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Shields RE, Teckchandani TA, Andrews KL, Ahlgrim B, Caissie DM, Hembroff CC, Nisbet J, Asmundson GJG, Krätzig GP, Carleton RN. Prevalence of current chronic pain in Royal Canadian Mounted Police cadets. Can J Pain 2024; 8:2354394. [PMID: 38915304 PMCID: PMC11195451 DOI: 10.1080/24740527.2024.2354394] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 05/08/2024] [Indexed: 06/26/2024]
Abstract
Background Nearly half of active duty Royal Canadian Mounted Police (RCMP) officers report experiencing current chronic pain (43%; i.e. pain lasting longer than 3 months). Most RCMP officers who report chronic pain indicate that the pain started after working as RCMP officers (91%). Baseline data on chronic pain prevalence among RCMP cadets has not been available. Aims The current study was designed to provide cross-sectional estimates of chronic pain prevalence among RCMP cadets starting the Cadet Training Program and to assess for sociodemographic differences among participants. Methods The RCMP Study uses a longitudinal prospective sequential experimental cohort design to create a clustered randomized trial that engages individual participants for 5.5 years. The current article provides cross-sectional associations between chronic pain prevalence and sociodemographic characteristics. Participants were RCMP cadets starting the Cadet Training Program (n = 770). Location, intensity (on a 0-10 scale and days per week experienced), and duration (number of months) of chronic pain were reported. Differences across sociodemographic characteristics were examined. Results Few RCMP cadets reported experiencing chronic pain (10%); lower back pain was rated as the most severe in terms of intensity and duration and second most frequently reported in number of days experienced per week. Prevalence of chronic pain was lower among RCMP cadets than among RCMP officers. Conclusions Chronic pain prevalence among active duty RCMP officers may result from or be moderated by operational duties, as well as routine aging. Future researchers could examine ways to mitigate chronic pain development during RCMP officer careers.
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Affiliation(s)
- Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment–Institut Canadien de recherché et de traitement en sécurité publique (CIPSRT-ICRTSP), Regina, Saskatchewan, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment–Institut Canadien de recherché et de traitement en sécurité publique (CIPSRT-ICRTSP), Regina, Saskatchewan, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment–Institut Canadien de recherché et de traitement en sécurité publique (CIPSRT-ICRTSP), Regina, Saskatchewan, Canada
| | - Billea Ahlgrim
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Danielle M. Caissie
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Chet C. Hembroff
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment–Institut Canadien de recherché et de traitement en sécurité publique (CIPSRT-ICRTSP), Regina, Saskatchewan, Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Gregory P. Krätzig
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment–Institut Canadien de recherché et de traitement en sécurité publique (CIPSRT-ICRTSP), Regina, Saskatchewan, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Khoshakhlagh AH, Yazdanirad S, Al Sulaie S, Mohammadian-Hafshejani A, Orr RM. The global prevalence of musculoskeletal disorders among firefighters: a systematic review and meta-analysis. INTERNATIONAL JOURNAL OF OCCUPATIONAL SAFETY AND ERGONOMICS 2024; 30:272-291. [PMID: 38105113 DOI: 10.1080/10803548.2023.2294627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023]
Abstract
This systematic review and meta-analysis study aimed to explore the global prevalence of musculoskeletal disorders (MSDs) among firefighters. A systematical search was performed in three international academic databases (Scopus, PubMed and Web of Science). Overall, 31 articles were included in this review. The pooled prevalence of total MSDs in firefighters was identified as 41% (95% confidence interval [CI] [33, 50]). The prevalence of MSDs in neck, shoulders, upper back, lower back, upper extremity and lower extremity was 9% (95% CI [7, 10]), 11% (95% CI [8, 15]), 8% (95% CI [5, 12]), 31% (95% CI [27, 34]), 13% (95% CI [9, 17]) and 16% (95% CI [14, 18]), respectively. No statistically significant relationship was observed between prevalence of MSDs and year of study, mean age, size of sample, duration of prevalence, region or income level. Demographic, occupational and medical condition factors were identified that can create these disorders among firefighters.
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Affiliation(s)
| | - Saeid Yazdanirad
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Iran
- School of Health, Shahrekord University of Medical Sciences, Iran
| | - Saleh Al Sulaie
- College of Engineering in Al-Qunfudah, Umm Al-Qura University, Saudi Arabia
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Lade S, Easterbrook B, Brown A, Millman H, D’Alessandro-Lowe AM, O’Connor C, McKinnon MC. The mental health toll of service: an examination of self-reported impacts of public safety personnel careers in a treatment-seeking population. Eur J Psychotraumatol 2023; 14:2269696. [PMID: 37965795 PMCID: PMC10653764 DOI: 10.1080/20008066.2023.2269696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 09/15/2023] [Indexed: 11/16/2023] Open
Abstract
Introduction: Public safety personnel (PSP), including firefighters, paramedics, and police officers, are exposed to traumatic events as part of their day-to-day jobs. These traumatic events often result in significant stress and increase the likelihood of negative mental health outcomes, including post-traumatic stress disorder (PTSD). The present study sought to develop an in-depth understanding of the lived experiences of PSPs as related to the mental health toll of their service. Through a series of targeted focus groups, Canadian PSP were asked to provide their perspectives on the PTSD-related symptoms that resulted as a by-product of their occupational service. The DSM-5-TR PSTD criteria (A-E) provided a thematic lens to map the self-described symptomatic expression of PSP's lived experiences.Methods: The present study employed a phenomenological focus-group approach with a treatment-seeking inpatient population of PSP. Participants included PSP from a variety of occupational backgrounds. Using semi-structured focus groups, fifty-one participants were interviewed. These focus groups were audio recorded, with consent, and transcribed verbatim. Using an interpretive phenomenological approach, emergent themes within the data were inductively developed, examined, and connected across individual cases.Results: Utilizing the primary criteria of PTSD (Criteria A-E) outlined by the DSM-5-TR, we identified qualitative themes that included exposure to a traumatic event, intrusion symptoms, avoidance symptoms, negative alterations in mood and cognition, and marked alterations in arousal and reactivity.Conclusion: PSP are exposed to extreme stressors as a daily part of their occupation and are at elevated risk of developing mental health difficulties, including PTSD. In the present study, focus groups were conducted with PSP about the mental health toll of their occupations. Their experiences mapped onto the five primary criteria of PTSD, as outlined by the DSM-5-TR. This study provides crucial descriptive information to guide mental health research aims and treatment goals for PSTD in PSP populations.
