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The Examination of Different Pathways Leading Towards Police Traumatization: Exploring the Role of Moral Injury and Personality
in Police Compassion Fatigue
by
Konstantinos Papazoglou
A thesis submitted in conformity with the requirements for the degree of Doctorate of Philosophy
1.1 Life Threat and Ethic of Care in Police Work ..................................................... 1
1.2 Psychological Trauma and Resilience in Police .................................................. 2
1.3 Police Culture: The “Blue Brothers and Sisters” ................................................. 4
1.4 Compassion Fatigue and Compassion Satisfaction in Police .............................. 5
1.4.1 Compassion Fatigue vs. Burnout ........................................................... 7
1.4.2 Compassion Fatigue vs. PTSD .............................................................. 8
1.5 The Role of Negative Personality Traits Towards Traumatization ................... 10
1.5.1 Dark Triad of Personality Traits .......................................................... 11
1.5.2 Dark Triad of Personality Traits and Trauma ...................................... 12
1.6 Moral Injury in Police Work .............................................................................. 13
1.7 Identifying the Gap in the Scientific Literature ................................................. 15
Chapter 2 Study 1 ........................................................................................................... 17
Study 1: Exploring the Association between Authoritarianism, Compassion Fatigue, and Compassion Satisfaction among Police Officers. ........................................ 17
2.4.4 The Challenge of Measuring Authoritarianism in Police .................... 36
2.4.5 Study Limitations ................................................................................. 39
2.4.6 Implications and Recommendations .................................................... 39
Chapter 3 Study 2 ........................................................................................................... 42
Study 2: Examining the Relationship between Dark Triad of Personality Traits, Compassion Satisfaction, and Compassion Fatigue among Police Officers. .................. 42
3.4.3 Dark Triad of Personality Traits .......................................................... 55
3.4.4 Limitations and Future Research ......................................................... 57
Chapter 4 Study 3 ........................................................................................................... 59
Study 3: Exploring the Role of Moral Injury and Personality towards Police Traumatization .................................................................................................................... 59
Table 5. Study 1 – Regression Model Predicting Compassion Satisfaction (n=276) ... 117
Table 6. Study 1 – Regression Model Predicting Compassion Fatigue (n=276) .......... 118
Table 7. Study 1 – Regression Model Predicting Burnout (n=276) .............................. 119
Table 8. Study 2 – Descriptive Results ......................................................................... 120
Table 9. Study 2 – Correlation Results ......................................................................... 121
Table 10. Study 2 – Regression Model Predicting Compassion Fatigue (n= 1,010) ...... 122
Table 11. Study 3 – Descriptive Statistics for the Variables Describing the Sample ..... 123
Table 12. Study 3 – Descriptive Statistics for the Study Variables ................................ 124
Table 13. Study 3 – Correlation Results ......................................................................... 125
Table 14. Study 3 – Fit Indices and Their Threshold Values .......................................... 126
Table 15. Study 3 – Fit Indices for the Measurement Models ........................................ 127
Table 16. Study 3 – Fit Indices for the Structural Models .............................................. 128
Table 17. Study 3 – Path Coefficients for the Structural Model with Path from DT to “Others-focused” Moral Injury Unconstrained (Model 2) .............................. 129
Table 18. Study 3 – Path Coefficients for the Structural Model without Direct Paths from the DT to Compassion Fatigue and PTSD (Model 3) ............................ 130
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List of Figures
Figure 1. Study 1 – Distribution of Compassion Fatigue ............................................... 131
Figure 2. Study 1 – Distribution of Compassion Satisfaction ........................................ 132
Figure 3. Study 1 – Distribution of Burnout ................................................................... 133
Figure 4. Study 2 – Distribution of Compassion Fatigue ............................................... 134
Figure 5. Study 2 – Distribution of Compassion Satisfaction ........................................ 135
Figure 6. Study 2 – Distribution of Burnout ................................................................... 136
Figure 7. Study 2 – Prevalence Rates: Compassion Fatigue, Compassion Satisfaction, and Burnout ................................................................................ 137
Figure 8. Study 2 – Prevalence Rates: Machiavellianism, Narcissism, and Psychopathy . 138
Figure 9. Study 3 – Distribution of Compassion Fatigue ............................................... 139
Figure 10. Study 3 – Distribution of Compassion Satisfaction ........................................ 140
Figure 11. Study 3 – Prevalence Rates: Compassion Fatigue and Compassion Satisfaction ...................................................................................................... 141
Figure 13. Study 3 – Prevalence Rates: Dark Triad of Personality .................................. 143
Figure 14. Study 3 – Prevalence Rates: Moral Injury ...................................................... 144
Figure 15. Study 3 – Structural Model with Path from DT to “Others-focused” Moral Injury Unconstrained (Model 2) ..................................................................... 145
Figure 16. Study 3 - Structural Model without Direct Effects from DT to Compassion Fatigue and PTSD symptoms (Model 3) ......................................................... 146
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List of Appendices
Appendix A Study 3 – Short Dark Triad (SD3) Scale – Narcissism Subscale Items Removed ............................................................................................ 147
Appendix B Study 3 – Short Dark Triad (SD3) Scale – Psychopathy Subscale Items Removed ............................................................................................ 148
Appendix C Study 3 – Items Used to Identify-Score Latent Variables in Measurement Model ................................................................................ 149
Appendix D Study 3 – Items Used to Identify-Score Latent Variables in Structural Model 1 ................................................................................... 151
Appendix E Study 3 – Items Used to Identify-Score Latent Variables in Structural Model 2 ................................................................................... 153
Appendix F Study 3 – Items Used to Identify-Score Latent Variables in Structural Model 3 ................................................................................... 155
1
Chapter 1
Introduction
1 Introduction
1.1 Life Threat and Ethic of Care in Police Work
Most people, if asked about the actual work involved in being a police officer, would
probably suggest that police work mainly focuses on crime investigations, patrol, and arrest
of criminals. Nevertheless, the reality of what first responders’ work entails is more complex
than many people may presume. Undeniably, police officers are often crime fighters and, as
such, they are sworn and mandated to respond to virulent crimes (i.e., terrorism attacks,
murders) and arrest the criminal(s) (Haugen, Evces, & Weiss, 2012). Notwithstanding, the
other side of the coin reveals that police officers often support victims of crimes (i.e., abused
children, battered women) as well as victims of natural disasters and accidents, being more
often amongst the first responders present at the accident and crime scenes and give solace to
Nevertheless, each DT personality trait is distinct in some ways from the other two.
