Cultural Considerations

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ACCESSING AND TRAINING POLICE AND SECURITY PERSONNEL RELEVANT TO ETHNIC AND

CULTURAL SENSITIVITY

Laurence Armand French, Ph.D.* . NealWailes,Ph.D.** •

ABSTRACT

Law enforcement cross-cultural training and psychological screening is an increasingly important topic, given the increasing need for intemational police initiatives throughout the world today. The intensity of inter-ethnic conflict obviates any meaningful in-house measures or evaluations of these forces, whether they are civilian or military. While objective psychological and cultural measures exist, there are no universal standards for the assessments and training protocols. Clearly, the dilemma gets more complicated when the military is assigned policing duties in occupied countries. Internal ethnic strife only adds to the complexity of this phenomenon. This paper assesses the nature of this current problem while offering insights into practical solutions.

INTRODUCTION

The need for objective clinical measurements of law enforcement and security personnel in Central and Eastern Europe is a critical issue of concern in the region, given the questionable practices of ethnic cleansing subsequent to the break up of the former Soviet Union and the continued expose of these practices before the World Court in The Hague. Another

•Laurence Armand French, Ph.D., is Professor Emeritus of Psychology at Western New Mexico University and a senior research associate, Justiceworks at the University of New Hampshire. :

**S.N. Wailes, Ph.D., is Professor of Sociology and Crimitial .Justice at Jackson State University.

dimension of this phenomenon is the prevalence of United Nation peace keeping forces in this region, notably Kosovo and adjacent regions where continued conflict exists between Muslims and Orthodox Christians. Abuses in Iraq, by both United States and British troops, has highlighted recent interracial/ethnic abuses by the occupation forces in fray and by local military and police agents trained by the occupation forces. This concern also extends to the torture and execution of detained suspected enemy combatants in in-country and out-of-country holding facilities, including Guantanamo Bay, Cuba. This problem is so prevalent and the world outcry so intense that the United States was forced to report progress in its treatment of military prisoners, hi May 2006, the United States reported to the United Nations' anti-torture body that it has held 103 courts martial for the mistreatment of detainees in Iraq and Afghanistan. Moreover, the United States reported that another 170 investigations are pending. This review of abuses by the U.S. military was part of the UN committee's regular review of the 141 nations that ratified the Convention against Torture. More significantly, it highlights the intensity of racial, ethnic, and religious differences in the contemporary War on Terrorism. To best assess this phenomenon, we need to look at the screening of security forces in volatile situations, the mechanism of inter-group hostilities, intemational human rights guarantees, and the nature of collective stress. Classical sociological theories aid in understanding cultural conflict issues. Eric Goode provided the social philosophical foundation for these theories:

All civilizations set rules concerning what is real and what is not, what is true and what is false. All societies select out of the data before them a world... and declare that the real world. Each one of these artificially constructed worlds is to some degree idiosyncratic, unique. No individual views reality directly (Plato's Republic, Allegory of the Cave), in the raw, so to speak. What is commonly thought of as reality, that which exists, or simply is, is a set of suppositions, rationalizations,justifications, defenses, all generally collectively agreed-upon¿ which guide and channel each individual's perceptions in a specific and distinct direction....

Every society establishes a kind of epistemological methodology.

(Goode, 1969)

Theories of Social and Cultural Conflict

George Simnel (1955) and the major student of his work, Lewis Coser, (1955), elucidated the mechanisms and functions of social conflict. Much of their work is applicable to the ethnic and religious strife occurring today, regardless if it is Northern Ireland, the Horn of Africa, the Balkans, or the Middle East. Accordingly, objective, or calculated conflict, what Sinimel teamed realistic conflict, is that which is directed toward tangible social objectives such as scarce status, power, and resources. Non-realistic {s\ib]QcXivQ) conflict, in comparison, stems from social frustrations. In the former, conflict is viewed as a rational process directed toward the accomplishment of a specific goal, while the latter, aggression, becomes an end in itself.

