“FBI Bureau Syndrome”: Understanding the FBI’s Unique Mental Health Struggles

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Dao, Ginnette Rivera-Hernandez, David Jenkins, Leah Kaylor, and 2 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-6597515/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background: The prevalence of mental health symptoms and diagnoses following exposure to traumatic events has been widely studied among the general population and first responders, including police officers and emergency personnel. However, a distinct yet comparable group—Federal Bureau of Investigation (FBI) personnel—also faces repeated exposure to trauma in the line of duty. Despite this, research on the mental health prevalence among FBI personnel remains limited. Purpose: This study is the first to assess the prevalence of mental health symptoms among FBI personnel, compare these rates to those observed in the general and local law enforcement populations, and examine whether they influence FBI employees' perceptions of their work performance. Methods The sample included 206 trauma-exposed FBI personnel who participated in a three-day intervention program. Results The prevalence of probable mental health diagnoses ranged from 5% (psychosis) to 52% (anxiety). Rates of depression, anxiety, sleep disturbances, substance use, and post-traumatic stress disorder (PTSD) were significantly higher among FBI personnel compared to the general and law enforcement populations. Mental health symptom severity, particularly PTSD, was a significant predictor of perceived work performance. Conclusion These findings highlight the mental health challenges faced by FBI personnel and their potential impact on job performance, underscoring the need for targeted mental health assessment and treatment for this unique population. Trauma exposure law enforcement FBI personnel prevalence study critical incidents Introduction The Federal Bureau of Investigation (FBI) is widely regarded as the premier law enforcement agency in the United States, responsible for investigating and enforcing federal laws. Its mission is to uphold the U.S. Constitution, protect the American people from terrorist and foreign intelligence threats, and provide leadership and criminal justice services to federal, state, municipal, and international partners. The FBI's efforts are guided by eight mission priorities: (1) preventing terrorist attacks, (2) countering foreign intelligence and espionage, (3) combating cybercrime, (4) addressing public corruption, (5) protecting civil rights, (6) dismantling transnational criminal enterprises, (7) investigating major white-collar crimes, and (8) reducing violent crime (Federal Bureau of Investigation 2016). As of 2023, the FBI employs approximately 38,000 individuals, including special agents and professional staff. The FBI's fiscal year 2023 budget request supports 37,083 positions, comprising 13,623 special agents, 3,337 intelligence analysts, and 20,123 professional staff (Federal Bureau of Investigation, 2023). A wide range of job roles exist within these positions, each with specific responsibilities. Special agents are responsible for investigating and enforcing federal laws. Their duties include conducting criminal, counterterrorism, and counterintelligence investigations, collecting and analyzing evidence, conducting surveillance and undercover operations, arresting suspects, and executing search warrants. The professional staff, which comprises most of the FBI, includes intelligence analysts, cybersecurity specialists, forensic accountants, linguists, surveillance specialists, evidence technicians, medical doctors, nurses, psychologists, forensic scientists, tactical specialists, legal and policy advisors, and other administrative and support roles. In addition to their primary responsibilities, special agents and professional staff take on collateral duties—additional responsibilities that support the FBI’s operations, enhance professional development, and contribute to the overall success of its mission. There are four mission areas that the FBI specializes in that expose the special agent and professional staff populations to significant direct and indirect traumatic experiences. First, the FBI has jurisdiction over crimes committed on approximately 200 Native American reservations, where investigations frequently involve sensitive and traumatic situations. These investigations typically address violent crime, drug trafficking, missing persons, human trafficking, homicides, physical assaults, child sexual abuse, and domestic violence—each of which can have severe psychological and emotional effects on all those involved. In 2024, the FBI concluded one of its many operations, “Operation Not Forgotten,” which deployed 51 special agents, analysts, and other personnel to nearly a dozen FBI field offices to support crimes on reservations. During this joint operation, the FBI and its partners opened or worked on more than 300 cases, made over 40 arrests, assisted more than 440 victims and their families, and identified or recovered nine child victims (Federal Bureau of Investigation, n.d.-b). Second, in addition to investigating violent crimes on Native American reservations, the FBI's Violent Crimes Against Children (VCAC) program investigates crimes against children that fall under federal statutes. This program provides a rapid, proactive, and comprehensive approach to countering all threats of child abuse and exploitation within the FBI’s jurisdiction. In carrying out these duties, agents and analysts are repeatedly exposed to disturbing material, including images and videos of child sexual exploitation, as well as direct interactions with alleged perpetrators. Third, one of the sophisticated techniques employed by the FBI involves undercover operations, which often include the use of online covert employees (OCEs) to investigate both domestic and international terrorism-related threats. These operations require agents and informants to pose as targets, build relationships, and gather intelligence. In doing so, they are often exposed to traumatic content, including graphic images and videos depicting acts of torture, executions, and other forms of violence. Lastly, a lesser-known aspect of the FBI’s role is its response to mass casualty events (Federal Bureau of Investigations, 2019, 2025). The agency deploys specialized teams of agents, analysts, victim specialists, and crime scene investigators to assist local law enforcement during these crises. The FBI has provided critical support in significant incidents such as the 9/11 terrorist attacks, the Boston Marathon bombings, the Virginia Tech shooting, the Navy Yard shooting, the Route 91 Harvest Music Festival shooting, the Sutherland Springs church shooting, the Uvalde school shooting, the Sandy Hook School shooting, the Pittsburgh synagogue shooting, and the 2025 New Orleans Truck Attack. The FBI defines a critical incident as any significant threat to public safety, national security, or law enforcement personnel that requires an immediate, coordinated response. These incidents typically involve mass casualties, terrorism, violent crimes, cyber threats, or other high-risk situations that demand specialized investigative and tactical resources (need FBI reference). The FBI responds to critical incidents through its Critical Incident Response Group (CIRG) and the Crisis Intervention Program (CIP). According to the FBI’s Human Resource Division, in 2023, the CIP initiated 22 “critical incident responses” (D. Jenkins, personal communication, February 5, 2025). A CIP involves deploying resources to a critical incident based on scale and impact. According to the FBI’s CIP protocol, essential responses to incidents resulting from a CIP are provided only at the request of the affected divisions or field offices, and they are primarily deployed in response to large-scale events such as terrorist attacks, mass shootings, natural disasters, and other incidents impacting large numbers of people. In all 22 cases in 2023, the FBI’s Evidence Response Team (ERT) was also deployed to assist with the critical incident. The ERT is a specialized unit responsible for processing crime scenes and collecting forensic evidence in complex investigations. ERT members undergo extensive training at the FBI Academy in Quantico, Virginia. They are highly skilled in crime scene documentation, fingerprint collection, bloodstain pattern analysis, digital evidence recovery, and hazardous materials handling. These teams collaborate with local, state, and international law enforcement partners to ensure that critical evidence is meticulously preserved, maintaining the integrity of investigations and supporting successful prosecutions. ERT team members are frequently exposed to traumatic events, including body recovery and processing violent crime scenes. Blak’s definition of a critical incident (1991) expands on the FBI’s definition by identifying it as any event that has a significant and stressful impact on an individual to the extent that their usual coping mechanisms are overwhelmed. These incidents are typically sudden and powerful and fall outside the scope of everyday human experiences. Even the most experienced individuals can be emotionally affected by these events (Blak, 1991). Such incidents can include, but are not limited to, shootings, mass casualty events, exposure to graphic evidence materials, and search-and-rescue operations (Blak, 1991). While anyone can experience a critical incident, FBI employees are exposed to these events—both directly and indirectly—more frequently than the general population or even the broader law enforcement community (Craddock & Telesco, 2022). Direct trauma exposure refers to experiencing trauma firsthand or witnessing it as it occurs (May & Wisco, 2016). Many FBI employees also experience indirect trauma exposure, often referred to as vicarious trauma, through frequent exposure to the traumatic experiences of others, particularly in service-related professions or through processing work-related media reports such as those in law enforcement (May & Wisco, 2016; Molnar et al., 2020). Despite the known exposure of FBI personnel to traumatic situations and events, there are currently no published studies focusing specifically on the mental health of FBI employees. Consequently, this study will draw on existing literature on law enforcement to explore the mental health challenges individuals face in such roles. These fields share similar exposures to critical incidents, operational stress, and psychological demands, making them valuable reference points for understanding the mental health impacts on FBI personnel. General and Law Enforcement Mental Health Prevalence The impact of critical incidents on the mental health of law enforcement officers (LEOs) became alarmingly evident following the recent suicides of four Harris County Sheriff’s deputies in Texas. According to Thomas McNeese, Director of the Harris County Sheriff’s Office (HCSO) Behavioral Health Division, “It’s a tough job, but every day, agencies like [the HCSO] get it done. The impact may not be seen on the outside, but it's felt on the inside... The average citizen, I think, in a lifetime may be exposed to two critical incidents—whereas one of our officers might experience that in a single shift. Over time, that definitely takes a toll” (Winfrey, 2024). Not surprisingly, a review of the literature suggests that LEOs are at a heightened risk for mental health issues due to frequent exposure to traumatic events, including violent crimes, accidents, and critical incidents (Gershon et al., 2009). Korre et al. (2015) note that such exposures contribute to some of the highest stress levels observed among LEOs. These stressors lead to various psychological, physical, and behavioral health consequences among law enforcement officers. Post-Traumatic Stress Disorder (PTSD) PTSD is a well-documented mental health condition that can develop following exposure to traumatic events such as natural disasters, serious accidents, combat, or assault. In the general population, between 6-9% experience PTSD, with women being more susceptible than men (U.S. Department of Veterans Affairs, 2023). However, studies found the prevalence of PTSD diagnosis to vary between 7-19% (Isabirye et al., 2022). Anxiety Disorders (ADs) Anxiety disorders (ADs) are characterized by excessive and persistent fear or worry that significantly interferes with daily life. In the general population, generalized anxiety disorder (GAD) affects approximately 3.1% to 5.7% of U.S. adults (National Institute of Mental Health, 2023). Among LEOs, prevalence estimates range from 8-25% for GAD or panic disorder (Arnetz et al., 2009), with some studies reporting rates as high as 20-30% (Wills & Schuldberg, 2016). Depressive Disorders (DDs) Persistent feelings of sadness, hopelessness, or loss of interest in daily activities mark major depressive disorder (MDD) and persistent depressive disorder. In the general population, the prevalence of MDD following a traumatic experience ranges from 10% to 31% (Shih et al., 2010). Among LEOs, a meta-analysis by Syed et al. (2020) found a pooled depression prevalence of 14.6%, while another systematic review estimated a rate of 26%, significantly higher than the global depression rate of 4.4% in the general population (World Health Organization, 2017). Substance Use Disorders (SUDs) Substance use disorders (SUDs) involve the compulsive use of substances despite harmful consequences. Trauma exposure is associated with an increased risk of SUDs in both the general and LEO populations. The World Health Organization reports that among individuals exposed to trauma, SUD prevalence is 14.5%, compared to 5.1% among those without trauma exposure (Benjet et al., 2022). Research suggests that LEOs may use substances such as alcohol as a coping mechanism for occupational trauma, leading to increased rates of alcoholism (Cross & Ashley, 2004). Studies indicate that 25-30% of officers engage in binge drinking (Ballenger et al., 2011), while alcohol dependence rates range from 16-25%, compared to 7-10% in the general population (Gershon et al., 2009). Physical and Sleep Disturbances LEOs frequently experience chronic pain and sleep disturbances at rates exceeding those seen in the general population. A study of nearly 5,000 North American police officers found that over 40% screened positive for sleep disorders—nearly double the estimated 15-20% prevalence in the general population (Rajaratnam et al., 2011). Another study reported high rates of psychosomatic symptoms, with 27% of officers experiencing frequent headaches and approximately 14% reporting frequent indigestion. Law Enforcement Culture and Mental Health Stigma A consistent finding in the literature is that LEOs not only experience significant mental health challenges but also internalize the emotional burdens of the public, as they are often the first to respond to critical incidents (Desmarais et al., 2014). Despite these adverse effects, many officers hold negative perceptions of mental health disorders (Soomro & Yanos, 2019; Wester et al., 2010). The law enforcement culture often emphasizes strength and resilience, which can serve as protective factors but may also discourage individuals from seeking help, as mental health struggles are sometimes perceived as signs of weakness (White et al., 2016). Similar to LEOs, FBI personnel are routinely exposed to critical incidents that can have significant mental health consequences. As a result, many are at high risk for primary and secondary trauma, stress-related disorders, and burnout, underscoring the need for comprehensive mental health support and resilience training. While