Narcissism encompasses excessive love for one’s self, self-centeredness, feelings of
superiority, and the tendency towards dominance (Vernon et al., 2008). Machiavellianism is
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characterized by cold and manipulative behavior as well as insincerity, self-interest, and
deception, especially in periods of acquaintance (Jakobwitz & Egan, 2006; Jonason, Li,
Webster, & Schmitt, 2009; Jonason & Tost, 2010; Jones & Paulhus, 2011). Psychopathy is
distinguished by the tendency to exploit others, a lack of empathy or remorse, high
impulsivity, stimulation-seeking behavior, and manipulation of others (Hodson, Hogg, &
MacInnis, 2009; Jones & Paulhus, 2011). In addition, individuals with psychopathic
subclinical personality traits may exhibit anti-social behavior, selfishness, and a lack of self-
control (Jonason, Koenig, & Tost, 2010; Jonason & Tost, 2010).
In a study with undergraduate students (n=84), Ali, Amorim, and Chamorro-Premuzic
(2009) presented their participants with sad images. Their results revealed that elevated
levels of Machiavellianism and psychopathy were positively associated with experienced
sadness by other people; that is, the participants in the study experienced (or at least self-
reported) pleasurable affect when they looked at images of people who were sad.
Furthermore, their findings indicated that, when participants were presented with neutral
images, elevated levels of Machiavellianism and psychopathy were both associated with
experienced negative affect among study participants. In their meta-analysis, O’Boyle et al.
(2012) explored the relationship between DT personality traits and job performance. Their
findings suggested that the presence of DT personality traits was often an indication of
counterproductive work behavior and poor job performance. Consequently, O’Boyle et al.
(2012) posited that elements pervasive in DT personality traits may lead to disrupted
workplace relationships and ostracism. Indeed, high levels of Machiavellianism in an
individual may be accompanied by a tendency for them to be overpowering in workplace
relationships and to manipulate their co-workers. Similarly, narcissism may be manifested in
the form of hyper-competitiveness and a sense of superiority in the work environment.
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Furthermore, psychopathic tendencies may find their outlet in emotionless, violent, and
aggressive behavior that jeopardizes the safety of other employees.
3.1.5 Study Aims and Hypotheses
Aim 1. The present study aims to examine the prevalence rates of the following variables
among police officers: compassion fatigue, compassion satisfaction, burnout,
Machiavellianism, narcissism, and psychopathy.
Hypothesis 1. It is expected that officers will report elevated compassion fatigue and
moderately elevated levels of burnout that are consistent with chronic exposure to trauma.
Based on the existing literature, it is also expected that compassion satisfaction will be
moderately elevated, and that the prevalence rates of DT personality traits
(Machiavellianism, narcissism, and psychopathy) will be low.
Aim 2. To explore the relationship among the following variables: compassion fatigue,
compassion satisfaction, burnout, years of experience, Machiavellianism, narcissism, and
psychopathy.
Hypothesis 2. Compassion fatigue and burnout will be positively correlated with one another
and negatively correlated with compassion satisfaction. Furthermore, it is also expected that
all three DT personality traits will be positively correlated. Significant correlation is
expected between the DT personality traits and compassion fatigue, compassion satisfaction,
and burnout. The author argues that the negative components (e.g., self-centered,
manipulative, ego-centricism) pervasive among individuals with DT personality traits
prevent those individuals from experiencing compassion satisfaction, as individuals with DT
traits may remain aloof and emotionally disconnected from victims of crimes. In addition,
the author contends that years of experience will be associated with compassion fatigue,
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compassion satisfaction, and burnout due to the fact that police officers experience multiple
potentially traumatic incidents over the course of their career.
Aim 3. To examine the role of certain variables (compassion satisfaction, years of police
experience, Machiavellianism, narcissism, and psychopathy) in predicting compassion
fatigue.
Hypothesis 3. It is expected that DT personality traits, compassion satisfaction, burnout, and
years of experience are significant predictors of compassion fatigue.
3.2 Method
3.2.1 Participants
All participants were White European (Finnish) individuals who, at the time of data
collection, served with the National Police of Finland. There was a total of (n=1,173)
participants, of which 880 were male. The participants in this study were employed in
different positions with the organization (e.g., police dispatchers, investigations officers) and
reported that they had experienced critical incidents during their police career (Table 8).
3.2.2 Procedures
Survey responses for this study were collected using an online internal police survey program
named “Webropol.” Webropol is a high-security web network that is commonly used to
distribute surveys to everyone employed by the National Police of Finland. Survey study
weblinks were sent to officers within various police departments in Finland as well as to
members of the National Bureau of Investigation, Police University College, and Finland’s
Security Intelligence Service. The officers that were included in this study were individuals in
positions where secondary trauma may be experienced on a regular basis. Participation in the
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study was completely voluntary and officers did not receive any compensation for completing
the survey. The response rate was 15.24% (1,173 respondents out of 7,695 officers who
received the study weblink). After clicking the weblink, participants were asked to give their
consent for their participation in the study; once consent had been obtained, the participants
were asked to provide demographic information related to topics such as their length of
service and their current area of work. Following the demographic questions, they then
completed the survey questionnaires, which are described in the following section.