It is generally understood that realistic conflict is widely used by botli special interest groups (power elites) and by those coveting power and authority (revolutionaries) while non-realistic conflict is most likely to engage individuals and/or groups who are caught up in crisis situations, including those generated by cultural conflict. Taken a step further, Simmel and Coser claimed that reciprocal animosities between cultural groups within a given society tend to strengthen both groups' internal cohesion while, at the same time, maintain the rigid class and/or caste structures and social distances that exist between these groups. This reciprocal process, in tum, creates a self-fulfilling prophecy that tends to perpetuate itself, and even to intensify, as the social distance between these groups increases. A corollary to this postulate is: The more rigid these divisions are within the society, the more insignificant will be the cultural gap and resulting psychological ambiguity among those caught up in this reciprocal conflict situation.

In these conflicts over ideologies and/or scarce resources, hostilities tend to preserve group boundaries, serving to establish and maintain the identity and boundaries of society and groups: "patterned enmities and

reciprocal antagonisms tend to conserve social divisions and systems of stratification." Here, realistic conflict, like the current fight over ideology and resources (oil), occurs when war is used as a deliberate means toward desired ends. Accordingly, war helps society overcome internal divisions, marginality, anomie, and alienation by providing an external source to target while, at the same time, it increases the internal cohesion of the group. The basic social psychological tenet here is: Out-group hostility increases in-group cohesion.

Similarly, R.E. Park (1950) and Schermerhom (1970) presented theories that addressed the psychological ramifications of cultural conflict. Park termed those people caught up in cultural conflict, marginals, viewing their plight to be the result of partial socialization within both their respective minority subculture and the majority society, without being adequately socialized in either social system. He linked this process to the colonial missionary effort among non-Christian cultures: "The Christian convert exhibits many, if not most, of the characteristics of the marginal man ^ the same spiritual instability, intensified self- consciousness, restlessness, andmalaise"(1950: 356). R. A. Schermerhom

. names the social outcasts, pariahs, suggesting their behavior could progress and/or regress along acontinuum, depending upon circumstances relevant to the majority/minority relations at any given time. He termed the variables ̂ tàges'.passive, exposed marginal, and activated inascending order of minority involvement within the majority society. Here, the passive stage is one of inactivity and ritualism, while the exposed marginal stage reflects social and/or personal strain between minorities and members of Hie dominant society. The activated stage is one of action on behalf of minority members often involving conflict and other forms of confrontation with the majority (ruling or occupying) society.

The works of both Park and Schermerhom address the behavioral and psychological ramifications associated with the transitional stages inherent within maj ority/minority relations, and their works certainly complement the Marxian concept of alienation. Clearly, similarities can be seen between Marx's (1965) Lumpenproletariat, Park's Marginal Man, and

Schermerhom's Pariah's concepts reflecting social disorganization. T. Sellin's (1938) conflict theoiy addresses similar concems from a cultural perspective. Sellin posited that contravening cultural conflict is often the basis of high incidents of crime, violence, and marginality within certain subcultures. His basic tenet is that the dominant society often imposes its ethnocentric perspective upon the minority culture(s). This strain results in primary conflict, while the resulting ambiguity activates infra-group hostilities ternied secondary conflict (conflicts in Palestine, Somalia, and Iraq are current illustrations of this phenomenon).

Hence, realistic conflict, planned animosities between competing powers, accounts for the initial conflict and the grounds for engagement, as well as for the propaganda needed to foster out group hostilities so as to solidify their members to support and participate in the ensuing conflict. However, psychological factors contribute greatly to the emergence of unrealistic conflict (such as mass murder, torture, and prisoner abuse) that accompanies these conflicts. Erik Erikson, the noted cultural psychiatrist, addressed the nature of mass alienation and its resulting trauma. Erikson termed this process cultural identity crises, a phenomenon he noted among U.S. military personnel returning home following World War II. The current situation is more complex, as the result of the merging of military and law enforcement personnel as peace keepers, law enforcement, including military police; standards do not adequately address the psychological factors associated with culturally engendered stress and trauma.