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Affiliation(s)
- Sarah Lade
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada
| | - Bethany Easterbrook
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada
- Homewood Research Institute, Guelph, Canada
- MacDonald Franklin Operational Stress Injury Research Centre, London, Canada
| | - Andrea Brown
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada
| | - Heather Millman
- Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada
| | | | | | - Margaret C. McKinnon
- Homewood Research Institute, Guelph, Canada
- Department of Psychiatry & Behavioural Neurosciences, McMaster University, Hamilton, Canada
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Carleton RN, Jamshidi L, Maguire KQ, Lix LM, Stewart SH, Afifi TO, Sareen J, Andrews KL, Jones NA, Nisbet J, Sauer-Zavala S, Neary JP, Brunet A, Krätzig GP, Fletcher AJ, Teckchandani TA, Keane TM, Asmundson GJ. Mental Health of Royal Canadian Mounted Police at the Start of the Cadet Training Program. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:651-662. [PMID: 37131322 PMCID: PMC10585131 DOI: 10.1177/07067437221147425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Abstract
OBJECTIVE Serving Royal Canadian Mounted Police (RCMP) have screened positive for one or more mental disorders based on self-reported symptoms with substantial prevalence (i.e., 50.2%). Mental health challenges for military and paramilitary populations have historically been attributed to insufficient recruit screening; however, cadet mental health when starting the Cadet Training Program (CTP) was unknown. Our objective was to estimate RCMP Cadet mental health when starting the CTP and test for sociodemographic differences. METHOD Cadets starting the CTP completed a survey assessing self-reported mental health symptoms (n = 772, 72.0% male) and a clinical interview (n = 736, 74.4% male) with a clinician or supervised trainee using the Mini-International Neuropsychiatric Interview to assess current and past mental health. RESULTS The percentage of participants screening positive for one or more current mental disorders based on self-reported symptoms (15.0%) was higher than the diagnostic prevalence for the general population (10.1%); however, based on clinical interviews, participants were less likely to screen positive for any current mental disorder (6.3%) than the general population. Participants were also less likely to screen positive for any past mental disorder based on self-report (3.9%) and clinical interviews (12.5%) than the general population (33.1%). Females were more likely to score higher than males (all ps<.01; Cohen's ds .23 to .32) on several self-report mental disorder symptom measures. CONCLUSIONS The current results are the first to describe RCMP cadet mental health when starting the CTP. The data evidenced a lower prevalence of anxiety, depressive, and trauma-related mental disorders than the general population based on clinical interviews, contrasting notions that more rigorous mental health screening would reduce the high prevalence of mental disorders among serving RCMP. Instead, protecting RCMP mental health may require ongoing efforts to mitigate operational and organizational stressors.
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Affiliation(s)
- R. Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Sherry H. Stewart
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jitender Sareen
- Departments of Psychiatry and Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Nicholas A. Jones
- Department of Justice Studies, University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY, USA
| | - J. Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, SK, Canada
| | - Alain Brunet
- McGill's Psychiatry Department, Douglas Institute Research Center, Montreal, QC, Canada
| | | | - Amber J. Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, SK, Canada
| | | | - Terence M. Keane
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System & Boston University School of Medicine, Boston, MA, USA
| | - Gordon J.G. Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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Mausz J, Donnelly EA. Violence Against Paramedics: Protocol for Evaluating 2 Years of Reports Through a Novel, Point-of-Event Reporting Process. JMIR Res Protoc 2023; 12:e37636. [PMID: 36928257 PMCID: PMC10131719 DOI: 10.2196/37636] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Revised: 12/05/2022] [Accepted: 12/09/2022] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Violence against paramedics has been described as a serious public health problem with the potential for significant physical and psychological harm, but the organizational culture within the profession encourages paramedics to consider violence as just "part of the job." Therefore, most incidents of violence are never formally documented. This limits the ability of researchers and policy makers to develop strategies that mitigate the risk and enhance paramedic safety. OBJECTIVE Following the development and implementation of a novel, point-of-event violence reporting process in February 2021, our objectives are to (1) estimate the prevalence of violence and generate a descriptive profile for incidents of reported violence; (2) identify potentially high-risk service calls based on characteristics of calls that are generally known to the responding paramedics at the point of dispatch; and (3) explore underpinning themes, including intolerance based on gender, race, and sexual orientation, that contribute to incidents of violence. METHODS Our work is situated in a single paramedic service in Ontario, Canada. Using a convergent parallel mixed methods approach, we will retrospectively review 2 years of quantitative and qualitative data gathered from the External Violence Incident Report (EVIR) system from February 1 2021 through February 28, 2023. The EVIR is a point-of-event reporting mechanism embedded in the electronic patient care record (ePCR) developed through an extensive stakeholder engagement process. When completing an ePCR, paramedics are prompted to file an EVIR if they experienced violence on the call. Our methods include using descriptive statistics to estimate the prevalence of violence and describe the characteristics of reported incidents (Objective 1), logistic regression modeling to identify high-risk service calls (Objective 2), and qualitative content analysis of incident report narratives to identify underpinning themes that contribute to violence (Objective 3). RESULTS As of January 1, 2023, 377 paramedics-approximately 1 in 5 active-duty paramedics in the service-have filed a total of 975 violence reports. Early analysis suggests 40% of reports involved a physical assault on the reporting paramedic. Our team is continuing to collect data with more fulsome analyses beginning in March 2023. Our findings will provide much-needed epidemiological data on the prevalence of violence against paramedics in a single paramedic service, its contributing themes, and potential risk factors. CONCLUSIONS Our findings will contribute to a growing body of literature demonstrating that violence against paramedics is a complex problem that requires a nuanced understanding of its scope, risk factors, and contributing circumstances. Collectively, our research will inform larger, multisite prospective studies already in the planning stage and inform organizational strategies to mitigate the risk of harm from violence. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/37636.
