0143 Tc -0.0625 Tw (Mothers were given measures of crystallized intelligence,)Tj 0 -1.398 TD -0.0034 Tc -0.01 Tw (psychiatric functioning, substance abuse, and treatment)Tj 0 -1.401 TD -0.0031 Tc 0.0807 Tw [(history)62.9(. )14.9(They also completed the parenting measures,)]TJ T* -0.0038 Tc 0.0034 Tw [(answered questions about their child)50.2(s functioning, and)]TJ 0 -1.398 TD -0.0037 Tc -0.0167 Tw (provided a urine sample.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0621 Tw (Diagnosis was determined by the Structured Clinical In-)Tj 0 -1.398 TD -0.0037 Tc -0.024 Tw [(terview for DSM-III-R/IV)125.3(, which was conducted by ex-)]TJ 0 -1.401 TD 0.0078 Tc 0.125 Tw (perienced assessors.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0086 Tc -0.0625 Tw (Based on the SCID results, women were categorized into)Tj 0 -1.401 TD -0.003 Tc 0.1118 Tw (four study groups based on their history of substance)Tj T* -0.0038 Tc 0.0158 Tw [(use disorder)35.2(, depression, and PTSD: substance use dis-)]TJ 0 -1.398 TD 0.0117 Tw [(order)38.2(, depressive disorder)35.2(, comorbid substance use and)]TJ 0 -1.401 TD 0.0002 Tc 0.1251 Tw [(depressive disorder)36.2(, and a control group without any)]TJ T* -0.0033 Tc 0.06 Tw (history of depression, substance use or PTSD.)Tj /TT1 1 Tf 11 0 0 11 309 476.25 Tm 0.0154 Tc 0 Tw [(RESUL)83.6(TS)]TJ /F36 1 Tf 10 0 0 10 309 460.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0893 Tw (There was a significant association between the inter-)Tj 0 -1.401 TD 0.0097 Tc 0.125 Tw (personal trauma category and study group, with the)Tj T* -0.004 Tc 0.1237 Tw (comorbid substance abuse-depression group reporting)Tj 0 -1.398 TD -0.0025 Tc 0.125 Tw (significantly greater overall exposure to interpersonal)Tj 0 -1.401 TD -0.0037 Tc 0.1177 Tw (trauma than the control group and with the SUD and)Tj T* -0.0035 Tc 0.0411 Tw [(depressed groups falling in between. 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There was also significantly more childhood)]TJ 0 -1.401 TD -0.0034 Tc -0.0306 Tw (physical abuse reported in the comorbid as compared to)Tj T* -0.0037 Tc 0.0625 Tw (the control group.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0059 Tc -0.0625 Tw [(A)62.3( one-way )]TJ 4.365 0 TD -0.0106 Tc -0.0597 Tw [(ANOV)124.4(A)54.6( found )]TJ 6.0195 0 TD -0.0081 Tc -0.0625 Tw [(significant dif)15.9(ferences among)]TJ -10.3845 -1.401 TD -0.0036 Tc 0.105 Tw (the four groups on trauma composite scores, with the)Tj 0 -1.398 TD -0.0003 Tc 0.125 Tw (SUD, depression, and comorbid groups showing sig-)Tj 0 -1.401 TD -0.0084 Tc -0.0625 Tw (nificantly greater levels of trauma exposure than the con-)Tj T* -0.0037 Tc 0.015 Tw (trol group.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.005 Tc -0.1083 Tw [(One-way ANOV)124(As )]TJ 7.8009 0 TD -0.0037 Tc -0.0593 Tw (were computed to determine if there)Tj -7.8009 -1.401 TD -0.0036 Tc 0.0107 Tw (were differences on parenting measures across the four)Tj 0 -1.398 TD -0.0033 Tc 0.0275 Tw [(study groups. Results show that there were significant)]TJ 0 -1.401 TD -0.0034 Tc -0.0413 Tw (differences in the CAP inventory with the SUD, depres-)Tj T* -0.0038 Tc 0.0929 Tw (sion, and comorbid groups showing greater abuse po-)Tj 0 -1.398 TD -0.0035 Tc -0.0621 Tw [(tential than the control groups. )17.6(There were, however)38.5(, no)]TJ 0 -1.401 TD -0.0034 Tc -0.0237 Tw [(significant differences among the four groups on any of)]TJ T* -0.0036 Tc 0.05 Tw (the other three parenting measures.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0421 Tw (Pearson correlations were computed to assess the rela-)Tj 0 -1.401 TD -0.0038 Tc 0.0541 Tw (tion between cumulative trauma exposure and specific)Tj 0 -1.398 TD -0.0034 Tc 0.0357 Tw (types of trauma exposure and parenting measures. The)Tj ET endstream endobj 336 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 338 0 obj << /Length 8332 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (151)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm 0.0042 Tc 0.125 Tw (trauma composite had the strongest associations and)Tj 0 -1.398 TD -0.0033 Tc -0.0621 Tw (was significantly correlated with all four parenting mea-)Tj 0 -1.401 TD -0.0101 Tc (sures, indicating that as trauma exposure increases, nega-)Tj T* -0.0035 Tc 0.0588 Tw (tive parenting scores also increase.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.125 Tw (Hierarchical multiple regression models were used to)Tj 0 -1.401 TD 0.005 Tc (assess the value of the trauma composite and PTSD)Tj 0 -1.398 TD -0.0036 Tc -0.0443 Tw (diagnosis as predictors of parenting outcomes after con-)Tj 0 -1.401 TD -0.0116 Tc -0.0625 Tw (trolling for demographic, SUD, and depression variables.)Tj T* -0.0011 Tc 0.125 Tw (The trauma composite and PTSD diagnosis were en-)Tj 0 -1.398 TD -0.0033 Tc 0.0472 Tw [(tered in the third step of the regression, and accounted)]TJ 0 -1.401 TD -0.0031 Tc -0.0082 Tw (for 4% of the variability in CAP scores, 6% of the vari-)Tj T* -0.0005 Tc 0.125 Tw (ability in psychological aggression scores, 3% of the)Tj 0 -1.398 TD -0.0029 Tc 0.1144 Tw (variability in PPS scores and 9% of the variability in)Tj 0 -1.401 TD -0.0034 Tc 0.0514 Tw [(physical discipline scores. The trauma composite was)]TJ T* -0.0032 Tc 0.0714 Tw (the only significant predictor for each dependent vari-)Tj 0 -1.398 TD -0.0081 Tc -0.0625 Tw (able, with the exception of physical discipline which was)Tj 0 -1.401 TD -0.0036 Tc -0.0585 Tw (predicted by the trauma composite and PTSD diagnosis.)Tj /TT1 1 Tf 11 0 0 11 66 466.26 Tm 0.0217 Tc 0 Tw [(CONCLUSIONS/SUMMAR)32.6(Y)]TJ /F36 1 Tf 10 0 0 10 66 450.24 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc 0.125 Tw (Findings support a significant relation between expo-)Tj 0 -1.398 TD -0.0035 Tc 0.0583 Tw (sure to interpersonal trauma and parenting difficulties.)Tj 0 -1.401 TD -0.0038 Tc -0.0283 Tw (Cumulative maternal trauma was a significant predictor)Tj T* -0.0033 Tc 0.045 Tw (of abuse potential, punitiveness, psychological aggres-)Tj 0 -1.398 TD -0.0031 Tc 0.0314 Tw (sion, and physical discipline, even after controlling for)Tj 0 -1.401 TD -0.0039 Tc 0.065 Tw (demographics and diagnostic variables.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0658 Tw (These results are consistent with the literature demon-)Tj 0 -1.401 TD -0.001 Tc 0.125 Tw (strating that complex trauma is often associated with)Tj T* -0.0033 Tc 0.0087 Tw (deficits across a range of life roles, including parenting)Tj 0 -1.398 TD -0.0026 Tc 0 Tw [(behavior)51.4(.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc -0.015 Tw (The study also supported its prediction that participants)Tj 0 -1.398 TD 0 Tc 0.125 Tw (in the SUD, depression, and comorbid groups would)Tj 0 -1.401 TD -0.0061 Tc -0.0621 Tw (report significantly higher levels of exposure to interper-)Tj T* 0.0012 Tc 0.125 Tw [(sonal trauma than those in the control group. There)]TJ 0 -1.398 TD -0.0036 Tc 0.0261 Tw (were no differences between the 3 groups and the con-)Tj 0 -1.401 TD -0.0059 Tc -0.0622 Tw (trol group in terms of noninterpersonal trauma exposure.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0432 Tw (As expected, a lifetime diagnosis of substance use and)Tj 0 -1.401 TD -0.0467 Tw (depressive disorders were significant predictors of child)Tj T* -0.001 Tc 0.125 Tw (abuse potential but were not significant predictors of)Tj 0 -1.398 TD -0.0031 Tc -0.035 Tw (punitiveness, psychological aggression, or physical dis-)Tj 0 -1.401 TD -0.0035 Tc 0.0192 Tw (cipline. Lifetime PTSD diagnosis was not significantly)Tj T* -0.0032 Tc 0.0416 Tw (related to abuse potential, punitiveness, or psychologi-)Tj 0 -1.398 TD 0.0001 Tc 0.1251 Tw [(cal aggression; however)39.1(, it was negatively correlated)]TJ 0 -1.401 TD -0.0031 Tc -0.0292 Tw [(with physical discipline. )51(A)59.1( dissociative process may ac-)]TJ T* -0.0035 Tc 0.0184 Tw (count for this finding.)Tj /F36 1 Tf 23.7 61.44 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.0186 Tw (One interpretation for the finding that diagnostic status)Tj 0 -1.398 TD 0.0019 Tc 0.125 Tw (did not significantly predict harsher parenting strate-)Tj 0 -1.401 TD -0.0032 Tc -0.01 Tw (gies is that substance use and psychiatric disorder diag-)Tj T* 0.125 Tw (noses could be considered proxies that indicate some)Tj 0 -1.398 TD -0.0029 Tc -0.0428 Tw (significant underlying factor but by themselves may not)Tj 0 -1.401 TD -0.0032 Tc 0.096 Tw (be the best way to capture the range of problems and)Tj T* -0.014 Tc -0.062 Tw (symptoms often associated with cumulative interpersonal)Tj 0 -1.398 TD -0.0169 Tc 0 Tw (trauma.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0507 Tw (In terms of emotion regulation, parenting problems may)Tj 0 -1.398 TD -0.0037 Tc 0.0736 Tw (be conceptualized in terms of disturbances in emotion)Tj 0 -1.401 TD -0.0035 Tc 0.0637 Tw [(that are not specific to depression. )50.4(Aggressive and co-)]TJ T* -0.0034 Tc 0.0871 Tw (ercive behaviors in mothers may account for negative)Tj 0 -1.398 TD 0.0421 Tw (affective states rather than depression or other specific)Tj 0 -1.401 TD 0.0066 Tc 0 Tw (disorders.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.0725 Tw (Another way of understanding the lack of relation be-)Tj 0 -1.401 TD -0.0037 Tc 0.0194 Tw [(tween diagnosis and three of the parenting outcomes is)]TJ T* -0.0036 Tc 0.0493 Tw [(to consider assessment issues. For example, consider-)]TJ 0 -1.398 TD -0.0028 Tc 0.125 Tw [(ing severity or number of symptoms of a disorder as)]TJ 0 -1.401 TD -0.0037 Tc -0.0033 Tw (opposed to dichotomous diagnostic variables may have)Tj T* -0.0029 Tc 0.0637 Tw [(yielded different findings and this study lacked a con-)]TJ 0 -1.398 TD -0.0032 Tc 0.0188 Tw [(tinuous measure of symptom severity)59.8(.)]TJ /TT1 1 Tf 11 0 0 11 321 408.24 Tm 0.0255 Tc 0 Tw [(CONTRIBUTIONS/IMPLICA)63.7(TIONS)]TJ /F36 1 Tf 10 0 0 10 321 392.25 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0542 Tw (Strengths of the study were controlling for demographic)Tj 0 -1.401 TD -0.0074 Tc -0.0622 Tw (variables \(i.e., maternal IQ, SES, and age\) that have been)Tj 0 -1.398 TD 0.0002 Tc 0.125 Tw [(shown to be associated with parenting behavior)36.2(, em-)]TJ 0 -1.401 TD -0.0026 Tc 0.1084 Tw (ploying a variety of established and psychometrically)Tj T* 0.0109 Tc 0.1249 Tw (sound measures of parenting behaviors, and a large)Tj 0 -1.398 TD -0.0093 Tc -0.06 Tw (sample size.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0625 Tw (The study adds to an important growing literature exam-)Tj 0 -1.398 TD -0.0175 Tc (ining the impact of complex trauma on interpersonal func-)Tj 0 -1.401 TD -0.0036 Tc 0.0028 Tw (tioning and the link between parental victimization and)Tj T* -0.0021 Tc 0.125 Tw (parenting behaviors.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc 0.0557 Tw (Evidence from the study suggests that parental trauma)Tj 0 -1.401 TD -0.0031 Tc -0.0608 Tw (history is significantly associated with serious parenting)Tj 0 -1.398 TD -0.0037 Tc 0.0191 Tw (problems and arrange of adverse child outcomes.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc 0.1069 Tw (There is a need for empirically based parenting skills)Tj 0 -1.398 TD -0.0035 Tc 0.1163 Tw (curricula targeting specific trauma-related difficulties,)Tj 0 -1.401 TD -0.0038 Tc 0.0657 Tw (such as regulating negative emotion and managing in-)Tj T* -0.0034 Tc 0.0088 Tw (terpersonal conflict and power dynamics.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0049 Tc -0.062 Tw (More development and incorporation of trauma-specific)Tj 0 -1.401 TD -0.0037 Tc -0.06 Tw (interventions are needed to help parents understand how)Tj 0 -1.398 TD -0.0133 Tc -0.0625 Tw (their traumatic experiences can negatively affect attitudes)Tj 0 -1.401 TD 0.0352 Tc 0.125 Tw (and behaviors to build a repertoire of alternative)Tj T* -0.0001 Tc (parenting strategies.)Tj ET endstream endobj 339 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 342 0 obj << /Length 8605 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0052 Tc 0.1209 Tw [(152 )]TJ /TT3 1 Tf 2.8388 0 TD -0.0058 Tc (Selected Annotated Journal Resources)Tj /TT1 1 Tf 11 0 0 11 54 722.64 Tm 0.0181 Tc 0 Tw (REFERENCES)Tj /TT2 1 Tf 10 0 0 10 54 706.65 Tm -0.0029 Tc 0.0763 Tw [(Blake, D.D., )15(W)97.9(eathers, F)75.1(.)14.9(W)90.1(., Nagy)60.1(, L.M., Kaloupek, D.G)120.1(.,)]TJ 1.2 -1.401 TD -0.0169 Tc -0.0619 Tw [(Klauminzer)34.1(, G)112.1(., Charney)64.1(, D., )-5.6(et al. \(1990\). )53.2(A)60.3( clinician rating)]TJ 0 -1.398 TD -0.007 Tc -0.0625 Tw (scale for assessing current and lifetime PTSD: The CAPS-)Tj 0 -1.401 TD -0.0129 Tc [(1. Behavior )17.1(Therapy)62.1(, 8, 187-188.)]TJ -1.2 -1.8 TD 0.0145 Tc 0.125 Tw [(Blane, H., Miller)38.5(, B., & Leonard, R. \(1988\). Intra- and)]TJ 1.2 -1.401 TD 0.0009 Tc 0.1253 Tw (intergenerational aspects of serious domestic violence,)Tj 0 -1.398 TD -0.0036 Tc -0.0143 Tw [(alcohol and drugs. )17.4(W)94.2(ashington, DC: National Institute of)]TJ 0 -1.401 TD 0.004 Tc 0 Tw (Justice.)Tj -1.2 -1.8 TD -0.0035 Tc -0.0326 Tw [(Milner)35.5(, J.S. \(1994\). )54(Assessing physical child abuse risk: )15(The)]TJ 1.2 -1.401 TD -0.0048 Tc -0.0617 Tw [(Child )55.2(Abuse Potential Inventory)58.2(. Clinical Psychology Re-)]TJ 0 -1.398 TD -0.0305 Tc [(view)59.5(, 14, 547-583.)]TJ -1.2 -1.8 TD -0.0352 Tc -0.062 Tw [(Spitzer)39.8(, R.L., )16(W)53.6(illiams, J.B.W)90.8(., Gibbon, M., & First, M.B. \(1992\).)]TJ 1.2 -1.401 TD -0.013 Tc -0.0625 Tw [(The Structured )-6.5(Clinical Interview for DSM-III-R \(SCID\) I.)]TJ T* -0.0033 Tc 0.0923 Tw [(History)62.7(, rationale, and description. )50.5(Archives of General)]TJ 0 -1.398 TD -0.0169 Tc -0.0634 Tw [(Psychiatry)64.1(, 49, 624-629.)]TJ -1.2 -1.8 TD -0.0028 Tc -0.0436 Tw [(S)22.4(traus, M.A., Hamby)63.2(, S.L., Boney-McCoy)63.2(, S., & Sugarman,)]TJ 1.2 -1.401 TD -0.0038 Tc 0.0287 