A Lack of Universal Standards for Law Enforcement Assessment

The problem with police and correctional personnel assessment is universal. While the scientific methods are clearly articulated, political interference obstructs their application. French (2002) offered objective measures in his article, "Intemationai Applications of Police Assessment: Predicting Aggression, Stress and Mental Disorders" cited in Milan's (2002) book. Policing in Central and Eastern Europe: Deviance, Violence,

and Victimization. In his article, French noted the convoluted legal battle in the United States to dilute objective measures because they might disclose intimate aspects of the person being tested, factors relevant to evaluating police, security, and correctional personnel (Blumberg, 1994; Bonifacio, 1991; Brewster & Staloff, 1999; Carpenter & Raza, 1987; Griffm & Ruiz, 1999; Hathaway & McKinley, 1989; Hargrave, et al., 1988; Hiatt & Hargrave, 1988; Matarazzo, et al., 1964).

The standard for recognition in the United States is the Commission on Accreditation for Law Enforcement Agencies (CALEA, 2002). CALEA was established in 1979 as an independent accrediting authority by the Intemational Association of Chiefs of Police (IACP); the National Organization of BlackLaw Enforcement Executive (NOBLE); the National Sheriffs' Association (NSA); and the Police Executive Research Forum (PEKE). While CALEA states global standards for "recruitment and selection" and training for police academies, it does not offer specific recommendations for psychological assessments (Pollone, 1992; Pope, et al., 1993; Rodgers, 1966; Rostov, et a l , 1999; Weiss, et al., 1999). The general standards are more directed toward existing anti-discriminatory laws in the United States: The academy has minority and female employees in approximate proportion to the makeup of the available work force in the academy's service community or has a recruitment plan (5.1.1).

A recent study of law enforcement screening in Texas indicates that a wide variety of psychological tools were used with few commonalties (Dantzker & McCoy, 2006). Moreover, on-going stress assessments are lacking. Marshall (2006), in her study, showed that repeated exposure to traumatic events was common among the law enforcement personnel involved in her Delaware sample. Clearly, on-going clinical assessments for stress are requisites for security personnel, regardless if they operate in military or civilian forces. The conflict between the National Guard personnel and the New Orleans Police toward Hurricane Katrina refugees in August 2005 clearly reflects this phenomenon.

Evidently, the United States does not offer the ideal model for the best practice in law enforcement assessment. Indeed,' its standards today

would obviate membership in the European Union, making the standards held out for former Soviet Union members such as Bosnia more stringent than those mandated in the United States. This is only speaking of civilian law enforcement and correctional agencies. It does not address the serious problem in the U.S. military where National Guard and Army, Air Force, Navy, and Marine Corps reserve units are reassigned as military police without adequate training fpr the MOS (Military Occupational Specialty).

Unfortunately, the U.S. military, in its quest for volunteers, has greatly relaxed its educational and criminal background requirements, even allowing neo-Nazi and other racist extremists to sign up. Holthouse (2006) notes that hundreds of neo-Nazis identify online as active duty soldiers and that extremists in the military are difficult to expose because they are not as open as gang members and other groups. The rules were tightened after the Oklahoma City bombing, when it was discovered that the principal participants all got their training in the U.S. Army. Even then, future terrorists slipped through the system, including Eric Rudolph who set off a bomb at the Atlanta Summer Olympics, as well as at abortion clinics. He was trained at the Air Assault School while in the lOP* Airborne Division at Fort Campbell, Kentucky. John Allen Muhammad, the convicted mastermind of the Beltway sniper attacks, was a U.S. Army Gulf War veteran who wanted the $ 10 million ransom to establish a black separatist nation in Canada. Making matters worse, racism is often

. promoted by high-ranking officers, allowing for a milieu of violence and abuse toward the perceived enemy (out-group), including civilians. This atmosphere gives credence to abuse among troops, especially when under stress. A common volatile combination is marginalized undereducated individuals with character deficits and/or mental instability and combat stress. Private Steven Green, the gang leader charged with the rape and murder of a 14-year-old Iraqi girl and her family is aprime example of this phenomenon (Childress & Hirsh, 2006). Also in the news is the accusation that a detachment of U.S. Marine Corps killed 24 Iraqi civilians following the death of one of their men in November 2005 (Thomas & Johnson, 2006).

These cases are only some that were found out by outside sources. It is common practice with the military culture, notably the United States military, to cover up these incidents. This practice is also common among police forces and among correctional officers. Here, the perceived notion that civilians, regaidless if they are their own people or foreign, represent a potential enemy (out-group) allows for a tight in-group cohesion among these armed personnel, ironically licensed to protect civilians.

