Psychological effects of trauma and police response

About one third of people exposed to traumatic incidents experience posttraumatic stress disorder (PTSD) (Tortella-Feliu et al., 2019). For those who develop PTSD, previous traumatic experiences and a variety of other risk factors (e.g., history of psychiatric disorder, physical disease, sociodemographic factors) can exacerbate future maladaptive psychological responses to trauma (Tortella-Feliu et al., 2019). To be diagnosed with PTSD, individuals must have experienced or witnessed a major traumatic event where they responded with fear, helplessness, or horror (Yehuda, 2002; Bryant, 2019). PTSD symptoms fit into three categories: (i) re-experiencing of the event (e.g., intrusive distressing memories or dreams, dissociative reactions like flashbacks, intense or prolonged psychological distress from reminders of the trauma); (ii) active avoidance of internal (e.g., thoughts, memories) and external (e.g., conversations) reminders of the traumatic event; and (iii) changes in cognition and mood (Yehuda, 2002; Bryant, 2019). In addition, victims experience alterations in cognition and mood that can affect their ability to remember important aspects of an event (Bryant, 2019), which in the context of victims of human trafficking victims or sexual assault experiencing PTSD may lead police officers to conclude a victim is being deceptive.

Human trafficking often consists of repeated exposures to traumatic events over a long time versus a one-time incident like a personal robbery. Repeated and cumulative exposure to trauma stress, which often includes coercive control, is referred to as complex trauma (Courtois, 2008) and manifests as complex PTSD (C-PTSD).

C-PTSD typically presents in individuals who have experienced multiple adversities in childhood (Hopper & Gonzalez, 2018) and is also a predictor of human-trafficking victimization (Oram et al., 2015) because these individuals are often more vulnerable.Footnote 1 This double exposure to trauma can negatively affect memory processing because victims often have learned dysfunctional ways of processing their previous traumatic memories (Abas et al., 2013). Symptoms of C-PTSD can include dysregulation, dissociation, changes in memory, somatic distress, changes in self-perception, and impulse control problems (Courtois, 2008; Loewenstein et al., 2014).

Child abuse can also increase the risk of C-PTSD (Abas et al., 2013).Footnote 2 Semi-structured clinical interviews with 131 trafficking victims in the United States (65 victims of labour trafficking and 66 victims of sex trafficking) found that victims who had previously experienced childhood physical and sexual abuse were particularly vulnerable to C-PTSD symptoms (Hopper & Gonzalez, 2018). In addition, 60% of the victims interviewed met the criteria for PTSD. In the same study, the majority of victims interviewed had at least one C-PTSD symptom, and two thirds met criteria for multiple categories of C-PTSD symptoms. Sex-trafficking victims were more likely to have comorbid symptoms of PTSD and depression than labour-trafficking victims (59% versus 40% of labour trafficking victims), and labour-trafficking victims were more likely to experience symptoms of depression (32% versus 11% of sex trafficking victims; Hopper & Gonzalez, 2018).

Traumatic incidents can manifest in depression, anxiety, self-injury, substance abuse, and eating disorders (Wemmers, 2013). Trafficked individuals may develop feelings of helplessness and lack of control of their lives. Their sense of safety is threatened, they may feel like they have been treated like an object, and they may develop self-esteem problems. Feelings of entrapment may persist long after they have escaped from their trafficker (Hopper, 2017).

In the context of victims of sexual assault, it is important to consider how police officers respond to disclosures of sex offences because the way they respond can influence the self-perceptions and emotional responses of victims (Bhuptani et al., 2019). Researchers have found that negative reactions to accounts of sexual assault that appear inconsistent with the “typical rape scenario” can increase the likelihood of victims experiencing PTSD symptoms and, ultimately, affect their recovery (Dumont et al., 2021).

In addition, officers need to be mindful not to blame or humiliate the victim, which can lead to their withdrawal and isolation when victims do report to police (Rich, 2019). The empathy police officers provide to victims is negatively correlated with victim shame, self-blame, victim perception, PTSD severity, and it is positively correlated with intention to go to court (Maddox et al., 2011).

A supportive environment during disclosure is essential (Bhuptani et al., 2019). Victims face many unknowns, and they use the perceived fairness of procedures as a way to determine whether to trust authorities to act in their interest. Victims may seek validation and support from authorities, and when they do not find reassurance, their stress remains high and can be further elevated. If victims are unable to have confidence in the police, they are less likely to rely on authorities in the event they are the victim of another crime (Wemmers, 2013).

Victims who are traumatized may suffer neuropsychiatric symptoms due to violence and maltreatment. This can also interfere with cognition and memory. Memories of traumatic experiences often involve less contextual information (i.e., when, where), are frequently fragmented, and richer in sensorial characteristics, such as the emotional state associated with the trauma, images, olfactory information, and other sensations (Manzanero et al., 2020; Saadi et al., 2021). Fragments and memory lapses may be interpreted by investigators and court officials as dishonesty, which can threaten the victim’s credibility (Saadi et al., 2021) and the criminal court proceedings. The court process is routinely associated with revictimization and the loss of confidence in the entire criminal justice system (Wemmers, 2013). In the context of human trafficking, conducting an assessment to determine whether the human-trafficking experience caused trauma allows for a better understanding of the psychological state of the victim (Hopper, 2017). Officials may want to include this information in any proceedings.

Human trafficking can be inherently complicated due to the criminal nature of the sex trade and the overlap with other crimes.Footnote 3 When victims do come forward, they need to be assured that they will not be investigated for engaging in the sex trade and that the police are there to help them. In other cases, some victims become involved in criminal acts themselves and may end up in police custody. In this circumstance, it is important that police officers recognize that arrest procedures can be deeply triggering for victims who previously experienced abuse and trauma. Speaking down to victims, taking them to the station only partially clothed, restraining them, and using condescending behaviour can be very provoking. Routine booking procedures, such as asking personal questions, confiscating clothing, and isolating prisoners, can also bring on traumatic memories (Ostad-Hashemi, 2017).

To help reduce ambiguity and fear in processing, it is recommended that officers explain what they are doing and why and not leave anything to the imagination. It is easy to overwhelm these victims; thus, care must be taken to explain each step of the process to reduce ambiguity. For example, officers should explain the process of providing a statement when a victim attends the police station, when they meet with justice officials, and when they attend court to testify. Using victim and community services and other support for victims of human trafficking is becoming increasingly common for assisting victims.