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Affiliation(s)
- Justin Mausz
- Peel Regional Paramedic Services, Brampton, ON, Canada
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6
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Bahji A, Di Nota PM, Groll D, Carleton RN, Anderson GS. Psychological interventions for post-traumatic stress injuries among public safety personnel: a systematic review and meta-analysis. Syst Rev 2022; 11:255. [PMID: 36434683 PMCID: PMC9701019 DOI: 10.1186/s13643-022-02112-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Accepted: 11/02/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP) are exposed to potentially psychologically traumatic events (PPTE) far more often than the general public, which increases the risk for various post-traumatic stress injuries (PTSIs). While there are many evidence-based psychological interventions for PTSI, the effectiveness of each intervention for PSP remains unclear. OBJECTIVES The current study assessed the effectiveness and acceptability of psychological interventions for PTSI among PSPs. METHODS A systematic review and random-effects meta-analysis were performed on the effectiveness and acceptability of psychotherapies for PTSIs (i.e., symptoms of depression, anxiety, post-traumatic stress disorder) among PSP. The review adhered to the PRISMA reporting guidelines and used standardized mean differences (Cohen's d), rate ratios (RR), and their 95% confidence intervals (95% CI) to measure pooled effect sizes across studies; negative d values and RR values less than one indicated a reduction in symptoms compared to baseline or control groups. In addition, heterogeneity was quantified using I2, and publication bias was evaluated using Egger's test. RESULTS The analyses included data from eight randomized controlled trials representing 402 PSP (79.4% male, 35.3 years). Psychological interventions included narrative exposure therapy (n = 1), cognitive behavioral therapy (n = 2), eclectic psychotherapy (n = 2), eye-movement desensitization and reprocessing (n = 1), supportive counseling (n = 2), and group critical incident stress debriefing (n = 1). The interventions were associated with statistically significant reductions in symptoms associated with PTSD (d = - 1.23; 95% CI - 1.81, - 0.65; 7 studies; I2 = 81%), anxiety (- 0.76; 95% CI - 1.28, - 0.24; 3 studies; I2 = 47%), and depression (d = - 1.10; 95% CI - 1.62, - 0.58; 5 studies; I2 = 64%). There were smaller but statistically significant improvements at follow-up for symptoms of PTSD (d = - 1.29 [- 2.31, - 0.27]), anxiety (d = - 0.82 [- 1.20, - 0.44]), and depression (d = - 0.46 [- 0.77, - 0.14]). There were no statistically significant differences in dropout rates (RR = 1.00 [0.96, 1.05]), suggesting high acceptability across interventions. CONCLUSIONS There is preliminary evidence that psychotherapies help treat PTSIs in PSP; however, the shortage of high-quality studies on PSP indicates a need for additional research into treating PTSI among PSP. SYSTEMATIC REVIEW REGISTRATION PROSPERO: CRD42019133534.
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Affiliation(s)
- Anees Bahji
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Paula M Di Nota
- Office of Applied Research and Graduate Studies, Justice Institute of British Columbia, Vancouver, BC, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON, Canada
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Ricciardelli R, Carleton RN, Anschuetz B, Gravel S, McKay B. Testifying after an Investigation: Shaping the Mental Health of Public Safety Personnel. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:13643. [PMID: 36294223 PMCID: PMC9602447 DOI: 10.3390/ijerph192013643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 10/01/2022] [Accepted: 10/20/2022] [Indexed: 06/16/2023]
Abstract
In this editorial, we draw on two Canadian cases to interrogate how mass causality events and investigations consume many responders before (e.g., public safety communicators, detachment service assistants), during (e.g., police, fire, paramedics), and after the incident (e.g., coroners, correctional workers, media coverage). Their well-being may suffer from the associated processes and outcomes. In the current article, we focus on the mass causality incident of 2020 in Nova Scotia, Canada, and the investigation following a prisoner death in 2019 in Newfoundland, Canada, to explore how testifying post-incident can be made more palatable for participating public safety personnel (PSP). Specifically, we study how testifying after an adverse event can affect PSP (e.g., recalling, vicarious trauma, triggers) and how best to mitigate the impact of testimony on PSP well-being, with a lens to psychological "recovery" or wellness. We focus here on how to support those who may have to testify in a judicial proceeding or official inquiry, given being investigated for best-intended actions can result in moral injury or a posttraumatic stress injury, both exacerbated by judicial review, charge, accusation, or inquiry.