3.2.3 Measures
Compassion Satisfaction and Fatigue (CSF) Test. The “Compassion Satisfaction and Fatigue
Self-Test for Helpers” (CSF) was used to assess the compassion satisfaction and fatigue
variables (Figley & Stamm, 1996). The CSF test is a scale based on self-reporting and
consists of three subscales with a total of 66 items that are presented on a Likert-type scale
ranging from 0-5 (0=never to 5=very often). The three subscales measure a participant’s
level of compassion fatigue, compassion satisfaction, and burnout, and their score for each
subscale corresponds to one of the following categories: extremely low, low, moderate, high,
and extremely high. The CSF shows good reliability with high Cronbach’s alpha reliability
values on all three subscales; this reliability has been demonstrated in previous research
wherein compassion fatigue, compassion satisfaction, and burnout had reliability levels of
.87, .87, and .90, respectively (Bride, Radey, & Figley, 2007). Within the measures of this
study, compassion fatigue showed a reliability score of .89, compassion satisfaction yielded
a score of .92, and burnout had a reliability score of .84.
Short Dark Triad of Personality (SD3). The short dark triad (SD3) is a scale used to measure
a cluster of three different personality traits—namely, Machiavellianism, narcissism, and
sub-clinical psychopathy—that provide insight into the individual characteristics of
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participants (Paulhus & Williams, 2002; Jones & Paulhus, 2014). The SD3 scale is
composed of 27-items in total with 9-items for each of the three targeted personality
characteristics. These 27-items have been found to have good construct, convergent, and
discriminant validity in previous research (Jonason & McCain, 2012). In addition, the
Cronbach’s alpha reliability scores for this study yielded similar values to those found in
previous studies in which narcissism yielded reliability scores of .84 and .86, psychopathy
produced scores of .75 and .78, and Machiavellianism scored of .75 and .58 (Jonason, Li,
Webster, & Schmitt, 2009; Jonason & Tost, 2010). More recently, research into the
reliability of the short dark triad has shown narcissism as having a score of .68, psychopathy
having a score of .72, and Machiavellianism with a score of .74 (Jones & Paulhus, 2014).
Within the present study, Machiavellianism received a reliability score of .76, narcissism had
a score of .61, and psychopathy yielded a score of .70.2
3.2.4 Data Analysis Plan
One of the present study primary research questions was to estimate prevalence rates of
compassion fatigue, compassion satisfaction, burnout, and DT personality traits
(Machiavellianism, narcissism, psychopathy). Thereby, descriptive statistics (calculation of
percentages) were utilized to calculate percentage of participants who reported different
levels of compassion fatigue, compassion satisfaction, burnout, and DT personality traits
(Machiavellianism, narcissism, psychopathy). Moreover, Pearson r correlation was
conducted to investigate the relationship between study variables (compassion fatigue,
compassion satisfaction, burnout, years of experience, and DT personality traits). Since one
of the research questions in present study aims to assess relationships between present study 2 Factor analysis on psychopathy subscale items showed that two items (Item 2: “I avoid dangerous situations”, and Item
7: “I have never gotten into trouble with the law”) indicated low factor loadings (Item 2: .066 and Item 7: .005). Therefore, those items were excluded from the psychopathy subscale used in this study. Indeed, since our sample was comprised of police officers, it was expected that our respondents would not have troubles with the law (Item 7) and they would not avoid dangerous situations (Item 2) as such behavior would result in being expelled from the force.
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variables, Pearson r correlation was the appropriate analysis for this purpose. Furthermore,
to examine one of the research questions, multiple regression was implemented as a way to
evaluate the role of certain variables in adding to the prediction of the dependent variable. To
this end, Adjusted R2 – the adjusted multiple correlation coefficient of determination – was
utilized to examine how much variance in the dependent variable can be explained by a set
of independent variables. Specifically, a multiple regression model was implemented to
determine how much variance in the dependent variable (compassion fatigue) can be
accounted for by predictor variables: demographics (gender, years of experience), DT
personality traits, and compassion satisfaction.
3.3 Results
Aim 1. The first aim of the present study was to examine the prevalence rates of the
following variables: compassion fatigue, compassion satisfaction, burnout,
Machiavellianism, narcissism, and psychopathy. The results revealed that 67.46% of the
study participants (n=817) reported low levels of compassion fatigue, while 10.24% (n=124)
reported high levels of compassion fatigue (Figure 4). In terms of compassion satisfaction,
the results indicated that 40.46% of participants (n=490) reported low levels of compassion
satisfaction, while 10.57% (n=128) indicated high levels of compassion satisfaction (Figure
5). Finally, the majority of study participants (78.03% or n=945) indicated low levels of
burnout (Figure 6). For further information on the estimated prevalence rates of compassion
fatigue, compassion satisfaction, and burnout please refer to Figure 7.
In terms of the DT personality traits, most study participants (n=709 or almost 70% of
participants) revealed moderate levels of Machiavellianism. Similarly, 94.67% of study
participants (n=959) indicated moderate levels of narcissism. Conversely, most participants
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(81.44% of participants or n=825) reported low levels of psychopathy. More information on the
prevalence rates of the DT personality traits in this study’s participants is presented in Figure 8.
Aim 2. The second aim of current study was to explore the relationship among the following
variables: compassion fatigue, compassion satisfaction, burnout, and years of experience,
Machiavellianism, narcissism, and psychopathy. Correlation analyses (Pearson r) revealed
that DT personality traits (n= 1,010) were significantly correlated (positive correlations
among DT variables; Table 9). Furthermore, compassion fatigue (n= 1,013) was found to be
negatively correlated with compassion satisfaction (r= -.33; p<.01), positively correlated
with burnout (r= .76; p<.01; Table 9), and significantly positively correlated with all DT
personality traits (Table 9). Burnout (n= 1,013) was found to be positively correlated (p<.01)
with all DT personality traits (Table 9), while compassion satisfaction (n= 1,010) was
negatively correlated with Machiavellianism (r= -.22; p<.01) and psychopathy (r= -.32;
p<.01). However, compassion satisfaction was not correlated with narcissism (Table 9).
