Prevalence and associated factors of stress in the Malaysian Police Force Retneswari Masilamani a, b, ⁎ , 1 , Awang Bulgiba b, c , Karuthan Chinna b, c , Azlan Darus a, b , Marzuki Isahak a, b , Shathanapriya Kandiben a, b , David Koh d, e a Centre for Occupational and Environmental Health, University of Malaya, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia b Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia c Julius Centre University of Malaya, Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia d PAPRSB Institute of Health Sciences, Universiti Brunei Darussalam, Jalan Tungku Link, Gadong, BE 1410, Brunei Darussalam e SSH School of Public Health, National University of Singapore, Blk MD3, 16 Medical Drive, Singapore 117597, Singapore abstract article info Available online 23 January 2013 Keywords: Police stress Police officers Stressors Job characteristics Income Police rank Objective. This study aims to determine the prevalence of stress and the associated socio-demographic and work factors among police personnel in Metropolitan Kuala Lumpur, Malaysia. Method. A cross-sectional study was conducted in two randomly selected police districts in Kuala Lumpur from 2009 to 2011. A total of 579 police officers from 11 police stations and two headquarters participated in this study. The 21-item Depression, Anxiety and Stress questionnaire was used. Multinomial logistic regres- sion analyses were carried out to examine the effect of socio-demographic and work factors on stress. Results. The overall prevalence of stress was 38.8% (95% CI 34.2, 43.6) with 5.9% (3.9, 8.8), 14.9% (11.6, 18.8) and 18.0% (14.5, 22.2) for severe, moderate and mild stress, respectively. Inspectors were more likely to suffer from severe stress (aOR 10.68, 95% CI 3.51, 32.53) compared to junior officers. Those who complained that their salaries were not commensurate with their jobs were more likely to suffer from moderate levels of stress (aOR 2.73, 95% CI 1.43, 5.22) compared to those who were happy with their salaries. Conclusions. This study strengthens findings that police job is stressful. Special attention needs to be paid to Inspector-level ranks and the remuneration structure of police officers to address this issue. © 2013 Elsevier Inc. All rights reserved. Introduction Police stress has been extensively studied looking at different types of stressors and their effects. Despite mounting evidence on police stress in America, The United Kingdom and Australia, research on police stress in South East Asia has been scanty. This has been attribut- ed to political censure, the divorce between police theory and practice, conservative Asian Police Organisations and a desire to protect the police mystique and the need to control information (Wong, 2003). Malaysia, a South-East Asian country has sparse research and no publications on police stress. The objective of this study was to assess the prevalence of stress and the associated socio-demographic and work factors among police personnel in Metropolitan Kuala Lumpur, Malaysia. Methods Study design and study population This is a cross-sectional study conducted from 2009 to 2011. A two stage sam- pling procedure was used to select police officers. In stage 1, two district police headquarters were randomly selected out of four in Kuala Lumpur. The first police district headquarters had 8 departments and 7 police stations, and the second had 8 departments and 4 police stations, with 3033 police officers stationed at the 2 police districts. In the second stage, data was collected from all police officers who attended the ‘roll call’ at the 16 departments and 11 police stations involved in this study. The study subjects included all ranks of police officers from constable to top management. Inclusion criteria were fully trained police officers (called regulars) who had served for at least 6 months. Assuming a police stress prevalence of 30%–65%, with a precision of 5% and a design effect of 2, the sample size was calculated as 880 (including 15% non-response rate). A total of 579 police officers with informed consent participated in this study giving a response rate of 75.5%. Data was collected between April and September 2011 from all departments and police stations through ‘roll call’. A self-administered Bahasa Malaysia version of the 21-Item Depression, Anxiety and Stress Scale (BM-DASS) as was used in the validation paper was the study instrument (Musa et al., 2007). This is a modified version of the orig- inal 42 item DASS questionnaire (Lovibond and Lovibond, 1995). The Cronbach's alpha values for the depression, anxiety and stress scores were 0.84, 0.74 and Preventive Medicine 57 (2013) S57–S59 ⁎ Corresponding author at: Department of Social and Preventive Medicine, Faculty of Medicine, University of Malaya, 50603 Kuala Lumpur, Malaysia. Fax: +60 3 79674975. E-mail addresses: retneswari@yahoo.com, retnes@gmail.com (R. Masilamani), awang@ummc.edu.my (A. Bulgiba), karuthan@ummc.edu.my (K. Chinna), azdarus@ummc.edu.my (A. Darus), drmarzuki@ummc.edu.my (M. Isahak), shathanagan@gmail.com (S. Kandiben), david_koh@nuhs.edu.sg (D. Koh). 1 Permanent address: 20, Jalan Jugra, Batu 3-1/4, Jalan Kelang Lama, 58100 Kuala Lumpur, Malaysia. Fax: +60 3 79800834. 0091-7435/$ – see front matter © 2013 Elsevier Inc. All rights reserved. http://dx.doi.org/10.1016/j.ypmed.2013.01.008 Contents lists available at SciVerse ScienceDirect Preventive Medicine journal homepage: www.elsevier.com/locate/ypmed