research has extensively examined mental health challenges among local law enforcement, little is known about the psychological toll on FBI personnel. A review of the literature revealed no studies specifically examining the mental health effects of critical incident exposure on FBI employees. Furthermore, no research has assessed the nature, scale, and scope of mental health concerns within this unique population. Understanding how mental health symptoms manifest among FBI personnel is essential for developing targeted risk prevention strategies. The goals of this study are to investigate how FBI personnel experience mental health symptoms and whether these symptoms significantly impact their job performance. Specifically, the study will: 1) Assess the prevalence of mental health symptoms among FBI personnel and compare them to those observed in the general and local law enforcement populations, and 2) Examine whether mental health symptoms influence FBI employees’ perceived work performance. By addressing these objectives, this study aims to contribute to developing effective support systems and interventions tailored to the unique needs of FBI personnel. Methodology Procedures Permission for this study was obtained through the FBI (541-20) and the University of Houston Institutional Review Boards (FY-2024-417). The FBI Employee Assistance Program (EAP) currently conducts Post-Critical Incident Seminars (PCIS) for FBI employees who have been exposed to critical incidents such as mass casualty events, shooting incidents, and violent crime scenes or for FBI employees who have been exposed to repeated stressful events over the course of their professional duties as an FBI employee. The seminar is 3 days long and provides education, support, and skills-based tools to help FBI employees cope with the thoughts and feelings they may be experiencing due to such exposure. FBI employees selected to attend PCIS were invited to participate in the research study. Once participants consented to be part of the research study, each participant completed self-report questionnaires on four separate occasions assessing demographic information, childhood experiences, psychological health, work impact, and protective factors such as resilience and social support. The first occasion occurred three to five days before attending the PCIS. The second and third occasions occurred on the same day and last day of the PCIS. The fourth occasion occurred a few months after the participants attended the PCIS and was administered as part of their 2-3 months follow-up. Measures Demographics. Demographic variables assessed in this study included age, tenure in the FBI (number of years), number of marriages since joining the FBI, gender, types of collateral duties while employed in the FBI, education level, marital status, military experience, race/ethnicity, and role within the agency. Age, tenure in the FBI, and number of marriages were treated as continuous variables, while all other demographic factors were categorical variables. Psychological Factors The DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure (DSM-5-TR Level 1; APA, 2022) was used to assess a broad range of mental health symptoms across multiple domains. This measure consists of 23 items, each rated on a 5-point Likert scale ranging from 0 (None) to 4 (Severe), and evaluates symptoms experienced by participants over the past two weeks. The Level 1 measure is designed to provide a comprehensive screening across 13 psychiatric domains: Depression (e.g., "Little interest or pleasure in doing things"); Anger (e.g., "Feeling angry or irritable"); Mania (e.g., "Feeling overly energetic, excited, or hyper"); Anxiety (e.g., "Feeling nervous, anxious, or scared"); Somatic Symptoms (e.g., "Feeling aches or pains"); Sleep Problems (e.g., "Problems falling or staying asleep"); Psychosis (e.g., "Hearing things other people couldn’t hear"); Repetitive Thoughts and Behaviors (e.g., "Unwanted thoughts that wouldn’t leave your mind"); Dissociation (e.g., "Feeling detached from yourself or your surroundings"); Personality Functioning (e.g., "Problems getting along with people"); Substance Use (e.g., "Drinking at least four alcoholic drinks in a day"). The Level 1 measure is not diagnostic but serves as a preliminary screening tool to identify potential mental health concerns and determine if further clinical assessment is warranted using the DSM-5-TR Level 2 measures for specific symptom domains. The DSM-5-TR Level 1 measure has demonstrated strong internal consistency across psychiatric symptom domains, with Cronbach’s alpha coefficients ranging from 0.75 to 0.91 in previous studies (Narrow et al., 2019). Additionally, the measure has shown good convergent validity with established psychiatric screening tools such as the PHQ-9 for depression and the GAD-7 for anxiety (Clarke et al., 2021). To assess the internal consistency of the DSM-5-TR Level 1 measure, Cronbach’s alpha (α) was calculated for each scale at time 1. The reliability coefficients for the primary measures were as follows: Depression α = .73; Mania α = .71; Anxiety α = .79; Somatic Symptoms α = .75; Psychosis α = .72; Repetitive Thoughts and Behaviors α = .82; Dissociation α = 76; Personality Functioning α = .79; Substance Use α = .81. All scales demonstrated acceptable to excellent reliability, with Cronbach’s α values exceeding the recommended threshold of .70 (Nunnally & Bernstein, 1994). These results indicate good internal consistency across the study’s measures, suggesting that the items within each scale reliably assess the intended constructs. The Adverse Childhood Experiences (ACE) Checklist (Felitti et al., 1998) was used to assess participants' exposure to early-life stressors and traumatic experiences before the age of 18. The ACE Checklist is a widely used self-report measure consisting of 10 items that evaluate exposure to adverse events, including emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, parental separation or divorce, household substance abuse, household mental illness, witnessing domestic violence, and having an incarcerated household member. Participants completed the ACE Checklist electronically via an online survey platform. Each item is scored as 0 (No) or 1 (Yes), with a possible score ranging from 0 to 10. Higher scores indicate greater exposure to childhood adversity. A score of 4 or higher is often associated with an increased risk of negative physical and mental health outcomes in adulthood (Felitti et al., 1998). The ACE Checklist has demonstrated strong test-retest reliability and internal consistency, with Cronbach’s alpha coefficients typically ranging from 0.76 to 0.88 in various populations (Anda et al., 2006). Additionally, it has shown good predictive validity for a range of mental health disorders, including depression, anxiety, and PTSD (Edwards et al., 2003). Internal consistency for the Adverse Childhood Experiences (ACE) scale was assessed using Cronbach’s alpha (α). The analysis revealed a high level of reliability, α = .93, indicating excellent internal consistency (Nunnally & Bernstein, 1994). This suggests that the items within the ACE scale reliably measure adverse childhood experiences in the sample. The PTSD Checklist for DSM-5 (Weathers et al., 2013; PCL-5) was used to assess post-traumatic stress disorder (PTSD) symptoms in participants. The PCL-5 is a 20-item self-report questionnaire that measures the presence and severity of PTSD symptoms based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; APA, 2013). Participants were asked to rate how much they had been bothered by each symptom in the past month on a 5-point Likert scale ranging from 0 (Not at all) to 4 (Extremely). The PCL-5 assesses the four symptom clusters of PTSD: Intrusion symptoms, avoidance symptoms, negative alterations in cognition and mood, and alterations in arousal and reactivity. For this study, the PCL-5 total score was used as a continuous variable to examine PTSD symptom severity. In contrast, categorical classification (≥ 33) was used to identify participants who met the provisional threshold for PTSD. A total score of 33 or higher is considered a provisional PTSD diagnosis (Weathers et al., 2013). The PCL-5 has demonstrated strong psychometric properties, including excellent internal consistency (Cronbach’s α = .94), good test-retest reliability, and high convergent validity with other PTSD measures (Blevins et al., 2015; Weathers et al., 2013). Internal consistency for the PCL-5 in the present study was evaluated using Cronbach’s α. The total scale demonstrated excellent reliability (α = .95), consistent with prior research (e.g., Bovin et al., 2016; Wortmann et al., 2016). Subscale reliabilities were also high, with Re-experiencing (α = 0.85), Avoidance (α = 0.86), Negative Alterations in Cognition and Mood (α = 0.89), and Hyperarousal (α = 0.81) all showing strong internal consistency. These findings suggest that the PCL-5 is a reliable measure for assessing PTSD symptoms in this sample. The Current Anxiety Level Measure (CALM) is a self-report instrument designed to assess an individual’s current state of anxiety. The measure captures both physiological and cognitive symptoms of anxiety and provides a real-time assessment of distress levels. Participants rate their anxiety on a 5-point Likert scale, ranging from 0 (Not at all anxious) to 4 (Extremely anxious), with higher scores indicating greater anxiety levels. In this study, CALM was used to assess participants' momentary anxiety levels. The total CALM score was calculated by summing responses across all items, with higher scores reflecting increased anxiety. Previous research has demonstrated that CALM has strong internal consistency, with Cronbach’s alpha (α) typically ranging between 0.85 and 0.92, indicating high reliability. The measure also correlates well with validated anxiety scales, such as the Generalized Anxiety Disorder-7 (GAD-7) and the State-Trait Anxiety Inventory (STAI) , supporting its construct validity. Internal consistency for the CALM in this sample was excellent (α = 0.75), aligning with previous findings. The Brief Resilience Scale (BRS) (Smith et al., 2008) is a self-report instrument designed to measure an individual's ability to recover from stress and adversity. The BRS consists of six items, with three positively worded (e.g., "I tend to bounce back quickly after hard times") and three negatively worded (e.g., "It is hard for me to snap back when something bad happens"). Participants respond on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). The three negatively worded items are reverse-scored to compute the final score, and the mean of all six items is calculated. Higher scores indicate greater resilience, while lower scores suggest difficulty recovering from stress. The BRS has demonstrated strong psychometric properties, with Cronbach’s alpha ranging from 0.80 to 0.91 across different populations (Smith et al., 2008). Test-retest reliability over one month has been reported at r = 0.62, indicating moderate stability. The scale also correlates well with stress, coping, and well-being measures, supporting its construct validity (Smith et al., 2008). Internal consistency for the BRS in this sample was excellent (α = 0.73), aligning with previous findings. The Medical Outcomes Study Social Support Survey (MOS-SSS) is a self-report instrument developed for individuals with chronic health conditions (Sherbourne & Stewart, 1991). The MOS-SSS comprises four social support subscales and a functional social support index. The parent project only utilized the first subscale that assesses emotional/informational support in their questionnaire packet. This subscale consists of 8 questions that ask about having someone to confide in, empathetic understanding, and informational support: providing advice, guidance, or feedback. A higher score on the MOS-SSS on an individual scale or total support index suggests more support. Obtaining a subscale score for the emotional/informational subscale occurs by calculating the average scores for each item, with higher scores suggesting a higher presence of social support. The MOS-SSS has indicated high reliability (α = 0.91) and stability over time in different clinical populations. Internal consistency for the MOSS-SSS in this sample was excellent (α = 0.73), aligning with previous findings. In this study, the Workplace Distress Subscale (WDS) was administered to assess how participants' experiences of distressing or critical workplace incidents influenced their ability to concentrate, perform tasks effectively, and remain engaged in their work responsibilities. The Workplace Outcome Suite (WOS) is a validated instrument designed to assess the impact of a distressing event at work (Lennox et al., 2010). This study specifically utilized the Workplace Distress Subscale, a component of the WOS that evaluates the degree to which workplace-related distress affects an individual's job performance, concentration, and overall work engagement. The Workplace Distress Subscale consists of items assessing the emotional and psychological impact of workplace stressors, such as difficulty concentrating due to distressing events at work, reduced productivity, and feelings of emotional strain in the workplace. Respondents rate their agreement with statements on a 5-point Likert scale, ranging from 1 (Strongly Disagree) to 5 (Strongly Agree). The WDS has demonstrated strong psychometric properties. Previous studies have reported high internal consistency reliability, with Cronbach’s alpha values typically ranging from 0.80 to 0.90 (Lennox et al., 2010). The subscale also has strong construct validity in predicting work-related impairment and job dissatisfaction. Internal consistency for the WDS in this sample was excellent (α = 0.85), aligning with previous findings. Data Analyses First, descriptive analyses (e.g., frequencies, means, and standard deviations) were conducted across all demographic variables. All demographic variables and potential covariates were determined using a method similar to the Forward method (Sauer et al., 2013). This method conducted correlation analyses between each potential variable and outcome variable of interest (i.e., work impact). The significant variables were then utilized in the final model as a covariate. Second, the prevalence estimates of Depression, Anxiety, Sleep Problems, Substance Use, and PTSD among the sample of FBI personnel were compared to the prevalence estimates for the general population (civilian) and local law enforcement groups (i.e., proxy groups). The other probable mental health diagnoses (i.e., Personality Functioning, Repetitive Thoughts & Behaviors, etc.) were not compared to the proxy groups due to difficulty finding well-established prevalence estimates in the literature in these groups. Given that the prevalence among these groups varies based on measurement, study design, and population examined, the mean prevalence estimates were derived based on reported prevalence rates in the literature and transformed into z scores for statistical significance testing. Third, hierarchical multiple regression analyses were used to assess if Mental Health Total Scores and PTSD total scores (while controlling for significant covariates) predicted perceived Work Impact. For this analysis, Resiliency and Social Support scores were entered in Block 1, while Mental Health Total Score and PTSD Total Score were entered into Block 2. Results Table 1 provides the results based on descriptive analysis and mental health prevalence for the general and law enforcement population. Data from a total of 206 participants were examined. The average age of participants was 44, and they had an average of 14 years