Furthermore, years of police experience (n= 1,013) was found to have a small but significant
correlation with compassion fatigue (r=.16; p<.01) and burnout (r=.10; p<.01; Table 9).
Aim 3. Multiple regression analysis was performed to assess predictors of compassion fatigue
(Table 10). The results showed that years of service (B= .201; SE= .033; β= .175; t= 6.047;
1994) such as recurring and disturbing memories, thoughts, or images of a stressful
experience from the past. PCL-C is consistent with the DSM-IV criteria for PTSD with its
three sub-scales corresponding to the three PTSD symptom clusters. Rated on a 5-point
Likert scale (not at all, a little bit, moderately, quite a bit, extremely) and with possible
scores ranging from 17 to 85, respondents are instructed to indicate how much they have
been bothered by each symptom in the past month. A total PCL-C score that is greater than
50 suggests a PTSD diagnosis (cut-off method). In the symptom cluster method, an item
rating of moderate or higher (e.g., a score of 3 or more on a 5-point scale) shows
endorsement for that symptom; that is, if individuals report that they are at least moderately
bothered by one or more recurring symptoms, three or more avoidance symptoms, and two
or more arousal symptoms over the last month, then they are classified as having PTSD
(Smith et al., 1999; Weathers et al., 1994). In previous research on veterans, PCL-C has
demonstrated a coefficient alpha of .97, a test-retest reliability of .96, and convergent
validity with other recognized PTSD scales (e.g., Mississippi Scale, Keane PTSD;
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Andrykowski et al., 1998; Conybeare et al., 2012). Within the measures of this study, moral
injury showed a reliability score of .93.
Short Dark Triad of Personality (SD3). The short dark triad (SD3) is a scale used to measure
a cluster of three different personality traits—Machiavellianism, narcissism, and sub-clinical
psychopathy—that provide insight into the individual characteristics of participants (Paulhus
& Williams, 2002; Jones & Paulhus, 2014). The SD3 is a 27-item scale consisting of 9-items
for each of the three targeted personality characteristics. Each item is rated on a Likert type
scale from 1 (“strongly disagree”) to 5 (“strongly agree”). The high and low levels of each
subscale of SD3 will be defined based on the median of the 1-5 Likert-type scale in each
SD3 item. These 27-items have been found to have good construct, convergent, and
discriminant validity in previous research (Jonason & McCain, 2012). In previous studies
using the SD3, the reliability scores for narcissism were .84 and .86, the scores for
psychopathy were .75 and .78, and the scores for Machiavellianism were .75 and .58
(Jonason, Li, Webster, & Schmitt, 2009; Jonason & Tost, 2010). More recently, the SD3 has
shown reliability scores for narcissism, psychopathy, and Machivellianism of .68, .72, and
.74, respectively (Jones & Paulhus, 2014). Within the present study, Machiavellianism
received a reliability score of .78, narcissism had a score of .704 (Appendix A), and
psychopathy yielded a score of .785 (Appendix B). Reliability score of the overall SD3 scale
was .85.
4 Initial Cronbach’s alpha for the narcissism subscale was unacceptable at .67. When items 2, 6, & 9 were removed
because their item-total correlations were below .20, Cronbach’s alpha increased to acceptable .70 (Appendix A). 5 Initial Cronbach’s alpha for the psychopathy subscale was unacceptable at .63. When items 2, 7, & 8 were removed
because their item-total correlations were below .20, Cronbach’s alpha increased to acceptable .78 (Appendix B).
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4.2.4 Data Analysis Plan
Initially, prevalence rates of compassion fatigue, compassion satisfaction, PTSD symptoms,
moral injury, and DT personality traits (Machiavellianism, narcissism, psychopathy) were
estimated. To this end, descriptive statistics (calculation of percentages) were utilized to
calculate percentage of participants who reported high levels of compassion fatigue,
compassion satisfaction, PTSD symptoms, moral injury, and DT personality traits
(Machiavellianism, narcissism, psychopathy). Furthermore, Pearson r correlation was
implemented to assess the relationship between study variables (compassion fatigue,
compassion satisfaction, PTSD symptoms, moral injury (self- and others-focused), and DT
personality traits). Since one of the research questions in the present study aimed to examine
relationships between present study variables, Pearson r correlation was the appropriate
analysis for this purpose. Furthermore, Fisher’s test was performed to assess if the
correlation coefficient between “self-focused” moral injury and DT personality traits was
significantly stronger compared to the correlation coefficient between “others-focused”
moral injury and DT personality traits. One of the present study primary interests was to
investigate the role of DT personality traits, moral injury (self- and others-focused), years of
service, and compassion satisfaction in predicting compassion fatigue and PTSD symptoms.
To this end, structural equation modeling (SEM) was performed to investigate relationships
(associations between variables and not causation) among aforementioned variables based on
a theoretical model that conceptualizes the association between study variables and it is
based on researcher’s theoretical conceptualization between study variables. After the
measurement model first tested to show acceptable fit, three structural models were tested.
Eventually, the structural model that best fits the data was accepted. Finally, a mediation
analysis was conducted to assess if “self-focused” and “others-focused” moral injury
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mediate the relationship between DT personality traits and traumatization (compassion
fatigue and PTSD symptoms).
4.3 Results
Compassion fatigue and satisfaction. The results (Figure 9; Figure 11) showed that almost
20% of study participants reported moderate to high levels of compassion fatigue.
