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      Development of a stepped care intervention model of evidence-based interventions for the management of posttraumatic stress in the Belgian Police Translated title: Desarrollo de un modelo de intervención de atención escalonada de intervenciones basadas en la evidencia para el manejo del estrés postraumático en la policía belga


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          Background: Police officers are frequently exposed to a wide variety of potentially traumatic events (PTE) and are therefore at a considerable risk of developing posttraumatic stress disorder (PTSD). Previous research estimated the point prevalence of PTSD in Belgian police officers at 7.4%, significantly higher than in the general population. An effective organisational strategy to manage posttraumatic stress is essential.

          Objective: We aimed to develop a novel organisational approach regarding traumatic stress for Belgian police, combining evidence-based strategies for the prevention and treatment of posttraumatic stress in a stepped care intervention model.

          Method: In a broad development process, we combined scientific literature, case studies of best practices from other police organisations with insights gathered from a number of expert panels, thematic working groups and feedback groups.

          Results: A comprehensive stepped care intervention model was developed, consisting of evidence-based interventions for the prevention and treatment of posttraumatic stress.

          Conclusions: The intervention model is a promising organisational strategy for the management of posttraumatic stress in police organisations based on evidence-based interventions. Its effectiveness will be studied in the coming years.


          • Police officers are at considerable risk of developing PTSD as they are consistently exposed to a wide array of PTE.

          • An adequate organisational response to manage the consequences of this exposure as much as possible is essential.

          • We developed a comprehensive stepped care intervention model consisting of evidence-based interventions, based on scientific literature, best practices in other police organisations, and thorough expert review.

          Translated abstract

          Antecedentes: Los oficiales de policía están frecuentemente expuestos a una gran variedad de eventos potencialmente traumáticos (EPT) y por ende corren un riesgo considerable de desarrollar trastorno de estrés postraumático (TEPT). Las investigaciones previas estimaron la prevalencia puntual de TEPT en el personal de policía belga de un 7.4%, significativamente más alta que la población general. Es esencial contar con una estrategia organizacional efectiva para manejar el estrés postraumático.

          Objetivo: Nuestro objetivo era desarrollar un enfoque organizacional novedoso relacionado con el estrés traumático en la policía belga, combinando estrategias basadas en evidencia para la prevención y tratamiento del estrés postraumático en un modelo de atención escalonada.

          Método: En un amplio proceso de desarrollo, combinamos literatura científica, estudios de caso de mejores prácticas de otras organizaciones de policía con puntos de vista recopilados de varios paneles de expertos, grupos de trabajo temáticos y grupos de retroalimentación.

          Resultados: Se desarrolló un modelo de intervención integral de atención escalonada, que consistía en intervenciones basadas en evidencia en la prevención y tratamiento del estrés postraumático.

          Conclusiones: El modelo de intervención es una estrategia organizacional promisoria para el manejo del estrés postraumático en las organizaciones policiales basado en intervenciones basadas en evidencia. Su eficacia se estudiara en los próximos años.

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          Most cited references66

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          Diagnostic and Statistical Manual of Mental Disorders

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            The Posttraumatic Stress Disorder Checklist for DSM-5 (PCL-5): Development and Initial Psychometric Evaluation.

            The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM-correspondent self-report measure of PTSD symptoms. The PCL was recently revised to reflect DSM-5 changes to the PTSD criteria. In this article, the authors describe the development and initial psychometric evaluation of the PCL for DSM-5 (PCL-5). Psychometric properties of the PCL-5 were examined in 2 studies involving trauma-exposed college students. In Study 1 (N = 278), PCL-5 scores exhibited strong internal consistency (α = .94), test-retest reliability (r = .82), and convergent (rs = .74 to .85) and discriminant (rs = .31 to .60) validity. In addition, confirmatory factor analyses indicated adequate fit with the DSM-5 4-factor model, χ2 (164) = 455.83, p < .001, standardized root mean square residual (SRMR) = .07, root mean squared error of approximation (RMSEA) = .08, comparative fit index (CFI) = .86, and Tucker-Lewis index (TLI) = .84, and superior fit with recently proposed 6-factor, χ2 (164) = 318.37, p < .001, SRMR = .05, RMSEA = .06, CFI = .92, and TLI = .90, and 7-factor, χ2 (164) = 291.32, p < .001, SRMR = .05, RMSEA = .06, CFI = .93, and TLI = .91, models. In Study 2 (N = 558), PCL-5 scores demonstrated similarly strong reliability and validity. Overall, results indicate that the PCL-5 is a psychometrically sound measure of PTSD symptoms. Implications for use of the PCL-5 in a variety of assessment contexts are discussed.
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              The Clinician-Administered PTSD Scale for DSM-5 (CAPS-5): Development and Initial Psychometric Evaluation in Military Veterans.

              The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record

                Author and article information

                Eur J Psychotraumatol
                Eur J Psychotraumatol
                European Journal of Psychotraumatology
                Taylor & Francis
                3 June 2024
                3 June 2024
                : 15
                : 1
                : 1-12
                [a ]Psychological Medical Service, Federal Police , Brussels, Belgium
                [b ]Center for the Psychology of Learning and Experimental Psychopathology , KU Leuven, Leuven, Belgium
                Author notes
                [CONTACT ] Nils Rentmeesters nils.rentmeesters@ 123456kuleuven.be Centre for the Psychology of Learning and Experimental Psychopathology , Tiensestraat 102, 3712, KU Leuven, 3000 Leuven, Belgium
                Author information
                © 2024 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group

                This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License ( http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. The terms on which this article has been published allow the posting of the Accepted Manuscript in a repository by the author(s) or with their consent.

                Page count
                Figures: 1, Tables: 1, Equations: 0, References: 68, Pages: 12
                Clinical Research Article
                Research Article

                Clinical Psychology & Psychiatry
                police,ptsd,stepped care,intervention model,evidence-based interventions,policía,tept,atención escalonada,modelo de intervención,intervenciones basadas en evidencia


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