Tw [(D.B. \(1996\). )15.4(The revised Conflict )12.9(T)73(actic Scales \(CTS2\):)]TJ T* -0.0034 Tc -0.062 Tw (Development and preliminary psychometric data. Journal)Tj 0 -1.398 TD -0.0136 Tc -0.0625 Tw (of Family Issues, 17, 283-316.)Tj -1.2 -1.8 TD -0.0033 Tc 0.0493 Tw [(S)21.9(traus, M.A., Hamby)62.7(, S.L., Finkelhor)35.7(, D., Moore, D.W)86.7(., &)]TJ 1.2 -1.401 TD -0.0227 Tc -0.0622 Tw [(Runyan, D. \(1998\). )-5.2(Identification of child maltreatment with)]TJ T* -0.0056 Tc -0.0625 Tw [(the Parent-Child Conflict )18.4(T)71.2(actics Scales \(CTSPC\): Devel-)]TJ 0 -1.398 TD -0.0034 Tc 0.0856 Tw (opment and psychometric data for a national sample of)Tj 0 -1.401 TD -0.0047 Tc -0.0621 Tw [(American parents. Child )55.3(Abuse and Neglect, 22, 249-270.)]TJ ET 3.99 w /GS1 gs 54 310.995 m 291 310.995 l S BT /TT1 1 Tf 11 0 0 11 54 291.99 Tm /GS2 gs 0.0597 Tc 0.1665 Tw [(Mueser)87(, K. )16.3(T)77.6(., Rosenberg, S. D., Haiyi, X.,)]TJ 0 -1.1809 TD 0.0175 Tc 0.1254 Tw [(Jankowski, M. K., Boton, E. E., )12.2(W)63(eili, L. et al.)]TJ T* -0.0031 Tc 0.0688 Tw [(\(2008\). )51.3(A)59.1( randomized contr)13.3(olled trial of cognitive-)]TJ 0 -1.1836 TD -0.003 Tc 0.0891 Tw (behavioral treatment for posttraumatic stress dis-)Tj 0 -1.1809 TD 0.0233 Tc 0.1245 Tw (order in severe mental illness. )Tj /TT4 1 Tf 14.31 0 TD 0.0223 Tc 0.1273 Tw (Journal of Con-)Tj ET 0.99 w /GS1 gs 54 218.505 m 291 218.505 l S BT 11 0 0 11 54 227.01 Tm /GS2 gs 0.0036 Tc 0.125 Tw [(sulting and Clinical Psychology)30.9(, 76)]TJ /TT1 1 Tf 15.1855 0 TD 0.004 Tc 0.1273 Tw (, 259-271.)Tj -15.1855 -2.9782 TD -0.008 Tc 0.1236 Tw [(TYPE OF)27.5( )46.5(A)10(R)27.5(TICLE)]TJ /F36 1 Tf 10 0 0 10 54 178.26 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0089 Tc -0.0625 Tw (Original empirical investigation)Tj /TT1 1 Tf 11 0 0 11 54 147.84 Tm 0.0066 Tc 0.126 Tw [(OBJECTIVE/PURPOSE OF)31.1( )14.4(THE )47.8(A)13.7(R)28.4(TICLE)]TJ /F36 1 Tf 10 0 0 10 54 131.85 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.0186 Tw (The authors conducted a randomized controlled trial to)Tj 0 -1.401 TD -0.0034 Tc 0.0557 Tw (evaluate an intervention they developed to treat PTSD)Tj 0 -1.398 TD -0.0036 Tc -0.0269 Tw [(in individuals with severe mental illness.)]TJ /TT1 1 Tf 11 0 0 11 309 722.64 Tm -0.0001 Tc 0.125 Tw (METHODS STUDY 1)Tj 0 -1.4536 TD 0.0026 Tc 0 Tw (Participants)Tj /F36 1 Tf 10 0 0 10 309 690.66 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0105 Tc -0.0624 Tw [(Out of 270 clients referred to the study)58.5(, 108 met inclusion)]TJ 0 -1.401 TD -0.0034 Tc -0.0041 Tw (criteria, provided consent, and were randomly assigned)Tj T* -0.0074 Tc -0.0625 Tw (to Cognitive-Behavioral Therapy \(CBT\) or Treatment as)Tj 0 -1.398 TD -0.0041 Tc -0.0585 Tw [(Usual group \(T)73.9(AU\). )17.2(There were no dif)13.9(ferences between)]TJ 0 -1.401 TD -0.0034 Tc 0.0001 Tw (the groups on any demographic, diagnostic, or baseline)Tj T* -0.0036 Tc 0.0321 Tw (measures or in the rates of follow-up assessments.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0082 Tc -0.0622 Tw (Inclusion criteria for participation were: a\) minimum age)Tj 0 -1.401 TD -0.003 Tc -0.002 Tw (of 18 years, b\) designation by the states of New Hamp-)Tj 0 -1.398 TD -0.0034 Tc 0.086 Tw [(shire or )17.5(V)112.8(ermont as having a severe mental illness, c\))]TJ /TT5 1 Tf 0 -1.401 TD -0.0094 Tc 0 Tw (DSM-IV)Tj /TT2 1 Tf 3.285 0 TD -0.0062 Tc -0.0625 Tw [( diagnosis of major depression, bipolar disorder)38.8(,)]TJ -3.285 -1.401 TD 0.0038 Tc 0.1252 Tw [(schizoaf)15.8(fective disorder)39.8(, or schizophrenia, d\) current)]TJ /TT5 1 Tf 0 -1.398 TD -0.0105 Tc 0 Tw (DSM-IV )Tj /TT2 1 Tf 3.456 0 TD -0.0086 Tc -0.0625 Tw (diagnosis of PTSD, and e\) legal ability and will-)Tj -3.456 -1.401 TD -0.0036 Tc 0.0467 Tw (ingness to provide informed consent to participate.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc -0.0125 Tw (Exclusion criteria were a\) psychiatric hospitalization or)Tj 0 -1.401 TD -0.0036 Tc 0.0078 Tw (suicide attempt within the past 3 months and b\) current)Tj /TT5 1 Tf T* -0.0038 Tc 0 Tw (DSM-IV )Tj /TT2 1 Tf 3.69 0 TD -0.0011 Tc 0.125 Tw (substance dependence.)Tj /TT1 1 Tf 11 0 0 11 309 446.25 Tm 0.0233 Tc 0 Tw (Materials)Tj /F36 1 Tf 10 0 0 10 309 430.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc 0.0588 Tw (Axis I psychiatric disorders other than PTSD were as-)Tj 0 -1.401 TD -0.0035 Tc 0.0107 Tw (sessed with the Structured Clinical Interview for )Tj /TT5 1 Tf 19.536 0 TD -0.0081 Tc 0 Tw (DSM-)Tj -19.536 -1.401 TD -0.0198 Tc [(IV)13.2( )]TJ /TT2 1 Tf 1.071 0 TD -0.0155 Tc -0.0621 Tw [(\(SCID-I; First, Spitzer)35.5(, Gibbon, & )14.5(W)55.3(illiams, 1996\) and)]TJ -1.071 -1.398 TD -0.0024 Tc 0.125 Tw (borderline personality disorder was assessed with the)Tj 0 -1.401 TD -0.0037 Tc -0.0258 Tw [(SCID-II \(First, Spitzer)35.3(, Gibbon, )17.3(W)55.1(illiams, & Benjamin,)]TJ T* -0.0005 Tc 0.125 Tw [(1994\). SCID assessments were only administered at)]TJ 0 -1.398 TD -0.0002 Tc 0 Tw (baseline.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD 0.014 Tc 0.125 Tw (History of trauma exposure was evaluated with the)Tj 0 -1.398 TD -0.0057 Tc -0.0622 Tw [(Trauma History Questionnaire \(Green, 1996\). PTSD di-)]TJ 0 -1.401 TD 0.0012 Tc 0.125 Tw (agnoses and symptom severity were based on CAPS)Tj T* -0.003 Tc -0.0525 Tw (\(Blake et al., 1995\), a widely used, semistructured inter-)Tj 0 -1.398 TD -0.0034 Tc -0.0365 Tw [(view for the assessment of PTSD. For each symptom, a)]TJ 0 -1.401 TD -0.003 Tc 0.01 Tw (frequency and intensity rating is provided, with overall)Tj T* 0.0021 Tc 0.125 Tw (severity scores computed by summing the frequency)Tj 0 -1.398 TD 0.0099 Tc (and intensity scores for all of the PTSD symptoms.)Tj 0 -1.401 TD -0.0104 Tc -0.0622 Tw [(Trauma-related cognitions were evaluated with the Post-)]TJ T* -0.0169 Tc -0.0624 Tw [(traumatic Cognitions Inventory \(Foa, Ehlers, Clark, )19.2(T)71.9(olin,)]TJ 0 -1.398 TD -0.0089 Tc -0.0625 Tw (& Orsillo, 1999\), a self-report measure of common nega-)Tj 0 -1.401 TD -0.0034 Tc 0.0738 Tw (tive beliefs about oneself, other people, and the world)Tj T* -0.0054 Tc -0.0624 Tw [(that frequently occur in people with PTSD. Understand-)]TJ 0 -1.398 TD -0.0041 Tc 0.0675 Tw (ing of PTSD was assessed with the PTSD Knowledge)Tj 0 -1.401 TD -0.0036 Tc -0.0386 Tw [(T)73.2(est, which contains 15 multiple choice questions about)]TJ T* -0.0363 Tc 0 Tw (PTSD.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.1225 Tw (Overall psychiatric symptoms were assessed with the)Tj 0 -1.401 TD -0.0034 Tc 0.0243 Tw (expanded version of the Brief Psychiatric Rating Scale)Tj ET endstream endobj 343 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 345 0 obj << /Length 9480 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (153)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm -0.0036 Tc -0.0231 Tw [(\(Lukof)17.4(f, Nuechterlein, & )17.6(V)112.6(entura, 1986\). Self-reported)]TJ 0 -1.398 TD -0.0034 Tc 0.1138 Tw (depression and anxiety were rated with the Beck De-)Tj 0 -1.401 TD -0.0109 Tc -0.0621 Tw [(pression Inventory II \(Beck, S)13.1(teer)37.1(, & Brown, 1996\) and)]TJ T* -0.0032 Tc -0.0504 Tw [(the Beck )51(Anxiety Inventory \(Beck & S)17.8(teer)35.8(, 1990\). Self-)]TJ 0 -1.398 TD -0.0034 Tc 0.125 Tw (reported mental health and physical functioning were)Tj 0 -1.401 TD -0.0044 Tc -0.0626 Tw [(also assessed with the Short-Form 12 \(W)79.6(are, Kosinski,)]TJ T* -0.0297 Tc -0.0624 Tw [(& Keller)39.3(, 1994\).)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0077 Tc -0.0625 Tw (The therapeutic alliance with the case manager was rated)Tj 0 -1.401 TD -0.0037 Tc 0.0127 Tw [(using the client version of the )17.5(W)94.1(orking )50.5(Alliance Inven-)]TJ 0 -1.398 TD -0.0071 Tc -0.0625 Tw (tory \(Horvath & Greenberg, 1989\).)Tj /TT1 1 Tf 11 0 0 11 66 564.24 Tm 0.0242 Tc 0 Tw (Procedure)Tj /F36 1 Tf 10 0 0 10 66 548.25 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0971 Tw [(All assessments were conducted by master)-39.6()53.4(s)-0.2( or Ph.D.)]TJ 0 -1.401 TD -0.0163 Tc -0.0621 Tw (level-trained clinical interviewers who were blind to treat-)Tj 0 -1.398 TD 0.032 Tc 0.1249 Tw [(ment assignment. )46.9(Assessments were conducted at)]TJ 0 -1.401 TD -0.0036 Tc 0.0535 Tw (baseline, following the 4- to 6-month treatment period)Tj T* -0.0038 Tc -0.0355 Tw [(for the CBT)14.2( program, and 3 and 6 months later)50.2(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.0083 Tw (All clients were receiving comprehensive treatment for)Tj 0 -1.401 TD -0.003 Tc 0.0065 Tw (their psychiatric illness at their local community health)Tj 0 -1.398 TD -0.0036 Tc 0.0107 Tw (center and continued to receive those services through-)Tj 0 -1.401 TD -0.0091 Tc -0.0625 Tw (out the study period, regardless of which treatment group)Tj T* -0.0035 Tc 0.0467 Tw (they were assigned. Comprehensive mental health ser-)Tj 0 -1.398 TD -0.0039 Tc -0.006 Tw (vices included pharmacological treatment and monitor-)Tj 0 -1.401 TD 0.0249 Tc 0.125 Tw (ing, case management, supportive counseling, and)Tj T* -0.0033 Tc 0.0363 Tw (access to psychiatric rehabilitation programs.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc 0.0538 Tw (Those assigned to the PTSD program participated in a)Tj 0 -1.401 TD -0.0242 Tw (12-16 week structured program that provided handouts,)Tj 0 -1.398 TD -0.0028 Tc 0.125 Tw (worksheets, and homework assignments. 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CBT was also more ef-)Tj T* -0.0034 Tc 0.0001 Tw [(fective than )14.7(T)82.4(AU at reducing depression, anxiety)62.6(, other)]TJ 0 -1.398 TD -0.0031 Tc 0.097 Tw (psychiatric symptoms, and health-related concerns, as)Tj 0 -1.401 TD -0.0036 Tc -0.0219 Tw (well as improving the working alliance between the cli-)Tj T* -0.0039 Tc 0.025 Tw [(ent and case manager)50.1(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0039 Tc 0.045 Tw (Higher rates of homework completion were associated)Tj 0 -1.401 TD -0.0112 Tc -0.0625 Tw (with greater improvements in symptoms, perceived men-)Tj 0 -1.398 TD -0.0034 Tc 0.09 Tw (tal health, negative trauma-related beliefs, and shorter)Tj 0 -1.401 TD -0.0033 Tc -0.0349 Tw [(time to complete therapy)59.7(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc -0.0238 Tw (An interaction effect was found for PTSD severity such)Tj 0 -1.401 TD -0.0039 Tc -0.0562 Tw [(that clients with severe PTSD benefited more from CBT)]TJ T* -0.004 Tc -0.0513 Tw (than those with mild-moderate PTSD.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.1159 Tw (Analysis testing whether changes in negative trauma-)Tj 0 -1.401 TD -0.0037 Tc 0.015 Tw (related beliefs mediated improvements in PTSD symp-)Tj 0 -1.398 TD -0.0009 Tc 0.125 Tw (tom severity following CBT showed that CBT had a)Tj 0 -1.401 TD -0.0035 Tc -0.005 Tw (significant effect on trauma-related beliefs \(Step 1\) and)Tj T* -0.0073 Tc -0.0623 Tw [(on PTSD severity \(S)19.7(tep 2\). Finally)61.7(, when trauma-related)]TJ 0 -1.398 TD -0.0033 Tc 0.0411 Tw (beliefs was added to the statistical model, the effect of)Tj 0 -1.401 TD -0.0188 Tc -0.0624 Tw [(CBT on PTSD severity was no longer significant, whereas)]TJ T* -0.0198 Tc -0.0625 Tw (trauma-related beliefs and PTSD were highly significantly)Tj 0 -1.398 TD -0.0033 Tc -0.0114 Tw (related \(Step 3\), supporting the hypothesis that changes)Tj 0 -1.401 TD -0.0036 Tc 0.0125 Tw (in trauma-related beliefs over the course of CBT medi-)Tj T* -0.0033 Tc 0 Tw [(ated reductions in PTSD symptom severity)59.7(.)]TJ /TT1 1 Tf 11 0 0 11 321 278.25 Tm 0.0217 Tc [(CONCLUSIONS/SUMMAR)32.6(Y)]TJ /F36 1 Tf 10 0 0 10 321 262.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0086 Tw (Clients in CBT improved significantly more than those)Tj 0 -1.401 TD 0.0676 Tw [(in )17.5(T)82.2(AU on PTSD symptoms and a range of other out-)]TJ T* -0.0005 Tc 0.125 Tw (comes, suggesting that despite the multitude of chal-)Tj 0 -1.398 TD -0.0032 Tc 0.0862 Tw (lenges faced by clients with severe mental illness and)Tj 0 -1.401 TD -0.0033 Tc -0.0156 Tw (PTSD, CBT can be effective in reducing the severity of)Tj T* -0.0032 Tc -0.025 Tw (their symptoms.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.1158 Tw (The interaction between PTSD severity and improve-)Tj 0 -1.401 TD -0.004 Tc 0.0743 Tw (ment with CBT suggests that the CBT program might)Tj 0 -1.398 TD -0.0035 Tc -0.0077 Tw (better be directed at clients with severe PTSD, which is)Tj 0 -1.401 TD -0.0034 Tc -0.0288 Tw (often three quarters of clients with severe mental illness)Tj T* -0.0068 Tc -0.06 Tw (and PTSD.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0009 Tc 0.125 Tw (Higher rates of homework completion contributed to)Tj 0 -1.401 TD -0.0037 Tc 0.0143 Tw (better outcomes in the CBT program, including greater)Tj 0 -1.398 TD -0.0038 Tc 0.01 Tw (improvements in PTSD symptoms and diagnosis, post-)Tj ET endstream endobj 346 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 348 0 obj << /Length 9194 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0052 Tc 0.1209 Tw [(154 )]TJ /TT3 1 Tf 2.8388 0 TD -0.0058 Tc (Selected Annotated Journal Resources)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm -0.004 Tc -0.0621 Tw [(traumatic cognitions, depression, anxiety)62(, and perceived)]TJ 0 -1.398 TD -0.0034 Tc 0.1013 Tw [(mental health functioning, with effect sizes of .95 for)]TJ 0 -1.401 TD -0.003 Tc -0.0529 Tw [(PTSD severity)63(, .97 for depression, and .65 for anxiety)60(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc -0.0172 Tw (The mediation analysis was consistent with the hypoth-)Tj 0 -1.401 TD -0.0035 Tc 0.0972 Tw (esis that changes in negative trauma-related beliefs in)Tj T* -0.0096 Tc -0.0617 Tw (CBT improved PTSD symptoms.