Furthermore, nearly 65% of study respondents reported low levels of compassion
satisfaction (Figure 10; Figure 11).
PTSD symptoms. The results indicated that approximately 5% of study participants suffered
from re-experiencing and avoidance-related symptoms of PTSD (Figure 12) and almost 10%
reported hyperarousal-related symptoms of PTSD. In terms of overall PTSD
symptomatology (re-experiencing, avoidance, hyperarousal), nearly 18% of the participants
reported suffering from symptoms belonging to one of the PTSD symptomatology clusters
(Figure 12).
Dark Triad of personality traits. Participant responses for each of the DT personality traits
(moderate level) indicated the following prevalence rates: Machiavellianism (36.34%),
Narcissism (46.25%), Psychopathy (10.42%). In addition, the percentage of participants with
moderate levels of DT personality traits was almost 24% (Figure 13).
Moral injury. The results (Figure 14) revealed that the percentage of study participants with
moderate levels of moral injury were approximately distributed as follows: 39% (“self-
focused” moral injury), 64% (“others-focused” moral injury), and 74% (overall moral injury).
In addition, almost 24% of study participants reported high levels of “others-focused” moral
injury, while roughly 10% indicated high levels of “self-focused” moral injury.
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Correlations between study variables. Correlations between study variables are shown on
Table 13.
Research question 1. The results (n=370) indicated that DT personality traits were
significantly positively associated with “self-focused” moral injury (r=.47; p<.001) and
“others-focused” moral injury (r=.29; p<.001; Table 13). Fisher’s test showed that
correlation coefficient between “self-focused” moral injury and DT personality traits was
significantly greater compared to correlation coefficient between “others-focused” moral
injury and DT personality traits (Z= 2.87; p=.004).
Research question 2. Structural equation modeling (SEM) is a statistical method (or a
collection of statistical techniques) that allows for the testing (and validation) of complex
and multifaceted theories by assessing empirical relationships among directly observed and
latent variables (Meyers, Gamst, & Guarino, 2013). To this end, SEM is used to assess the
possibility of an a priori theoretical model to be supported by the collected sample data. As
such, the researcher’s theoretical knowledge of the relationships between variables plays a
vital role in the development of the theoretical model that is to be tested. However, since
SEM attempts to determine the correlations among variables, it cannot establish causal
relationships among variables (Crockett, 2012; Games, 1990).
The present study employed a two-step procedure to test the proposed model. The model was
first tested using confirmatory factor analysis (CFA), and, once it had shown acceptable fit,
three structural models were then tested (Anderson & Gerbing, 1988; Meyers, Gamst, &
Guarino, 2013). The fit of both the measurement and structural models was assessed via the
following fit indices: Comparative Fit Index (CFI), Root Mean Square Error of
Approximation (RMSEA), and Standardized Root Mean Square Residual (SRMR; Kline,
2016; Schumacker & Lomax, 2004), the inferential thresholds for which are provided in
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Table 14. Since one of the study’s aims was to explore whether DT significantly predicts
“self-focused” moral injury, two structural models were generated and tested: one that
considered the pathway from DT to “others-focused” moral injury constrained to zero, and
another that considered the pathway from DT to “others-focused” moral injury unconstrained.
In addition, a third model was generated and tested in order to determine whether DT would
directly or indirectly (via moral injury) predict compassion fatigue and PTSD symptoms.
Measurement model. Initially, the measurement model did not fit the data well, as the CFI
was below the threshold criterion (.95, Table 14 & Table 15). The proposed measurement
model was trimmed to better fit the data following two conditions (Kline, 2016): first, the
modification indices as suggested by LISREL output files were examined and error terms
were made to co-vary only if it made theoretical sense (items were measured from the same
scale); and second, items with standardized factor loadings below .50 were removed if the
construct had at least three indicators left. Thus, in the revised measurement model, the first
two items (Items 1 and 2) of “others-focused” moral injury were removed, and the error of
the first item measuring compassion satisfaction was made to correlate with the errors of
third and fifth items measuring compassion satisfaction (Appendix C). The revised
measurement model appeared to fit the data well (Table 15; Appendix C). Specifically, the
likelihood ratio test between the initial and revised models was statistically significant (Δχ2
(46)=301.82; p<.001), and the CFI was .95, RMSEA was .06 (90% CI: [0.5-0.6]) , and
SRMR was .06.
Structural models (Model 1) – Model with the path from DT to “others-focused” moral
injury constrained to zero. The results indicated that Structural Model 1 had close to
acceptable fit (Table 16, Appendix D): the CFI was .93, RMSEA was .06 (90% CI: [0.5-
0.7]), and SRMR was .09. In addition, Model 1’s predictors accounted for 23.7% of the
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variance in “self-focused” moral injury, 18.1% of the variance in compassion fatigue, and
39% of the variance in PTSD symptoms.
Structural models (Model 2) – Model with the unconstrained path from DT to “others-
focused” moral injury. Results indicated that for Structural Model 2 the CFI was .94, RMSEA
was .06 (90% CI: [0.5-0.7]), and SRMR was .08. Therefore, Structural Model 2 (Figure 15,
Appendix E) showed a better fit among indices than in Structural Model 1(Table 16,
Δχ2(1)=24.38; p<.001), which indicates that the unconstrained path from DT to “other-
focused” moral injury improved model fit. Structural Model 2’s (Figure 15) predictors
accounted for 12.7% of the variance in “others-focused” moral injury, 26.4% of the variance in
“self-focused” moral injury, 18.7% of the variance in compassion fatigue, and 40% of the
variance in PTSD symptoms. Furthermore, the results indicated that DT positively predicted
“others-focused” moral injury (β= .36; t=4.75; p<.001) and “self-focused” moral injury (β=
.51; t=6.60; p<.001), but did not significantly predict (direct effect) compassion fatigue or
PTSD symptoms (Table 17; Figure 15). In addition, the results showed that neither DT nor
“others-focused” moral injury significantly predicted compassion fatigue and PTSD symptoms
(Table 17; Figure 15). However, it was found that “self-focused” moral injury significantly
In terms of moral injury, some hospitals require medical personnel to record any moral
dilemmas that they experience with patients in order to create a system wherein staff can
receive recommendations and support from their peers. The moral dilemma component may
be also incorporated in police briefing and de-briefing meetings in ways that are similar to
those used by medical personnel in hospitals.