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Affiliation(s)
- Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | | | | | | | - Brad McKay
- Badge of Life Canada, Orillia, ON L3V 5X6, Canada
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Hansen NB, Møller SR, Elklit A, Brandt L, Andersen LL, Pihl-Thingvad J. Are You All right (AYA)? Association of cumulative traumatic events among Danish police officers with mental health, work environment and sickness absenteeism: protocol of a 3-year prospective cohort study. BMJ Open 2022; 12:e049769. [PMID: 35613817 PMCID: PMC9131071 DOI: 10.1136/bmjopen-2021-049769] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION Police officers are frequently exposed to potentially traumatic events at work that increases risk of developing mental health problems, in particular post-traumatic stress disorder (PTSD). Individual and organisational factors may influence the detrimental effects of cumulative exposure to traumatic events. Occupational stress and lack of organisational support are associated with increased risk of PTSD among police officers. The Are You All right? (AYA) project is a prospective cohort study investigating the cumulative effect of traumatic events at work on mental health problems and absenteeism among police officers. The study also investigates whether potential risk and protective factors modify the association of traumatic events at work with mental health problems and absenteeism. METHOD AND ANALYSIS The AYA-study includes the entire Danish police force. Prospective survey data are collected over a 3-year period beginning in the spring of 2021. Electronic surveys are sent out at baseline with 1-year, 2-year and 3-year follow-up. Further, short surveys are sent out every third month, covering exposure to traumatic events and current mental health status. The survey data are paired with workplace register data on sickness absence. Register data on sickness absence cover the period from 2020 to 2025. ETHICS AND DISSEMINATION This study was presented for evaluation at the National Ethics Committee in Denmark (reference number: 20202000-216), but according to Danish legislation, survey studies do not require approval by official Danish scientific or ethical committees. Participation in the project is based on informed consent, and data are handled in accordance with the Danish data legislation (journal number: 20/41457). Results are published in scientific journals and disseminated at international conferences.
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Affiliation(s)
- Nina Beck Hansen
- Department of Psychology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
- Department of Occupational and Environmental Medicine, Odense Universitetshospital, Odense, Denmark
| | - Sara Rosenbeck Møller
- Department of Occupational and Environmental Medicine, Odense Universitetshospital, Odense, Denmark
| | - Ask Elklit
- Department of Psychology, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Lars Brandt
- Department of Occupational and Environmental Medicine, Odense Universitetshospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
| | - Lars L Andersen
- National Research Centre for the Working Environment, Kobenhavn, Denmark
| | - Jesper Pihl-Thingvad
- Department of Occupational and Environmental Medicine, Odense Universitetshospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark Faculty of Health Sciences, Odense, Denmark
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Mental Disorder Symptoms and the Relationship with Resilience among Paramedics in a Single Canadian Site. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19084879. [PMID: 35457746 PMCID: PMC9030944 DOI: 10.3390/ijerph19084879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 04/13/2022] [Accepted: 04/15/2022] [Indexed: 02/04/2023]
Abstract
There is growing recognition in research and policy of a mental health crisis among Canada’s paramedics; however, despite this, epidemiological surveillance of the problem is in its infancy. Just weeks before the emergence of the COVID-19 pandemic, we surveyed paramedics from a single, large, urban paramedic service in Ontario, Canada to assess for symptom clusters consistent with post-traumatic stress disorder (PTSD), major depressive disorder, and generalized anxiety disorder and to identify potential risk factors for each. In total, we received 589 completed surveys (97% completion rate) and found that 11% screened positive for PTSD, 15% screened positive for major depressive disorder, and 15% screened positive for generalized anxiety disorder, with one in four active-duty paramedics screening positive for any of the three as recently as February 2020. In adjusted analyses, the risk of a positive screen varied as a function of employment classification, gender, self-reported resilience, and previous experience as a member of the service’s peer support team. Our findings support the position that paramedics screen positive for mental disorders at high rates—a problem likely to have worsened since the onset of the COVID-19 pandemic. We echo the calls of researchers and policymakers for urgent action to support paramedic mental health in Canada.
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Dębska-Janus M, Dębski P, Główczyński P, Rozpara M, Badura-Brzoza K. Emotional Functioning in the Context of Health Behaviors During the COVID-19 Pandemic in Health Sciences Students: The Polish Case. Psychol Res Behav Manag 2022; 15:953-964. [PMID: 35469168 PMCID: PMC9034885 DOI: 10.2147/prbm.s352279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 03/04/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Małgorzata Dębska-Janus
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Paweł Dębski
- Chair and Clinical Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
- Correspondence: Paweł Dębski, Tel/Fax +48 322854358, Email
| | - Patryk Główczyński
- Chair and Clinical Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
| | - Michał Rozpara
- Institute of Sport Sciences, The Jerzy Kukuczka Academy of Physical Education in Katowice, Katowice, Poland
| | - Karina Badura-Brzoza
- Chair and Clinical Department of Psychiatry, Faculty of Medical Sciences in Zabrze, Medical University of Silesia in Katowice, Katowice, Poland
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Wojciechowska M, Jasielska A, Ziarko M, Sieński M, Różewicki M. Mediating Role of Stress at Work in the Relationship of Alexithymia and PTSD among Emergency Call Operators. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312830. [PMID: 34886555 PMCID: PMC8657674 DOI: 10.3390/ijerph182312830] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/16/2021] [Accepted: 11/22/2021] [Indexed: 12/01/2022]
Abstract
Aim: The main purpose of this research was to investigate the relationship between alexithymia, stress at work, and post-traumatic stress disorder (PTSD) in impact emergency call center operators working in Poland (province of Greater Poland). The risk of exposure to critical life events was also considered. Methods: Data were collected using self-report questionnaires administered after dispatchers’ shifts. The emergency call center operators (N = 66) completed the Impact of Event Scale—Revised, 20-item Toronto Alexithymia Scale, Workplace Perceived Stress Questionnaire, and a questionnaire measuring the frequency and intensity of potentially traumatic events faced by emergency operators (a questionnaire developed by the authors). Results: Twenty of the most frequent events (e.g., child sexual harassment, rape, etc.) were identified. Results indicated that post-traumatic stress positively correlated with (a) work-related stress and (b) one aspect of alexithymia: difficulty expressing feelings. Additionally, work-related stress was identified as a mediator for the relation between alexithymia and the intensity of post-traumatic stress. Conclusions: The results of this study confirm that emergency operators are a high-risk group for the development of PTSD. The study results suggest that performing the work of an emergency dispatcher is not only demanding but also inherently involves participation in potentially traumatic events (as encountered through emergency calls).