Clearly, the mix of contravening ethnic/religious groups provides for potentially volatile eruptions, both between the indigenous groups and between the indigenous group and the outside peace keeping forces. The potential for both manifest and latent sources of inter-group violence needs to be addressed if the policing agents are to control, and not exacerbate, existing potentials for hostilities and aggression. Added to this combustible formula is the lack of a consistent training baseline among these various policing forces. To illustrate, an increasing number of military personnel are being assigned policing duties in the occupational regions, including Iraq, Afghanistan and Kosovo, regardless of their original MO S (Military Occupational Specialty). This practice included using U.S. National Guard and Reserve units, as well as active-duty Navy and Air Force enlisted personnel, as military police and security forces. Most often, the military persormel assigned as police do not receive adequate law enforcement training or ethnic/cultural sensitivity training. Indeed, many of these same individuals may have recently completed a combat tour in Iraq or Afghanistan under their regular MO S and, hence, still carry the proactive stigma of viewing the enemy in extremely negative terms. Trading battle hate for community compassion is not an easy transition under any circumstance but is even more difficult when there is little, or no, retaining in the area of law enforcement. Part ofthe problem with civilian and detainee abuse has been attributed to the effectiveness of America's military psychology of presenting the enemy in clearly negative, hostile stereotypes—those of radical, anti-Christian, Muslims.

Add to this the collective impact of a social crisis, such as the terrorist attacks of September 11,2001 and the dynamics ofgroup inclusion versus exclusion become simplified into an us-versus-them polarization. Indeed, the neurophysiology of the human brain allows for up to six months for a rational assessment to overcome our emotional disorganization (ICD, DSM, Adjustment Disorder; Acute Stress Disorder, Post-Traumatic Stress Disorder). It is during this period that geopolitical action is crucially relevant to a reasonable solution to the crisis. When the polarization of the out-group arid the cohesion of the in-group become reciprocal, hostilities are likely to abound. Here, the group attribution bias plays a significant role where negative actions of the out-group are seen as being deliberate and pervasive (internal disposition), and misdeeds of the in- group are dismissed as exceptionalities (a few bad apples) and not attributed to the group norm (external situation). Often, the out-group is dehumanized (uncivilized, barbaric, animalistic, great Satans, fanatic Islamic butchers) thereby providing a justification for harsh treatment (shock-and-awe massive bombardments, assassinations, torture, and homicide) of the perceived enemy. In pitted ideological combat situations, the degree of in-group cohesion intensifies leading to loss of individuation (diminished capacity for value assessment) and the increased likelihood of group-think and risky behaviors (risky-shift phenomenon). This phenomenon occurs at the top political and military echelons, as well as on the battlefield.

Suicide bombers fit E. Durkheim's concept of altruistic suicide. This act represents the highest degree ofgroup cohesion and loss of individuation. While these acts are deplored by those targeted, they carry the highest honor among the in-group. All societies have recognized altruistic suicide during war as a high honor presenting their most coveted medals for these acts, whether it be a Marine jumping on a grenade to save his buddies, a kamikaze pilot, or a suicide bomber. Out-group hostilities intensify when in-group dissension is suppressed, as it was during the George W. Bush administration and the Taliban. No one was allowed to play the Devil's advocate role, hence leading to a quagmire where both

parties feel compelled to "stay the course" or "lose face." Obviously, sociocultural analysis of out-grpups is paramount for effective training of security forces, whether they are military, police, or corrections. This needs to be done at both the political and tactical levels if the level of hatred and hostility toward an entire population is to be reduced. This would also aid in reducing the overall stress level of those on the front lines. What is also needed is a better understanding of police and combat stress and ways to assess and treat it.