5.7 Limitations and Future Research
The present project’s findings indicated that, overall, compassion fatigue and compassion
satisfaction are negatively associated. In addition, the results showed a positive association
between compassion fatigue and negative personality traits, as well as between “self-
focused” moral injury and negative personality traits. Although traumatization among those
with high levels of negative personality traits appeared to be mediated by “self-focused”
moral injury, one of the present project’s major limitations is that it was unable to establish
causal relationships between the variables. As previously mentioned, the present project
explored the relationships between the above-mentioned variables; however, association
between variables does not lead to any concrete conclusions about their causal relationships.
Moreover, the samples for two of the project’s studies were comprised of all White and
predominantly male operational officers. Therefore, caution must be exercised when
extending any of this project’s conclusions to officers from minority groups (e.g., gender,
racial, ethnic, sexual minority groups), since they may experience discrimination from
civilians as well as their peers, which may render them more susceptible to traumatization. In
addition, studies 2 and 3 were conducted with European samples. Thus, caution should also
93
be exercised when applying the findings of those studies to the North American (US and
Canada) police population.
Participants for the studies contained in this thesis were gathered from North America (US
and Canada) as well as Finland. Future research may replicate present project in police
organizations in North America, Europe, as well as other democratic countries. The author
refers to the notion of studying police traumatization in democratic countries given the fact
that police role in totalitarian regimes violates human rights and any attempt to study police
traumatization in countries controlled by totalitarian regimes would defeat the purpose of
developing research to help those who serve. Nonetheless, the development of cross-cultural
research that examines police traumatization in democratic countries will allow future
research to explore police compassion fatigue taking into consideration police national-
cultural context among other factors. To this end, future research may replicate the current
project’s studies using officers from minority cultural groups in order to explore whether
there are differences in how they experience moral injury and traumatization as well as to
examine whether negative personality traits play a similar role in contributing to police
traumatization. Similarly, officers who serve in low socio-economic status (SES)
communities may experience different levels of compassion fatigue and satisfaction
compared to officers who serve in high SES communities. That being said, future research
may explore the aforementioned crucial research questions that approach police
traumatization from different perspectives.
Moreover, future research may investigate police traumatization considering officers’
specific positions. For instance, future research may attempt to answer the question on what
would be the difference (if so) between officers who serve in two different operational units:
officers who serve in a child exploitation unit versus officers who serve in a crowd
94
management unit and so forth. Perhaps, different police positions may be associated with the
experience of different levels of compassion fatigue or even different types of
traumatization. For instance, a SWAT team officer may experience PTSD symptoms
considering the experience of life-threatening situations in the line of duty as opposed to an
officer who serves in a child pornography unit and s/he is exposed to child abuse cases by
investigating child pornography materials on a regular basis and s/he may experience high
levels of compassion fatigue.
As mentioned, police work is unique considering the multiple potentially traumatic incidents
that officers often experience in the line of duty. Nevertheless, current research project
findings may not be generalized to the general population since it is likely that most civilians
do not experience compassion fatigue or moral injury in their workplace. However, trauma is
often embedded in human life and, hence, the association among variables explored in
current research project may pave the way for the investigation of mechanisms towards
traumatization among civilians (e.g., survivors of natural disasters, victims of violent
crimes). For instance, future research may consider the association of variables explored in
present project aiming to investigate mechanisms towards traumatization based on civilians’
levels of negative personality traits; analogously, future research may examine moral injury
(self- and others-focused) among civilians who happened to experience traumatic incidents
and the association of moral injury with traumatization.
One challenge that emerged in all three studies was related to the method used to measure
negative personality traits (or authoritarianism). The authoritarianism scale employed in
study 1 was replaced by the DT personality scale (called “SD3”); the reasons for this
substitution were discussed in detail in study 1. However, the DT personality scale contains
items that seem to be contradictory with the mission of police work. For instance, items such
95
as, “It’s not wise to tell your secrets,” “I know I am special because everyone keeps telling
me so,” and “I avoid dangerous situations” are probably endorsed by many operational
police officers (e.g., detectives, intelligence service agents, SWAT team officers). However,
endorsement of such items may indicate elevated DT levels among law enforcement officers.
Of course, the last suggestion would not preclude the alternative explanation that some law-
enforcement officers may really have elevated levels of negative personality traits.
Therefore, future research should be conducted to develop an authoritarianism self-report
psychosocial scale that is specifically designed to account for the idiosyncrasies of law-
enforcement work; for instance, such a scale may consider the values and tenets of police
culture as well as the unique nature of police work.
All three studies in the current project were cross-sectional, which indicates that the role of
years of service towards traumatization could not be explored in-depth. Even though study 2
findings showed that years of service was one of the significant predictors towards
compassion fatigue, results in the other two studies (study 1 and study 3) did not endorse the
significant role of years of service in predicting traumatization. Therefore, the role of years
of service towards police traumatization appears to be ambiguous across the three studies of
present project. However, it should be emphasized that many officers may serve in special
units that involve intense exposure to trauma for a certain period of time and, afterwards,
they may decide to move to another position that involves minimal exposure to trauma. For
instance, an officer who serves in a child pornography unit for 3 years may decide to move
to an administrative position because s/he feels that compassion fatigue has deleterious
impact on his/her wellbeing, health, and job performance. Nevertheless, a cross-sectional
research design (as occurs in present study) is limited to capture such cases as the one
aforementioned. As such, future researchers may wish to conduct longitudinal studies of
96
police compassion fatigue, moral injury, compassion satisfaction, and the role of negative
personality traits. A longitudinal approach would allow researchers to explore police
traumatization patterns over years of service through the scope of negative personality traits
and, perhaps, officers’ occupied positions within the organization.