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0068 Tc -0.0622 Tw (While the CBT program led to significant improvements)Tj 0 -1.401 TD -0.0091 Tc -0.0625 Tw (in PTSD and other symptoms, in the overall sample it did)Tj 0 -1.398 TD -0.0033 Tc -0.0168 Tw (not result in significantly greater reduction of PTSD di-)Tj 0 -1.401 TD -0.0035 Tc -0.0137 Tw [(agnosis, and symptoms remained in the moderate to se-)]TJ T* -0.0037 Tc 0.0736 Tw (vere range at posttreatment and follow-up clients who)Tj 0 -1.398 TD -0.004 Tc -0.0312 Tw [(received CBT)71(. )14.5(The findings suggest that CBT)14( results in)]TJ 0 -1.401 TD -0.0054 Tc -0.0625 Tw (clinically significant improvements for some clients, but)Tj T* -0.0032 Tc 0.0034 Tw (many still experience persistent and severe symptoms.)Tj /TT1 1 Tf 11 0 0 11 54 506.25 Tm 0.0255 Tc 0 Tw [(CONTRIBUTIONS/IMPLICA)63.7(TIONS)]TJ /F36 1 Tf 10 0 0 10 54 490.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.055 Tw (Over 90% of the clients who participated in this study)Tj 0 -1.401 TD -0.0229 Tw (had prior psychiatric hospitalizations and most were re-)Tj T* 0.003 Tc 0.125 Tw (ceiving Social Security entitlements because of their)Tj 0 -1.398 TD -0.0035 Tc 0.0378 Tw [(mental illness. Despite the chronic and disabled nature)]TJ 0 -1.401 TD -0.0028 Tc -0.0472 Tw (of the study population, they were successfully engaged)Tj T* -0.0248 Tc -0.0623 Tw (in the CBT program, with a comparable dropout rate \(19%\))Tj 0 -1.398 TD -0.0036 Tc 0.0157 Tw (to PTSD treatment studies it the general population.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0122 Tc -0.0622 Tw (Improvements in clients working alliance with their case)Tj 0 -1.398 TD -0.0032 Tc 0 Tw (manager may be due to the effects of cognitive restruc-)Tj 0 -1.401 TD 0.0001 Tc 0.125 Tw (turing on challenging beliefs related to the pervasive)Tj T* -0.0067 Tc -0.0622 Tw (interpersonal distrust often present in clients with PTSD,)Tj 0 -1.398 TD -0.0036 Tc 0.0559 Tw [(leading to improved trust in the case manager)50.4(. )17.7(Thera-)]TJ 0 -1.401 TD -0.0533 Tw (peutic alliance with the case manager has been shown to)Tj T* 0.1243 Tw (predict outcome in clients with severe mental illness.)Tj 0 -1.398 TD -0.0037 Tc 0.0156 Tw (Thus, the findings suggest that CBT could improve the)Tj 0 -1.401 TD -0.0123 Tc -0.0625 Tw (working alliance with case managers, which in turn could)Tj T* -0.0033 Tc 0.006 Tw (improve the course of psychiatric treatment.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.0606 Tw (Given the magnitude of the effect sizes for homework)Tj 0 -1.401 TD -0.0033 Tc 0.0284 Tw [(completion on PTSD severity)62.7(, depression, and anxiety)59.7(,)]TJ 0 -1.398 TD -0.0038 Tc 0.0084 Tw (strategies for increasing homework adherence could be)Tj 0 -1.401 TD -0.06 Tw (an important approach to maximizing treatment gains of)Tj T* -0.0044 Tc -0.0625 Tw (clients in the CBT for PTSD program.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.004 Tc -0.0507 Tw (Although PTSD symptoms in the CBT group improved,)Tj 0 -1.401 TD -0.0033 Tc 0.0164 Tw (the fact that they continued to experience moderate-se-)Tj 0 -1.398 TD -0.0034 Tc 0.0175 Tw (vere symptoms indicates that further work is needed to)Tj 0 -1.401 TD -0.0039 Tc 0.0689 Tw (explore whether the CBT for PTSD model can be im-)Tj T* -0.0108 Tc -0.0625 Tw (proved to make it more effective. For example, providing)Tj 25.5 60.24 TD -0.0037 Tc -0.0425 Tw (additional sessions for clients who have PTSD that does)Tj 0 -1.398 TD 0.105 Tw (not remit in 12-16 sessions or incorporating exposure)Tj 0 -1.401 TD -0.003 Tc 0.07 Tw (therapy into the approach.)Tj /TT1 1 Tf 11 0 0 11 309 664.26 Tm 0.0181 Tc 0 Tw (REFERENCES)Tj /TT2 1 Tf 10 0 0 10 309 648.24 Tm -0.0034 Tc -0.0579 Tw [(Beck, )51.5(A. )18.5(T)76.4(., & S)17.6(teer)35.6(, R. )51.5(A. \(1990\). )]TJ /TT5 1 Tf 13.44 0 TD -0.004 Tc -0.0585 Tw [(Manual for the Beck )17.3(Anxi-)]TJ -12.24 -1.398 TD -0.0037 Tc 0.0347 Tw [(ety Inventory)53.1(.)]TJ /TT2 1 Tf 5.43 0 TD 0.035 Tw [( San )50.3(Antonio, )17.3(TX: Psychological Corpora-)]TJ -5.43 -1.401 TD -0.0014 Tc 0 Tw (tion.)Tj -1.2 -1.8 TD -0.0203 Tc -0.0619 Tw [(Beck, )49.1(A. )19.1(T)80.5(., S)21.7(teer)39.7(, R. )55.1(A., & Brown, G)117.7(.)-0.5( K. \(1996\). )]TJ /TT5 1 Tf 18.111 0 TD -0.022 Tc -0.0625 Tw (Manual for the)Tj -16.911 -1.401 TD -0.0041 Tc 0.123 Tw [(Beck Depr)31.9(ession InventoryII. )]TJ /TT2 1 Tf 13.104 0 TD -0.0038 Tc 0.0731 Tw [(San Antonio, )-36(TX: )-51.4(Psy-)]TJ -13.104 -1.398 TD -0.004 Tc -0.035 Tw (chological Corporation.)Tj -1.2 -1.8 TD -0.0028 Tc -0.0404 Tw [(Blake, D. D., )18.3(W)95(eathers, F)78.2(.)-2.3( )15.3(W)107.1(., Nagy)63.2(, L. M., Kaloupek, D. G)117.2(.)-3.8(,)]TJ 1.2 -1.401 TD -0.0071 Tc -0.0612 Tw [(Charney)61.9(, D. S., & Keane, )19.7(T)78.7(.)0.5( M. \(1995\). )]TJ /TT5 1 Tf 15.24 0 TD -0.0087 Tc -0.065 Tw (Clinician adminis-)Tj -15.24 -1.401 TD -0.0044 Tc 0.0501 Tw [(ter)31.6(ed PTSD scale for DSMIV)]TJ /TT2 1 Tf 12.219 0 TD -0.0037 Tc (. Boston: National Center)Tj -12.219 -1.398 TD -0.004 Tc -0.0017 Tw [(for Posttraumatic S)14(tress Disorder)50(.)]TJ -1.2 -1.8 TD -0.0028 Tc -0.0395 Tw [(First, M. B., Spitzer)39.2(, R. L., Gibbon, M., & )18.3(W)56(illiams, J. B. )18.3(W)104(.)]TJ 1.2 -1.401 TD -0.0036 Tc 0 Tw (\(1996\). )Tj /TT5 1 Tf 3.216 0 TD -0.0038 Tc 0.076 Tw (Structured clinical interview for DSM-IV Axis-I)Tj -3.216 -1.401 TD -0.0045 Tc 0.0152 Tw [(disor)28.5(derspatient edition)]TJ /TT2 1 Tf 10.35 0 TD -0.0038 Tc 0.0198 Tw [( \(SCIDI/P)107.2(, )14(V)115.4(ersion 2.0\). New)]TJ -10.35 -1.398 TD -0.004 Tc 0.0265 Tw [(Y)103.2(ork: Biometrics Research Department, New )31.8(Y)103.2(ork S)17(tate)]TJ 0 -1.401 TD -0.0029 Tc 0.09 Tw (Psychiatric Institute.)Tj -1.2 -1.8 TD -0.0028 Tc -0.0603 Tw [(First, M. B., Spitzer)39.2(, R. L., Gibbon, M., )15.3(W)56(illiams, J. B. )18.3(W)107(., &)]TJ 1.2 -1.401 TD -0.0208 Tc -0.0617 Tw (Benjamin, L. \(1994\). )Tj /TT5 1 Tf 8.046 0 TD -0.0214 Tc -0.0625 Tw (Structured clinical interview for DSM-)Tj -8.046 -1.398 TD -0.004 Tc 0.0727 Tw [(IV)17( )18.7(Axis-II personality disor)32(ders )]TJ /TT2 1 Tf 13.041 0 TD -0.0036 Tc 0.0551 Tw [(\(SCIDII, V)115.6(ersion )-18(2.0\).)]TJ -13.041 -1.401 TD -0.0042 Tc 0.0479 Tw [(New )32.2(Y)103(ork: Biometrics Research Department, New )32.2(Y)103(ork)]TJ T* -0.003 Tc 0.055 Tw (State Psychiatric Institute.)Tj -1.2 -1.8 TD -0.023 Tc -0.0625 Tw [(Foa, E. B., Ehlers, )52(A., Clark, D. M., )16(T)71.8(olin, D. F)79(., & Orsillo, S. M.)]TJ 1.2 -1.398 TD -0.0037 Tc 0.0177 Tw (\(1999\). The Posttraumatic Cognitions Inventory \(PTCI\):)Tj 0 -1.401 TD -0.0039 Tc 0.0384 Tw (Development and validation. )Tj /TT5 1 Tf 11.841 0 TD -0.0042 Tc 0.04 Tw (Psychological Assessment,)Tj -11.841 -1.401 TD -0.101 Tc 0 Tw (11)Tj /TT2 1 Tf 0.879 0 TD -0.0216 Tc -0.06 Tw (, 303314.)Tj -2.079 -1.8 TD -0.0032 Tc 0.0963 Tw (Green, B. L. \(1996\). Trauma History Questionnaire. In B.)Tj 1.2 -1.398 TD -0.0145 Tc -0.0625 Tw (H.Stamm \(Ed.\), )Tj /TT5 1 Tf 6.246 0 TD -0.0148 Tc (Measurement of stress, self-report trauma,)Tj -6.246 -1.401 TD -0.0041 Tc 0.0825 Tw (and adaptation )Tj /TT2 1 Tf 6.441 0 TD -0.0038 Tc 0.085 Tw (\(pp. 366368\). Lutherville, MD: Sidran)Tj -6.441 -1.401 TD 0.0077 Tc 0 Tw (Press.)Tj -1.2 -1.8 TD -0.0054 Tc -0.0622 Tw [(Horvath, )54.6(A. O., & Greenber)12.6(g, L. S. \(1989\). Development and)]TJ 1.2 -1.398 TD -0.0034 Tc 0.02 Tw [(validation of the )14.6(W)97.4(orking )50.6(Alliance Inventory)62.6(. )]TJ /TT5 1 Tf 18.375 0 TD -0.0043 Tc 0.025 Tw (Journal of)Tj -18.375 -1.401 TD 0.0082 Tw [(Counseling Psychology)49.7(, 36)]TJ /TT2 1 Tf 10.776 0 TD -0.004 Tc 0.01 Tw (, 223233.)Tj -11.976 -1.8 TD -0.0094 Tc -0.0618 Tw [(Lukof)14.6(f, D., Nuechterlein, K. H., & )18(V)112.8(entura, J. \(1986\). Manual)]TJ 1.2 -1.401 TD -0.0035 Tc 0.004 Tw (for the expanded Brief Psychiatric Rating Scale \(BPRS\).)Tj /TT5 1 Tf 0 -1.398 TD -0.0041 Tc -0.015 Tw (Schizophrenia Bulletin)Tj /TT2 1 Tf 9.036 0 TD -0.0035 Tc -0.02 Tw (, 12, 594602.)Tj -10.236 -1.8 TD -0.0129 Tc -0.0619 Tw [(W)96.9(are, J. E., Kosinski, M., & Keller)38.1(, S. D. \(1994\). )]TJ /TT5 1 Tf 18.675 0 TD -0.0144 Tc -0.065 Tw (SF-36 Physi-)Tj -17.475 -1.401 TD -0.004 Tc -0.0507 Tw [(cal and Mental Health Summary Scales: )16.9(A)21.8( user)-40()128(s)0.3( manual.)]TJ ET endstream endobj 349 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 351 0 obj << /Length 8508 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (155)Tj /TT2 1 Tf 10 0 0 10 78 722.64 Tm -0.0042 Tc 0.0567 Tw [(Boston: Health )52.8(Assessment Lab.)]TJ ET 3.99 w /GS1 gs 66 712.005 m 303 712.005 l S BT /TT1 1 Tf 11 0 0 11 66 693 Tm /GS2 gs 0.0284 Tc 0.1251 Tw [(Goldstein, )20.1(T)76.3(.)0.1( R., Br)14.8(ent, D. )52.8(A., & Bridge, J. )50.1(A)5.1(.)]TJ 0 -1.1809 TD 0.027 Tc 0.125 Tw (\(2008\). Sleep disturbance preceding completed)Tj 0 -1.1836 TD 0.0047 Tc 0.1257 Tw (suicide in adolescents. )Tj /TT4 1 Tf 10.0991 0 TD 0.0039 Tc (Journal of Consulting and)Tj ET 0.99 w /GS1 gs 66 645.495 m 303 645.495 l S BT 11 0 0 11 66 654 Tm /GS2 gs 0.0055 Tc 0.1254 Tw [(Clinical Psychology)32.8(, 76)]TJ /TT1 1 Tf 10.0418 0 TD 0.0062 Tc 0.1273 Tw (, 84-91.)Tj -10.0418 -2.9782 TD -0.008 Tc 0.1236 Tw [(TYPE OF)27.5( )46.5(A)10(R)27.5(TICLE)]TJ /F36 1 Tf 10 0 0 10 66 605.25 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0112 Tc -0.0625 Tw (Original Empirical Investigation)Tj /TT1 1 Tf 11 0 0 11 66 574.86 Tm 0.0066 Tc 0.126 Tw [(OBJECTIVE/PURPOSE OF)31.1( )14.4(THE )47.8(A)13.7(R)28.4(TICLE)]TJ /F36 1 Tf 10 0 0 10 66 558.84 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.0588 Tw (This study sought to better understand the relation be-)Tj 0 -1.398 TD 0.0557 Tw (tween disturbed sleep and suicidality in adolescents in)Tj 0 -1.401 TD -0.0035 Tc 0.1019 Tw (order to inform efforts at suicide prevention with this)Tj T* 0.0048 Tc 0 Tw (population.)Tj /TT1 1 Tf 11 0 0 11 66 486.45 Tm 0.0344 Tc (METHODS)Tj 0 -1.4536 TD 0.0026 Tc (Participants)Tj /F36 1 Tf 10 0 0 10 66 454.44 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.0971 Tw (The suicide completer group consisted of 140 adoles-)Tj 0 -1.398 TD 0.0056 Tw [(cent suicide victims from 28 counties in )17.3(W)94.1(estern Penn-)]TJ 0 -1.401 TD -0.0034 Tc -0.0071 Tw (sylvania and represents 72% of all individuals assigned)Tj T* 0.004 Tw (a definite verdict of suicide between the ages of 13 and)Tj 0 -1.398 TD -0.0031 Tc -0.06 Tw (19 years.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0031 Tc 0.0615 Tw (The families were contacted by letter approximately 3)Tj 0 -1.398 TD 0.0978 Tw (months after the death and were called by the project)Tj 0 -1.401 TD -0.0036 Tc -0.0071 Tw [(coordinator a week later to schedule an interview)59.4(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.006 Tc 0.125 Tw (The 131 community controls were obtained by geo-)Tj 0 -1.401 TD -0.0038 Tc 0.1183 Tw (graphic cluster sampling of communities with similar)Tj T* -0.0035 Tc -0.014 Tw [(median income, population density)59.5(, racial composition,)]TJ 0 -1.398 TD -0.0032 Tc -0.0555 Tw [(and age distribution to those of the study victims. Fami-)]TJ 0 -1.401 TD -0.0033 Tc 0.0244 Tw (lies with an adolescent were randomly selected and in-)Tj T* -0.0034 Tc 0.0013 Tw (vited to participate. There was a 74% acceptance rate.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0031 Tc -0.034 Tw (The suicide victims had a mean age of 17.3 years \()Tj /TT5 1 Tf 19.806 0 TD -0.006 Tc -0.035 Tw (SD =)Tj /TT2 1 Tf -19.806 -1.401 TD -0.0035 Tc 0.0155 Tw [(1.9\), 95.7% were Caucasian, and 85% were male. The)]TJ 0 -1.398 TD -0.0075 Tc -0.0622 Tw (mean age of the control group was 17.5 years \()Tj /TT5 1 Tf 17.871 0 TD -0.0092 Tc -0.0625 Tw (SD = )Tj /TT2 1 Tf 2.229 0 TD -0.0083 Tc 0 Tw (1.7\),)Tj -20.1 -1.401 TD -0.0068 Tc -0.0625 Tw (100% of whom were Caucasian and 70% were male.)Tj /TT1 1 Tf 11 0 0 11 66 180.06 Tm 0.0233 Tc 0 Tw (Materials)Tj /F36 1 Tf 10 0 0 10 66 164.04 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0219 Tw [(Current )50.2(Axis I diagnoses were assessed with the Sched-)]TJ 0 -1.398 TD -0.0149 Tc -0.062 Tw [(ule for )54.2(A)5.3(f)15.1(fective Disorders and Schizophrenia for School-)]TJ 0 -1.401 TD 0.0003 Tc 0.125 Tw (Aged ChildrenPresent Episode version \(K-SADS-P;)Tj T* -0.0037 Tc -0.0529 Tw (Chambers et al., 1985\) and Epidemiological version \(K-)Tj 0 -1.398 TD -0.0076 Tc -0.0619 Tw [(SADS-E; Orvaschel, Puig-Antich, Chambers, )19.5(T)72.2(abrizi, &)]TJ 0 -1.401 TD -0.0054 Tc -0.0621 Tw (Johnson, 1982\), yielding individual item ratings for both)Tj 25.5 62.859 TD -0.0035 Tc 0.1156 Tw (the worst period during the present episode of illness)Tj 0 -1.398 TD -0.004 Tc 0.0399 Tw [(\(PE\) and the preceding week \(L)71(W\). For nondepressed)]TJ 0 -1.401 TD -0.0034 Tc -0.0271 Tw (participants, PE ratings reflect the prior 12 months.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0129 Tw (Participants were considered to have a current affective)Tj 0 -1.401 TD -0.0029 Tc -0.0265 Tw (disorder if they met full K-SADS criteria for any one of)Tj T* 0.0089 Tc 0.125 Tw (the assessed diagnoses.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0002 Tc 0.125 Tw (Sleep difficulties were assessed by consensus ratings)Tj 0 -1.401 TD -0.0036 Tc 0.0535 Tw [(of the six items pertaining to sleep from the K-SADS)]TJ 0 -1.398 TD -0.0038 Tc 0.0362 Tw [(Depression section. )50.3(A)58.4( rating of 3 or higher was used)]TJ 0 -1.401 TD -0.0034 Tc 0.0689 Tw (to indicate that the problem was present and a partici-)Tj T* 0.0047 Tc 0.125 Tw (pant was considered to have an overall sleep distur-)Tj 0 -1.398 TD -0.012 Tc -0.0623 Tw (bance if any one or more of the items was rated present.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc 0.0975 Tw (Depression severity was computed for all participants)Tj 0 -1.398 TD -0.0039 Tc 0.0707 Tw (as a mean of 10 K-SADS depression items, excluding)Tj 0 -1.401 TD -0.0059 Tc -0.0625 Tw (items that would be confounded with the analyses \(items)Tj T* -0.0035 Tc 0.008 Tw (relating to sleep and suicidal ideation\))Tj /TT1 1 Tf 11 0 0 11 321 476.25 Tm 0.0242 Tc 0 Tw (Procedure)Tj /F36 1 Tf 10 0 0 10 321 460.