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Affiliation(s)
- Małgorzata Wojciechowska
- Department of Mother and Child Health, Poznan University of Medical Sciences, 33 Polna Street, 60-535 Poznan, Poland;
| | - Aleksandra Jasielska
- Faculty of Psychology and Cognitive Science, Adam Mickiewicz University, 89AB Szamarzewskiego Street, 60-568 Poznan, Poland; (M.Z.); (M.S.)
- Correspondence: ; Tel.: +48-61292307
| | - Michał Ziarko
- Faculty of Psychology and Cognitive Science, Adam Mickiewicz University, 89AB Szamarzewskiego Street, 60-568 Poznan, Poland; (M.Z.); (M.S.)
| | - Michał Sieński
- Faculty of Psychology and Cognitive Science, Adam Mickiewicz University, 89AB Szamarzewskiego Street, 60-568 Poznan, Poland; (M.Z.); (M.S.)
| | - Maciej Różewicki
- Emergency Notification Centre, 13a Wiśniowa Street, 61-477 Poznan, Poland;
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12
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Canadian Career Firefighters' Mental Health Impacts and Priorities. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182312666. [PMID: 34886394 PMCID: PMC8656638 DOI: 10.3390/ijerph182312666] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 11/26/2021] [Accepted: 11/29/2021] [Indexed: 12/16/2022]
Abstract
Firefighters' perceptions of mental health can inform management. This qualitative study explored Canadian career firefighters' experiences, needs, and research priorities with respect to mental health. Thirty-nine career firefighters (33 men, 6 women) of different ranks and geographic locales were interviewed using a semi-structured interview guide. The interviews were recorded, transcribed, and qualitatively analyzed using thematic analysis within an interpretive description approach. Firefighters reported that critical incidents and chronic job stressors contributed to mental health symptoms that led to burnout, compassion fatigue, and mental and physical injury. They were concerned with family impacts, like lack of full openness, reduced financial stability, and risk of divorce; and work impacts, like interpersonal conflict, lack of support to fellow firefighters, task avoidance, and absenteeism. A broad array of barriers and facilitators were found in firefighter work, culture, programs, social supports, health care, and societal factors. Variability in access to help, the changing fire service, and the complexity of knowing what to do to achieve mental health were evident across themes. Firefighters identified the need for research in four areas: awareness and monitoring, understanding etiology of mental health, better prevention and treatment, and access to care. Across domains of inquiry, context, "two sides to the coin", and uncertainty were overarching themes.
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Pace TWW, Zeiders KH, Cook SH, Sarsar ED, Hoyt LT, Mirin NL, Wood EP, Tatar R, Davidson RJ. Feasibility, Acceptability, and Preliminary Efficacy of an App-Based Meditation Intervention to Decrease Firefighter Psychological Distress and Burnout: A One-Group Pilot Study (Preprint). JMIR Form Res 2021; 6:e34951. [PMID: 35675115 PMCID: PMC9218885 DOI: 10.2196/34951] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2021] [Revised: 04/15/2022] [Accepted: 04/18/2022] [Indexed: 12/15/2022] Open
Abstract
Background Firefighters are often exposed to occupational stressors that can result in psychological distress (ie, anxiety and depression) and burnout. These occupational stressors have only intensified with the onset of the COVID-19 pandemic and will likely persist in the postpandemic world. Objective To address occupational stressors confronting firefighters, we pilot tested a novel, cost-effective, smartphone app–based meditation intervention created by Healthy Minds Innovations that focused on mindfulness (awareness) training along with practices designed to cultivate positive relationships (connection), insight into the nature of the self (insight), and a sense of purpose in the context of challenge (purpose) with a sample of professional firefighters from a large metropolitan area in southwestern United States. Methods A total of 35 participants were recruited from a closed online group listserv and completed the self-guided 10-unit meditation app over the course of 10 days, at 1 unit per day. We assessed anxiety symptoms, depression symptoms, burnout, and negative affect as well as saliva diurnal cortisol rhythm, an objective indicator of stress-related biology, before and after use of the meditation app. Results This study demonstrated the meditation app was both feasible and acceptable for use by the majority of firefighters. We also found significant reductions in firefighters’ anxiety (P=.01), burnout (P=.05), and negative affect (P=.04), as well as changes in cortisol diurnal rhythm, such as waking cortisol (P=.02), from before to after use of the meditation app. Conclusions Our study findings call for future research to demonstrate the efficacy of this meditation app to reduce psychological distress and burnout in firefighters.