of employment with the FBI. The majority of the sample self-identified as male (54%), White (77%), now married (77%), a Special Agent (61%), and experienced childhood trauma (65%). Most had an undergraduate or advanced degree (89%), no military experience (78%), and were part of the evidence recovery team (41%). Table 2 presents the descriptive statistics of the sample’s Total Mental Health Scores by time, including mean and standard deviation at two-time points (Time One: N = 205, Time Two: N = 257). Overall, there were slight increases in several mental health symptoms over time. The CALM score increased from 8.72 ( SD = 9.46) at Time One to 11.07 ( SD = 11.91) at Time Two, indicating higher distress. Anxiety symptoms also rose from 2.69 ( SD = 2.89) to 3.10 ( SD = 2.85), and depressive symptoms saw a minor increase. Measures of repetitive thoughts and behaviors, dissociation, and personality functioning also showed slight increases, while substance use decreased slightly over time. The DSM-5 total score, reflecting overall psychiatric symptoms, increased from 15.38 ( SD = 13.64) to 16.90 ( SD = 13.84). Similarly, the PTSD Checklist (PCL) aggregate score increased from 16.87 ( SD = 15.35) to 18.88 ( SD = 16.33), with negative alterations in cognition and mood and hyperarousal showing the most notable increases. Work impact and suicidal ideation remained relatively stable, while resiliency slightly declined from 22.4 ( SD = 4.42) to 21.37 ( SD = 4.89). These results suggest an overall increase in anxiety, PTSD-related symptoms, and personality functioning issues over time, while some measures, such as substance use, showed minor improvement Table 3 presents the descriptive statistics of the sample’s potential positive mental health diagnoses over time. The percentages of Depression, Anxiety, Sleep Problems, Substance Use, and PTSD—as measured by the PCL—were significantly higher in the study sample compared to general and law enforcement population estimates found in the literature. Table 4 provides the results for the hierarchal multiple regression analyses used to assess if Mental Health and PTSD Total Scores (while controlling for scores on resiliency and social support) would predict perceived Work Impact. Preliminary analyses were conducted to ensure that no normality, linearity, multicollinearity, or homoscedasticity assumptions were violated. Resiliency and Social Support scores were entered at Step 1, explaining 7% of the variance of perceived Work Impact. After the entry of Mental Health and PTSD total Scores at Step 2, the total variance explained by the model as a whole was 18%, F (4, 192) = 7.49, p < .001. Discussion The study’s findings elucidate the mental health challenges faced by FBI personnel and their implications for job performance. The findings of this study underscore the significant prevalence of mental health challenges among FBI personnel, particularly those who respond to critical incidents, highlighting both the psychological toll of their roles and the factors influencing their capacity to perform effectively. By comparing mental health symptoms in FBI personnel to those experienced in the general population and local law enforcement, this study provides a nuanced understanding of the unique stressors inherent in federal investigative work. Addressing these issues through tailored interventions and organizational reforms is essential to safeguarding the well-being of those tasked with protecting national security. Prevalence of Mental Health Symptoms The data reveal high rates of mental health challenges among FBI employees, with a substantial proportion of study participants reporting symptoms consistent with depression (41.0–42.4%), anxiety (43.9–52.1%), and sleep disturbances (44.4–51.2%) over two-time points. This reinforces the assertion that exposure to both direct and vicarious trauma is a defining feature of FBI work, mirroring patterns observed in other high-stress occupations. The increase in potential positive diagnoses across nearly all psychological factors (i.e., depression, anger, mania, anxiety, somatic symptoms, psychosis, dissociation, personality functioning, substance use, and PTSD) between Time One and Time Two further underscores the compounding effects of cumulative trauma exposure. Comparison with Other Populations The study identifies both parallels and distinctions by contextualizing FBI personnel’s mental health outcomes within broader occupational and general population frameworks. Notably, these rates align with or exceed those reported in prior studies of local law enforcement officers responding to critical incidents (Centers for Disease Control, 2006; Stellman et al., 2008 ). The presence of similar psychological factors further reinforces the parallels between these groups in terms of stress exposure and its psychological consequences. However, the severity of reported psychological distress among FBI personnel was significantly higher than that observed in both the general and local law enforcement populations. This heightened distress may be attributed to the unique demands of federal investigative work, which encompasses not only casework but also collateral duties—such as processing sensitive or graphic evidence and prolonged exposure to vicarious trauma. These factors distinguish FBI personnel from other law enforcement and military cohorts (May & Wisco, 2016 ). Workplace Impact Hierarchical regression analysis revealed that mental health symptoms, particularly PTSD scores, were significant predictors of perceived work impact. While social support and resilience played mitigating roles in earlier models, these protective factors—though important—were insufficient to fully offset the adverse effects of PTSD and broader mental health challenges. This finding aligns with existing literature indicating that the intensity of exposure to critical incidents and the cumulative nature of occupational stress significantly influence job performance (Arble, Daugherty, & Arnetz, 2019 ). The finding that mental health symptoms predict work impact is particularly noteworthy given the current landscape, which has seen a large exodus of federal employees from the Department of Justice (DOJ) and the FBI (Beitsch, 2025 ). According to media reports, the Trump administration has removed dozens of DOJ and FBI officials and is considering potentially dismissing thousands more in an unprecedented purge (Klein, 2025 ; Palmer, 2024 ). The politicization of the FBI has led James Dennehy, assistant director in charge of the FBI’s New York field office, to state, “Today, we find ourselves in the middle of a battle of our own, as good people are being walked out of the FBI and others are being targeted because they did their jobs in accordance with the law and FBI policy,” in an email reported by The New York Times (Goldman, 2025 ). The impact of these developments on the mental health of FBI personnel is likely to extend beyond issues related to critical incidents. Concerns about job security and the potential for targeted prosecution now add to the psychological burden, further exacerbating workplace stress and uncertainty. Practical Implications The high rates of mental health challenges among FBI employees across a myriad of psychological factors suggest that these symptoms arise from an underlying combination of causes that is unique to FBI employees. This widespread distress pattern suggests that FBI personnel might have Bureau Syndrome, similar to Operator Syndrome, a term introduced by Christopher Frueh. Frueh et al. ( 2020 ) described Operator Syndrome as a cluster of physical, neurological, and psychological health issues affecting SOF due to the extreme demands of their profession. It arises from a combination of traumatic brain injuries (TBI), chronic sleep deprivation, endocrine dysfunction, prolonged stress, and emotional suppression, all of which interact and worsen over time. These factors contribute to cognitive decline, PTSD, chronic pain, addiction, cardiovascular problems, and difficulties transitioning to civilian life. Unlike traditional views that treat these issues separately, Operator Syndrome highlights the synergistic damage caused by repeated high-stress exposure, requiring a multidisciplinary approach to treatment, including neurocognitive rehabilitation, hormonal therapy, sleep restoration, and psychological support. More research needs to be conducted, but it is not a wide stretch of imagination to view FBI personnel as having Bureau Syndrome since many are exposed to TBI, chronic sleep deprivation, endocrine dysfunction, prolonged stress, and emotional suppression. With a substantial proportion of study participants reporting symptoms consistent with “Operator Syndrome”, the findings suggest several actionable insights for improving mental health outcomes and operational performance among FBI personnel. First, there needs to be enhanced access to confidential mental health services. These services must combine initiatives to reduce stigma within the agency and focus on the holistic approach proposed by Frueh et al. ( 2020 ). Second, there needs to be resources and interventions that could foster a more supportive work environment since findings from this study clearly indicate a connection between mental health symptoms and work impact. Additionally, integrating resilience-building programs and regular debriefing sessions may mitigate the long-term effects of trauma exposure, particularly for those engaged in roles with high allostatic load (Frueh et al., 2020 ). Limitations and Future Research Directions While the findings of this study are significant, several limitations must be acknowledged. First, reliance on self-report assessments introduces potential response and recall biases, which may lead to inaccurate prevalence estimates. Second, the study focused on FBI personnel, and the prevalence estimates were compared to various proxy law enforcement groups. However, differences among these groups may have resulted in less precise comparisons, limiting the generalizability of the findings. Third, the assessment instruments used may not fully capture the complexity of mental health experiences, potentially overlooking key psychological factors relevant to this population. Despite these limitations, this study contributes to a deeper understanding of mental health among FBI personnel while identifying critical areas for future research. Future studies should explore the longitudinal trajectories of mental health symptoms in this population, emphasizing the interactions between chronic stress, organizational support, and job performance. Additionally, examining the effectiveness of targeted interventions, such as trauma-informed training and peer-support programs, could provide evidence-based strategies to address mental health challenges in law enforcement personnel. Declarations Ethical Approval Permission for this study was obtained through the FBI (541-20) and the University of Houston Institutional Review Boards (FY-2024-417). Funding Acknowledgement The author received no financial support for the research, authorship, and/or publication of this article. Data Declaration This study contains sensitive human research participant data of FBI employees and may present a risk of reidentification if shared openly. Author Contribution T.D., G.R.H., D.J., and L.K. conceptualized the research study. T.D., G.R.H., D.J., and L.K. were responsible for data curation. TD conducted the statistical analysis for the study. T.D., G.R.H., D.J., L.K., T.M., and R.M. wrote the main manuscript text. Data Availability This study contains sensitive human research participant data of FBI employees and may present a risk of reidentification if shared openly. References Arble, E., Daugherty, A. M., & Arnetz, B. (2019). Differential effects of physiological arousal following acute stress on police officer performance in a simulated critical incident. Frontiers in Psychology , 10 , 759. Arnetz, B. B., Nevedal, D. C., Lumley, M. A., Backman, L., & Lublin, A. (2009). Trauma resilience training for police: Psychophysiological and performance effects. Journal of Police and Criminal Psychology , 24 (1), 1–9. https://doi.org/10.1007/s11896-008-9030-y Ballenger, J. F., Best, S. R., Metzler, T. J., Wasserman, D. A., Mohr, D. C., Liberman, A., & Marmar, C. R. (2011). Patterns and predictors of alcohol use in male and female urban police officers. The American Journal on Addictions , 20 (1), 21–29. https://doi.org/10.1111/j.1521-0391.2010.00092.x Benjet, C., Bromet, E., Karam, E. G., Kessler, R. 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Trump to purge FBI agents who investigated him . Political Wire. https://politicalwire.com/2025/01/31/trump-to-purge-fbi-agents-who-investigated-him Korre, M., Farioli, A., Varvarigou, V., Sato, S., & Kales, S. N. (2015). A survey of stress levels and time spent across law enforcement duties: Police chief and officer agreement. Journal of Occupational and Environmental Medicine , 57 (5), 612–617. May, C. L., & Wisco, B. E. (2016). Defining trauma: How level of exposure and proximity affect risk for posttraumatic stress disorder. Psychological Trauma: Theory, Research, Practice, and pPolicy , 8 (2), 233. Molnar, B. E., Meeker, S. A., Manners, K., Tieszen, L., Kalergis, K., Fine, J. E., … Wells, M. K. (2020). Vicarious traumatization among child welfare and child protection professionals: A systematic review. Child Abuse & Neglect , 110 , 104679. National Institute of Mental Health. (2023). Generalized anxiety disorder . U.S. Department of Health and Human Services. https://www.nimh.nih.gov/health/statistics/generalized-anxiety-disorder Palmer, E. (2024). Trump administration's 'purge' of FBI agents sparks backlash . Newsweek. https://www.newsweek.com/trump-purge-fbi-agents-doj-jan6-retaliation-2024590 Rajaratnam, S. M. W., Barger, L. K., Lockley, S. W., Shea, S. A., Wang, W., Landrigan, C. P., O’Brien, C. S., Qadri, S., Sullivan, J. P., Cade, B. E., Epstein, L. J., White, D. P., & Czeisler, C. A. (2011). Sleep disorders, health, and safety in police officers. JAMA , 306 (23), 2567–2578. https://doi.org/10.1001/jama.2011.1851 Shih, R. A., Schell, T. L., Hambarsoomian, K., Belzberg, H., & Marshall, G. N. (2010). Prevalence of posttraumatic stress disorder and major depression after trauma center hospitalization. Journal of Trauma: Injury, Infection, and Critical Care , 69(6), 1560–1566. https://doi.org/10.1097/TA.0b013e3181e59c05 Stellman, J. M., Smith, R. P., Katz, C. L., Sharma, V., Charney, D. S., Herbert, R., … Southwick, S. (2008). Enduring mental health morbidity and social function impairment in world trade center rescue, recovery, and cleanup workers: the psychological dimension of an environmental health disaster. Environmental health perspectives , 116 (9), 1248–1253. Syed, S., Ashwick, R., Schlosser, M., Jones, R., & Sundin, J. (2020). Global prevalence and risk factors for mental health problems in police personnel: A systematic review and meta-analysis. Occupational and Environmental Medicine , 77 (11), 737–747. https://oem.bmj.com/content/77/11/737 U.S. Department of Veterans Affairs. (2023). How common is PTSD in adults? National Center for PTSD. https://www.ptsd.va.gov/understand/common/common_adults.asp Wills, T. A., & Schuldberg, D. (2016). Chronic stress and depression among police officers: A case-control study. Journal of Occupational Health Psychology , 21 (1), 67–79. https://doi.org/10.1037/a0039874 Winfrey, K. (2025). Tragedy hits Harris County: Sheriff shares news of suicide losses . KHOU. https://www.khou.com/article/news/local/harris-county/harris-county-sheriffs-office-deputy-suicide/285-ca759fed-3b98-4960-a8d 5-1f1ba5b81656 World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. World