Over the past, researchers examined etiological approaches of PTSD based on a proposed
stress-diathesis model (McKeever & Huff, 2003). To this end, researchers attempted to
consolidate medical and psychological research findings towards exploring pathways that
shed light on to how PTSD is developed from a biological, psychological stress experience,
and ecological perspective. Similar to previous research in the area of traumatization, present
research project findings illuminate pathways towards police traumatization (compassion
fatigue and PTSD symptoms) taking into consideration levels of negative personality traits
and moral injury (self- and others-focused) among police officers. Based on the stress-
diathesis model perspective (Salomon & Jin, 2013), it is possible that high levels of negative
personality traits (diathesis) interact with “self-focused” morally injurious incidents
(situational traumatic stressors). Consequently, officers’ exposure to situational traumatic
incidents (“self-focused” morally injurious incidents) may activate the diatheses (negative
personality traits) that may then instigate the development of traumatization. That being said,
a model that aims to investigate an etiological approach to police traumatization based on the
stress-diathesis model appears to be compelling and future research should aim to study it.
As above-mentioned, other factors (e.g., years of service, positions served) may be also
considered in the exploration/development of an etiological model towards police
traumatization.
Furthermore, future research may study certain techniques that could be used to prevent or
decrease police compassion fatigue. To this end, experimental and longitudinal studies may
97
shed light on certain strategies that could potentially prevent the debilitating impact of police
compassion fatigue on officers’ health. In addition, experimental studies may explore the
effectiveness of certain techniques that could be employed to help officers who are suffering
from compassion fatigue. Clinical research may also study techniques that can be used to
increase police officers’ compassion satisfaction. Future research might also explore
techniques that officers could use to shield themselves against the significant impact that
moral injury can have on their health and wellbeing.
One of the current project’s main contributions is its delineation of the role played by
negative personality traits vis-a-vis traumatization. Consequently, future research may
further explore interventions that would be more effective in helping officers with elevated
levels of negative personality traits effectively cope with traumatization; likewise, future
research may also look into approaches that may be more efficient when dealing with
officers with low levels of negative personality traits. Such research would not only improve
our ability to develop interventions that could be used to support officers against
traumatization, but they would also offer approaches that are tailored to officers’ personality
traits.
98
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Tables
Table 1. Study 1 – Demographic Data
Demographic Variable Participants Percent (%)
Gender
Male 667 87.3
Female 97 12.7
Ethnic Background
African American/Black 19 2.5
Asian/Pacific American 11 1.4
Caucasian/White 683 89.4
Hispanic/Latino 27 3.5
Native/Indian 3 0.4
Other 21 2.7
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Table 2. Study 1 – Demographic Data
Regions Number of Organizations With Public Contact Information
Percent of Organizations Responding
Number of Participants n (%)
U.S.
Midwest 3654 32.67 183(27.60)
Northeast 1855 16.58 126(19.00)
Southeast 3013 26.94 167(25.19)
Southwest 1244 11.12 71(10.71)
West 1365 12.20 111(16.74)
Other 54 0.48 5(0.75)
Canada
Eastern 118 76.62 60(72.29)
Western 36 23.38 24(28.92)
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Table 3. Study 1 – Compassion Satisfaction, Compassion Fatigue, and Burnout Prevalence Rates
Scores Participants (n)%
Compassion Satisfaction Low (0 to 81) 234(27.08)
Moderate (82 to 99) 356(41.20)
High (100 to 188+) 274(31.72)
Total 864(100.00)
Compassion Fatigue
Low (30 or less) 573(66.52)
Moderate (31 to 35) 92(10.65)
High (36 to 41+) 199(23.03)
Total 864(100.00)
Burnout
Low (36 or less) 715(82.75)
Moderate (37 to 50) 121(14.00)
High (51 to 85) 28(3.24)
Total 864(100.00)
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Table 4. Study 1 – Authoritarian Attitudes Prevalence Rates
aAuthoritarian Score Participants (n) %
1 4(1.23)
2 65(19.94)
3 198(60.74)
4 57(17.48)
5 2(0.61)
Total 326(100.00)
aAuthoritarian Score of 1 = strongly disagree and score of 5= strongly agree.
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Table 5. Study 1 – Regression Model Predicting Compassion Satisfaction (n=276)
5. Other-focused moral injury .18** .28*** .29*** -.21*** .75
6. Self-focused moral injury .36*** .45*** .47*** -.35*** .37*** .79
* p < .05. ** p < .01. *** p < .001.
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Table 14. Study 3 – Fit Indices and Their Threshold Values
Index Threshold
Comparative Fit Index (CFI) > .95
Root Mean Square Error of Approximation (RMSEA) < .08
Standardized root mean square residual (SRMR) < .08
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Table 15. Study 3 – Fit Indices for the Measurement Models
Index Proposed Revised
Comparative Fit Index (CFI) .89 .95
Root Mean Square Error of Approximation (RMSEA) .07 .06
Lower bound 90% confidence interval .07 .05
Upper bound 90% confidence interval .08 .06
P-close .00 .04
Standardized root mean square residual (SRMR) .08 .06
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Table 16. Study 3 – Fit Indices for the Structural Models
Index Model 1 Model 2 Model 3
Chi-square 518.11 493.73 496.02
Degrees of freedom 213 212 214
Probability level .00 .00 .00
Comparative Fit Index (CFI) .93 .94 .94
Root Mean Square Error of Approximation (RMSEA) .06 .06 .06
Standardized root mean square residual (SRMR) .09 .08 .08
Note: Model 1 = path between DT and “Others-Focused” Moral Injury constrained to zero. Model 2 = path between DT and “Others-Focused” Moral Injury unconstrained. Model 3 = path without direct effects from DT to Compassion Fatigue and PTSD symptoms.