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Affiliation(s)
- Thaddeus W W Pace
- Division of Biobehavioral Health Science, College of Nursing, University of Arizona, Tucson, AZ, United States
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, United States
- Department of Psychology, College of Science, University of Arizona, Tucson, AZ, United States
| | - Katharine H Zeiders
- Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Stephanie H Cook
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
- Department of Biostatistics, School of Global Public Health, New York University, New York, NY, United States
| | - Evelyn D Sarsar
- Norton School of Family and Consumer Sciences, College of Agriculture and Life Sciences, University of Arizona, Tucson, AZ, United States
| | - Lindsay T Hoyt
- Department of Psychology, Fordham University, Bronx, NY, United States
| | - Nicholas L Mirin
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Erica P Wood
- Department of Social and Behavioral Sciences, School of Global Public Health, New York University, New York, NY, United States
| | - Raquel Tatar
- Healthy Minds Innovation, Madison, WI, United States
| | - Richard J Davidson
- Department of Psychology, University of Wisconsin, Madison, WI, United States
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Jiang YP, Jin Y, Bao J, Wang S, Lai WD, Wen CP, Xu ZH, Yu J. Inconsistent Time-Dependent Effects of Tetramethylpyrazine on Primary Neurological Disorders and Psychiatric Comorbidities. Front Pharmacol 2021; 12:708517. [PMID: 34489702 PMCID: PMC8417558 DOI: 10.3389/fphar.2021.708517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Accepted: 07/19/2021] [Indexed: 12/26/2022] Open
Abstract
The aim of this study was to investigate the time dependent effects of tetramethylpyrazine (TMP, main activity compound of Ligusticum chuanxiong Hort) on two neurological disorders and their neuropsychiatric comorbidities. 6 Hz corneal rapid kindling was used to induce epileptogenesis and the inflammatory pain was induced by intra-articular Complete Freund's adjuvant (CFA) injection. The mechanical pain thresholds were measured using von Frey hair (D4, D11, D18, D25 after CFA first injection), and the vertical rearings of the mice was observed. To test the neuropsychiatric comorbidities, anxiety-like behaviors of mice were examined by open field and elevated plus maze tests. Two behavioral despair models, tail suspension test and forced swimming test were also used to evaluate the depressive like behaviors. The results showed that TMP administered from the initial day (D1-D35 in kindling model, D0-D14 and D0-D28 in CFA model) of modeling retarded both the developments of 6 Hz corneal rapid kindling epileptogenesis and the CFA induced inflammatory pain. In comparison, late periods administration of TMP (D21-D35 in kindling and D14-D28 in CFA model) showed no effect on the epileptogenesis and the generalized seizures (GS) of kindling, but alleviated maintenance of CFA induced inflammatory pain. Furthermore, we also found all TMP treatments from the initial day of modeling alleviated the co-morbid depressive and anxiety-like behaviors in both models; however, late periods treatments did not, either in kindling or the CFA induced inflammatory pain. BDNF/ERK signaling impairment was also tested by western blot, and the results showed that TMP administered from the initial day of modeling increased the hippocampal BDNF/ERK expression, whereas late period administration showed no effects. Overall, our findings reveal the inconsistent time dependent effects of Tetramethylpyrazine on neurological disorders and their relative neuropsychiatric comorbidities, and provide novel insight into the early application of TMP that might enhance hippocampal BDNF/ERK signaling to alleviate neuropsychiatric comorbidities in neurological diseases.
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Affiliation(s)
- Yue-Peng Jiang
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Yan Jin
- Second Affiliated Hospital, Zhejiang Chinese Medical University, Hangzhou, China
| | - Jie Bao
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Song Wang
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Wei-Dong Lai
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Cheng-Ping Wen
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China
| | - Zheng-Hao Xu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China.,Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, Hangzhou, China
| | - Jie Yu
- College of Basic Medical Science, Zhejiang Chinese Medical University, Hangzhou, China.,Key Laboratory of Neuropharmacology and Translational Medicine of Zhejiang Province, Hangzhou, China
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15
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Obuobi-Donkor G, Eboreime E, Bond J, Phung N, Eyben S, Hayward J, Zhang Y, MacMaster F, Clelland S, Greiner R, Jones C, Cao B, Brémault-Phillips S, Wells K, Li XM, Hilario C, Greenshaw AJ, Agyapong VIO. An E-Mental Health Solution to Prevent and Manage Post-Traumatic Stress Injuries among First Responders in Alberta: Protocol for the Implementation and Evaluation of Text4PTSI and Text4Wellbeing (Preprint). JMIR Res Protoc 2021; 11:e30680. [PMID: 35468094 PMCID: PMC9086885 DOI: 10.2196/30680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 02/07/2022] [Accepted: 02/22/2022] [Indexed: 11/17/2022] Open
Abstract
Background First responders are confronted with traumatic events in their work that has a substantial toll on their psychological health and may contribute to or result in posttraumatic stress injuries (PTSIs) for many responders. Persons with a PTSI usually seek management therapies. Evidence indicates that digital delivery of these therapies is an innovative, efficient, and effective way to improve PTSI symptoms as an adjunct to in-person delivery. Objective This project aims to implement and provide accessible, convenient, and economical SMS text messaging services, known as Text4PTSI and Text4Wellbeing, to first responders in Alberta, Canada; to prevent and improve the symptoms of PTSI among first responders; and to improve their overall quality of life. We will evaluate posttraumatic symptoms and the impact of Text4PTSI and Text4Wellbeing on stress, anxiety, and depression in relation to the correspondents’ demographic backgrounds. Methods First responders who subscribe to Text4PTSI or Text4Wellbeing receive daily supportive and psychoeducational SMS text messages for 6 months. The SMS text messages are preprogrammed into an online software program that delivers messages to subscribers. Baseline and follow-up data are collected through online questionnaires using validated scales at enrollment, 6 weeks, 12 weeks, and 24 weeks (end point). In-depth interviews will be conducted to assess satisfaction with the text-based intervention. Results We hypothesize that participants who enroll in this program will have improved PTSI symptoms; increased or improved quality of life; and significant reduction in associated stress, depression, and anxiety symptoms, among other psychological concerns. Improvement will be determined in comparison to established baseline parameters. Conclusions This research will be beneficial for practitioners and will inform policy-making and decision-making regarding psychological interventions for PTSI. Lessons from this study will inform the scale-up of the intervention, a cost-effective, zero contact therapeutic option to manage PTSI. International Registered Report Identifier (IRRID) PRR1-10.2196/30680