Health Organization. https://apps.who.int/iris/handle/10665/254610 Tables Table 1 Sample Characteristics N = 206 Range M (SD) Age 24–65 44.54 (7.94) No. Years in the FBI 0–36 14.57 (7.93) No. of Marriages since Joining the FBI 0–2 1.13 (.74) Freq. Percentage Gender Male 111 53.9 Childhood Trauma No Trauma 71 34.6 One to Three Traumatic Experiences 85 41.5 Four or More Traumatic Experiences 49 23.9 Role in the FBI Special Agent 125 60.7 Professional Staff 77 37.4 Task Force Officer 4 1.9 Collateral Duties None 10 4.9 Employee Assistance Peer 28 13.7 Evidence Recovery Team 84 41.2 Special Weapons and Tactics 55 27.0 Crisis Negotiation Team 8 3.9 Other 6 3 Multiple 13 6.4 Education High School 7 3.4 Some College 15 7.3 Undergraduate Degree 92 44.7 Advanced Degree 92 44.7 Marital Status Now Married 114 42.5 Separated 25 12.1 Divorced 37 13.8 Widowed 5 1.9 Never Married 25 12.7 Race/Ethnicity White 158 76.7 Black 9 4.4 Asian 6 2.9 Multi-Racial 10 4.9 Hispanic 20 9.7 Other 3 1.5 Military Experience Yes 45 21.8 No 161 78.2 Table 2 Mental Health Total Scores at Time One and Time Two Time One (N = 205) Time Two (N = 257) Range Mean Range Mean ACE Total Score 0–9 2.10 (2.30) - - CALM 0–52 8.72 (9.46) 0–59 11.07 (11.91) Work Impact 1–12 5.03 (1.87) 2–10 4.95 (1.86) Depression 0–10 2.01 (2.11) 0–8 2.12 (2.22) Anger 0–4 1.33 (1.19) 0–4 1.39 (1.23) Mania 0–10 1.50 (1.88) 0–8 1.70 (1.66) Anxiety 0–14 2.69 (2.89) 0–12 3.10 (2.85) Somatic Symptoms 0–11 1.28 (2.00) 0–8 1.42 (1.92) Suicidal Ideation 0–3 .11 (.48) 0–3 .09 (.47) Psychosis 0–5 .13 (.66) 0–6 .14 (.74) Sleep Problems 0–5 1.48 (1.33) 0–4 1.63 (1.34) Memory 0–4 .75 (1.05) 0–4 .84 (1.02) Repetitive Thoughts & Behaviors 0–9 1.14 (1.62) 0–7 1.28 (1.51) Dissociation 0–6 .49 (.95) 0–4 .72 (1.09) Personality Functioning 0–22 1.67 (2.35) 0–8 2.01 (2.18) Substance Use 0–8 .69 (1.51) 0–8 .58 (1.26) DSM-5 0–78 15.38 (13.64) 0–69 16.90 (13.84 Life Event Checklist 1–58 17.50 (10.25) - - PCL – Aggregate 0–65 16.87 (15.35) 0–75 18.88 (16.33) Reexperiencing 0–16 4.17 (3.19) 0–20 4.15 (4.05) Avoidance 0–8 2.20 (2.27) 0–8 2.39 (2.03) Negative Alterations 0–25 5.16 (5.89) 0–27 6.24 (6.68) Hyperarousal 0–20 5.37 (4.88) 0–21 6.10 (9.59) Resiliency 10–30 22.4 (4.42) 0–30 21.37 (4.89) Table 3 Mental Health Diagnoses and Prevalence in General and Law Enforcement Populations Across Time Points Time One Time Two General Population Law Enforcement Freq. % Freq. % % % Depression 84 41.0 109 42.4 10–31* 19–26*** Anger 79 38.7 105 40.9 - - Mania 69 33.8 113 44.0 - - Anxiety 90 43.9 134 52.1 3–6*** 8–30*** Somatic Symptoms 59 28.8 80 31.1 - 27* Suicidal Ideation 1 0.50 0 0 - - Psychosis 10 4.90 13 5.10 - - Sleep Problems 91 44.4 131 51.2 15–20*** 40** Memory 49 23.9 58 22.6 - - Repetitive Thoughts & Behaviors 60 29.3 75 29.5 - - Dissociation 31 15.1 54 21.0 - - Personality Functioning 71 34.6 102 39.7 - - Substance Use 17 8.3 62 24.1 14.5** 16 ** PCL ≥ 33 40 19.5 58 22.6 6–9*** 7–19* Note. * p < .05. ** p < .01. *** p < .001. Table 4 Hierarchical Regression Analysis for Mental Health and PTSD Scores Predicting Work Impact (N = 195) Model 1 Model 2 B SE B β B SE B β Resiliency − .071 .028 − .183* − .010 .028 − .027 Social Support − .031 .014 − .160* − .001 .014 − .004 Mental Health Total Score .041 .013 .300** PCL Total Score R 2 .073 .024 .011 .223 .195*. F for change in R 2 7.498** 18.147** Note. *p < .05. **p < .01. Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-6597515","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":459859335,"identity":"1d75f712-3e3b-4dc7-a990-e25a4784e6fc","order_by":0,"name":"Tam K. Dao","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAAp0lEQVRIiWNgGAWjYFCC5AMHPjBIgJkSRGngYUhLPDiDRC05yod5oBzitNiz5zActt1jIc/PwHzwNg9hDUBbeN4eOJzzTMJwZgNbsjVxWiTyEg7nHJBIMDjAYyZNpJYcg8MWQC32B/i/kaCFAWQLAw8bkVrOPEs42HNAwnDGYTZjyznEaGFvTz784ceBOnn+9uaHN94QowUBmElTPgpGwSgYBaMAHwAAQcgt2HesWvgAAAAASUVORK5CYII=","orcid":"","institution":"Rice University","correspondingAuthor":true,"prefix":"","firstName":"Tam","middleName":"K.","lastName":"Dao","suffix":""},{"id":459859337,"identity":"620ec52a-7c97-469c-a724-d190dab27f6f","order_by":1,"name":"Ginnette Rivera-Hernandez","email":"","orcid":"","institution":"Federal Bureau of Investigation","correspondingAuthor":false,"prefix":"","firstName":"Ginnette","middleName":"","lastName":"Rivera-Hernandez","suffix":""},{"id":459859339,"identity":"369c7ead-b165-40c1-97a2-c3ed22664a32","order_by":2,"name":"David Jenkins","email":"","orcid":"","institution":"Federal Bureau of Investigation","correspondingAuthor":false,"prefix":"","firstName":"David","middleName":"","lastName":"Jenkins","suffix":""},{"id":459859341,"identity":"c90f074b-3532-4702-9420-7edf571d99e0","order_by":3,"name":"Leah Kaylor","email":"","orcid":"","institution":"Federal Bureau of Investigation","correspondingAuthor":false,"prefix":"","firstName":"Leah","middleName":"","lastName":"Kaylor","suffix":""},{"id":459859342,"identity":"a0b97652-18a9-4c09-86e0-cfe876d33a28","order_by":4,"name":"Trinidee Mercado","email":"","orcid":"","institution":"Federal Bureau of Investigation","correspondingAuthor":false,"prefix":"","firstName":"Trinidee","middleName":"","lastName":"Mercado","suffix":""},{"id":459859343,"identity":"38b3f69a-31e2-4d87-b11f-5ac3343e68af","order_by":5,"name":"Robert H. McPherson","email":"","orcid":"","institution":"University of Houston","correspondingAuthor":false,"prefix":"","firstName":"Robert","middleName":"H.","lastName":"McPherson","suffix":""}],"badges":[],"createdAt":"2025-05-05 22:23:14","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-6597515/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-6597515/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":86353675,"identity":"79e785f7-6537-4e39-8de9-ff0c624cc91f","added_by":"auto","created_at":"2025-07-09 16:31:58","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":821091,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-6597515/v1/77f4c30e-6db3-4ada-8ed8-d98b45b8b1a7.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"“FBI Bureau Syndrome”: Understanding the FBI’s Unique Mental Health Struggles","fulltext":[{"header":"Introduction","content":"\u003cp\u003eThe Federal Bureau of Investigation (FBI) is widely regarded as the premier law enforcement agency in the United States, responsible for investigating and enforcing federal laws. Its mission is to uphold the U.S. Constitution, protect the American people from terrorist and foreign intelligence threats, and provide leadership and criminal justice services to federal, state, municipal, and international partners. The FBI\u0026apos;s efforts are guided by eight mission priorities: (1) preventing terrorist attacks, (2) countering foreign intelligence and espionage, (3) combating cybercrime, (4) addressing public corruption, (5) protecting civil rights, (6) dismantling transnational criminal enterprises, (7) investigating major white-collar crimes, and (8) reducing violent crime (Federal Bureau of Investigation 2016).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;As of 2023, the FBI employs approximately 38,000 individuals, including special agents and professional staff. The FBI\u0026apos;s fiscal year 2023 budget request supports 37,083 positions, comprising 13,623 special agents, 3,337 intelligence analysts, and 20,123 professional staff (Federal Bureau of Investigation, 2023). A wide range of job roles exist within these positions, each with specific responsibilities. Special agents are responsible for investigating and enforcing federal laws. Their duties include conducting criminal, counterterrorism, and counterintelligence investigations, collecting and analyzing evidence, conducting surveillance and undercover operations, arresting suspects, and executing search warrants. The professional staff, which comprises most of the FBI, includes intelligence analysts, cybersecurity specialists, forensic accountants, linguists, surveillance specialists, evidence technicians, medical doctors, nurses, psychologists, forensic scientists, tactical specialists, legal and policy advisors, and other administrative and support roles. In addition to their primary responsibilities, special agents and professional staff take on collateral duties\u0026mdash;additional responsibilities that support the FBI\u0026rsquo;s operations, enhance professional development, and contribute to the overall success of its mission.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;There are four mission areas that the FBI specializes in that expose the special agent and professional staff populations to significant direct and indirect traumatic experiences. First, the FBI has jurisdiction over crimes committed on approximately 200 Native American reservations, where investigations frequently involve sensitive and traumatic situations. These investigations typically address violent crime, drug trafficking, missing persons, human trafficking, homicides, physical assaults, child sexual abuse, and domestic violence\u0026mdash;each of which can have severe psychological and emotional effects on all those involved. In 2024, the FBI concluded one of its many operations, \u0026ldquo;Operation Not Forgotten,\u0026rdquo; which deployed 51 special agents, analysts, and other personnel to nearly a dozen FBI field offices to support crimes on reservations. During this joint operation, the FBI and its partners opened or worked on more than 300 cases, made over 40 arrests, assisted more than 440 victims and their families, and identified or recovered nine child victims (Federal Bureau of Investigation, n.d.-b).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Second, in addition to investigating violent crimes on Native American reservations, the FBI\u0026apos;s Violent Crimes Against Children (VCAC) program investigates crimes against children that fall under federal statutes. This program provides a rapid, proactive, and comprehensive approach to countering all threats of child abuse and exploitation within the FBI\u0026rsquo;s jurisdiction. In carrying out these duties, agents and analysts are repeatedly exposed to disturbing material, including images and videos of child sexual exploitation, as well as direct interactions with alleged perpetrators.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Third, one of the sophisticated techniques employed by the FBI involves undercover operations, which often include the use of online covert employees (OCEs) to investigate both domestic and international terrorism-related threats. These operations require agents and informants to pose as targets, build relationships, and gather intelligence. In doing so, they are often exposed to traumatic content, including graphic images and videos depicting acts of torture, executions, and other forms of violence.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Lastly, a lesser-known aspect of the FBI\u0026rsquo;s role is its response to mass casualty events (Federal Bureau of Investigations, 2019, 2025). The agency deploys specialized teams of agents, analysts, victim specialists, and crime scene investigators to assist local law enforcement during these crises. The FBI has provided critical support in significant incidents such as the 9/11 terrorist attacks, the Boston Marathon bombings, the Virginia Tech shooting, the Navy Yard shooting, the Route 91 Harvest Music Festival shooting, the Sutherland Springs church shooting, the Uvalde school shooting, the Sandy Hook School shooting, the Pittsburgh synagogue shooting, and the 2025 New Orleans Truck Attack.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The FBI defines a critical incident as any significant threat to public safety, national security, or law enforcement personnel that requires an immediate, coordinated response. These incidents typically involve mass casualties, terrorism, violent crimes, cyber threats, or other high-risk situations that demand specialized investigative and tactical resources (need FBI reference). The FBI responds to critical incidents through its Critical Incident Response Group (CIRG) and the Crisis Intervention Program (CIP). According to the FBI\u0026rsquo;s Human Resource Division, in 2023, the CIP initiated 22 \u0026ldquo;critical incident responses\u0026rdquo; (D. Jenkins, personal communication, February 5, 2025). A CIP involves deploying resources to a critical incident based on scale and impact. According to the FBI\u0026rsquo;s CIP protocol, essential responses to incidents resulting from a CIP are provided only at the request of the affected divisions or field offices, and they are primarily deployed in response to large-scale events such as terrorist attacks, mass shootings, natural disasters, and other incidents impacting large numbers of people.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In all 22 cases in 2023, the FBI\u0026rsquo;s Evidence Response Team (ERT) was also deployed to assist with the critical incident. The ERT is a specialized unit responsible for processing crime scenes and collecting forensic evidence in complex investigations. ERT members undergo extensive training at the FBI Academy in Quantico, Virginia. They are highly skilled in crime scene documentation, fingerprint collection, bloodstain pattern analysis, digital evidence recovery, and hazardous materials handling. These teams collaborate with local, state, and international law enforcement partners to ensure that critical evidence is meticulously preserved, maintaining the integrity of investigations and supporting successful prosecutions. ERT team members are frequently exposed to traumatic events, including body recovery and processing violent crime scenes.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Blak\u0026rsquo;s definition of a critical incident (1991) expands on the FBI\u0026rsquo;s definition by identifying it as any event that has a significant and stressful impact on an individual to the extent that their usual coping mechanisms are overwhelmed. These incidents are typically sudden and powerful and fall outside the scope of everyday human experiences. Even the most experienced individuals can be emotionally affected by these events (Blak, 1991). Such incidents can include, but are not limited to, shootings, mass casualty events, exposure to graphic evidence materials, and search-and-rescue operations (Blak, 1991). While anyone can experience a critical incident, FBI employees are exposed to these events\u0026mdash;both directly and indirectly\u0026mdash;more frequently than the general population or even the broader law enforcement community (Craddock \u0026amp; Telesco, 2022). Direct trauma exposure refers to experiencing trauma firsthand or witnessing it as it occurs (May \u0026amp; Wisco, 2016). Many FBI employees also experience indirect trauma exposure, often referred to as vicarious trauma, through frequent exposure to the traumatic experiences of others, particularly in service-related professions or through processing work-related media reports such as those in law enforcement (May \u0026amp; Wisco, 2016; Molnar et al., 2020).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Despite the known exposure of FBI personnel to traumatic situations and events, there are currently no published studies focusing specifically on the mental health of FBI employees. Consequently, this study will draw on existing literature on law enforcement to explore the mental health challenges individuals face in such roles. These fields share similar exposures to critical incidents, operational stress, and psychological demands, making them valuable reference points for understanding the mental health impacts on FBI personnel.