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0607 Tw (Parents, siblings, and friends of suicide completers were)Tj 0 -1.401 TD -0.0149 Tw [(interviewed about the victim)50.5(s)-0.4( current and past psycho-)]TJ T* 0.1158 Tw (pathology and the circumstances surrounding the sui-)Tj 0 -1.398 TD -0.0055 Tc -0.0622 Tw [(cide. The primary informant included at least one parent)]TJ 0 -1.401 TD -0.0037 Tc 0.0125 Tw (or guardian with whom the adolescent resided.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.1225 Tw (The controls and their parents participated in a semi-)Tj 0 -1.401 TD -0.0033 Tc -0.03 Tw [(structured interview with a trained master)-39.3()53.7(s)-1.4( psychology)]TJ T* 0.023 Tc 0 Tw (student.)Tj /TT1 1 Tf 11 0 0 11 321 329.85 Tm 0.0154 Tc [(RESUL)83.6(TS)]TJ /F36 1 Tf 10 0 0 10 321 313.86 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0009 Tc 0.125 Tw (Chi-square analyses indicate the rate of overall sleep)Tj 0 -1.401 TD -0.0037 Tc -0.0364 Tw (disturbance was higher for suicide completers than con-)Tj T* -0.0034 Tc -0.0078 Tw (trols, for both the week preceding death and the current)Tj 0 -1.398 TD 0.0028 Tc 0.125 Tw (depressive episode.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0375 Tw (Completers had high rates for both insomnia and hyper-)Tj 0 -1.398 TD -0.0065 Tc -0.0623 Tw [(somnia for the last week \(L)71.5(W\) as well as the past episode)]TJ 0 -1.401 TD -0.052 Tc 0 Tw (\(PE\).)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc -0.0625 Tw (Controlling for differences between groups in the rate of)Tj 0 -1.401 TD -0.0072 Tc (current affective disorder \(48% of completers vs. 10% of)Tj T* -0.0034 Tc 0.0143 Tw (controls\), the rate of overall sleep difficulties remained)Tj 0 -1.398 TD 0.005 Tw [(significantly higher among completers for both the L)71.6(W)]TJ 0 -1.401 TD -0.0033 Tc -0.0418 Tw [(and the PE. Over and above the effects of current affec-)]TJ T* -0.0125 Tc -0.0624 Tw [(tive disorder)32.5(, completers were more likely to have insom-)]TJ 0 -1.398 TD -0.0037 Tc 0.021 Tw [(nia and/or hypersomnia in the L)71.3(W)34.1( but not the PW)86.3(.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.0518 Tw [(Gender did not emerge as a significantly moderator of)]TJ 0 -1.398 TD -0.0037 Tc 0.045 Tw (the associations between sleep disturbance and suicide)Tj 0 -1.401 TD -0.012 Tw [(when controlling for current af)17.3(fective disorder)50.3(.)]TJ ET endstream endobj 352 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 354 0 obj << /Length 8522 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0052 Tc 0.1209 Tw [(156 )]TJ /TT3 1 Tf 2.8388 0 TD -0.0058 Tc (Selected Annotated Journal Resources)Tj /F36 1 Tf 10 0 0 10 54 722.64 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0261 Tc 0.125 Tw (Suicide completers had higher depressive severity)Tj 0 -1.398 TD -0.0036 Tc -0.0211 Tw [(scores than the controls for both L)71.4(W)34.2( and PE. )53.8(Adjusting)]TJ 0 -1.401 TD -0.0031 Tc -0.0374 Tw [(for depressive severity)62.9(, the rate of overall sleep dif)14.9(ficul-)]TJ T* -0.0071 Tc -0.0622 Tw (ties remained significantly elevated in completers for the)Tj 0 -1.398 TD -0.0035 Tc -0.05 Tw [(L)76.3(W)37.3( and PE with higher rates of insomnia for the L)71.5(W)34.3( but)]TJ 0 -1.401 TD -0.0034 Tc 0.0439 Tw [(not the PE. 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In the current)Tj 0 -1.398 TD 0.0018 Tc 0.1248 Tw [(study)61.8(, insomnia in the last week, but not the present)]TJ 0 -1.401 TD 0.017 Tc 0.125 Tw (depressive episode, distinguished the groups in the)Tj T* -0.003 Tc 0.06 Tw [(analyses controlling for depressive severity)60(.)]TJ /F36 1 Tf 23.7 63.48 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0029 Tc 0.125 Tw (The mechanism for this relation remains to be estab-)Tj 0 -1.398 TD 0.0023 Tc (lished. Several possibilities include that sleep distur-)Tj 0 -1.401 TD -0.0036 Tc 0.0908 Tw (bances increase suicidal risk in vulnerable individuals)Tj T* 0.003 Tc 0.125 Tw (by impairing cognitive functions such that processes)Tj 0 -1.398 TD -0.0076 Tc -0.062 Tw (including judgment and concentration are compromised.)Tj 0 -1.401 TD -0.0218 Tc -0.0621 Tw [(Similarly)56.2(, fatigue resulting from sleep dif)20.2(ficulties may lead)]TJ T* -0.0029 Tc 0.125 Tw (to hopelessness and decreased impulse control. Sleep)Tj 0 -1.398 TD 0.0026 Tc [(deprivation may also impair problem solving ability)62.6(,)]TJ 0 -1.401 TD -0.0034 Tc 0.0608 Tw (coupled with decreased capacity to regulate emotional)Tj T* -0.0063 Tc -0.0621 Tw (states when tired vulnerable adolescents may utilize lim-)Tj 0 -1.398 TD -0.0031 Tc -0.0438 Tw [(ited alternatives for coping with distress. )50.8(Alternatively)62.9(,)]TJ 0 -1.401 TD -0.0033 Tc 0.0791 Tw (sleep deprivation may activate or exacerbate suscepti-)Tj T* -0.0022 Tc 0.11 Tw [(bility to psychopathology)60.8(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0073 Tc -0.0625 Tw (Sleep difficulties in adolescents at risk for suicide should)Tj 0 -1.401 TD -0.003 Tc 0.0257 Tw (be regularly assessed, as such disturbances may render)Tj 0 -1.398 TD -0.0036 Tc 0.0194 Tw (the individual vulnerable to suicide over and above the)Tj 0 -1.401 TD -0.0027 Tc 0.0278 Tw (vulnerability conferred by the presence and severity of)Tj T* -0.0038 Tc 0.0024 Tw [(an af)17.2(fective disorder)50.2(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc 0.0587 Tw (Any acute changes in sleep patterns should alert clini-)Tj 0 -1.401 TD -0.0028 Tc 0.046 Tw (cians to carefully consider safety concerns.)Tj /TT1 1 Tf 11 0 0 11 309 422.25 Tm 0.0181 Tc 0 Tw (REFERENCES)Tj /TT2 1 Tf 10 0 0 10 309 406.26 Tm 0.0187 Tc 0.1253 Tw [(Chambers, )19(W)107.5(.)-0.3( J., Puig-Antich, J., Hirsch, M., Paez, P)102.7(.)-0.3(,)]TJ 1.2 -1.401 TD -0.0051 Tc -0.062 Tw [(Ambrosini, P)102.9(.)-2.3( J., & )22.4(T)68.7(a)-0.7(brizi, M. )58.4(A.et al. \(1985\). )16.4(The assess-)]TJ T* -0.0033 Tc -0.0519 Tw (ment of affective disorders in children and adolescents by)Tj 0 -1.398 TD 0.0081 Tc 0.1252 Tw [(semistructured interview: )20.3(T)72.9(estretest reliability of the)]TJ 0 -1.401 TD 0.0049 Tc 0.125 Tw (schedule for affective disorders and schizophrenia for)Tj T* 0.0013 Tc 0.1252 Tw [(school-age children, present episode version. )49.5(Archives)]TJ 0 -1.398 TD -0.0035 Tc 0 Tw (of )Tj /TT5 1 Tf 1.026 0 TD -0.0041 Tc -0.0497 Tw [(General Psychiatry)55.7(,)-0.8( 42)]TJ /TT2 1 Tf 9.063 0 TD -0.0038 Tc -0.055 Tw (, 696702.)Tj -11.289 -1.8 TD -0.0057 Tc -0.0624 Tw [(Orvaschel, H., Puig-Antich, J., Chambers, )18.4(W)110.1(.)-7(,)-6.9( )18.4(T)74.1(abrizi, M. )54.4(A.,)]TJ 1.2 -1.401 TD -0.0037 Tc 0.0605 Tw (& Johnson, R. \(1982\). Retrospective assessment of pre-)Tj T* -0.01 Tc -0.0625 Tw (pubertal major depression with the KiddieSADS-E. Jour-)Tj 0 -1.398 TD 0 Tc 0.125 Tw (nal of the )Tj /TT5 1 Tf 4.401 0 TD -0.0011 Tc 0.1253 Tw [(American )17.2(Academy of Child Psychiatr)-7.1(y)58.7(,)-1.4( 21)]TJ /TT2 1 Tf 17.85 0 TD 0 Tc 0 Tw (,)Tj -22.251 -1.401 TD -0.0429 Tc (392397.)Tj ET 3.99 w /GS1 gs 309 201.615 m 546 201.615 l S BT /TT1 1 Tf 11 0 0 11 309 182.61 Tm /GS2 gs 0.0181 Tc 0.1253 Tw [(W)58.1(eierich, M. R., Nock, M. K. \(2008\). 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years)Tj 0 -1.401 TD 0 Tc 0 Tw (\()Tj /TT5 1 Tf 0.33 0 TD (M)Tj /TT2 1 Tf 0.819 0 TD -0.0066 Tc -0.0616 Tw [( = 17.03, )]TJ /TT5 1 Tf 3.57 0 TD -0.0116 Tc 0 Tw (SD )Tj /TT2 1 Tf 1.392 0 TD -0.007 Tc -0.0621 Tw (= 1.92\) completed all the measures in the)Tj -6.111 -1.401 TD 0.0245 Tc 0 Tw [(study)63.5(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc -0.0521 Tw (Both self-injurers and non self-injurers were included in)Tj 0 -1.401 TD -0.0031 Tc -0.0094 Tw (the study but the self-injurers group was larger \()Tj /TT5 1 Tf 19.044 0 TD -0.005 Tc 0 Tw (n )Tj /TT2 1 Tf 0.735 0 TD -0.004 Tc -0.01 Tw (= 56\))Tj -19.779 -1.398 TD -0.0035 Tc (than the non self-injurers group \()Tj /TT5 1 Tf 13.026 0 TD 0 Tc 0 Tw (n)Tj /TT2 1 Tf 0.495 0 TD -0.003 Tc -0.0125 Tw [( = 30\).)]TJ /F36 1 Tf -15.321 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0205 Tw [(Participants in the study were 73% Causasian, 3% )50.6(Afri-)]TJ 0 -1.398 TD -0.0038 Tc 0.0407 Tw [(can )50.3(American, 7% Latino, 5% )50.3(Asian, and other for the)]TJ 0 -1.401 TD -0.0194 Tc -0.06 Tw (remaining 12%.)Tj /TT1 1 Tf 11 0 0 11 66 263.46 Tm 0.0242 Tc 0 Tw (Procedure)Tj /F36 1 Tf 10 0 0 10 66 247.44 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD 0.0122 Tc 0.125 Tw (Adolescents were interviewed and assessed without)Tj 0 -1.398 TD -0.0034 Tc 0.0078 Tw (their parents present in order to increase the chances of)Tj 0 -1.401 TD 0.006 Tc 0.125 Tw (candid responses.)Tj /TT1 1 Tf 11 0 0 11 66 189.06 Tm 0.0557 Tc 0 Tw (Measures)Tj /F36 1 Tf 10 0 0 10 66 173.04 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.004 Tc 0.0265 Tw (Childhood abuse was assessed using the Child Trauma)Tj 0 -1.398 TD -0.0035 Tc 0.0343 Tw (Questionnaire that assesses five different areas of mal-)Tj 0 -1.401 TD -0.0143 Tc -0.0625 Tw (treatment \(physical abuse, sexual abuse, emotional abuse,)Tj T* -0.0032 Tc 0.005 Tw (physical neglect, and emotional neglect\).)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc 0.125 Tw (The 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Present symptoms)]TJ T* -0.0034 Tc -0.0167 Tw (were focused on rather than lifetime symptoms.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0039 Tc 0.0422 Tw (The presence of major depression \(MDD\) was investi-)Tj 0 -1.401 TD -0.003 Tc 0.0135 Tw (gated in order to control for this variable in data analy-)Tj 0 -1.398 TD 0.0146 Tc 0 Tw (sis.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0207 Tc -0.0621 Tw [(The S)18.3(tructured Clinical Interview for DSM-IV)84.3(-II was used)]TJ 0 -1.398 TD -0.0046 Tc -0.0625 Tw (to assess for Borderline Personality Disorder symptoms.)Tj /TT1 1 Tf 11 0 0 11 321 576.24 Tm 0.0154 Tc 0 Tw [(RESUL)83.6(TS)]TJ /F36 1 Tf 10 0 0 10 321 560.25 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.004 Tc 0.105 Tw (Female participants who engaged in NSSI were more)Tj 0 -1.401 TD -0.0168 Tc -0.0625 Tw (likely to participate pick wounds when compared to males)Tj 0 -1.398 TD -0.0093 Tc [(who engaged in NSSI \()]TJ /TT5 1 Tf 8.889 0 TD 0 Tc 0 Tw (F)Tj /TT2 1 Tf 0.6 0 TD -0.008 Tc -0.0625 Tw [( \(1,54\) = 4.59, )]TJ /TT5 1 Tf 5.607 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.489 0 TD -0.0081 Tc -0.0625 Tw [( < .05\).)]TJ /F36 1 Tf -17.385 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc -0.0464 Tw (Sexual abuse was significantly associated with the pres-)Tj 0 -1.398 TD -0.0041 Tc -0.045 Tw (ence \()Tj /TT5 1 Tf 2.349 0 TD 0 Tc 0 Tw (r)Tj /TT2 1 Tf 0.387 0 TD -0.0021 Tc -0.045 Tw [( = .26, )]TJ /TT5 1 Tf 2.664 0 TD -0.006 Tc 0 Tw (p )Tj /TT2 1 Tf 0.699 0 TD -0.0027 Tc -0.045 Tw (< .05\) and frequency \()Tj /TT5 1 Tf 8.685 0 TD 0 Tc 0 Tw (r)Tj /TT2 1 Tf 0.387 0 TD -0.0021 Tc -0.045 Tw [( = .32, )]TJ /TT5 1 Tf 2.664 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0028 Tc -0.045 Tw [( < .01\) of)]TJ -18.33 -1.401 TD -0.0113 Tc -0.0625 Tw (NSSI as well as PTSD symptom clusters \(reexperincing )Tj /TT5 1 Tf 21.516 0 TD 0 Tc 0 Tw (r)Tj /TT2 1 Tf -21.516 -1.401 TD -0.0038 Tc -0.06 Tw (= .28, )Tj /TT5 1 Tf 2.415 0 TD -0.006 Tc 0 Tw (p )Tj /TT2 1 Tf 0.681 0 TD -0.0063 Tc -0.0617 Tw (< .01; avoidance/numbing \()Tj /TT5 1 Tf 10.719 0 TD 0 Tc 0 Tw (r)Tj /TT2 1 Tf 0.384 0 TD -0.004 Tc -0.0617 Tw [( = .26, )]TJ /TT5 1 Tf 2.595 0 TD -0.006 Tc 0 Tw (p )Tj /TT2 1 Tf 0.681 0 TD -0.0053 Tc -0.065 Tw (< .01\).)Tj /F36 1 Tf -19.275 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0068 Tc -0.0617 Tw (Major Depressive Disorder \()Tj /TT5 1 Tf 11.1 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0065 Tc -0.062 Tw [( = .89\) and Borderline Per-)]TJ -11.595 -1.401 TD -0.0188 Tc -0.06 Tw (sonality Disorder \()Tj /TT5 1 Tf 7.026 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.48 0 TD -0.0196 Tc -0.0629 Tw [( = .056\) were not correlated with NSSI)]TJ -7.506 -1.398 TD 0.0017 Tc 0 Tw [(frequency)61.7(.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0097 Tc -0.0625 Tw (Sexual abuse \()Tj /TT5 1 Tf 5.574 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.492 0 TD -0.0093 Tc -0.0625 Tw [( = .019\) was significantly associated with)]TJ -6.066 -1.398 TD -0.0038 Tc 0.1092 Tw (NSSI after controlling for Major Depressive Disorder)Tj 0 -1.401 TD -0.0035 Tc -0.0483 Tw [(and Borderline Personality Disorder)50.5(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0064 Tc 0.01 Tw (MDD \()Tj /TT5 1 Tf 2.901 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0032 Tc 0.01 Tw [( = .041\), reexperiencing \()]TJ /TT5 1 Tf 10.128 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0031 Tc 0.0112 Tw [( = .021\), and avoid-)]TJ -14.019 -1.401 TD -0.0045 Tc 0.06 Tw (ance/numbing \()Tj /TT5 1 Tf 6.249 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.003 Tc 0.064 Tw [( = .024\) were significantly associated)]TJ -6.744 -1.401 TD -0.0035 Tc 0.0608 Tw (with NSSI when controlling for borderline personality)Tj 0 -1.398 TD -0.0037 Tc 0.0383 Tw (disorder and sexual abuse.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0134 Tc -0.062 Tw (Reexperiencing symptoms mediated the relation between)Tj 0 -1.398 TD -0.0045 Tc -0.0625 Tw (sexual abuse and NSSI frequency \(Sobel z-value = 2.15\))Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0055 Tc 0.125 Tw [(A)76.7(voidance/numbing symptoms mediated the relation)]TJ 0 -1.398 TD -0.014 Tc -0.0621 Tw (between sexual abuse and NSSI frequency \(Sobel z-value)Tj 0 -1.401 TD -0.0353 Tc -0.06 Tw (= 3.44\))Tj /TT1 1 Tf 11 0 0 11 321 223.86 Tm 0.0217 Tc 0 Tw [(CONCLUSIONS/SUMMAR)32.6(Y)]TJ /F36 1 Tf 10 0 0 10 321 207.84 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD 0.0018 Tc 0.1249 Tw [(In a retrospective study)61.8(, childhood sexual abuse was)]TJ 0 -1.398 TD -0.0039 Tc 0.0325 Tw (associated with NSSI during adolescence.