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Affiliation(s)
- Gloria Obuobi-Donkor
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Ejemai Eboreime
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Jennifer Bond
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Natalie Phung
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Scarlett Eyben
- Operational Stress Injury Clinic, Alberta Health Services, Edmonton, AB, Canada
| | - Jake Hayward
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Yanbo Zhang
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Frank MacMaster
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Steven Clelland
- Addiction and Mental Health, Alberta Health Services, Edmonton, AB, Canada
| | - Russell Greiner
- Department of Computer Science, Faculty of Science, University of Alberta, Edmonton, AB, Canada
| | - Chelsea Jones
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Suzette Brémault-Phillips
- Department of Occupational Therapy, Faculty of Rehabilitation, University of Alberta, Edmonton, AB, Canada
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB, Canada
| | - Kristopher Wells
- Department of Child and Youth Care, Faculty of Health and Community Studies, MacEwan University, Edmonton, AB, Canada
| | - Xin-Min Li
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Carla Hilario
- Faculty of Nursing, University of Alberta, Edmonton, AB, Canada
| | - Andrew J Greenshaw
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
| | - Vincent Israel Opoku Agyapong
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
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16
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Kyron MJ, Rees CS, Lawrence D, Carleton RN, McEvoy PM. Prospective risk and protective factors for psychopathology and wellbeing in civilian emergency services personnel: a systematic review. J Affect Disord 2021; 281:517-532. [PMID: 33388463 DOI: 10.1016/j.jad.2020.12.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Revised: 11/12/2020] [Accepted: 12/05/2020] [Indexed: 10/22/2022]
Abstract
Emergency services personnel have an elevated risk of developing mental health conditions. Most research in this area is cross-sectional, which precludes inferences about temporal and potentially causal relationships between risk and protective factors and mental health outcomes. The current study systematically reviewed prospective studies of risk and protective factors for mental health outcomes in civilian emergency services personnel (firefighters, paramedics, police) assessed at pre-operational and operational stages. Out of 66 eligible prospective studies identified, several core groups of risk and protective factors emerged: (1) cognitive abilities; (2) coping tendencies; (3) personality factors; (4) peritraumatic reactions and post-trauma symptoms; (5) workplace factors; (6) interpersonal factors; (7) events away from work. Although there was insufficient evidence for many associations, social support was consistently found to protect against the development of mental health conditions, and peritraumatic dissociation, prior mental health issues, and prior trauma exposure were risk factors for future mental health conditions. Among operational studies, neuroticism was significantly associated with future PTSD symptoms, burnout, and general poor mental health, and avoidance and intrusion symptoms of PTSD were associated with future PTSD and depression symptoms. The current review results provide important targets for future research and interventions designed to improve the mental health of emergency services personnel.
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Affiliation(s)
- Michael J Kyron
- School of Psychology, Curtin University, Perth, Western Australia
| | - Clare S Rees
- School of Psychology, Curtin University, Perth, Western Australia
| | - Donna Lawrence
- Wellbeing and Support Services, St John Ambulance, Perth, Western Australia
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Peter M McEvoy
- School of Psychology, Curtin University, Perth, Western Australia; Centre for Clinical Interventions, Perth, Western Australia.
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Pain intensity, alcohol use motives, and alcohol use among firefighters: The moderating role of pain-related anxiety. Addict Behav 2020; 107:106415. [PMID: 32247252 DOI: 10.1016/j.addbeh.2020.106415] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 03/24/2020] [Accepted: 03/25/2020] [Indexed: 12/27/2022]
Abstract
Firefighters are an understudied population that reports high rates of alcohol use and hazardous drinking. Pain, which is also commonly experienced by firefighters, may be associated with alcohol use and alcohol use motives, as research among the general population suggests that pain is associated with coping-oriented drinking. Pain-related anxiety, reflecting a tendency to respond to pain with anxiety or fear, may link pain to coping-oriented drinking among firefighters. Therefore, the current study examined the moderating role of pain-related anxiety on the association between pain intensity and alcohol use motives as well as alcohol use severity. The sample was comprised of 189 (Mage = 40.33, SD = 9.97, 89.9% male) firefighters. Results from the current study supported a significant moderation effect of pain-related anxiety on the association between pain intensity and alcohol use coping motives, whereby the association between pain intensity and coping motives was stronger for those with high compared to low pain-related anxiety. No significant moderation effects were documented for social, enhancement, or conformity motives; and no significant moderation effect was found for alcohol use severity. These results highlighted the potential importance of pain intensity and pain-related anxiety in coping-oriented alcohol use among firefighters.