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eGeneral and Law Enforcement Mental Health Prevalence\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe impact of critical incidents on the mental health of law enforcement officers (LEOs) became alarmingly evident following the recent suicides of four Harris County Sheriff\u0026rsquo;s deputies in Texas. According to Thomas McNeese, Director of the Harris County Sheriff\u0026rsquo;s Office (HCSO) Behavioral Health Division, \u0026ldquo;It\u0026rsquo;s a tough job, but every day, agencies like [the HCSO] get it done. The impact may not be seen on the outside, but it\u0026apos;s felt on the inside... The average citizen, I think, in a lifetime may be exposed to two critical incidents\u0026mdash;whereas one of our officers might experience that in a single shift. Over time, that definitely takes a toll\u0026rdquo; (Winfrey, 2024).\u003c/p\u003e\n\u003cp\u003eNot surprisingly, a review of the literature suggests that LEOs are at a heightened risk for mental health issues due to frequent exposure to traumatic events, including violent crimes, accidents, and critical incidents (Gershon et al., 2009). Korre et al. (2015) note that such exposures contribute to some of the highest stress levels observed among LEOs. These stressors lead to various psychological, physical, and behavioral health consequences among law enforcement officers.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePost-Traumatic Stress Disorder (PTSD)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePTSD is a well-documented mental health condition that can develop following exposure to traumatic events such as natural disasters, serious accidents, combat, or assault. In the general population, between 6-9% experience PTSD, with women being more susceptible than men (U.S. Department of Veterans Affairs, 2023). However, studies found the prevalence of PTSD diagnosis to vary between 7-19% (Isabirye et al., 2022).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eAnxiety Disorders (ADs)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eAnxiety disorders (ADs) are characterized by excessive and persistent fear or worry that significantly interferes with daily life. In the general population, generalized anxiety disorder (GAD) affects approximately 3.1% to 5.7% of U.S. adults (National Institute of Mental Health, 2023). Among LEOs, prevalence estimates range from 8-25% for GAD or panic disorder (Arnetz et al., 2009), with some studies reporting rates as high as 20-30% (Wills \u0026amp; Schuldberg, 2016).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eDepressive Disorders (DDs)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePersistent feelings of sadness, hopelessness, or loss of interest in daily activities mark major depressive disorder (MDD) and persistent depressive disorder. In the general population, the prevalence of MDD following a traumatic experience ranges from 10% to 31% (Shih et al., 2010). Among LEOs, a meta-analysis by Syed et al. (2020) found a pooled depression prevalence of 14.6%, while another systematic review estimated a rate of 26%, significantly higher than the global depression rate of 4.4% in the general population (World Health Organization, 2017).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eSubstance Use Disorders (SUDs)\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eSubstance use disorders (SUDs) involve the compulsive use of substances despite harmful consequences. Trauma exposure is associated with an increased risk of SUDs in both the general and LEO populations. The World Health Organization reports that among individuals exposed to trauma, SUD prevalence is 14.5%, compared to 5.1% among those without trauma exposure (Benjet et al., 2022). Research suggests that LEOs may use substances such as alcohol as a coping mechanism for occupational trauma, leading to increased rates of alcoholism (Cross \u0026amp; Ashley, 2004). Studies indicate that 25-30% of officers engage in binge drinking (Ballenger et al., 2011), while alcohol dependence rates range from 16-25%, compared to 7-10% in the general population (Gershon et al., 2009).\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePhysical and Sleep Disturbances\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eLEOs frequently experience chronic pain and sleep disturbances at rates exceeding those seen in the general population. A study of nearly 5,000 North American police officers found that over 40% screened positive for sleep disorders\u0026mdash;nearly double the estimated 15-20% prevalence in the general population (Rajaratnam et al., 2011). Another study reported high rates of psychosomatic symptoms, with 27% of officers experiencing frequent headaches and approximately 14% reporting frequent indigestion.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eLaw Enforcement Culture and Mental Health Stigma\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eA consistent finding in the literature is that LEOs not only experience significant mental health challenges but also internalize the emotional burdens of the public, as they are often the first to respond to critical incidents (Desmarais et al., 2014). Despite these adverse effects, many officers hold negative perceptions of mental health disorders (Soomro \u0026amp; Yanos, 2019; Wester et al., 2010). The law enforcement culture often emphasizes strength and resilience, which can serve as protective factors but may also discourage individuals from seeking help, as mental health struggles are sometimes perceived as signs of weakness (White et al., 2016).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Similar to LEOs, FBI personnel are routinely exposed to critical incidents that can have significant mental health consequences. As a result, many are at high risk for primary and secondary trauma, stress-related disorders, and burnout, underscoring the need for comprehensive mental health support and resilience training. While research has extensively examined mental health challenges among local law enforcement, little is known about the psychological toll on FBI personnel. A review of the literature revealed no studies specifically examining the mental health effects of critical incident exposure on FBI employees. Furthermore, no research has assessed the nature, scale, and scope of mental health concerns within this unique population. Understanding how mental health symptoms manifest among FBI personnel is essential for developing targeted risk prevention strategies.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The goals of this study are to investigate how FBI personnel experience mental health symptoms and whether these symptoms significantly impact their job performance. Specifically, the study will: 1) Assess the prevalence of mental health symptoms among FBI personnel and compare them to those observed in the general and local law enforcement populations, and 2) Examine whether mental health symptoms influence FBI employees\u0026rsquo; perceived work performance. By addressing these objectives, this study aims to contribute to developing effective support systems and interventions tailored to the unique needs of FBI personnel.\u003c/p\u003e"},{"header":"Methodology","content":"\u003cp\u003e\u003cem\u003eProcedures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003ePermission for this study was obtained through the FBI (541-20) and the University of Houston Institutional Review Boards (FY-2024-417). The FBI Employee Assistance Program (EAP) currently conducts Post-Critical Incident Seminars (PCIS) for FBI employees who have been exposed to critical incidents such as mass casualty events, shooting incidents, and violent crime scenes or for FBI employees who have been exposed to repeated stressful events over the course of their professional duties as an FBI employee. The seminar is 3 days long and provides education, support, and skills-based tools to help FBI employees cope with the thoughts and feelings they may be experiencing due to such exposure. FBI employees selected to attend PCIS were invited to participate in the research study. Once participants consented to be part of the research study, each participant completed self-report questionnaires on four separate occasions assessing demographic information, childhood experiences, psychological health, work impact, and protective factors such as resilience and social support. The first occasion occurred three to five days before attending the PCIS. The second and third occasions occurred on the same day and last day of the PCIS. The fourth occasion occurred a few months after the participants attended the PCIS and was administered as part of their 2-3 months follow-up.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cem\u003eMeasures\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eDemographics. Demographic variables assessed in this study included age, tenure in the FBI (number of years), number of marriages since joining the FBI, gender, types of collateral duties while employed in the FBI, education level, marital status, military experience, race/ethnicity, and role within the agency. Age, tenure in the FBI, and number of marriages were treated as continuous variables, while all other demographic factors were categorical variables.\u003c/p\u003e\n\u003cp\u003e\u003cem\u003ePsychological Factors\u003c/em\u003e\u003c/p\u003e\n\u003cp\u003eThe DSM-5-TR Self-Rated Level 1 Cross-Cutting Symptom Measure (DSM-5-TR Level 1; APA, 2022) was used to assess a broad range of mental health symptoms across multiple domains. This measure consists of 23 items, each rated on a 5-point Likert scale ranging from 0 (None) to 4 (Severe), and evaluates symptoms experienced by participants over the past two weeks. The Level 1 measure is designed to provide a comprehensive screening across 13 psychiatric domains: Depression (e.g., \u0026quot;Little interest or pleasure in doing things\u0026quot;); Anger (e.g., \u0026quot;Feeling angry or irritable\u0026quot;); Mania (e.g., \u0026quot;Feeling overly energetic, excited, or hyper\u0026quot;); Anxiety (e.g., \u0026quot;Feeling nervous, anxious, or scared\u0026quot;); Somatic Symptoms (e.g., \u0026quot;Feeling aches or pains\u0026quot;); Sleep Problems (e.g., \u0026quot;Problems falling or staying asleep\u0026quot;); Psychosis (e.g., \u0026quot;Hearing things other people couldn\u0026rsquo;t hear\u0026quot;); Repetitive Thoughts and Behaviors (e.g., \u0026quot;Unwanted thoughts that wouldn\u0026rsquo;t leave your mind\u0026quot;); Dissociation (e.g., \u0026quot;Feeling detached from yourself or your surroundings\u0026quot;); Personality Functioning (e.g., \u0026quot;Problems getting along with people\u0026quot;); Substance Use (e.g., \u0026quot;Drinking at least four alcoholic drinks in a day\u0026quot;). The Level 1 measure is not diagnostic but serves as a preliminary screening tool to identify potential mental health concerns and determine if further clinical assessment is warranted using the DSM-5-TR Level 2 measures for specific symptom domains.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe DSM-5-TR Level 1 measure has demonstrated strong internal consistency across psychiatric symptom domains, with Cronbach\u0026rsquo;s alpha coefficients ranging from 0.75 to 0.91 in previous studies (Narrow et al., 2019). Additionally, the measure has shown good convergent validity with established psychiatric screening tools such as the PHQ-9 for depression\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eand the\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eGAD-7 for anxiety (Clarke et al., 2021).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eTo assess the internal consistency of the DSM-5-TR Level 1 measure, Cronbach\u0026rsquo;s alpha (\u0026alpha;) was calculated for each scale at time 1. The reliability coefficients for the primary measures were as follows: Depression \u0026alpha; = .73; Mania \u0026alpha; = .71; Anxiety \u0026alpha; = .79; Somatic Symptoms \u0026alpha; = .75; Psychosis \u0026alpha; = .72; Repetitive Thoughts and Behaviors \u0026alpha; = .82; Dissociation \u0026alpha; = 76; Personality Functioning \u0026alpha; = .79; Substance Use \u0026alpha; = .81. All scales demonstrated acceptable to excellent reliability, with Cronbach\u0026rsquo;s \u0026alpha; values exceeding the recommended threshold of .70 (Nunnally \u0026amp; Bernstein, 1994). These results indicate good internal consistency across the study\u0026rsquo;s measures, suggesting that the items within each scale reliably assess the intended constructs.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The Adverse Childhood Experiences (ACE) Checklist (Felitti et al., 1998) was used to assess participants\u0026apos; exposure to early-life stressors and traumatic experiences before the age of 18. The ACE Checklist is a widely used self-report measure consisting of 10 items that evaluate exposure to adverse events, including emotional abuse, physical abuse, sexual abuse, emotional neglect, physical neglect, parental separation or divorce, household substance abuse, household mental illness, witnessing domestic violence, and having an incarcerated household member. Participants completed the ACE Checklist electronically via an online survey platform. Each item is scored as 0 (No) or 1 (Yes), with a possible score ranging from 0 to 10. Higher scores indicate greater exposure to childhood adversity. A score of 4 or higher is often associated with an increased risk of negative physical and mental health outcomes in adulthood (Felitti et al., 1998).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; The ACE Checklist has demonstrated strong test-retest reliability and internal consistency, with Cronbach\u0026rsquo;s alpha coefficients typically ranging from 0.76 to 0.88 in various populations (Anda et al., 2006). Additionally, it has shown good predictive validity for a range of mental health disorders, including depression, anxiety, and PTSD (Edwards et al., 2003). Internal consistency for the Adverse Childhood Experiences (ACE) scale was assessed using Cronbach\u0026rsquo;s alpha (\u0026alpha;). The analysis revealed a high level of reliability, \u0026alpha; = .93, indicating excellent internal consistency (Nunnally \u0026amp; Bernstein, 1994). This suggests that the items within the ACE scale reliably measure adverse childhood experiences in the sample.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The PTSD Checklist for DSM-5 (Weathers et al., 2013; PCL-5) was used to assess post-traumatic stress disorder (PTSD) symptoms in participants. The PCL-5 is a 20-item self-report questionnaire that measures the presence and severity of PTSD symptoms based on the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5; APA, 2013). Participants were asked to rate how much they had been bothered by each symptom in the past month on a 5-point Likert scale ranging from 0 (Not at all) to 4 (Extremely). The PCL-5 assesses the four symptom clusters of PTSD: Intrusion symptoms, avoidance symptoms, negative alterations in cognition and mood, and alterations in arousal and reactivity. For this study, the PCL-5 total score was used as a continuous variable to examine PTSD symptom severity. In contrast, categorical classification (\u0026ge; 33) was used to identify participants who met the provisional threshold for PTSD. A total score of 33 or higher is considered a provisional PTSD diagnosis (Weathers et al., 2013).