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.125 Tw (Non-sexual abuse was not associated with adolescent)Tj 0 -1.398 TD -0.0419 Tc 0 Tw (NSSI.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0033 Tw (Reexperiencing symptoms of PTSD mediated the asso-)Tj 0 -1.398 TD 0.0058 Tw (ciation between childhood sexual abuse and NSSI.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.004 Tc 0.094 Tw [(A)79.2(voidance/numbing symptoms of PTSD mediated the)]TJ 0 -1.398 TD -0.0039 Tc 0.0217 Tw (association between childhood sexual abuse and NSSI.)Tj ET endstream endobj 358 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 360 0 obj << /Length 8608 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0052 Tc 0.1209 Tw [(158 )]TJ /TT3 1 Tf 2.8388 0 TD -0.0058 Tc (Selected Annotated Journal Resources)Tj /TT1 1 Tf 11 0 0 11 54 708.24 Tm 0.0267 Tc 0 Tw [(LIMIT)62.2(A)72.5(TIONS)]TJ /F36 1 Tf 10 0 0 10 54 692.25 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.0194 Tw (The data are cross-sectional making it difficult to draw)Tj 0 -1.401 TD -0.0018 Tc 0.125 Tw (inferences across the constructs.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc -0.0625 Tw (The study was retrospective making it difficult to ensure)Tj 0 -1.401 TD -0.0033 Tc 0.03 Tw (the accuracy of childhood sexual abuse reporting.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.003 Tc -0.0472 Tw (The sample size may be considered relatively small.)Tj ET 3.99 w /GS1 gs 54 591.585 m 291 591.585 l S BT /TT1 1 Tf 11 0 0 11 54 572.61 Tm /GS2 gs 0.025 Tc 0.1249 Tw [(Kleim, B., Ehlers, )49.4(A. \(2008\). 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How-)]TJ 0 -1.401 TD -0.0039 Tc 0.0987 Tw [(ever)35.1(, research findings between trauma and OGM are)]TJ T* -0.0034 Tc 0.055 Tw (inconsistent and suggest that OGM may not be the re-)Tj 25.5 63.021 TD -0.009 Tc -0.0621 Tw [(sult of trauma. Difficulty with autobiographical memory)]TJ 0 -1.401 TD -0.0032 Tc 0.0794 Tw (retrieval may make it difficult for trauma survivors to)Tj 0 -1.398 TD -0.0033 Tc -0.0307 Tw (come to terms with the trauma they experienced.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc 0.0586 Tw [(Additionally)59.8(, research suggests that OGM plays a role)]TJ 0 -1.398 TD -0.0033 Tc 0.092 Tw (in the maintenance of depression and it is not clear if)Tj 0 -1.401 TD -0.0035 Tc -0.0437 Tw [(OGM plays a role in the maintenance of PTSD.)]TJ /TT1 1 Tf 11 0 0 11 309 619.26 Tm 0.0265 Tc 0 Tw (PROCEDURE)Tj 0 -1.4564 TD 0.0026 Tc (Participants)Tj /F36 1 Tf 10 0 0 10 309 587.25 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0174 Tc -0.0622 Tw (There were 203 participants recruited from the emergency)Tj 0 -1.401 TD -0.0037 Tc 0.0579 Tw (department of a large urban teaching hospital between)Tj 0 -1.398 TD -0.0137 Tc -0.0625 Tw (July 2003 and December 2004.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc -0.0538 Tw [(Individuals who were not able to speak English fluently)59.6(,)]TJ 0 -1.398 TD -0.007 Tc -0.0622 Tw (with current psychosis or substance dependence, or were)Tj 0 -1.401 TD -0.0036 Tc -0.0186 Tw (not able to remember the assault were excluded.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0044 Tc 0.125 Tw (The majority of participants had been physically as-)Tj 0 -1.401 TD -0.0037 Tc -0.02 Tw (saulted \()Tj /TT5 1 Tf 3.366 0 TD -0.004 Tc 0 Tw (n )Tj /TT2 1 Tf 0.723 0 TD -0.0032 Tc -0.0206 Tw (= 200\) and a few had been sexually assaulted)Tj -4.089 -1.401 TD 0 Tc 0 Tw (\()Tj /TT5 1 Tf 0.324 0 TD (n)Tj /TT2 1 Tf 0.486 0 TD -0.0114 Tc -0.0625 Tw [( = 3\).)]TJ /F36 1 Tf -2.61 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0062 Tc -0.0619 Tw [(After 6 months, 190 participants completed the )51(Autobio-)]TJ 0 -1.401 TD -0.0037 Tc -0.0201 Tw [(graphical Memory )14.2(T)73.1(est \(AMT\).)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc -0.0072 Tw (The participant sample did not significantly differ from)Tj 0 -1.401 TD -0.0035 Tc 0.0008 Tw (patients who presented at the emergency department of)Tj 0 -1.398 TD -0.003 Tc 0.013 Tw (the hospital with regard to age, sex, or severity of inju-)Tj 0 -1.401 TD -0.0031 Tc 0.0983 Tw [(ries. However)38.9(, participants in the study were 57.6 %)]TJ T* -0.0113 Tc -0.0621 Tw (Caucasian while assault survivors presenting at the emer-)Tj 0 -1.398 TD -0.0034 Tc -0.0037 Tw (gency department were 36.9% Caucasian. This differ-)Tj 0 -1.401 TD 0.0521 Tc 0.125 Tw (ence is attributed to the study requirement that)Tj T* -0.0036 Tc -0.045 Tw (individuals were fluent in English.)Tj /TT1 1 Tf 11 0 0 11 309 296.85 Tm 0.0242 Tc 0 Tw (Procedure)Tj /F36 1 Tf 10 0 0 10 309 280.86 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD 0.002 Tc 0.125 Tw (Assault survivors were mailed information about the)Tj 0 -1.401 TD -0.0032 Tc 0.0588 Tw (study and invited to participate in the research session)Tj T* -0.0035 Tc 0.0238 Tw (two weeks after the assault.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0024 Tc 0.125 Tw (At the research session, participants provided details)Tj 0 -1.401 TD -0.0034 Tc 0.0119 Tw (about their assault, gave a short trauma narrative, com-)Tj 0 -1.398 TD -0.0035 Tc -0.0407 Tw (pleted a picture identification task, and completed ques-)Tj 0 -1.401 TD -0.0379 Tw [(tionnaires. Participants then completed the )50.4(A)8(M)8(T)17.4( which)]TJ T* -0.0034 Tc -0.015 Tw [(was followed by a diagnostic interview)59.6(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc -0.015 Tw (After six months, participants completed the Structured)Tj 0 -1.401 TD -0.0221 Tc -0.0621 Tw (Clinical Interview for DSM-IV \(SCID\) over the telephone.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0069 Tc -0.062 Tw (Participants were reimbursed 50 \($97\).)Tj /TT1 1 Tf 11 0 0 11 309 104.46 Tm 0.0557 Tc 0 Tw (Measures)Tj /F36 1 Tf 10 0 0 10 309 88.44 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0617 Tw [(In the )53.4(A)8(M)8(T)68.4(, participants were shown 12 cue words \(6)]TJ 0 -1.398 TD -0.0025 Tc 0.125 Tw (positive and 6 negative\) and asked to briefly recall a)Tj ET endstream endobj 361 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 363 0 obj << /Length 11566 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (159)Tj /TT2 1 Tf 10 0 0 10 84 722.64 Tm -0.0034 Tc -0.055 Tw (specific personal memory in response to the cue word in)Tj 0 -1.398 TD -0.0118 Tc -0.0622 Tw (30 seconds. If a memory was not given in this time frame,)Tj 0 -1.401 TD -0.0037 Tc 0.0225 Tw (a score of omission was recorded. Memories were also)Tj T* -0.0034 Tc 0.065 Tw (recorded as assault related.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc -0.0371 Tw [(Criteria for major depression, )53.4(ASD, specific phobia \(as-)]TJ 0 -1.401 TD -0.0068 Tc -0.0624 Tw [(sault related\) were established using the SCID and )53.3(Acute)]TJ 0 -1.398 TD -0.004 Tc -0.0047 Tw [(S)21.2(tress Disorder Scales- Interview )17.3(V)112.2(ersion \(ASDS\). )17.3(The)]TJ 0 -1.401 TD -0.0037 Tc 0.0445 Tw (SCID allows for a diagnosis of major depression to be)Tj T* 0.001 Tc 0.125 Tw (made as well as severity to )Tj 11.7755 0 TD -0.0004 Tc 0.1264 Tw [(be assessed. )16(The )52(ASDS)]TJ -11.7755 -1.398 TD -0.0034 Tc 0.0388 Tw [(rates the presence of )53.5(ASD symptoms in order to deter)14.6(-)]TJ 0 -1.401 TD -0.0036 Tc 0.0409 Tw [(mine if a diagnosis of )50.4(ASD is warranted as well as the)]TJ T* -0.0029 Tc 0.025 Tw [(severity of the disorder)51.1(.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0039 Tc 0.0423 Tw [(The )50.3(Assault Phobia Questionnaire was used to investi-)]TJ 0 -1.401 TD -0.0035 Tc 0.0001 Tw (gate for the presence of Specific Phobia.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0285 Tw (The Diagnostic and Statistical Manual of Mental Disor-)Tj 0 -1.401 TD -0.0033 Tc -0.0305 Tw (ders \(DSM\) uses a hierarchal rule that a phobia may not)Tj 0 -1.398 TD 0.1006 Tw (be diagnosed if it was better accounted for by PTSD.)Tj 0 -1.401 TD -0.0053 Tc -0.0625 Tw (This rule was not adhered to in order allow for investiga-)Tj T* -0.0034 Tc 0.0225 Tw (tion of the presence of specific phobia.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0039 Tc 0.0669 Tw (After six months, the SCID modules for PTSD, major)Tj 0 -1.401 TD 0.0023 Tc 0.125 Tw (depression, and assault-related phobia were adminis-)Tj 0 -1.398 TD -0.0035 Tc 0.0425 Tw (tered via telephone.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0337 Tc 0.125 Tw (The Response to Intrusion questionnaire assesses)Tj 0 -1.398 TD 0.0008 Tc [(dysfunctional cognitive strategies used to combat in-)]TJ 0 -1.401 TD -0.0081 Tc -0.06 Tw (trusive memories.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0066 Tc 0.125 Tw (Participants were asked to complete the Rumination)Tj 0 -1.401 TD -0.0037 Tc 0.105 Tw (subscale in order to understand how assault survivors)Tj T* -0.0113 Tw (coped with assault related memories.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 0.42 0 TD 0.0269 Tc 0.125 Tw [()-1020.1(The Posttraumatic Cognitions Inventory measured)]TJ 1.38 -1.401 TD -0.0038 Tc 0.016 Tw (trauma-related thoughts and beliefs which discriminate)Tj 0 -1.398 TD -0.0014 Tc 0.125 Tw (between trauma survivors with PTSD from survivors)Tj 0 -1.401 TD -0.0076 Tc -0.06 Tw (without PTSD.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.1091 Tw (Premorbid intelligence levels were assessed using the)Tj 0 -1.401 TD -0.0042 Tc -0.0415 Tw [(National Adult )-49.6(Reading )-36(T)72.6(est.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.0367 Tw (In order to assess history of childhood abuse and adult)Tj 0 -1.401 TD -0.0049 Tc -0.0621 Tw (trauma, participants were asked if during childhood they)Tj T* -0.0024 Tc 0.125 Tw (had been physically abused or experienced unwanted)Tj 0 -1.398 TD -0.0077 Tc -0.06 Tw (sexual experiences.)Tj /TT1 1 Tf 11 0 0 11 66 156.24 Tm 0.0154 Tc 0 Tw [(RESUL)83.6(TS)]TJ 0 -1.4536 TD 0.0448 Tc (Diagnoses)Tj /F36 1 Tf 10 0 0 10 66 124.26 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0738 Tw (After two weeks, 18.7% of participants had major de-)Tj 0 -1.401 TD -0.0037 Tc 0.0039 Tw [(pression, 16.7% had )53.3(ASD and 23.6% had an assault re-)]TJ T* -0.0038 Tc 0.055 Tw (lated phobia.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0037 Tc 0.0188 Tw (After two weeks, 36.8% of participants who had major)Tj 25.5 64.239 TD -0.0034 Tc 0.0558 Tw (depression, indicated they had become depressed after)Tj 0 -1.398 TD -0.0033 Tc 0 Tw (the assault and 63.2% indicated they had felt depressed)Tj 0 -1.401 TD -0.0034 Tc 0.0651 Tw [(before the assault. However)35.6(, all reported that their de-)]TJ T* -0.0035 Tc 0.088 Tw (pression had increased since the assault.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.1022 Tw [(At two weeks, 41% of the participants who had )50.4(A)6.6(S)6.7(D)]TJ 0 -1.401 TD -0.0037 Tc -0.015 Tw (also had major depression and 37% of participants with)Tj 0 -1.398 TD -0.0043 Tc 0.0018 Tw [(major depression also had )50.2(ASD.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0669 Tw (After six months, 16.3% of the participants had major)Tj 0 -1.398 TD -0.0061 Tc -0.0625 Tw (depression, 24.2% had PTSD, and 20.0% had an assault-)Tj 0 -1.401 TD -0.0035 Tc 0.0025 Tw (related specific phobia.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0139 Tw (At six months, 43% of participants with PTSD also had)Tj 0 -1.401 TD -0.0037 Tc -0.0014 Tw (depression, and 64% of participants with major depres-)Tj T* -0.004 Tc 0.0017 Tw (sion also had PTSD.)Tj 11 0 0 11 321 518.25 Tm -0.0038 Tc 0.0778 Tw [(Dif)12.6(ferences in Memory after 2 )15.8(W)81(eeks)]TJ /F36 1 Tf 10 0 0 10 321 502.26 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.026 Tw (After two weeks, participants retrieved )Tj /TT5 1 Tf 15.561 0 TD 0 Tc 0 Tw (M)Tj /TT2 1 Tf 0.825 0 TD -0.0027 Tc -0.025 Tw [( = 7.63 \()]TJ /TT5 1 Tf 3.3 0 TD -0.0066 Tc 0 Tw (SD )Tj /TT2 1 Tf 1.434 0 TD -0.034 Tc ( =)Tj -21.12 -1.401 TD -0.0074 Tc -0.0619 Tw [(2.51\) specific memories after 12 trials \(positive cues )]TJ /TT5 1 Tf 20.34 0 TD 0 Tc 0 Tw (M)Tj /TT2 1 Tf 0.819 0 TD -0.073 Tc ( =)Tj -21.159 -1.401 TD -0.0072 Tc (3.81, )Tj /TT5 1 Tf 2.151 0 TD -0.0162 Tc (SD)Tj /TT2 1 Tf 1.2 0 TD -0.0076 Tc -0.062 Tw [( = 1.47; negative cues )]TJ /TT5 1 Tf 8.523 0 TD 0 Tc 0 Tw (M)Tj /TT2 1 Tf 0.822 0 TD -0.0067 Tc -0.0617 Tw [( = 3.82, )]TJ /TT5 1 Tf 3.069 0 TD -0.0162 Tc 0 Tw (SD)Tj /TT2 1 Tf 1.2 0 TD -0.0077 Tc -0.0625 Tw [( = 1.46\).)]TJ /F36 1 Tf -18.765 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0029 Tc -0.0272 Tw (Memory specificity was found to be significantly lower)Tj 0 -1.401 TD -0.0037 Tc -0.0218 Tw (in participants who had major depression and those that)Tj 0 -1.398 TD -0.0122 Tc -0.06 Tw (did not \()Tj /TT5 1 Tf 3.159 0 TD 0 Tc 0 Tw (F)Tj /TT2 1 Tf 0.597 0 TD -0.0119 Tc -0.0625 Tw (\(1, 201\) = 6.08, )Tj /TT5 1 Tf 6.03 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.483 0 TD -0.0116 Tc -0.0617 Tw [( = .014, )]TJ /F36 1 Tf 3.027 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 477.84 433.59 Tm (2)Tj 0.4914 -1.1535 TD -0.0069 Tc (p )Tj 10 0 0 10 484.56 430.26 Tm -0.0126 Tc -0.065 Tw (= .029\).)Tj /F36 1 Tf -16.356 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0231 Tc -0.062 Tw [(Participants with )52(ASD had lower memory specificity when)]TJ 0 -1.398 TD -0.0041 Tc 0.0257 Tw [(compared to those without )52.6(ASD \()]TJ /TT5 1 Tf 13.425 0 TD 0 Tc 0 Tw (F)Tj /TT2 1 Tf 0.606 0 TD -0.0029 Tc 0.025 Tw (\(1, 201\) = 3.98, )Tj /TT5 1 Tf 6.534 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD 0.026 Tc ( =)Tj -21.06 -1.401 TD -0.0222 Tc (.047, )Tj /F36 1 