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Hadjistavropoulos HD, McCall HC, Dear BF, Beahm JD, Carleton RN, Titov N. Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study. J Anxiety Disord 2024; 104:102861. [PMID: 38640867 DOI: 10.1016/j.janxdis.2024.102861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 01/07/2024] [Accepted: 04/09/2024] [Indexed: 04/21/2024]
Abstract
First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges' g) in symptoms of depression (g = 1.3), anxiety (g =1.48), posttraumatic stress (g =1.24), panic (g =1.19), and anger (g =1.07) and moderate reductions in symptoms of social anxiety (g =.48-.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.
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Affiliation(s)
- Heather D Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada.
| | - Hugh C McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Blake F Dear
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - Janine D Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada; Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia; eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
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Hatcher S, Sinyor M, Edgar NE, Schaffer A, MacLean SE, Carleton RN, Colman I, Jayakumar N, Ward B, Zaheer R. A Comparison of Suicides in Public Safety Personnel With Suicides in the General Population in Ontario, 2014 to 2018. Crisis 2024. [PMID: 38597229 DOI: 10.1027/0227-5910/a000953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/11/2024]
Abstract
Background: There is conflicting evidence on the suicide rates of different public safety personnel (PSP). There have been few studies that compare suicides in PSP with the general population and none that have used a detailed comparison of coroner records. Aims: The current study estimates suicide rates among different PSP and compares PSP suicides with the general population. Method: We identified coroner records of PSP suicides from January 2014 to December 2018 and compared each one to two matched general population controls. Results: We identified 36 PSP suicides and 72 general population controls. Police had a higher suicide rate than other PSP groups. PSP were more likely to die by firearm, be separated/divorced or married, die in a motor vehicle, have problems at work, and have a PTSD diagnosis. PSP were less likely to die by jumping. Limitations: The study may have not identified all PSP suicides. Apart from the cause of death, data in coroner records are not systematically collected, so information may be incomplete. Conclusion: PSP suicides appear different than the general population. Death records need to have an occupation identifier to enable monitoring of trends in occupational groups, such as PSP.
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Affiliation(s)
- Simon Hatcher
- Department of Psychiatry, University of Ottawa, ON, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
| | - Mark Sinyor
- Department of Psychiatry, University of Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Nicole E Edgar
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
| | - Ayal Schaffer
- Department of Psychiatry, University of Toronto, ON, Canada
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Sarah E MacLean
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
- School of Journalism and Communication, Carleton University, Ottawa, ON, Canada
| | - R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, University of Regina, SK, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, University of Ottawa, ON, Canada
| | - Navitha Jayakumar
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - Brooklyn Ward
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, ON, Canada
- Health and Rehabilitation Sciences, Western University, London, ON, Canada
| | - Rabia Zaheer
- Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto, ON, Canada
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Beahm JD, McCall HC, Carleton RN, Jones N, Hadjistavropoulos HD. Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework. Internet Interv 2024; 35:100718. [PMID: 38318086 PMCID: PMC10840103 DOI: 10.1016/j.invent.2024.100718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Revised: 01/21/2024] [Accepted: 01/23/2024] [Indexed: 02/07/2024] Open
Abstract
Background Within Canada, internet-delivered cognitive behavioural therapy (ICBT) has recently been tailored by PSPNET to meet the needs of public safety personnel (PSP) to help address high rates of mental health problems within this population. Perceptions and outcomes of ICBT among PSP are promising, but it remains unknown how PSPNET is perceived by PSP organizational leaders. It is important to assess this gap because these leaders have significant potential to influence the uptake of ICBT. Methods In the current study, PSP leaders (n = 10) were interviewed to examine their perceptions of PSPNET and opportunities to improve ICBT implementation. The RE-AIM evaluation framework was used to assess PSP leaders' perceptions of PSPNET in terms of reach, effectiveness, adoption, implementation, and maintenance. Results The results evidenced that leaders perceived PSPNET as effective in reaching and serving PSP and PSP organizations. PSP leaders reported perceiving ICBT as effectively implemented, especially for being freely offered to individual PSP and for improving PSP's access to experienced therapists specifically trained to work with PSP. Participants indicated organizations have promoted and will continue promoting PSPNET longer-term, facilitating adoption and maintenance. Factors perceived as facilitating successful service delivery included building relationships and trust with PSP organizations and general support for PSP leadership mental health initiatives. PSP leaders identified perceived areas for improving ICBT implementation (e.g., ensuring leaders have access to data on PSPNET uptake and outcomes, creating promotional videos, expanding availability of PSPNET to other provinces, offering additional options for receiving therapist support). Implications Overall, the study provides insights into PSP leaders' perceptions of the implementation of ICBT among PSP and ideas for optimizing implementation efforts.