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18
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Sommer JL, El-Gabalawy R, Taillieu T, Afifi TO, Carleton RN. Associations between Trauma Exposure and Physical Conditions among Public Safety Personnel: Associations entre l'exposition à un traumatisme et les problèmes physiques chez le personnel de la santé publique. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2020; 65:548-558. [PMID: 32275461 PMCID: PMC7361655 DOI: 10.1177/0706743720919278] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Trauma exposure is associated with adverse health-related correlates, including physical comorbidities, and is highly prevalent among public safety personnel (PSP). The current study (1) examined the association between context of index trauma exposure (part of job vs. other) and physical conditions and (2) established the prevalence of physical conditions according to PSP category (e.g., police, paramedic) and index trauma type (e.g., serious accident, physical assault) in a large Canadian sample of PSP. METHODS PSP completed an online survey between September 2016 and January 2017. Multivariable logistic regressions examined associations between context of index trauma exposure (i.e., part of job vs. other) and physical condition categories. Cross-tabulations with chi-square analyses examined whether the prevalence of physical conditions significantly differed according to PSP category and index trauma type. RESULTS There were 5,267 PSP included in the current study. Results from the most stringent model of logistic regressions demonstrated that, compared to PSP who experienced their index trauma in any other context, PSP who experienced it as part of their job had reduced odds of "other" physical conditions (adjusted odds ratio = 0.73, 95% confidence interval, 0.57 to 0.94, P < 0.05). Results also revealed significant differences in the prevalence of physical conditions across all PSP categories and select index trauma types. CONCLUSION Results highlight the relevance of trauma exposure outside of an occupational context among PSP and may have implications for the positive impact of stress inoculation and resiliency training programs for PSP.
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Affiliation(s)
- Jordana L. Sommer
- Department of Psychology, University of Manitoba, Winnipeg,
Canada
- Department of Anesthesiology, Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, Canada
| | - Renée El-Gabalawy
- Department of Psychology, University of Manitoba, Winnipeg,
Canada
- Department of Anesthesiology, Perioperative and Pain Medicine,
University of Manitoba, Winnipeg, Canada
- Department of Clinical Health Psychology, University of Manitoba,
Winnipeg, Canada
- Department of Psychiatry, University of Manitoba, Winnipeg,
Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba,
Winnipeg, Canada
| | - Tracie O. Afifi
- Department of Psychiatry, University of Manitoba, Winnipeg,
Canada
- Department of Community Health Sciences, University of Manitoba,
Winnipeg, Canada
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A population-based examination of suicidality in comorbid generalized anxiety disorder and chronic pain. J Affect Disord 2019; 257:562-567. [PMID: 31326689 DOI: 10.1016/j.jad.2019.07.016] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Revised: 05/27/2019] [Accepted: 07/04/2019] [Indexed: 11/20/2022]
Abstract
BACKGROUND Generalized anxiety disorder (GAD) and chronic pain conditions commonly co-occur, and are both independently associated with suicidality; however, little is known about the impact of chronic pain on suicidality among individuals with GAD. The aim of this study was to examine the associations between comorbid GAD and chronic pain conditions with suicide ideation, plans, and attempts in a population-based sample. METHODS We analyzed data from the 2012 Canadian Community Health Survey-Mental Health (CCHS-MH; N = 25,113). Multiple logistic regressions examined the associations between comorbid GAD and chronic pain conditions (i.e., arthritis, migraine, back pain; reference = GAD alone) with suicidality (i.e., ideation, plans, and attempts). RESULTS After adjusting for sociodemographics, other psychiatric conditions, and other chronic pain conditions, results indicated that compared to GAD alone, comorbid GAD and migraine was associated with increased odds of suicide ideation and plans (adjusted odds ratio (AOR) range: 2.55-3.00) and comorbid GAD and arthritis was associated with increased odds of suicide attempts (AOR = 4.10, 95% CI [1.05-16.01]). LIMITATIONS The cross-sectional nature of the survey design does not permit causal assumptions regarding the emergent associations and the self-report assessment of chronic pain conditions may be associated with response biases. CONCLUSIONS Results highlight the burden of chronic pain on suicidality among individuals with GAD. These results emphasize the importance of assessing risk of suicidality among individuals with comorbid GAD and chronic pain conditions, particularly migraine and arthritis.
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Kim SY, Shigemoto Y, Neduvelil A. Survive or Thrive? Longitudinal Relation Between Chronic Pain and Well-Being. Int J Behav Med 2019; 26:486-498. [DOI: 10.1007/s12529-019-09805-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Posttraumatic stress, alcohol use, and alcohol use reasons in firefighters: The role of sleep disturbance. Compr Psychiatry 2018; 87:64-71. [PMID: 30219373 DOI: 10.1016/j.comppsych.2018.09.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Revised: 08/28/2018] [Accepted: 09/04/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Firefighters are at elevated risk for posttraumatic stress and alcohol use, with research indicating that individuals with posttraumatic stress are likely to use alcohol as a coping strategy. A behavioral mechanism of clinical relevance to these associations is sleep disturbance. Thus, it was hypothesized that higher posttraumatic stress and sleep disturbance would be associated with higher alcohol use and alcohol use coping reasons; and sleep disturbance would moderate the association between posttraumatic stress and alcohol use and alcohol use coping reasons. PROCEDURE Participants included 639 urban career firefighters (93.6% male; 77.9% White; Mage = 38.5). Covariates included fire department years and occupational stress. Structural equation models were tested. RESULTS Posttraumatic stress severity was significantly, positively associated with alcohol use severity and alcohol use coping reasons. Similarly, sleep disturbance severity was significantly, positively associated with alcohol use severity and alcohol use coping reasons. After accounting for covariates and main effects, the interaction of PTSD severity and sleep disturbance was significantly associated with alcohol use severity, with the model accounting for 23.6% of variance, and alcohol use coping reasons, with the model accounting for 37.6% of variance. As predicted, the interaction of posttraumatic stress severity and sleep disturbance was not significantly associated with alcohol use enhancement, conformity, or social reasons. CONCLUSION These findings indicate that posttraumatic stress severity is related to heightened alcohol use severity and alcohol use coping reasons, and this association is markedly stronger when firefighters' levels of sleep disturbance are heightened. Clinical and research implications are to be discussed.
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