Tf 2.064 0 TD 0 Tc ()Tj /TT2 1 Tf 5.8 0 0 5.8 365.4 389.61 Tm (2)Tj 0.481 -1.1586 TD -0.0155 Tc (p )Tj 10 0 0 10 372 386.25 Tm -0.0224 Tc -0.065 Tw (= .019\).)Tj /F36 1 Tf -5.1 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc -0.015 Tw (There were no significant differences in memory speci-)Tj 0 -1.401 TD 0.125 Tw [(ficity between individuals with assault related phobia)]TJ T* -0.0036 Tc 0.11 Tw (and those without assault related phobia \()Tj /TT5 1 Tf 17.121 0 TD 0 Tc 0 Tw (F)Tj /TT2 1 Tf 0.603 0 TD -0.0032 Tc 0.1125 Tw (\(1, 201\) =)Tj -17.724 -1.398 TD -0.0168 Tc 0 Tw (0.17, )Tj /TT5 1 Tf 2.091 0 TD 0 Tc (p)Tj /TT2 1 Tf 0.48 0 TD -0.0175 Tc -0.06 Tw [( = .681, )]TJ /F36 1 Tf 2.979 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 400.29 331.59 Tm (2)Tj 0.4914 -1.1534 TD -0.0172 Tc (p )Tj 10 0 0 10 406.95 328.26 Tm -0.0181 Tc -0.065 Tw (= .001\).)Tj /F36 1 Tf -8.595 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc 0.0107 Tw (In all diagnostic groups participants produced more as-)Tj 0 -1.398 TD -0.0038 Tc 0.0175 Tw (sault-related memories when presented with a negative)Tj 0 -1.401 TD -0.0036 Tc -0.0405 Tw (word than when presented with a positive word \(all )Tj /TT5 1 Tf 20.256 0 TD -0.0102 Tc 0 Tw (ps)Tj /TT2 1 Tf 0.879 0 TD -0.049 Tc ( <)Tj -21.135 -1.401 TD -0.0029 Tc 0.0525 Tw (.001; all )Tj /F36 1 Tf 3.606 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 381 273.6 Tm (2)Tj 0.5017 -1.1535 TD (p )Tj 10 0 0 10 388.56 270.24 Tm -0.0033 Tc 0.054 Tw [(> .133\). Specifically)62.7(, the )50.5(ASD group gave)]TJ -4.956 -1.398 TD -0.0047 Tc -0.062 Tw (more assault-related memories than participants without)Tj 0 -1.401 TD -0.0056 Tc -0.005 Tw (ASD \()Tj /TT5 1 Tf 2.556 0 TD 0 Tc 0 Tw (M)Tj /TT2 1 Tf 5.8 0 0 5.8 372.81 238.89 Tm -0.0097 Tc (ASD)Tj 10 0 0 10 384.3 242.25 Tm -0.0033 Tc -0.0045 Tw ( = 61.27, )Tj /TT5 1 Tf 3.774 0 TD -0.0132 Tc 0 Tw (SD)Tj /TT2 1 Tf 1.212 0 TD -0.003 Tc -0.0066 Tw [( = 38.02; )]TJ /TT5 1 Tf 3.795 0 TD 0 Tc 0 Tw (M)Tj /TT2 1 Tf 5.8 0 0 5.8 480.36 238.89 Tm -0.0078 Tc (NOASD)Tj 10 0 0 10 500.16 242.25 Tm -0.0033 Tc -0.0045 Tw ( = 42.13, )Tj /TT5 1 Tf 3.774 0 TD -0.0132 Tc 0 Tw (SD)Tj /TT2 1 Tf 1.209 0 TD -0.013 Tc ( =)Tj -21.099 -1.401 TD -0.0045 Tc -0.0625 Tw (42.78\). The interaction between valence and depression,)Tj 0 -1.398 TD -0.0038 Tc -0.0008 Tw (and valence and phobia participants was nonsignificant)Tj 0 -1.401 TD -0.004 Tc 0 Tw (\(both )Tj /TT5 1 Tf 2.301 0 TD -0.0102 Tc (ps)Tj /TT2 1 Tf 0.879 0 TD -0.0034 Tc -0.045 Tw [( > 570; both )]TJ /F36 1 Tf 4.899 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 425.76 203.61 Tm (2)Tj 0.4966 -1.1586 TD (p )Tj 10 0 0 10 432.69 200.25 Tm -0.003 Tc -0.045 Tw (< .002\).)Tj /F36 1 Tf -11.169 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.004 Tc 0.06 Tw (Participants with depression produced more omissions)Tj 0 -1.401 TD -0.0036 Tc 0.04 Tw (in response to positive cues when compared to partici-)Tj T* -0.0141 Tc -0.0616 Tw (pants without depression \()Tj /TT5 1 Tf 9.981 0 TD 0 Tc 0 Tw (F)Tj /TT2 1 Tf 0.594 0 TD -0.0132 Tc -0.0612 Tw (\(1, 201\) = 3.42, )Tj /TT5 1 Tf 6.015 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.486 0 TD -0.0131 Tc -0.0617 Tw [( = .066, )]TJ /F36 1 Tf 3.015 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 545.76 159.6 Tm (2)Tj 0.4914 -1.1534 TD -0.0086 Tc (p )Tj 10 0 0 10 552.39 156.24 Tm 0 Tc (=)Tj -21.339 -1.398 TD -0.0466 Tc (.017\).)Tj 11 0 0 11 321 111.84 Tm -0.0032 Tc 0.0061 Tw (Prediction of PTSD, Major Depression, and Specific)Tj 0 -1.2709 TD -0.0033 Tc 0.0076 Tw (Phobia at 6 Months)Tj /F36 1 Tf 10 0 0 10 321 81.84 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0106 Tc -0.0621 Tw [(For PTSD, )52.5(ASD symptom severity at 2 weeks was forced)]TJ 0 -1.398 TD -0.0036 Tc 0.0744 Tw (into the regression and explained 43% of the variance)Tj ET endstream endobj 364 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /F36 291 0 R /TT1 8 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 366 0 obj << /Length 13678 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0052 Tc 0.1209 Tw [(160 )]TJ /TT3 1 Tf 2.8388 0 TD -0.0058 Tc (Selected Annotated Journal Resources)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm 0 Tc 0 Tw (\()Tj /F36 1 Tf 0.306 0 TD ()Tj /TT2 1 Tf 5.8 0 0 5.8 80.25 726 Tm (2)Tj 10 0 0 10 83.01 722.64 Tm -0.0293 Tc (\(1, )Tj /TT5 1 Tf 1.155 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.633 0 TD -0.0294 Tc -0.062 Tw [( = 190\) = 64.33, )]TJ /TT5 1 Tf 5.901 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.471 0 TD -0.0299 Tc -0.0613 Tw [( < .001, Nagelkerke )]TJ /TT5 1 Tf 7.329 0 TD 0 Tc 0 Tw (R)Tj /TT2 1 Tf 5.8 0 0 5.8 243.66 726 Tm (2)Tj 10 0 0 10 246.39 722.64 Tm -0.0299 Tc -0.0633 Tw [( = .43\). Low)]TJ -17.439 -1.398 TD -0.0029 Tc 0.084 Tw (memory specificity significantly improved the predic-)Tj 0 -1.401 TD -0.0167 Tc -0.06 Tw (tion \()Tj /F36 1 Tf 1.986 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 97.2 698.01 Tm (2)Tj 10 0 0 10 99.99 694.65 Tm -0.0143 Tc (\(1, )Tj /TT5 1 Tf 1.215 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.651 0 TD -0.015 Tc -0.062 Tw [( = 190\) = 7.04, )]TJ /TT5 1 Tf 5.661 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.48 0 TD -0.0156 Tc -0.061 Tw [( = .008, total Nagelkerke )]TJ /TT5 1 Tf 9.489 0 TD 0 Tc 0 Tw (R)Tj /TT2 1 Tf 5.8 0 0 5.8 280.86 698.01 Tm (2)Tj 10 0 0 10 283.71 694.65 Tm -0.085 Tc ( =)Tj -21.171 -1.401 TD -0.0138 Tc (.47, )Tj /F36 1 Tf 1.62 0 TD -0.016 Tc ( )Tj /TT5 1 Tf 0.771 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 101.79 684 Tm (2)Tj 10 0 0 10 104.61 680.64 Tm -0.0154 Tc -0.0625 Tw [( = .04\).)]TJ /F36 1 Tf -5.061 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc -0.0115 Tw (For major depression, depression severity at two weeks)Tj 0 -1.401 TD -0.0036 Tc -0.0411 Tw (was forced into the regression and explained 13% of the)Tj 0 -1.398 TD -0.0227 Tc -0.06 Tw (variance \()Tj /F36 1 Tf 3.684 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 114.15 639.99 Tm (2)Tj 10 0 0 10 116.91 636.66 Tm -0.0223 Tc (\(1, )Tj /TT5 1 Tf 1.188 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.642 0 TD -0.0219 Tc -0.062 Tw [( = 187\) = 14.59, )]TJ /TT5 1 Tf 6.03 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.48 0 TD -0.0225 Tc -0.0612 Tw [( < .001, Nagelkerke )]TJ /TT5 1 Tf 7.479 0 TD 0 Tc 0 Tw (R)Tj /TT2 1 Tf 5.8 0 0 5.8 281.01 639.99 Tm (2)Tj 10 0 0 10 283.74 636.66 Tm -0.088 Tc ( =)Tj -21.174 -1.401 TD -0.0028 Tc 0.1141 Tw [(.13\). )51.1(Again, low memory specificity significantly im-)]TJ T* -0.0196 Tc -0.0616 Tw (proved the prediction \()Tj /F36 1 Tf 8.505 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 162.36 612 Tm (2)Tj 10 0 0 10 165.15 608.64 Tm -0.0193 Tc (\(1, )Tj /TT5 1 Tf 1.2 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.645 0 TD -0.019 Tc -0.062 Tw [( = 187\) = 7.45, )]TJ /TT5 1 Tf 5.601 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.48 0 TD -0.019 Tc -0.0617 Tw [( = .006, total)]TJ -17.241 -1.398 TD -0.0127 Tc 0 Tw (Nagelkerke )Tj /TT5 1 Tf 4.665 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 124.59 597.99 Tm (2)Tj 10 0 0 10 127.5 594.66 Tm -0.0113 Tc -0.0616 Tw [( = .19, )]TJ /F36 1 Tf 2.544 0 TD -0.013 Tc 0 Tw ( )Tj /TT5 1 Tf 0.78 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 166.71 597.99 Tm (2)Tj 10 0 0 10 169.56 594.66 Tm -0.0111 Tc -0.0625 Tw [( = .06\).)]TJ /F36 1 Tf -11.556 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc -0.0622 Tw (For specific phobia at six months, phobia severity at two)Tj 0 -1.398 TD -0.0034 Tc 0.1239 Tw (weeks was forced into the regression in the first step)Tj 0 -1.401 TD -0.0207 Tc -0.0616 Tw (and explained 27% of the variance \()Tj /F36 1 Tf 13.35 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 210.81 554.01 Tm (2)Tj 10 0 0 10 213.6 550.65 Tm -0.0197 Tc (\(1, )Tj /TT5 1 Tf 1.191 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.645 0 TD -0.0205 Tc -0.0625 Tw [( = 187\) = 32.59,)]TJ /TT5 1 Tf -15.996 -1.401 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0033 Tc -0.055 Tw [( < .001, Nagelkerke )]TJ /TT5 1 Tf 7.89 0 TD 0 Tc 0 Tw (R)Tj /TT2 1 Tf 5.8 0 0 5.8 161.91 540 Tm (2)Tj 10 0 0 10 164.79 536.64 Tm -0.0026 Tc -0.0559 Tw [( = .27\). Low memory specificity)]TJ -9.279 -1.398 TD -0.006 Tc -0.0615 Tw (did not significantly add to the prediction \()Tj /F36 1 Tf 16.434 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 241.8 525.99 Tm (2)Tj 10 0 0 10 244.65 522.66 Tm -0.0047 Tc (\(1, )Tj /TT5 1 Tf 1.251 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.654 0 TD -0.007 Tc -0.0625 Tw [( = 187\))]TJ -19.17 -1.401 TD -0.0091 Tc -0.06 Tw (= 1.45, )Tj /TT5 1 Tf 2.871 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.483 0 TD -0.0104 Tc -0.062 Tw [( = .230, total Nagelkerke )]TJ /TT5 1 Tf 9.621 0 TD 0 Tc 0 Tw (R)Tj /TT2 1 Tf 5.8 0 0 5.8 207.75 512.01 Tm (2)Tj 10 0 0 10 210.6 508.65 Tm -0.0091 Tc -0.0617 Tw [( = .28, )]TJ /F36 1 Tf 2.556 0 TD -0.011 Tc 0 Tw ( )Tj /TT5 1 Tf 0.774 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 249.9 512.01 Tm (2)Tj 10 0 0 10 252.75 508.65 Tm -0.0103 Tc -0.0625 Tw [( = .01\).)]TJ /F36 1 Tf -19.875 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.1041 Tw (Memory specificity predicted both PTSD and depres-)Tj 0 -1.401 TD -0.0037 Tc 0.095 Tw [(sion over and above initial )53.3(ASD and depression diag-)]TJ T* 0.0139 Tc 0.125 Tw (noses \(PTSD)Tj /F36 1 Tf 5.535 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 132.96 468 Tm (2)Tj 10 0 0 10 135.99 464.64 Tm 0.016 Tc (\(1, )Tj /TT5 1 Tf 1.527 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.678 0 TD 0.0163 Tc 0.125 Tw [( = 190\) = 7.29, )]TJ /TT5 1 Tf 7.101 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.516 0 TD 0.0164 Tc 0.125 Tw [( = .008, total)]TJ -16.221 -1.398 TD -0.0042 Tc 0 Tw (Nagelkerke )Tj /TT5 1 Tf 4.791 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 125.94 453.99 Tm (2)Tj 10 0 0 10 128.85 450.66 Tm -0.0025 Tc -0.025 Tw [( = .292, )]TJ /F36 1 Tf 3.219 0 TD -0.007 Tc 0 Tw ( )Tj /TT5 1 Tf 0.825 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 175.35 453.99 Tm (2)Tj 10 0 0 10 178.26 450.66 Tm -0.0036 Tc -0.025 Tw [( = .047; Depression)]TJ /F36 1 Tf 7.698 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 260.7 453.99 Tm (2)Tj 10 0 0 10 263.61 450.66 Tm -0.003 Tc (\(1, )Tj /TT5 1 Tf 1.299 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.66 0 TD -0.034 Tc ( =)Tj -21.12 -1.401 TD -0.0031 Tc -0.0433 Tw (190\) = 6.23, )Tj /TT5 1 Tf 4.98 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0032 Tc -0.044 Tw [( = .014, total Nagelkerke )]TJ /TT5 1 Tf 9.9 0 TD 0 Tc 0 Tw (R)Tj /TT2 1 Tf 5.8 0 0 5.8 231.81 440.01 Tm (2)Tj 10 0 0 10 234.69 436.65 Tm -0.0025 Tc -0.045 Tw [( = .229, )]TJ /F36 1 Tf 3.162 0 TD -0.007 Tc 0 Tw ( )Tj /TT5 1 Tf 0.81 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 280.44 440.01 Tm (2)Tj 10 0 0 10 283.35 436.65 Tm -0.049 Tc ( =)Tj -21.135 -1.401 TD -0.0466 Tc (.046\).)Tj /TT1 1 Tf 11 0 0 11 54 392.25 Tm 0.0127 Tc 0.1272 Tw (OGM Correlations)Tj /F36 1 Tf 10 0 0 10 54 376.26 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.004 Tc -0.0228 Tw (OGM at two weeks predicted both PTSD and major de-)Tj 0 -1.401 TD -0.0036 Tc 0.04 Tw (pression at six months over and above predictions tak-)Tj T* 0.0097 Tc 0.125 Tw (ing into account intelligence and severity of assault)Tj 0 -1.398 TD -0.0083 Tc 0 Tw (\(PTSD)Tj /F36 1 Tf 2.745 0 TD 0 Tc ()Tj /TT2 1 Tf 5.8 0 0 5.8 104.91 337.59 Tm (2)Tj 10 0 0 10 107.76 334.26 Tm -0.0043 Tc (\(1, )Tj /TT5 1 Tf 1.26 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.66 0 TD -0.0041 Tc -0.061 Tw [( = 181\) = 3.68, )]TJ /TT5 1 Tf 5.838 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0037 Tc -0.0617 Tw [( = .055, )]TJ /F36 1 Tf 3.096 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 0.606 0 TD -0.0058 Tc (Nagelkerke )Tj /TT5 1 Tf 4.734 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 280.71 337.59 Tm (2)Tj 10 0 0 10 283.59 334.26 Tm -0.073 Tc ( =)Tj -21.159 -1.401 TD 0.0073 Tc 0.125 Tw (.029; Depression)Tj /F36 1 Tf 7.02 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 5.8 0 0 5.8 147.75 323.61 Tm (2)Tj 10 0 0 10 150.69 320.25 Tm 0.007 Tc (\(1, )Tj /TT5 1 Tf 1.497 0 TD 0 Tc (N)Tj /TT2 1 Tf 0.675 0 TD 0.0083 Tc 0.125 Tw [( = 181\) = 5.76, )]TJ /TT5 1 Tf 6.975 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.504 0 TD 0.0088 Tc 0.125 Tw [( = .016, )]TJ /F36 1 Tf 3.774 0 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf -21.294 -1.401 TD -0.0178 Tc (Nagelkerke )Tj /TT5 1 Tf 4.611 0 TD 0 Tc (R)Tj /TT2 1 Tf 5.8 0 0 5.8 123.99 309.6 Tm (2)Tj 10 0 0 10 126.84 306.24 Tm -0.0164 Tc -0.0625 Tw [( = .052\).)]TJ /F36 1 Tf -7.284 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc -0.0481 Tw (Sex, childhood abuse and ethnicity did not moderate the)Tj 0 -1.401 TD -0.0073 Tc -0.0625 Tw (effect of specificity on PTSD or depression \(all )Tj /TT5 1 Tf 18.306 0 TD -0.0132 Tc 0 Tw (ps)Tj /TT2 1 Tf 0.87 0 TD -0.0069 Tc -0.0625 Tw [( > .11\).)]TJ /F36 1 Tf -20.976 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.003 Tc 0.0772 Tw (History of depression prior to the assault significantly)Tj 0 -1.401 TD -0.0057 Tc -0.0625 Tw (moderated the effect of memory specificity on the sever-)Tj 0 -1.398 TD -0.0024 Tc -0.0522 Tw (ity of depression \( = - .19, )Tj /TT5 1 Tf 10.71 0 TD 0 Tc 0 Tw (p)Tj /TT2 1 Tf 0.495 0 TD -0.0027 Tc -0.0525 Tw [( = .042\).)]TJ /F36 1 Tf -13.005 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc 0.0088 Tw (For both PTSD and depression, the amount of variance)Tj 0 -1.398 TD -0.003 Tc -0.0193 Tw (explained by memory specificity was reduced when ru-)Tj 0 -1.401 TD -0.0039 Tc 0.045 Tw (mination or perceived permanent change was included)Tj T* -0.0033 Tc -0.0538 Tw (in the regression \(all )Tj /TT5 1 Tf 8.154 0 TD -0.0102 Tc 0 Tw (ps)Tj /TT2 1 Tf 0.882 0 TD -0.0029 Tc -0.055 Tw [( < .042\).)]TJ /TT1 1 Tf 11 0 0 11 54 143.85 Tm 0.0217 Tc 0 Tw [(CONCLUSIONS/SUMMAR)32.6(Y)]TJ /F36 1 Tf 10 0 0 10 54 127.86 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD 0.0045 Tc 0.125 Tw [(At two weeks assault survivors with )49.5(ASD generated)]TJ 0 -1.401 TD -0.0116 Tc -0.0625 Tw (fewer autobiographical memories when compared to sur-)Tj T* -0.0047 Tc 0.0007 Tw [(vivors without )50(ASD.