\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The PCL-5 has demonstrated strong psychometric properties, including excellent internal consistency (Cronbach\u0026rsquo;s \u0026alpha; = .94), good test-retest reliability, and high convergent validity with other PTSD measures (Blevins et al., 2015; Weathers et al., 2013). Internal consistency for the PCL-5 in the present study was evaluated using Cronbach\u0026rsquo;s \u0026alpha;. The total scale demonstrated excellent reliability (\u0026alpha; = .95), consistent with prior research (e.g., Bovin et al., 2016; Wortmann et al., 2016). Subscale reliabilities were also high, with Re-experiencing (\u0026alpha; = 0.85), Avoidance (\u0026alpha; = 0.86), Negative Alterations in Cognition and Mood (\u0026alpha; = 0.89), and Hyperarousal (\u0026alpha; = 0.81) all showing strong internal consistency. These findings suggest that the PCL-5 is a reliable measure for assessing PTSD symptoms in this sample.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The Current Anxiety Level Measure (CALM) is a self-report instrument designed to assess an individual\u0026rsquo;s current state of anxiety. The measure captures both physiological and cognitive symptoms of anxiety and provides a real-time assessment of distress levels. Participants rate their anxiety on a 5-point Likert scale, ranging from 0 (Not at all anxious) to 4 (Extremely anxious), with higher scores indicating greater anxiety levels. In this study, CALM was used to assess participants\u0026apos; momentary anxiety levels. The total CALM score was calculated by summing responses across all items, with higher scores reflecting increased anxiety.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp; Previous research has demonstrated that CALM has strong internal consistency, with Cronbach\u0026rsquo;s alpha (\u0026alpha;) typically ranging between 0.85 and 0.92, indicating high reliability. The measure also correlates well with validated anxiety scales, such as the Generalized Anxiety\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003eDisorder-7 (GAD-7) and the State-Trait Anxiety Inventory (STAI)\u003cstrong\u003e,\u003c/strong\u003e supporting its construct validity. Internal consistency for the CALM in this sample was excellent (\u0026alpha; = 0.75), aligning with previous findings.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The Brief Resilience Scale (BRS) (Smith et al., 2008) is a self-report instrument designed to measure an individual\u0026apos;s ability to recover from stress and adversity. The BRS consists of six items, with three positively worded (e.g., \u0026quot;I tend to bounce back quickly after hard times\u0026quot;) and three negatively worded (e.g., \u0026quot;It is hard for me to snap back when something bad happens\u0026quot;). Participants respond on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). \u0026nbsp;The three negatively worded items are reverse-scored to compute the final score, and the mean of all six items is calculated. Higher scores indicate greater resilience, while lower scores suggest difficulty recovering from stress.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe BRS has demonstrated strong psychometric properties, with Cronbach\u0026rsquo;s alpha ranging from 0.80 to 0.91 across different populations (Smith et al., 2008). Test-retest reliability over one month has been reported at r = 0.62, indicating moderate stability. The scale also correlates well with stress, coping, and well-being measures, supporting its construct validity (Smith et al., 2008). Internal consistency for the BRS in this sample was excellent (\u0026alpha; = 0.73), aligning with previous findings.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;The Medical Outcomes Study Social Support Survey (MOS-SSS) is a self-report instrument developed for individuals with chronic health conditions (Sherbourne \u0026amp; Stewart, 1991). The MOS-SSS comprises four social support subscales and a functional social support index. The parent project only utilized the first subscale that assesses emotional/informational support in their questionnaire packet. This subscale consists of 8 questions that ask about having someone to confide in, empathetic understanding, and informational support: providing advice, guidance, or feedback. A higher score on the MOS-SSS on an individual scale or total support index suggests more support. Obtaining a subscale score for the emotional/informational subscale occurs by calculating the average scores for each item, with higher scores suggesting a higher presence of social support. The MOS-SSS has indicated high reliability (\u0026alpha; = 0.91) and stability over time in different clinical populations. Internal consistency for the MOSS-SSS in this sample was excellent (\u0026alpha; = 0.73), aligning with previous findings.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;In this study, the Workplace Distress Subscale (WDS) was administered to assess how participants\u0026apos; experiences of distressing or critical workplace incidents influenced their ability to concentrate, perform tasks effectively, and remain engaged in their work responsibilities. The Workplace Outcome Suite (WOS) is a validated instrument designed to assess the impact of a distressing event at work (Lennox et al., 2010). This study specifically utilized the Workplace Distress Subscale, a component of the WOS that evaluates the degree to which workplace-related distress affects an individual\u0026apos;s job performance, concentration, and overall work engagement. The Workplace Distress Subscale consists of items assessing the emotional and psychological impact of workplace stressors, such as difficulty concentrating due to distressing events at work, reduced productivity, and feelings of emotional strain in the workplace. Respondents rate their agreement with statements on a 5-point Likert scale, ranging from 1 (Strongly Disagree) to 5 (Strongly Agree).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe WDS has demonstrated strong psychometric properties. Previous studies have reported high internal consistency reliability, with Cronbach\u0026rsquo;s alpha values typically ranging from 0.80 to 0.90 (Lennox et al., 2010). The subscale also has strong construct validity in predicting work-related impairment and job dissatisfaction. Internal consistency for the WDS in this sample was excellent (\u0026alpha; = 0.85), aligning with previous findings.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Analyses\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eFirst, descriptive analyses (e.g., frequencies, means, and standard deviations) were conducted across all demographic variables. All demographic variables and potential covariates were determined using a method similar to the Forward method (Sauer et al., 2013). This method conducted correlation analyses between each potential variable and outcome variable of interest (i.e., work impact). The significant variables were then utilized in the final model as a covariate.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Second, the prevalence estimates of Depression, Anxiety, Sleep Problems, Substance Use, and PTSD among the sample of FBI personnel were compared to the prevalence estimates for the general population (civilian) and local law enforcement groups (i.e., proxy groups). The other probable mental health diagnoses (i.e., Personality Functioning, Repetitive Thoughts \u0026amp; Behaviors, etc.) were not compared to the proxy groups due to difficulty finding well-established prevalence estimates in the literature in these groups. Given that the prevalence among these groups varies based on measurement, study design, and population examined, the mean prevalence estimates were derived based on reported prevalence rates in the literature and transformed into z scores for statistical significance testing.\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;Third, hierarchical multiple regression analyses were used to assess if Mental Health Total Scores and PTSD total scores (while controlling for significant covariates) predicted perceived Work Impact. For this analysis, Resiliency and Social Support scores were entered in Block 1, while Mental Health Total Score and PTSD Total Score were entered into Block 2.\u0026nbsp;\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e provides the results based on descriptive analysis and mental health prevalence for the general and law enforcement population. Data from a total of 206 participants were examined. The average age of participants was 44, and they had an average of 14 years of employment with the FBI. The majority of the sample self-identified as male (54%), White (77%), now married (77%), a Special Agent (61%), and experienced childhood trauma (65%). Most had an undergraduate or advanced degree (89%), no military experience (78%), and were part of the evidence recovery team (41%).\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e presents the descriptive statistics of the sample\u0026rsquo;s Total Mental Health Scores by time, including mean and standard deviation at two-time points (Time One: \u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;205, Time Two: \u003cem\u003eN\u003c/em\u003e\u0026thinsp;=\u0026thinsp;257). Overall, there were slight increases in several mental health symptoms over time. The CALM score increased from 8.72 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;9.46) at Time One to 11.07 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;11.91) at Time Two, indicating higher distress. Anxiety symptoms also rose from 2.69 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.89) to 3.10 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;2.85), and depressive symptoms saw a minor increase. Measures of repetitive thoughts and behaviors, dissociation, and personality functioning also showed slight increases, while substance use decreased slightly over time.\u003c/p\u003e \u003cp\u003eThe DSM-5 total score, reflecting overall psychiatric symptoms, increased from 15.38 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;13.64) to 16.90 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;13.84). Similarly, the PTSD Checklist (PCL) aggregate score increased from 16.87 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;15.35) to 18.88 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;16.33), with negative alterations in cognition and mood and hyperarousal showing the most notable increases. Work impact and suicidal ideation remained relatively stable, while resiliency slightly declined from 22.4 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4.42) to 21.37 (\u003cem\u003eSD\u003c/em\u003e\u0026thinsp;=\u0026thinsp;4.89). These results suggest an overall increase in anxiety, PTSD-related symptoms, and personality functioning issues over time, while some measures, such as substance use, showed minor improvement\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e presents the descriptive statistics of the sample\u0026rsquo;s potential positive mental health diagnoses over time. The percentages of Depression, Anxiety, Sleep Problems, Substance Use, and PTSD\u0026mdash;as measured by the PCL\u0026mdash;were significantly higher in the study sample compared to general and law enforcement population estimates found in the literature.\u003c/p\u003e \u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e provides the results for the hierarchal multiple regression analyses used to assess if Mental Health and PTSD Total Scores (while controlling for scores on resiliency and social support) would predict perceived Work Impact. Preliminary analyses were conducted to ensure that no normality, linearity, multicollinearity, or homoscedasticity assumptions were violated. Resiliency and Social Support scores were entered at Step 1, explaining 7% of the variance of perceived Work Impact. After the entry of Mental Health and PTSD total Scores at Step 2, the total variance explained by the model as a whole was 18%, \u003cem\u003eF\u003c/em\u003e (4, 192)\u0026thinsp;=\u0026thinsp;7.49, \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001.\u003c/p\u003e"},{"header":"Discussion","content":"\u003cp\u003eThe study\u0026rsquo;s findings elucidate the mental health challenges faced by FBI personnel and their implications for job performance. The findings of this study underscore the significant prevalence of mental health challenges among FBI personnel, particularly those who respond to critical incidents, highlighting both the psychological toll of their roles and the factors influencing their capacity to perform effectively. By comparing mental health symptoms in FBI personnel to those experienced in the general population and local law enforcement, this study provides a nuanced understanding of the unique stressors inherent in federal investigative work. Addressing these issues through tailored interventions and organizational reforms is essential to safeguarding the well-being of those tasked with protecting national security.\u003c/p\u003e \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003ePrevalence of Mental Health Symptoms\u003c/h2\u003e \u003cp\u003eThe data reveal high rates of mental health challenges among FBI employees, with a substantial proportion of study participants reporting symptoms consistent with depression (41.0\u0026ndash;42.4%), anxiety (43.9\u0026ndash;52.1%), and sleep disturbances (44.4\u0026ndash;51.2%) over two-time points. This reinforces the assertion that exposure to both direct and vicarious trauma is a defining feature of FBI work, mirroring patterns observed in other high-stress occupations. The increase in potential positive diagnoses across nearly all psychological factors (i.e., depression, anger, mania, anxiety, somatic symptoms, psychosis, dissociation, personality functioning, substance use, and PTSD) between Time One and Time Two further underscores the compounding effects of cumulative trauma exposure.\u003c/p\u003e \u003c/div\u003e\n\u003ch3\u003eComparison with Other Populations\u003c/h3\u003e\n\u003cp\u003eThe study identifies both parallels and distinctions by contextualizing FBI personnel\u0026rsquo;s mental health outcomes within broader occupational and general population frameworks. Notably, these rates align with or exceed those reported in prior studies of local law enforcement officers responding to critical incidents (Centers for Disease Control, 2006; Stellman et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2008\u003c/span\u003e). The presence of similar psychological factors further reinforces the parallels between these groups in terms of stress exposure and its psychological consequences. However, the severity of reported psychological distress among FBI personnel was significantly higher than that observed in both the general and local law enforcement populations. This heightened distress may be attributed to the unique demands of federal investigative work, which encompasses not only casework but also collateral duties\u0026mdash;such as processing sensitive or graphic evidence and prolonged exposure to vicarious trauma. These factors distinguish FBI personnel from other law enforcement and military cohorts (May \u0026amp; Wisco, \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2016\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eWorkplace Impact\u003c/h3\u003e\n\u003cp\u003eHierarchical regression analysis revealed that mental health symptoms, particularly PTSD scores, were significant predictors of perceived work impact. While social support and resilience played mitigating roles in earlier models, these protective factors\u0026mdash;though important\u0026mdash;were insufficient to fully offset the adverse effects of PTSD and broader mental health challenges. This finding aligns with existing literature indicating that the intensity of exposure to critical incidents and the cumulative nature of occupational stress significantly influence job performance (Arble, Daugherty, \u0026amp; Arnetz, \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2019\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe finding that mental health symptoms predict work impact is particularly noteworthy given the current landscape, which has seen a large exodus of federal employees from the Department of Justice (DOJ) and the FBI (Beitsch, \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2025\u003c/span\u003e). According to media reports, the Trump administration has removed dozens of DOJ and FBI officials and is considering potentially dismissing thousands more in an unprecedented purge (Klein, \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Palmer, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). The politicization of the FBI has led James Dennehy, assistant director in charge of the FBI\u0026rsquo;s New York field office, to state, \u0026ldquo;Today, we find ourselves in the middle of a battle of our own, as good people are being walked out of the FBI and others are being targeted because they did their jobs in accordance with the law and FBI policy,\u0026rdquo; in an email reported by The New York Times (Goldman, \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2025\u003c/span\u003e).