The Clinical Spectrum of Trauma

Physical trauma, such as loss of limbs, bums, lacerations, and the like, heals more quickly than do the psychological residual associated with traumatic events. Experiencing a traumatic eVent in which others died can also have a devastating psychological effect on survivors. Often the psychological effects are Isáent and subtle and only surface later following losses in one's life. Anniversaries of traumatic events act as triggers, as do similar events, as those that caused the initial psychological trauma. Effective treatment of traumatic events is challenging, given that these events are registered in the sub-cortical regions of the brain where emotions are processed. Although post-traumatic stress disorder was first classified as a specific mental condition in 1980 in the Diagnostic and Statistical Manual of Mental Disorders, Third Edition (DSM-III) the actual mechanisms of trauma were not well understood until the 1990s when the advent of advanced brain imaging became available. Neurophysiologic and neuropsychological research challenged the long- held psychoanalytical premises that serious psychological problems could be treated rationally engaging the cerebral cortex. Research has found that sub-cortical functions, notably those in the greater limbic system, play a significant role in emotional disturbances, and treatment that addresses those areas of the central nervous system (CNS) offer the best chances for remission of severe symptoms (Shin, et al., 2005). These treatments rely heavily on new advances made in psychopharmacology

with medications that address the major neurotransmitters and rieuromodulators associated with anxiety, depression and psychosis (Adams, etal., 1996; APA, 1980; 2002). ^

Brain activity associated with anxiety and depression, the most common symptoms of psychological trauma, include the ventral prefrontal cortex, the eingulate cortex, the amygdale and the hippocampus. These are the major central nervous system components associated with the regulation of emotions. Moreover, serotonin, the major neuromodulator, plays a significant role in how these regions communicate. Here, the ventral prefrontal cortex (lying within the cerebral cortex) plays the executive role within the brain's neural circuitry providing us vvith an interpretation of sub-cortical dysregulation. Theneurophysiological effect of emotional stress secondary to depression or anxiety results in a reduction of glial cells and, subsequently, diminished capacity for GA- ergic processes vital to inhibitory responses, (GABA being the major inhibitory neurotransmitter) (Woods, et al., 1988). An article in the Journal of Clinical Psychiatry surveyed recent research on this topic:

... studies implicate abnormalities in the ventral prefrontal cortex in anxiety disorders, including posttraumatic stress disorder (PTSD) and panic disorder. Reduced inhibition in the ventral prefrontal cortex is suggested by reduced ligand binding to GAEA receptors in both panic disorder and PTSD. Those with PTSD or panic disorder showed enhanced norepinephrine release and activation of the noradrenergic systems compared with health subjects when exposed to traumatic reminders, phobic stimuli, or yohiznbine. The orbital frontal cortex was one of the areas in the brain that distinguished patients with PTSD or panic disorder from healthy subjects. (Keller, 2005: 1478)

Similar research indicates significant impact within the greater limbic system, notably within the amygdale and hippocampus. The amygdale is the sub-cortical CNS component most closely associated with emotional expression and it is found to have a direct connection to the orbital frontal cortex. The amygdale, in tum, is wired to other brain regions that control aspects of physiologic, hormonal and cognitive expressions of emotions including the responses of the autonomie nervous system (ANS), located within the peripheral nervous system (PNS). Exaggerated activity in the amygdale is shown when PTSD is present, hence contributingtoadistortionofemotional experiences and perceptions. Similarly, the hippocampus, that region of the CNS that accesses and processes memory, is impacted by stress. It also has the capacity to influence emotional context or mood. Postmortem findings indicate serious atrophy of the hippocampus among clients suffering from severe or chronic stress, including those diagnosed with PTSD (Fava, et al., 2005).

Chronic stress depletes the body of its restorative functioning, often leading to a host of associated health issues. This phenomenon was first noted by Hans Selye in the 1920s as the General Adaptation Syndrome. Selye posited that continued stress causes a spiraling decomposition of the body's immune system through a three-stage process: an alarm reaction, a stage of resistance, and a stage of exhaustion or desperation (Huethner, 1996). Research since the 1990s better explains the particulars involved in this process. The physiological reactions involve the major stress hormones. Glucocorticoids, notably cortisol, is released by the adrenal gland of the PNS which helps maintain homeosatatis by regulating certain enzymes. During stress, cortisol plays a major role in increasing blood glucose levels and elevating blood pressure, necessary processes within the arousal state of the autonomie nervous system. The limbic system controls cortisone production by regulating the release of the corticotrophin, releasing hormone (CRH) from the hypothalamus via serotoniergic, dopaminergic, and cholinergic neurons. CRH stimulates release for the adrenocorticotrophic hormone (ACTH) from the anterior pituitary. ACTH,

in tum, activates adenylae cyclase in the adrenal cortex. The adrenal cortex represents the endocrine organ that secretes corticosteroirds for metabolic processing—aldostrone for sodium retention in the kidneys, androgens for male sexual development, and estrogens for female sexual development. In addition, the adrenal medulla secretes epinephrine (adrenaline) and norepineephrlne (NE) for the activation ofthe sympathetic mode ofthe autonomie nervous system responses (French, 2003; 2005).