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc 0.015 Tw (Participants with depression had less memory specific-)Tj 25.5 63.879 TD -0.0032 Tc 0.0614 Tw (ity than those who did not have depression.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0036 Tc -0.0621 Tw (Low memory specificity at two weeks predicted chronic)Tj 0 -1.401 TD -0.0039 Tc 0.0537 Tw [(PTSD and major depression at six months above what)]TJ 0 -1.398 TD -0.0031 Tc -0.0187 Tw [(was expected for symptom severity)59.9(.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.003 Tc 0.0918 Tw [(Sex, ethnicity)63(, and history of childhood abuse did not)]TJ 0 -1.398 TD -0.0038 Tc -0.015 Tw (interact with OGM in predicting PTSD or depression at)Tj 0 -1.401 TD -0.0052 Tc -0.06 Tw (six months.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc -0.0608 Tw (Overgeneralized memory correlated with the severity of)Tj 0 -1.401 TD 0.0006 Tc 0.125 Tw (the assault.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0051 Tc -0.0622 Tw (A history of major depression prior to the assault moder-)Tj 0 -1.401 TD -0.0039 Tc 0.05 Tw (ated the relationship between OGM and major depres-)Tj T* 0.0083 Tc 0 Tw (sion.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc -0.0014 Tw (Low memory specificity was related to greater rumina-)Tj 0 -1.401 TD 0.0161 Tc 0.125 Tw (tion about trauma and greater perceived permanent)Tj 0 -1.398 TD 0.0114 Tc 0 Tw (change.)Tj /TT1 1 Tf 11 0 0 11 309 486.24 Tm 0.0267 Tc [(LIMIT)62.2(A)72.5(TIONS)]TJ /F36 1 Tf 10 0 0 10 309 470.25 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0145 Tc -0.0621 Tw (It is unclear whether low autobiographical memory speci-)Tj 0 -1.401 TD -0.0025 Tc 0.125 Tw (ficity is a predisposing factor or a consequnce of the)Tj 0 -1.398 TD -0.0169 Tc 0 Tw (trauma.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0035 Tc -0.0238 Tw (There was a high comorbidity among the disorders thus)Tj 0 -1.398 TD -0.0033 Tc -0.0501 Tw [(making it dif)14.7(ficult to demonstrate specificity)62.7(.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0038 Tc -0.0455 Tw (The diagnoses at six months were based on a SCID con-)Tj 0 -1.398 TD -0.0037 Tc 0.0884 Tw (ducted over the telephone.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0031 Tc 0.0064 Tw (The sample primarily consisted of physical assault sur-)Tj 0 -1.398 TD 0.0042 Tc 0 Tw (vivors.)Tj ET 3.99 w /GS1 gs 309 311.595 m 546 311.595 l S BT /TT1 1 Tf 11 0 0 11 309 292.59 Tm /GS2 gs 0.0227 Tc 0.1249 Tw [(Ellis, B. H., MacDonald, H. Z., Lincoln, )55.3(A. K.,)]TJ 0 -1.1809 TD -0.003 Tc 0.0449 Tw (Cabral, H. J. \(2008\). Mental health of Somali ado-)Tj T* 0.0065 Tc 0.1253 Tw (lescent refugees: The role of trauma, stress, and)Tj 0 -1.1836 TD 0.0174 Tc 0.125 Tw (perceived discrimination. )Tj /TT4 1 Tf 11.7873 0 TD 0.0169 Tc (Journal of Consulting)Tj ET 0.99 w /GS1 gs 309 232.095 m 546 232.095 l S BT 11 0 0 11 309 240.6 Tm /GS2 gs 0.0077 Tc 0.1262 Tw [(and Clinical Psychology)35(, 76)]TJ /TT1 1 Tf 12.0491 0 TD 0.008 Tc 0 Tw (\(2\),)Tj /TT4 1 Tf 1.4509 0 TD 0 Tc ( )Tj /TT1 1 Tf 0.39 0 TD 0.0071 Tc (184-193.)Tj -13.89 -2.9782 TD -0.008 Tc 0.1236 Tw [(TYPE OF)27.5( )46.5(A)10(R)27.4(TICLE)]TJ /F36 1 Tf 10 0 0 10 309 191.85 Tm 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0009 Tc 0.125 Tw (Correlation study of the relationship between trauma)Tj 0 -1.401 TD -0.0036 Tc -0.015 Tw [(exposure, post-settlement stressors, perceived discrimi-)]TJ 0 -1.398 TD -0.0037 Tc 0.0292 Tw (nation and symptoms of PTSD and depression.)Tj /TT1 1 Tf 11 0 0 11 309 133.44 Tm 0.0066 Tc 0.126 Tw [(OBJECTIVE/PURPOSE OF)31.1( )14.4(THE 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-1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.0251 Tc 0.125 Tw (Post-resettlement literature emphasizes the role of)Tj 0 -1.401 TD 0.0064 Tc (acculturative stressors as well as the association be-)Tj T* -0.0037 Tc 0.0541 Tw [(tween perceived discrimination and mental health out-)]TJ 0 -1.398 TD -0.0059 Tc 0 Tw (comes.)Tj /F36 1 Tf -1.8 -1.602 TD 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD 0.008 Tc 0.125 Tw (Acculturative stressors and perceived discrimination)Tj 0 -1.398 TD -0.0066 Tc -0.0625 Tw (may make it difficult for adolescents to achieve develop-)Tj 0 -1.401 TD -0.0002 Tc 0.125 Tw (mentally important milestone such as developing au-)Tj T* -0.0026 Tc -0.0017 Tw [(tonomy and self- identity)60.4(.)]TJ /TT1 1 Tf 11 0 0 11 66 401.25 Tm 0.0265 Tc 0 Tw (PROCEDURE)Tj 0 -1.4536 TD 0.0026 Tc (Participants)Tj /F36 1 Tf 10 0 0 10 66 369.24 Tm 0 Tc ()Tj /TT2 1 Tf 1.8 0 TD -0.0073 Tc -0.0621 Tw (135 adolescent-parent dyads self -identified as Somali or)Tj 0 -1.398 TD -0.0037 Tc 0.0264 Tw (Somali Bantu 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This scale yields an overall PSTD severity)Tj 0 -1.401 TD -0.0035 Tc 0.1007 Tw (score as well as subscales for reexperienceing, avoid-)Tj T* 0.0517 Tw (ance, and increased arousal.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0039 Tc 0.082 Tw (The Depression Self-Rating Scale assessed depressive)Tj 0 -1.401 TD -0.0034 Tc 0.09 Tw (symptoms in adolescents.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0078 Tc -0.0625 Tw [(The )19.2(W)96.1(ar )16.2(T)39(rauma Screening Scale is checklist of violence)]TJ 0 -1.401 TD -0.0056 Tc -0.0627 Tw [(and adversity experienced in the context of war)54.4(. )15.2(T)71.2(wenty-)]TJ 0 -1.398 TD -0.0034 Tc -0.0541 Tw (six of the original 72 the items were found to be relevant)Tj 0 -1.401 TD 0.0062 Tc 0.125 Tw (to Somali adolescents. Items were adapted to assess)Tj T* -0.0037 Tc 0.0506 Tw (when the adolescent was exposed to trauma as well as)Tj 0 -1.398 TD -0.0034 Tc -0.02 Tw [(ascertain the timing of the trauma.)]TJ /F36 1 Tf -1.8 -1.602 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0034 Tc 0.0099 Tw (Post-war difficulties such as housing, financial, and in-)Tj 0 -1.398 TD 0.0008 Tc 0.1252 Tw [(terpersonal problems were assessed with the )52(Adoles-)]TJ 0 -1.401 TD -0.0043 Tc 0.0496 Tw [(cent Post-W)76.7(ar )52.3(Adversities Scale.)]TJ /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0032 Tc -0.0428 Tw (Caregivers were asked to rate their level of fluency with)Tj 0 -1.401 TD -0.0038 Tc 0.0325 Tw (the English language.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD -0.0033 Tc 0.0381 Tw (Adolescents were also asked to rate how satisfied they)Tj 0 -1.401 TD -0.0071 Tw (were with their housing based on family need.)Tj /F36 1 Tf -1.8 -1.599 TD 0 Tc 0 Tw ()Tj /TT2 1 Tf 1.8 0 TD 0.005 Tc 0.1251 Tw [(The )50.1(Acculturative Hassles Inventory measures stres-)]TJ 0 -1.401 TD -0.0035 Tc 0.045 Tw (sors across four domains- school, peers, language, and)Tj T* -0.0029 Tc -0.037 Tw [(family)63.1(. 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reference guide to per-)]TJ -12.801 -1.398 TD -0.003 Tc -0.0085 Tw (sonality styles, written for executives, managers, and super-)Tj 0 -1.401 TD -0.0033 Tc -0.0209 Tw [(visors. The author states in his preface, I dont want this to)]TJ T* -0.0033 Tw (be another murky tome youll thumb through once and then)Tj 0 -1.398 TD -0.0031 Tc 0.005 Tw (consign to bookshelf purgatorythe book you hold in your)Tj 0 -1.401 TD -0.003 Tc 0.0531 Tw (hand is a practical resource that you can refer to again and)Tj T* -0.0035 Tc -0.0622 Tw (again as you confront the challenges of a complex workplace)Tj 0 -1.398 TD -0.0125 Tc (filled with complex, real live people \(p. xi\).)Tj 1.8 -2.001 TD -0.0036 Tc -0.0125 Tw (One of the purposes of this book is prevention of work-)Tj -1.8 -1.401 TD -0.0033 Tc 0.12 Tw (place crises through understanding of, and early interven-)Tj 0 -1.398 TD -0.0027 Tc 0.0793 Tw (tion in, work dynamics, including personality traits, types,)Tj 0 -1.401 TD -0.0032 Tc -0.0111 Tw [(and disorders. The author asserts that hindsight \(analysis of)]TJ T* -0.0033 Tc 0.1068 Tw (past events\) can lead to insight, which in turn can lead to)Tj 0 -1.398 TD -0.0035 Tc 0.0945 Tw (developing new courses of action for the next incident, or)Tj 0 -1.401 TD 0.0023 Tc 0 Tw (foresight.)Tj 1.8 -2.001 TD -0.0031 Tc -0.0481 Tw [(T)73.7(o)0( this end, the first half of the book details traits, think-)]TJ -1.8 -1.398 TD -0.0026 Tc -0.0245 Tw (ing styles, perceptions, and work styles for a wide variety of)Tj 0 -1.401 TD 0.0037 Tc 0.125 Tw [(personalities. Brief case studies effectively illustrate the)]TJ T* -0.0042 Tc 0.0736 Tw [(author)-40.2()52.8(s)-0.2( descriptions and recommendations.)]TJ 1.8 -1.998 TD -0.0035 Tc 0.1224 Tw (Using the chapter on avoidant personalities as an ex-)Tj -1.8 -1.401 TD -0.0037 Tc 0.11 Tw (ample, the author describes how the person with avoidant)Tj T* -0.0036 Tc -0.0355 Tw [(traits thinks, and describes common traits. )50.5(A)79.6(voidant person-)]TJ 0 -1.398 TD -0.0026 Tc 0 Tw (ality types typically think, Keep a low profile. Dont make)Tj 0 -1.401 TD -0.0027 Tc 0.005 Tw (waves. They will likely feel inadequate, socially inhibited,)Tj T* -0.0059 Tc -0.0622 Tw [(and hypersensitive to criticism. Overall, they are reliable and)]TJ 0 -1.398 TD -0.0035 Tc -0.035 Tw (compliant workers, but may often be described as likeable)Tj 0 -1.401 TD -0.0034 Tc -0.0025 Tw (and wallflowers. These employees may struggle with so-)Tj T* 0.065 Tw (cial engagements, becoming entrapped in cycles of feeling)Tj 0 -1.398 TD -0.0035 Tc -0.0069 Tw (uncomfortable talking with clients, which leads the client to)Tj 0 -1.401 TD 0.0686 Tw (become uncomfortable, which the employee senses, so the)Tj ET 0.99 w 1000 M /GS1 gs 67.495 731.305 490.51 -28.81 re S BT /TT4 1 Tf 14 0 0 14 197.25 713.34 Tm /GS2 gs 0.0031 Tc 0.1236 Tw (Media Reviews Daniel Clark, Editor)Tj /F1 1 Tf -3.2679 -5.6421 TD -0.0033 Tc 0.1378 Tw [(From Difficult to Disturbed: Understanding and)]TJ 2.5714 -1.1421 TD 0.0128 Tc 0.1375 Tw (Managing Dysfunctional Employees)Tj /TT2 1 Tf 12 0 0 12 252.75 603.66 Tm -0.0239 Tc -0.0611 Tw [(By Laurence Miller)33.6(, Ph.D.)]TJ 10 0 0 10 166.89 591 Tm -0.0003 Tc -0.0623 Tw [(American Management )47.9(Association, 2008, 240 pages, Hard cover)35.7(, $22.00)]TJ 0.861 -1.2 TD -0.002 Tc [(Edina, MN: Beaver)-35()55(s)-0.1( Pond Press, 2006, 130 pages, Soft cover)31(, $20.00)]TJ 1.875 -1.2 TD -0.0089 Tc -0.0626 Tw [(Order from www)63.1(.seedsofhopebooks.com or 1-800-901-3480)]TJ 12.675 -5.736 TD -0.0037 Tc 0.0075 Tw [(employee becomes even more uncomfortable. Understand-)]TJ 0 -1.398 TD -0.0034 Tc -0.0261 Tw (ing this cycle allows managers and supervisors to work with)Tj 0 -1.401 TD -0.0035 Tc 0.1225 Tw (the avoidant employee and develop effective countermea-)Tj T* 0.0562 Tw (sures to help them succeed.)Tj 1.8 -1.998 TD 0.0037 Tc 0.125 Tw [(Later in the chapter)39.7(, the author describes the typical)]TJ -1.8 -1.401 TD -0.0036 Tc 0.1237 Tw [(experience of working for an avoidant boss, and suggests)]TJ T* -0.0034 Tc 0.0468 Tw [(how to adapt to the avoidant aspects. The next section de-)]TJ 0 -1.398 TD -0.002 Tc 0.125 Tw (scribes the avoidant employee, and offers suggestions for)Tj 0 -1.401 TD -0.0033 Tc -0.0436 Tw [(successfully managing them. For example, when employers)]TJ T* -0.0034 Tc 0.0531 Tw (are working with an avoidant employee, the author recom-)Tj 0 -1.398 TD -0.0074 Tc -0.0624 Tw (mends keeping supervision light, more in line with coaching)Tj 0 -1.401 TD -0.0035 Tc 0.125 Tw (and counseling approach.)Tj 1.8 -2.001 TD 0.0975 Tw (The chapter concludes by describing avoidant bosses/)Tj -1.8 -1.398 TD 0.0808 Tw (employees, with recommendations for being as productive)Tj 0 -1.401 TD -0.0125 Tc -0.0625 Tw (as possible. For example, the author recommends the avoidant)Tj T* -0.0032 Tc -0.0271 Tw (boss schedule regular supervisory sessions \(which are likely)Tj 0 -1.398 TD -0.0035 Tc 0.0355 Tw (to be uncomfortable for the avoidant boss\) to allow time to)Tj 0 -1.401 TD -0.0033 Tc -0.0222 Tw [(plan and prepare. Further)35.7(, prepare for meetings by develop-)]TJ T* -0.0036 Tc 0.094 Tw [(ing a written protocol to follow)62.4(. Continuing the theme of)]TJ 0 -1.398 TD -0.0037 Tc -0.0206 Tw (planning, the author recommends developing a file of work-)Tj 0 -1.401 TD 0.0048 Tc 0.125 Tw (place scenarios and responses, thus allowing preparatory)Tj T* -0.0036 Tc -0.0522 Tw [(time before the actual situation occurs. He also recommends)]TJ 0 -1.398 TD -0.0243 Tw (finding a sympathetic mentor with which to brainstorm.)Tj 1.8 -2.001 TD -0.0027 Tc 0.065 Tw [(If you are the avoidant employee, the author similarly)]TJ -1.8 -1.401 TD -0.0034 Tc -0.0282 Tw [(recommends preparation in order to reduce anxiety)62.6(. He also)]TJ 0 -1.398 TD 0.0037 Tc 0.125 Tw (recommends listening attentively to the person speaking,)Tj 0 -1.401 TD -0.0031 Tc -0.0142 Tw [(then responding naturally)62.9(, rather than focusing internally on)]TJ T* -0.0205 Tw [(developing your response to the speaker)38.9(, which leads you to)]TJ 0 -1.398 TD -0.0028 Tc 0.0109 Tw (miss what the speaker is actually saying.)Tj ET endstream endobj 377 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT4 20 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 379 0 obj << /Length 6743 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 54 59.745 m 546 59.745 l S BT /F1 1 Tf 8 0 0 8 54.99 41.64 Tm 0 0 0 1 k /GS2 gs -0.0052 Tc 0.0771 Tw [(164 )]TJ /TT3 1 Tf 2.7075 0 TD -0.006 Tc 0.0791 Tw (Clark Media Reviews)Tj /TT2 1 Tf 10 0 0 10 72 722.64 Tm -0.0037 Tc 0.06 Tw (The second section of )Tj /TT5 1 Tf 9.159 0 TD -0.004 Tc (From Difficult to Disturbed)Tj /TT2 1 Tf 11.16 0 TD -0.0036 Tc 0.065 Tw [( ad-)]TJ -22.119 -1.398 TD -0.0023 Tc 0.125 Tw (dresses mental disorders, and offers recommendations for)Tj 0 -1.401 TD 0.0158 Tc 0.1249 Tw [(effectively approaching the challenges these employees)]TJ T* -0.0033 Tc 0.0389 Tw [(present. The author reassures the reader that, as managers,)]TJ 0 -1.398 TD -0.0035 Tc -0.0292 Tw [(in cases where the employee)53.5(s behavior becomes disruptive,)]TJ 0 -1.401 TD -0.0029 Tc 0.0518 Tw (their best course of action may be to refer the employee to)Tj T* -0.0036 Tc -0.051 Tw [(mental health professionals. However)35.4(, he adds that the man-)]TJ 0 -1.398 TD -0.0083 Tc -0.0625 Tw [(ager/supervisor still plays an important role in the employee)51.7(s)]TJ 0 -1.401 TD -0.0133 Tc (life at work.)Tj 1.8 -2.001 TD -0.003 Tc 0.0578 Tw [(D)8.2(r)51(. Miller addresses a variety of situations in this sec-)]TJ -1.8 -1.398 TD -0.0035 Tc -0.045 Tw (tion, including dealing with employees struggling with anxi-)Tj 0 -1.401 TD 0.0049 Tc 0.1248 Tw [(ety)58.9(, depression, suicidal thoughts/plans, substance abuse,)]TJ T* -0.0033 Tc 0.1058 Tw (and neuropsychological syndromes such as dementia, epi-)Tj 0 -1.398 TD -0.003 Tc -0.0353 Tw [(lepsy)63(, and traumatic brain injuries.)]TJ 1.8 -2.001 TD -0.0038 Tc -0.0207 Tw (The third section focuses on workplace misconduct and)Tj -1.8 -1.401 TD 0.0031 Tc 0.125 Tw [(marginal performance. The author presents a systematic)]TJ 0 -1.398 TD -0.0143 Tc -0.0621 Tw (model of employee selection, training, and management based)Tj 0 -1.401 TD -0.0038 Tc -0.01 Tw (on his experience working with law enforcement and public)Tj T* -0.0035 Tc -0.0225 Tw [(safety agencies. His recommendations span the gamut from)]TJ 0 -1.398 TD -0.0015 Tc 0.125 Tw (basic screen-in and screen-out protocols to discipline and)Tj 0 -1.401 TD -0.0123 Tc 0 Tw (termination.)Tj 1.8 -2.001 TD -0.0026 Tc 0.125 Tw [(This section also addresses workplace violence. The)]TJ -1.8 -1.398 TD -0.0035 Tc -0.0515 Tw (author repeats his principle that the best form of crisis inter-)Tj 0 -1.401 TD -0.0032 Tc 0.0545 Tw [(vention is crisis prevention. He notes the statistic that al-)]TJ T* -0.0037 Tc -0.003 Tw (though homicide is the number one killer of women and the)Tj 0 -1.398 TD -0.0034 Tc 0.0875 Tw (third leading cause of death for men in the workplace, for)Tj 25.5 36.798 TD 0.0394 Tw [(every one workplace homicide, there are over 100 nonfatal)]TJ 0 -1.398 TD 0.0011 Tc 0.125 Tw (acts of violence such as fistfights, assaults, bullying, and)Tj 0 -1.401 TD -0.0035 Tc 0.0619 Tw [(harassment. The author offers specific suggestions for de-)]TJ T* -0.0031 Tc 0.0393 Tw (fusing a potentially dangerous situation, focusing on safety)Tj 0 -1.398 TD 0.1214 Tw (issues, body language, and communication style and con-)Tj 0 -1.401 TD -0.0037 Tc 0.11 Tw [(tent. He concludes the section with recommendations for)]TJ T* -0.038 Tw (recovering from incidents of workplace violence.)Tj 1.8 -1.998 TD -0.0036 Tc 0.0143 Tw (The last section describes elements of good leadership,)Tj -1.8 -1.401 TD -0.0025 Tc 0.125 Tw (especially relating to both daily challenges and command)Tj T* -0.0037 Tc 0.0207 Tw [(decision making. The author concludes with guidelines for)]TJ 0 -1.398 TD -0.0038 Tc 0.0075 Tw (managing organizational stress for managers.)Tj /TT5 1 Tf 1.8 -2.001 TD -0.0064 Tc -0.0617 Tw (From Difficult to Disturbed)Tj /TT2 1 Tf 10.731 0 TD -0.006 Tc -0.0625 Tw [( is a valuable tool for manag-)]TJ -12.531 -1.401 TD -0.0037 Tc 0.094 Tw (ers, supervisors, human resource administrators, risk-man-)Tj 0 -1.398 TD -0.0038 Tc 0.0367 Tw (agers, and EAP coordinators.)Tj 1.8 -2.001 TD -0.0167 Tc -0.0623 Tw [(Laurence Miller)40.3(, Ph.D. is a clinical and forensic psycholo-)]TJ -1.8 -1.401 TD -0.0037 Tc 0.0192 Tw [(gist, educator)38.3(, author)35.3(, speaker)38.3(, and management consultant.)]TJ 0 -1.398 TD -0.0003 Tc 0.125 Tw (He maintains a private practice in psychology and works)Tj 0 -1.401 TD -0.0037 Tc -0.0621 Tw [(extensively with law enforcement, the judicial system, social)]TJ T* 0.0066 Tc 0.125 Tw [(service agencies, and private corporations. He conducts)]TJ 0 -1.398 TD -0.0036 Tc 0.0141 Tw (local, regional, and national continuing education programs)Tj 0 -1.401 TD -0.0512 Tw (and training seminars for mental health and legal profession-)Tj T* -0.0032 Tc 0.0122 Tw [(als, executives, managers, and employees. Dr)50.8(. Miller is the)]TJ 0 -1.398 TD -0.0036 Tc 0.0733 Tw (author of more than 200 print and online publications per-)Tj 0 -1.401 TD -0.0032 Tc 0.0555 Tw [(taining to the brain, behavior)35.8(, health, criminal justice, civil)]TJ T* -0.0035 Tc 0.0329 Tw [(law)62.5(, business management, and or)17.5(ganizational psychology)59.5(.)]TJ /F1 1 Tf 14 0 0 14 167.76 255.36 Tm 0.0008 Tc 0.1375 Tw (The Elements of Disaster Psychology:)Tj 1.5536 -1.1443 TD 0.012 Tc 0.1379 Tw [(Mana)5.6(ging Psyc)5.6(hosocial )96(T)78.7(rauma)]TJ /TT2 1 Tf 12 0 0 12 244.26 224.64 Tm -0.0143 Tc -0.0611 Tw (by James L. Greenstone)Tj 10 0 0 10 172.65 212.01 Tm -0.0048 Tc -0.0625 Tw [(Publisher: Charles C. Thomas, Springfield, Illinois 2008, 288pp.)]TJ 12 0 0 12 219.51 173.64 Tm -0.0232 Tc -0.0616 Tw [(Reviewed by Laurence Miller)31.8(, PhD)]TJ 10 0 0 10 72.51 148.65 Tm -0.0033 Tc 0.0775 Tw (Many mental health and emergency service personnel)Tj -1.8 -1.401 TD 0.124 Tw (recall that one of the less laudable aspects of the disaster)Tj 0 -1.398 TD -0.0036 Tc 0.06 Tw (response to the 1994 Oklahoma City bombing was the un-)Tj 0 -1.401 TD -0.0037 Tc 0.0878 Tw (called and uncoordinated convergence of scores of mental)Tj T* -0.0036 Tc 0.0957 Tw (health clinicians and volunteer debriefers from around the)Tj 0 -1.398 TD 0.0256 Tc 0.125 Tw [(country)61.6(, creating unintentionally and certainly well-)]TJ 25.449 6.999 TD -0.0037 Tc 0.0379 Tw (meaningly a second minidisaster as accommodations and)Tj 0 -1.401 TD 0.0535 Tc 0.125 Tw (resources had to be found for this new population.)Tj 0 -1.398 TD -0.0036 Tc -0.015 Tw (Overpromotion of services by untrained interveners became)Tj 0 -1.401 TD 0.0122 Tw (such a problem that reports emerged of firefighters and res-)Tj T* -0.0033 Tc 0.0885 Tw [(cue personnel wearing signs, saying Go )53.5(A)91.9(way)62.7(, Ive Been)]TJ 0 -1.398 TD -0.0125 Tw [(Debriefed. By 2001, training and service coordination had)]TJ ET endstream endobj 380 0 obj << /ProcSet [/PDF /Text ] /Font << /F1 4 0 R /TT2 9 0 R /TT3 10 0 R /TT5 21 0 R >> /ExtGState << /GS1 12 0 R /GS2 13 0 R >> >> endobj 382 0 obj << /Length 7641 >> stream 0 0 0 1 K 0 J 0 j 0.51 w 10 M []0 d /GS1 gs 1 i 66 59.745 m 558 59.745 l S BT /TT3 1 Tf 8 0 0 8 423.24 42.6 Tm 0 0 0 1 k /GS2 gs -0.0051 Tc 0.0326 Tw [(IJEMH Vol. 10, No. 2 2008 )]TJ /F1 1 Tf 15.3188 0 TD -0.009 Tc 0 Tw (165)Tj /TT2 1 Tf 10 0 0 10 66 722.64 Tm -0.0034 Tc 0.0668 Tw (improved to the point that, when emergency mental health)Tj 0 -1.398 TD 0.001 Tc 0.125 Tw (personnel were needed to aid victims and rescuers at the)Tj 0 -1.401 TD -0.0066 Tc -0.0622 Tw [(W)97.2(orld )20.4(T)34.2(rade Center disaster in New )32.4(Y)106.6(ork, most observers felt)]TJ T* -0.0034 Tc 0.1164 Tw (that the response was well-planned and effectively imple-)Tj 0 -1.398 TD -0.0072 Tc 0 Tw (mented.)Tj 1.8 -2.001 TD -0.0035 Tc 0.026 Tw (The lesson here is that good intentions and even top-)Tj -1.8 -1.401 TD -0.0034 Tc -0.0244 Tw (notch clinical skills are not enough if insufficient attention)Tj 0 -1.398 TD 0 Tw (is paid to the nuts-and-bolts practicalities of planning, coor-)Tj 0 -1.401 TD -0.0069 Tc -0.0622 Tw [(dinating, and implementing the disaster response. If the devil)]TJ T* -0.0031 Tc 0.0025 Tw (is in the details, then Jim Greenstone has got the old boy on)Tj 0 -1.398 TD -0.0035 Tc 0.0793 Tw (the run in his new book on )Tj /TT5 1 Tf 11.379 0 TD -0.0039 Tc 0.08 Tw (The Elements of Disaster Psy-)Tj -11.379 -1.401 TD -0.0051 Tc 0 Tw (chology)Tj /TT2 1 Tf 3.135 0 TD -0.0033 Tc 0.0294 Tw [(. Elements describes this book in two ways, first)]TJ -3.135 -1.401 TD 0.0683 Tw (by content, as a compendium of basic principles and prac-)Tj 0 -1.398 TD -0.0034 Tc -0.0495 Tw (tices of mental health disaster response, and second, in terms)Tj 0 -1.401 TD -0.0024 Tc 0.125 Tw (of structure, in that the entire volume consists almost en-)Tj T* -0.0028 Tc -0.0465 Tw (tirely of lists, charts, and tables, useful at first for delineating)Tj 0 -1.398 TD -0.0036 Tc 0.0343 Tw (important points, but after awhile bordering on becoming a)Tj 0 -1.401 TD -0.0039 Tc 0.0242 Tw (mind-numbing succession of numerals and bullet points.)Tj 1.8 -2.001 TD -0.0033 Tc 0.0862 Tw (The book begins by describing the basic principles of)Tj -1.8 -1.398 TD -0.0036 Tc 0.0883 Tw [(disaster management. )53.4(A)58.6( theme that runs through this vol-)]TJ 0 -1.401 TD 0.1206 Tw (ume is the vital importance of coordinating mental health)Tj T* 0.0015 Tc 0.125 Tw (services with other operational components of the rescue)Tj 0 -1.398 TD -0.0029 Tc (effort: mental health clinicians who are used to being the)Tj 0 -1.401 TD 0.0019 Tc (bosses in our little clinical offices are often shocked and)Tj T* -0.003 Tc -0.0473 Tw [(dismayed when they show up at the site of a disaster)36(, expect-)]TJ 0 -1.398 TD -0.0028 Tc 0.025 Tw [(ing to be treated like royalty)63.2(, but then relegated to the side-)]TJ 0 -1.401 TD -0.003 Tc -0.056 Tw [(lines or offered more mundane duties. Sorry doc, before you)]TJ T* -0.0032 Tc -0.0155 Tw (can conduct your debriefing groups and do your stress man-)Tj 0 -1.398 TD -0.0034 Tc 0.0605 Tw (agement exercises, weve got to stop the bleeding, pile the)Tj 0 -1.401 TD 0.0101 Tc 0.125 Tw (sandbags, and hand out the sandwiches want to help?)Tj T* -0.0052 Tc -0.0622 Tw (Mental health responders to any type of critical incident must)Tj 0 -1.398 TD -0.003 Tc -0.0556 Tw (learn to be team players, sometimes even secondary or ancil-)Tj 0 -1.401 TD -0.0072 Tc -0.0623 Tw [(lary members of the team. The overall goal is coordination of)]TJ T* -0.0035 Tc 0.0943 Tw (services, because without this organization, rescue and re-)Tj 0 -1.398 TD -0.003 Tc -0.0175 Tw (covery efforts will be wasted.)Tj 1.8 -2.001 TD 0.0017 Tc 0.125 Tw (Subsequent chapters deal with response mobilization)Tj -1.8 -1.401 TD -0.0032 Tc 0.0744 Tw (and call-out, what happens when you arrive at the disaster)Tj 0 -1.398 TD 0.07 Tw (site, and the types of stress intervention services provided.)Tj 0 -1.401 TD -0.0206 Tw (A particularly important topic is a discussion of psychologi-)Tj 25.5 54.999 TD -0.007 Tc -0.0624 Tw [(cal triage, determining priorities for treatment and what kinds)]TJ 0 -1.398 TD -0.0036 Tc 0.0283 Tw (of intervention \(debriefing, individual counseling\) are most)Tj 0 -1.401 TD 0.0142 Tw (appropriate for which individuals \(victims, relatives, rescue)Tj T* -0.0607 Tw [(personnel\) at which times \(before deployment, during rescue)]TJ 0 -1.398 TD -0.0034 Tc 0.01 Tw (and recovery operations, in the immediate and/or long-term)Tj 0 -1.401 TD -0.0019 Tc 0.125 Tw [(aftermath\). In other words, one size does not fit all, and)]TJ T* -0.0037 Tc 0.045 Tw (mental health responders must possess a range of interven-)Tj 0 -1.398 TD -0.0023 Tc 0.0955 Tw (tion skills that they can apply efficiently and flexibly to a)Tj 0 -1.401 TD -0.0032 Tc 0.0243 Tw (range of critical incident and mass casualty situations.)Tj 1.8 -2.001 TD -0.0036 Tc -0.0129 Tw (Interventions discussed in this book include taking care)Tj -1.8 -1.398 TD 0.0375 Tw (of victims, dealing with parents and children, handling sui-)Tj 0 -1.401 TD -0.0039 Tc -0.0625 Tw (cidal crises, and the appropriate use of communication skills.)Tj T* -0.003 Tc -0.05 Tw (It is probably here that the tabular format of this book is least)Tj 0 -1.398 TD 0.0894 Tw [(effective in conveying how clinical skills can be fruitfully)]TJ 0 -1.401 TD -0.0037 Tc -0.0244 Tw (applied one wishes the author would have illustrated some)Tj T* -0.0032 Tc -0.0075 Tw [(of his points through a more narrative expositional style. In)]TJ 0 -1.398 TD -0.0029 Tc -0.015 Tw (addition, this book may be trying to do too much, to be both)Tj 0 -1.401 TD -0.0034 Tc -0.0105 Tw [(an operations manual and a clinical guide. In this endeavor)35.6(,)]TJ T* -0.0032 Tc -0.0238 Tw (while it excels at the first, it appears to scrimp on the second)Tj 0 -1.398 TD 0.0097 Tc 0.125 Tw (and readers should consult more comprehensive clinical)Tj 0 -1.401 TD -0.0048 Tc -0.0622 Tw [(guides including many of the author)-40.8()52.2(s)0.4( own previous works,)]TJ T* -0.0032 Tc 0.078 Tw [(listed in the book)50.8(s bibliography to flesh out the clinical)]TJ 0 -1.398 TD -0.0036 Tc 0.0075 Tw (bullet points made in the present volume.)Tj 1.8 -2.001 TD -0.0015 Tc 0.125 Tw [(Still, it is these very bullet points, charts, tables, and)]TJ -1.8 -1.401 TD -0.0035 Tc 0.0305 Tw (numbered lists that are the elemental nuggets of this obses-)Tj 0 -1.398 TD 0.0064 Tw (sively \(in the good sense\) detailed operational compendium)Tj 0 -1.401 TD -0.0033 Tc 0.0379 Tw [(for mental health disaster responders. It is hard to imagine)]TJ T* -0.0029 Tc 0.1065 Tw (any item left out by this book, including what clothing to)Tj 0 -1.398 TD -0.0035 Tc 0.0545 Tw (pack, how to access and follow local rules and ordinances,)Tj 0 -1.401 TD -0.003 Tc 0.0327 Tw [(types of shelter)36(, and how to deal with injured pets \(did you)]TJ T* -0.0031 Tc 0.0373 Tw [(know youre not supposed to give aspirin to cats? Me nei-)]TJ 0 -1.398 TD -0.0075 Tc 0 Tw (ther\).)Tj 1.8 -2.001 TD -0.003 Tc -0.0372 Tw (While this is not the only book you should have on your)Tj -1.8 -1.401 TD 0.026 Tw [(shelf if you are a mental health disaster responder)36(, it is cer)18(-)]TJ 0 -1.398 TD -0.0034 Tc 0.1025 Tw [(tainly an indispensable one. 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