\u003c/p\u003e \u003cp\u003eThe impact of these developments on the mental health of FBI personnel is likely to extend beyond issues related to critical incidents. Concerns about job security and the potential for targeted prosecution now add to the psychological burden, further exacerbating workplace stress and uncertainty.\u003c/p\u003e\n\u003ch3\u003ePractical Implications\u003c/h3\u003e\n\u003cp\u003eThe high rates of mental health challenges among FBI employees across a myriad of psychological factors suggest that these symptoms arise from an underlying combination of causes that is unique to FBI employees. This widespread distress pattern suggests that FBI personnel might have Bureau Syndrome, similar to Operator Syndrome, a term introduced by Christopher Frueh. Frueh et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e) described Operator Syndrome as a cluster of physical, neurological, and psychological health issues affecting SOF due to the extreme demands of their profession. It arises from a combination of traumatic brain injuries (TBI), chronic sleep deprivation, endocrine dysfunction, prolonged stress, and emotional suppression, all of which interact and worsen over time. These factors contribute to cognitive decline, PTSD, chronic pain, addiction, cardiovascular problems, and difficulties transitioning to civilian life. Unlike traditional views that treat these issues separately, Operator Syndrome highlights the synergistic damage caused by repeated high-stress exposure, requiring a multidisciplinary approach to treatment, including neurocognitive rehabilitation, hormonal therapy, sleep restoration, and psychological support. More research needs to be conducted, but it is not a wide stretch of imagination to view FBI personnel as having Bureau Syndrome since many are exposed to TBI, chronic sleep deprivation, endocrine dysfunction, prolonged stress, and emotional suppression.\u003c/p\u003e \u003cp\u003eWith a substantial proportion of study participants reporting symptoms consistent with \u0026ldquo;Operator Syndrome\u0026rdquo;, the findings suggest several actionable insights for improving mental health outcomes and operational performance among FBI personnel. First, there needs to be enhanced access to confidential mental health services. These services must combine initiatives to reduce stigma within the agency and focus on the holistic approach proposed by Frueh et al. (\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Second, there needs to be resources and interventions that could foster a more supportive work environment since findings from this study clearly indicate a connection between mental health symptoms and work impact. Additionally, integrating resilience-building programs and regular debriefing sessions may mitigate the long-term effects of trauma exposure, particularly for those engaged in roles with high allostatic load (Frueh et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\n\u003ch3\u003eLimitations and Future Research Directions\u003c/h3\u003e\n\u003cp\u003eWhile the findings of this study are significant, several limitations must be acknowledged. First, reliance on self-report assessments introduces potential response and recall biases, which may lead to inaccurate prevalence estimates. Second, the study focused on FBI personnel, and the prevalence estimates were compared to various proxy law enforcement groups. However, differences among these groups may have resulted in less precise comparisons, limiting the generalizability of the findings. Third, the assessment instruments used may not fully capture the complexity of mental health experiences, potentially overlooking key psychological factors relevant to this population.\u003c/p\u003e \u003cp\u003eDespite these limitations, this study contributes to a deeper understanding of mental health among FBI personnel while identifying critical areas for future research. Future studies should explore the longitudinal trajectories of mental health symptoms in this population, emphasizing the interactions between chronic stress, organizational support, and job performance. Additionally, examining the effectiveness of targeted interventions, such as trauma-informed training and peer-support programs, could provide evidence-based strategies to address mental health challenges in law enforcement personnel.\u003c/p\u003e "},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical Approval \u003c/strong\u003e\u003cbr\u003e\u0026nbsp;Permission for this study was obtained through the FBI (541-20) and the University of Houston Institutional Review Boards (FY-2024-417).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding Acknowledgement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe author received no financial support for the research, authorship, and/or publication of this article.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eData Declaration\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThis study contains sensitive human research participant data of FBI employees and may present a risk of reidentification if shared openly.\u0026nbsp;\u003c/p\u003e\u003ch2\u003eAuthor Contribution\u003c/h2\u003e\u003cp\u003eT.D., G.R.H., D.J., and L.K. conceptualized the research study. T.D., G.R.H., D.J., and L.K. were responsible for data curation. TD conducted the statistical analysis for the study. T.D., G.R.H., D.J., L.K., T.M., and R.M. wrote the main manuscript text.\u003c/p\u003e\u003ch2\u003eData Availability\u003c/h2\u003e\u003cp\u003eThis study contains sensitive human research participant data of FBI employees and may present a risk of reidentification if shared openly.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eArble, E., Daugherty, A. M., \u0026amp; Arnetz, B. (2019). Differential effects of physiological arousal following acute stress on police officer performance in a simulated critical incident. \u003cem\u003eFrontiers in Psychology\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e, 759.\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eArnetz, B. B., Nevedal, D. C., Lumley, M. A., Backman, L., \u0026amp; Lublin, A. (2009). 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(2023). \u003cem\u003eHow common is PTSD in adults?\u003c/em\u003e National Center for PTSD. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.ptsd.va.gov/understand/common/common_adults.asp\u003c/span\u003e\u003cspan address=\"https://www.ptsd.va.gov/understand/common/common_adults.asp\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWills, T. A., \u0026amp; Schuldberg, D. (2016). 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KHOU. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://www.khou.com/article/news/local/harris-county/harris-county-sheriffs-office-deputy-suicide/285-ca759fed-3b98-4960-a8d\u003c/span\u003e\u003cspan address=\"https://www.khou.com/article/news/local/harris-county/harris-county-sheriffs-office-deputy-suicide/285-ca759fed-3b98-4960-a8d\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e5-1f1ba5b81656\u003c/span\u003e\u003c/li\u003e \u003cli\u003e\u003cspan\u003eWorld Health Organization. (2017). Depression and other common mental disorders: Global health estimates. \u003cem\u003eWorld Health Organization.\u003c/em\u003e \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://apps.who.int/iris/handle/10665/254610\u003c/span\u003e\u003cspan address=\"https://apps.who.int/iris/handle/10665/254610\" targettype=\"URL\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eSample Characteristics N\u0026thinsp;=\u0026thinsp;206\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"4\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colname=\"c3\"\u003e \u003cp\u003eRange\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c4\"\u003e \u003cp\u003eM (SD)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAge\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e24\u0026ndash;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.54 (7.94)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo. Years in the FBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026ndash;36\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e14.57 (7.93)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNo. of Marriages since Joining the FBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0\u0026ndash;2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.13 (.74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eFreq.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003ePercentage\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eGender\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMale\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e111\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e53.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eChildhood Trauma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo Trauma\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e34.6\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOne to Three Traumatic Experiences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e85\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFour or More Traumatic Experiences\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e23.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRole in the FBI\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpecial Agent\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e125\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e60.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eProfessional Staff\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e77\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e37.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eTask Force Officer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCollateral Duties\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNone\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEmployee Assistance Peer\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eEvidence Recovery Team\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e41.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSpecial Weapons and Tactics\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e55\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e27.0\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eCrisis Negotiation Team\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMultiple\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e6.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eEducation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHigh School\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e3.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSome College\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e7.3\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eUndergraduate Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAdvanced Degree\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e92\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e44.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMarital Status\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNow Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e114\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e42.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eSeparated\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.1\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eDivorced\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e37\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWidowed\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNever Married\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e12.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRace/Ethnicity\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eWhite\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e158\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e76.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eBlack\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.4\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eAsian\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eMulti-Racial\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e4.9\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eHispanic\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e9.7\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eOther\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e1.5\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMilitary Experience\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eYes\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e45\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e21.8\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eNo\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e161\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e78.2\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eMental Health Total Scores at Time One and Time Two\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"5\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eTime One\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;205)\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eTime Two\u003c/p\u003e \u003cp\u003e(N\u0026thinsp;=\u0026thinsp;257)\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eRange\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eRange\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003eMean\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eACE Total Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.10 (2.30)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eCALM\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;52\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.72 (9.46)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e11.07 (11.91)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eWork Impact\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.03 (1.87)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e2\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.95 (1.86)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.01 (2.11)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.12 (2.22)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.33 (1.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.39 (1.23)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMania\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.50 (1.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.70 (1.66)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;14\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.69 (2.