Another stress response involves the locus coemleus, located in the brain stem where the rich supply of norepinephrine (NE) is stored. The noradrenergic hypothesis holds that intense, recurring anxiety, such as that caused by PTSD, is caused by either hypersensitive neurons in the locus coeruleus or by a dysfunction in the natural braking mechanism (hyperpolarizationprocess), or both. Excitable stimuli, drugs/medications, or subtle factors, independently or in combination, can act as acute anxiety triggers that can result in impulsive responses. The fimction ofthe locus coeruleus is to allow the brain stem neuron to release NE (noradrenaline) back upon itself, a mechanism that is more rapid than that which occurs within the traditional synaptic inter-neuronal network (a major web of hypervigilance in PTSD clients). Once stimulated, the locus ceruleus cell continues to fire, alerting signals to the sub-cortical limbic system, uninhibited by the normal braking mechanisms. Here, anti-panic agents (antidepressants, anxiolytics medications) are thought to have an effect by normalizing the cell's self-stimulation. Benzodiazepines, a class of anxiolytics, reinforce the braking effect by acting as a GABA agonist. Beta-blockers and ace inhibitors may also be helpful in maintaining future episodes by raising the excitability threshold ofthe autonomie sympathetic reaction. Other interventions address the intensity of the limbic system impulses with the use of mood stabilizers.

Assessing and Diagnosing Trauma

Traumatic stress falls in a clinical continuum that, in ascending order according to Intemationai Classifications of Diseases (1CD-3-CM & ICD-10), would include bereavement (V62.82); adjustment disorders;

substance-related disorders; depressive disorders; anxiety disorders, and even psychotic disorders (APA, 2000; Groth-Mamat, 1997). The most common serious mental disorder associated with stress is Posttraumatic Stress Disorder (PTSD). Untreated acute or chronic stress secondary to traumatic events can result in PTSD. Adequate clinical responses to traumatic disasters, however, can do much to prevent PTSD, relegating the stress reaction to a more treatable condition such as an Adjustment Disorder or an Acute Stress Disorder (Ursano, at al., 1999, 2006).

Collective trauma is a consequence to significant disasters, either natural or man-made, such as a deadly tsunami or hurricane or terrorist attack. Everyone involved gets caught up in mass social and emotional disorganization because of the disruptive nature of the event on his or her everyday life. Generally speaking, those directly involved in these stressful events suffer, at minimum, from an Adjustment Disorder: "The development of emotional or behavioral symptoms in response to an identifiable Stressor occurring within three months of the onset of the- Stressor" (APA, 2000:285). The Adjustment Disorder is considered to be acute if the disturbance lasts less than six months and chronic if it persists for six months or longer. Adjustment Disorders can be with Depressed Mood (3 09.00), with Anxiety (309.24), with Mixed Anxiety and Depressed Mood (309.28), with Disturbance of Conduct (309.30), or with Mixed Disturbance of Emotions and Conduct (309.4(3). Adjustments Disorders reflect the nature and extent of neurological deregulation significant Stressors have on our Central Nervous System. Adequate neuro- compensation usually occurs within six months. If symptoms persist, then other diagnoses need to be ruled out, including depression, anxiety, and psychosis.

Most people affected by the 2001 terrorist attacks on the U.S.A., the 2004 massive South Asia tsunami, or the 2005 hurricanes, Katrina and Rita, likely experience a bout of Adjustment Disorder. For the vast majority of these individuals, the major symptoms diminished six months or so following the initial disaster. Some would retain residuals of depression or anxiety depending on their pre-morbid susceptibility to

these conditions. People adversely affected by these disasters are more likely to experience the more severe Acute Stress Disorder, while those only tangentially affected could be afflicted by sympathetic bereavement. Self-medication by means of substance use is also common during these times of stress adjustment.