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Table 17. Study 3 – Path Coefficients for the Structural Model with Path from DT to “Others-focused” Moral Injury Unconstrained (Model 2)
Path B SE β t
Dark Triad to:
Other-focused moral injury 2.00 .42 .36 4.75***
Self-focused moral injury 3.01 .46 .51 6.60***
Compassion fatigue .14 .11 .11 1.30
PTSD .15 .11 .10 1.35
Other-focused moral injury to:
Compassion fatigue .01 .02 .03 .40
PTSD .02 .02 .07 1.22
Self-focused moral injury to:
Compassion fatigue .05 .02 .21 2.86**
PTSD .06 .02 .22 3.40**
Years of service to:
Compassion fatigue .00 .00 .11 2.12*
PTSD .00 .00 .02 .39
Compassion satisfaction to:
Compassion fatigue -.12 .03 -.26 -4.43***
PTSD -.28 .03 -.50 -8.37***
Note: * p < .05. ** p < .01. *** p < .001.
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Table 18. Study 3 – Path Coefficients for the Structural Model without Direct Paths from the DT to Compassion Fatigue and PTSD (Model 3)
Path B SE β t
Dark Triad to:
Other-focused moral injury 1.99 .42 .36 4.77***
Self-focused moral injury 3.03 .45 .52 6.67***
Other-focused moral injury to:
Compassion fatigue .12 .01 .05 .86
PTSD .13 .02 .10 1.76
Self-focused moral injury to:
Compassion fatigue .06 .01 .27 4.32**
PTSD .07 .01 .27 4.94**
Years of service to:
Compassion fatigue .00 .00 .10 1.92
PTSD .00 .00 .01 .17
Compassion satisfaction to:
Compassion fatigue -.12 .03 -.27 -4.60***
PTSD -.28 .03 -.51 -8.54***
Note: * p < .05. ** p < .01. *** p < .001.
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Figures
Figure 1. Study 1 – Distribution of Compassion Fatigue
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Figure 2. Study 1 – Distribution of Compassion Satisfaction
133
Figure 3. Study 1 – Distribution of Burnout
134
Figure 4. Study 2 – Distribution of Compassion Fatigue
135
Figure 5. Study 2 – Distribution of Compassion Satisfaction
136
Figure 6. Study 2 – Distribution of Burnout
137
Figure 7. Study 2 – Prevalence Rates: Compassion Fatigue, Compassion Satisfaction, and Burnout
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Figure 8. Study 2 – Prevalence Rates: Machiavellianism, Narcissism, and Psychopathy
29.02%
69.99%
0.69%5.03%
94.67%
0.00%
81.44%
18.16%
0.00%0.00%
10.00%
20.00%
30.00%
40.00%
50.00%
60.00%
70.00%
80.00%
90.00%
100.00%
Low Moderate High
PercentageofParticipants
ParticipantScores
Machiavellianism,Narcissism,andPsychopathy
Machiavellianism
Narcissism
Psychopathy
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Figure 9. Study 3 – Distribution of Compassion Fatigue
140
Figure 10. Study 3 – Distribution of Compassion Satisfaction
141
Figure 11. Study 3 – Prevalence Rates: Compassion Fatigue and Compassion Satisfaction
142
Figure 12. Study 3 – Prevalence Rates: PTSD Symptoms
143
Figure 13. Study 3 – Prevalence Rates: Dark Triad of Personality
144
Figure 14. Study 3 – Prevalence Rates: Moral Injury
145
Figure 15. Study 3 – Structural Model with Path from DT to “Others-focused” Moral Injury Unconstrained (Model 2)
146
Figure 16. Study 3 - Structural Model without Direct Effects from DT to Compassion Fatigue and PTSD symptoms (Model 3)
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Appendices
Appendix A Study 3 – Short Dark Triad (SD3) Scale – Narcissism Subscale Items Removed
The following items of the SD3 – Narcissism subscale (Paulhus & Williams, 2002; Jones &
Paulhus, 2014) were removed because their item-total correlations were below .20,
Cronbach’s alpha increased to acceptance .70:
Item 2: I hate being the center of attention. (R)
Item 6: I feel embarrassed if someone compliments me. (R)
Item 9: I insist on getting the respect I deserve.
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Appendix B Study 3 – Short Dark Triad (SD3) Scale – Psychopathy Subscale Items Removed
The following items of the SD3 – Psychopathy subscale (Paulhus & Williams, 2002; Jones
& Paulhus, 2014) were removed because their item-total correlations were below .20,
Cronbach’s alpha increased to acceptance .78:
Item 2: I avoid dangerous situations. (R)
Item 7: I have never gotten into trouble with the law. (R)
Item 8: I enjoy having sex with people I hardly know.
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Appendix C Study 3 – Items Used to Identify-Score Latent Variables in Measurement Model
Compassion Satisfaction and Fatigue Test (CSF - Figley & Stamm, 1996):
All CSF items utilized (compassion fatigue and compassion satisfaction subscales) for
calculating/scoring the variables: Compassion Fatigue and Compassion Satisfaction.
Moral Injury Events Scale (MIES – Nash et al., 2013):
Items 1 and 2 (“others-focused” moral injury) of MIES were removed so that the model fit
the data well.
Item 1: I saw things that were morally wrong.
Item 2: I am troubled by having witnessed others’ immoral acts.
In addition, Item 6 of MIES was not included in the data collection by accident.
Item 6: I am troubled because I violated my morals by failing to do something that I felt I