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;12\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e3.10 (2.85)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomatic Symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;11\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.28 (2.00)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.42 (1.92)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuicidal Ideation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.11 (.48)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.09 (.47)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.13 (.66)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.14 (.74)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleep Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.48 (1.33)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.63 (1.34)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMemory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.75 (1.05)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.84 (1.02)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRepetitive Thoughts \u0026amp; Behaviors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.14 (1.62)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e1.28 (1.51)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissociation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.49 (.95)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.72 (1.09)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonality Functioning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;22\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e1.67 (2.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.01 (2.18)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance Use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.69 (1.51)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.58 (1.26)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDSM-5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;78\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.38 (13.64)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e16.90 (13.84\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eLife Event Checklist\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u0026ndash;58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e17.50 (10.25)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCL \u0026ndash; Aggregate\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;65\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e16.87 (15.35)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e18.88 (16.33)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eReexperiencing\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;16\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.17 (3.19)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e4.15 (4.05)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAvoidance\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e2.20 (2.27)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e2.39 (2.03)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eNegative Alterations\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;25\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.16 (5.89)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;27\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.24 (6.68)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eHyperarousal\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e0\u0026ndash;20\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e5.37 (4.88)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;21\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e6.10 (9.59)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResiliency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e22.4 (4.42)\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u0026ndash;30\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.37 (4.89)\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eMental Health Diagnoses and Prevalence in General and Law Enforcement Populations Across Time Points\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c3\" namest=\"c2\"\u003e \u003cp\u003eTime One\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"2\" nameend=\"c5\" namest=\"c4\"\u003e \u003cp\u003eTime Two\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c6\"\u003e \u003cp\u003eGeneral Population\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colname=\"c7\"\u003e \u003cp\u003eLaw Enforcement\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003eFreq.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003eFreq.\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e%\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDepression\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e84\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e41.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e109\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e42.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e10\u0026ndash;31*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e19\u0026ndash;26***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnger\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e79\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e38.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e105\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e40.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMania\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e69\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e33.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e113\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e44.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eAnxiety\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e43.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e134\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e52.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e3\u0026ndash;6***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e8\u0026ndash;30***\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSomatic Symptoms\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e59\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e28.8\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e80\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e31.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e27*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSuicidal Ideation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e0.50\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePsychosis\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e4.90\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e13\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e5.10\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSleep Problems\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e91\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e44.4\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e131\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e51.2\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e15\u0026ndash;20***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e40**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMemory\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e49\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e23.9\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eRepetitive Thoughts \u0026amp; Behaviors\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e60\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e29.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e75\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e29.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eDissociation\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e31\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e15.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e54\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e21.0\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePersonality Functioning\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e71\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e34.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e102\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e39.7\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e-\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSubstance Use\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e17\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e8.3\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e62\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e24.1\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e14.5**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e16 **\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003ePCL\u0026thinsp;\u0026ge;\u0026thinsp;33\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e40\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e19.5\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e58\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e22.6\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e6\u0026ndash;9***\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e7\u0026ndash;19*\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNote. * \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05. ** \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01. *** \u003cem\u003ep\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.001.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e \u003cp\u003e \u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e \u003ccaption language=\"En\"\u003e \u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e \u003cdiv class=\"CaptionContent\"\u003e \u003cp\u003e\u003cem\u003eHierarchical Regression Analysis for Mental Health and PTSD Scores Predicting Work Impact (N\u0026thinsp;=\u0026thinsp;195)\u003c/em\u003e\u003c/p\u003e \u003c/div\u003e \u003c/caption\u003e \u003ccolgroup cols=\"7\"\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e \u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e \u003cthead\u003e \u003ctr\u003e \u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c4\" namest=\"c2\"\u003e \u003cp\u003eModel 1\u003c/p\u003e \u003c/th\u003e \u003cth align=\"left\" colspan=\"3\" nameend=\"c7\" namest=\"c5\"\u003e \u003cp\u003eModel 2\u003c/p\u003e \u003c/th\u003e \u003c/tr\u003e \u003c/thead\u003e \u003ctbody\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e\u003cem\u003eSE B\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u003cem\u003eB\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e\u003cem\u003eSE B\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u003cem\u003eβ\u003c/em\u003e\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eResiliency\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.071\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.183*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.010\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.028\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.027\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eSocial Support\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.031\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.160*\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.001\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.014\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e\u0026minus;\u0026thinsp;.004\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003eMental Health Total Score\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.041\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.013\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.300**\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003ePCL Total Score\u003c/em\u003e\u003c/p\u003e \u003cp\u003e\u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e.073\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e \u003cp\u003e.024\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e.011\u003c/p\u003e \u003cp\u003e.223\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e \u003cp\u003e.195*.\u003c/p\u003e \u003c/td\u003e \u003c/tr\u003e \u003ctr\u003e \u003ctd align=\"left\" colname=\"c1\"\u003e \u003cp\u003e\u003cem\u003eF\u003c/em\u003e for change in \u003cem\u003eR\u003c/em\u003e\u003csup\u003e\u003cem\u003e2\u003c/em\u003e\u003c/sup\u003e\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c3\"\u003e \u003cp\u003e7.498**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e \u003ctd align=\"left\" colname=\"c6\"\u003e \u003cp\u003e18.147**\u003c/p\u003e \u003c/td\u003e \u003ctd align=\"left\" colname=\"c7\"\u003e\u0026nbsp;\u003c/td\u003e \u003c/tr\u003e \u003c/tbody\u003e \u003c/colgroup\u003e \u003ctfoot\u003e \u003ctr\u003e\u003ctd colspan=\"7\"\u003eNote. \u003cem\u003e*p\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.05. \u003cem\u003e**p\u003c/em\u003e\u0026thinsp;\u0026lt;\u0026thinsp;.01.\u003c/td\u003e\u003c/tr\u003e \u003c/tfoot\u003e \u003c/table\u003e\u003c/div\u003e \u003c/p\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Trauma exposure, law enforcement, FBI personnel, prevalence study, critical incidents","lastPublishedDoi":"10.21203/rs.3.rs-6597515/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-6597515/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eBackground:\u003c/h2\u003e \u003cp\u003eThe prevalence of mental health symptoms and diagnoses following exposure to traumatic events has been widely studied among the general population and first responders, including police officers and emergency personnel. However, a distinct yet comparable group\u0026mdash;Federal Bureau of Investigation (FBI) personnel\u0026mdash;also faces repeated exposure to trauma in the line of duty. Despite this, research on the mental health prevalence among FBI personnel remains limited.\u003c/p\u003e\u003ch2\u003ePurpose:\u003c/h2\u003e \u003cp\u003eThis study is the first to assess the prevalence of mental health symptoms among FBI personnel, compare these rates to those observed in the general and local law enforcement populations, and examine whether they influence FBI employees' perceptions of their work performance.\u003c/p\u003e\u003ch2\u003eMethods\u003c/h2\u003e \u003cp\u003eThe sample included 206 trauma-exposed FBI personnel who participated in a three-day intervention program.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e \u003cp\u003eThe prevalence of probable mental health diagnoses ranged from 5% (psychosis) to 52% (anxiety). Rates of depression, anxiety, sleep disturbances, substance use, and post-traumatic stress disorder (PTSD) were significantly higher among FBI personnel compared to the general and law enforcement populations. Mental health symptom severity, particularly PTSD, was a significant predictor of perceived work performance.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e \u003cp\u003eThese findings highlight the mental health challenges faced by FBI personnel and their potential impact on job performance, underscoring the need for targeted mental health assessment and treatment for this unique population.\u003c/p\u003e","manuscriptTitle":"“FBI Bureau Syndrome”: Understanding the FBI’s Unique Mental Health Struggles","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-05-22 06:09:04","doi":"10.21203/rs.3.rs-6597515/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"3e92cd28-9abe-48d5-a3a0-acf578ebc5af","owner":[],"postedDate":"May 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-08-10T05:23:06+00:00","versionOfRecord":[],"versionCreatedAt":"2025-05-22 06:09:04","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-6597515","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-6597515","identity":"rs-6597515","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}