Acute Stress Disorder is likely when, a person is exposed to a traumatic event in wliich they feel that they are threatened by serious injury or even death. The autonomie neurological deregulation process here involves three or more ofthe following dissociative symptoms:

1. A subjective sense of numbing, detachment, or absence of emotional responsiveness,

2. A reduction in awareness ofhis or her surroundings (being in a daze),

3. De-realization,

4. Depersonalization, and

5. Dissociative amnesia (inability to recall significant aspects ofthe trauma).

Also, the traumatic event is persistently re-experienced as the result of recurrent images, thoughts, dreams, illusions, flashbacks, or a sense of reliving the experience; or distress on exposure to reminders of the tratimatic event; marked avoidance of stimuli that arouse recollections of the trauma with marked symptoms of anxiety or increased arousal (difficulty with sleep, irritability, poor concentration, hyper vigilance, exaggerated startle response, or motor restlessness). For this diagnosis, the disturbance needs to exist for a minimum of two days and a maximum of four weeks occurring within four weeks of the traumatic event, resulting in a serious impairment in social, occupational, or other important aspects of one's life (APA, 2000: 221-22).

Posttraumatic Stress Disorder has similar symptoms but is even more severe in that the dissociative nature ofthe disorder is more difficult to address clinically. PTSD patients often feel as if the traumatic event

is recurring, causing them to seek methods of escape, including self medication with mind-altering substances (alcohol, tobacco, etc.). Attempts at avoiding stimuli perceived as being associated with the trauma and numbing experiences include:

1. Efforts to avoid thoughts, feelings, or conversations associated with the trauma. Efforts to avoid activities, places, or people that arouse recollections of the trauma.

2. Liability to recall an important aspect of the trauma.

3. Markedly diminished interest or participation in significant activities.

4. Feelings of detachment or estrangement from others. 5. Restrictive range of affect (unable to maintain intimate

relationships). 6. Sense of foreshortened future (does not expect to have a career,

family or a normal life span).

Persistent symptoms of PTSD include: 1. difficulty falling or staying asleep,

2. irritability or outbursts of anger, . 3. difficulty concentrating, 4. hyper vigilance, and/or 5. exaggerated startle response.

PTSD can be classified as acute if the duration of symptoms is less than 3 months, chronic if the duration of symptoms is 3 months or longer, or with delayed response if the onset of symptoms is at least 6 months following the Stressor (APA, 2000:219-20).

A serious side affect of delayed PTSD is suicide (Raymond, 1988; Stockmeier, et al., 1998). This is problematic among combatants fighting a prolonged war where suicide bombings and roadside explosive devices exacerbate anxiety levels. Survival guilt is yet another symptom that impacts PTSD. It is now estimated that four out of five service members returning from the wars in Iraq and Afghanistan, who are considered risks for PTSD, do not receive adequate assessments or treatment. While a number of assessment tools are available, the most widely used evaluation

methods include the Kdental Stares Exani, the diagnostic criteria of the DSM-IV-TR, and the MinnesotaMultiphasic Personality Inventory (MMPI; IvINIPi-2) (Graham, 2000; Green, 2000; Pope, et a l , 1993). The U.S. Veterans Administration employs group therapy sessions, substance-use disorder therapy, and the use of sertraline (Zoloft)--an SSRI (select serotonin reuptake inhibitor) that addresses both depressive and anxiolj'tic symptoms. Serious dissociative symptoms, including Brief Psychotic Disorders (298.80) often require the addition of a neuroleplic agent.

Any viable cross-cultural and psychological training mission with security forces, especially those seeing action in alien cultures, needs to be cognizant of the mitigating psychological factors that are likely to trigger either marginality and / or intense outwardly directed hate toward the group that they perceive as causing their stress. Adequate police training needs to involve independent, objective measures of charter logic, psychiatric, and socio-religious biases and how individual law enforcement or correctional personnel can check these human attributes in the conduct of their professional duties. All military and law enforcement personnel should also be schooled in the geo-politics surrounding the social divisions with which they are involved in their peace keeping capacit}'. This is no easy order, but it is required if the levels of stress and resulting trauma and violence are to be curbed.

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