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Affiliation(s)
- Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nicholas Jones
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Department of Justice Studies, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
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Houle SA, Ein N, Gervasio J, Plouffe RA, Litz BT, Carleton RN, Hansen KT, Liu JJW, Ashbaugh AR, Callaghan W, Thompson MM, Easterbrook B, Smith-MacDonald L, Rodrigues S, Bélanger SAH, Bright K, Lanius RA, Baker C, Younger W, Bremault-Phillips S, Hosseiny F, Richardson JD, Nazarov A. Measuring moral distress and moral injury: A systematic review and content analysis of existing scales. Clin Psychol Rev 2024; 108:102377. [PMID: 38218124 DOI: 10.1016/j.cpr.2023.102377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 11/03/2023] [Accepted: 12/21/2023] [Indexed: 01/15/2024]
Abstract
BACKGROUND Moral distress (MD) and moral injury (MI) are related constructs describing the negative consequences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use. METHOD We identified psychometric studies describing the development or validation of MD or MI scales and extracted information on methodological and psychometric qualities. Content analyses identified specific outcomes measured by each scale. RESULTS We reviewed 77 studies representing 42 unique scales. The quality of psychometric approaches varied greatly across studies, and most failed to examine convergent and divergent validity. Content analyses indicated most scales measure exposures to potential moral stressors and outcomes together, with relatively few measuring only exposures (n = 3) or outcomes (n = 7). Scales using the term MD typically assess general distress. Scales using the term MI typically assess several specific outcomes. CONCLUSIONS Results show how the terms MD and MI are applied in research. Several scales were identified as appropriate for research and clinical use. Recommendations for the application, development, and validation of MD and MI scales are provided.
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Affiliation(s)
- Stephanie A Houle
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Research Directorate, Veterans Affairs Canada, Charlottetown, Canada
| | - Natalie Ein
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada
| | - Julia Gervasio
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada
| | - Rachel A Plouffe
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychology, University of Dundee, Dundee, UK
| | - Brett T Litz
- Department of Psychiatry, Boston University, Boston, USA; Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Boston, USA; Department of Psychological and Brain Sciences, Boston University, Boston, USA
| | | | - Kevin T Hansen
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada
| | - Jenny J W Liu
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada
| | | | - Walter Callaghan
- Department of Anthropology, University of Toronto, Toronto, Canada
| | | | - Bethany Easterbrook
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychology, Neuroscience & Behaviour, McMaster University, Hamilton, Canada
| | | | - Sara Rodrigues
- The Atlas Institute for Veterans and Families, Ottawa, Canada
| | | | | | - Ruth A Lanius
- Department of Psychiatry, Western University, London, Canada
| | - Clara Baker
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada
| | - William Younger
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada
| | | | | | - J Don Richardson
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada; St. Joseph's Operational Stress Injury Clinic, St. Joseph's Health Care London, London, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada
| | - Anthony Nazarov
- MacDonald Franklin OSI Research Centre, Lawson Health Research Institute, London, Canada; Department of Psychiatry, Western University, London, Canada; Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Canada.
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Afifi TO, Taillieu T, Salmon S, Stewart-Tufescu A, Sareen J, Enns MW, Mota N, Bolton SL, Carleton RN, Heber A, VanTil L. Child Maltreatment History, Deployment-Related Traumatic Events, and Past 12-Month Cannabis Use Among Veterans in Canada. Can J Psychiatry 2024; 69:116-125. [PMID: 37563976 PMCID: PMC10789231 DOI: 10.1177/07067437231192740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/12/2023]
Abstract
OBJECTIVE Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans. METHOD Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only n = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use. RESULTS The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, - 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found. CONCLUSIONS Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans.
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Affiliation(s)
- Tracie O. Afifi
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, MN, Canada
| | - Tamara Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MN, Canada
| | - Samantha Salmon
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MN, Canada
| | | | - Jitender Sareen
- Department of Psychiatry, University of Manitoba, Winnipeg, MN, Canada
| | - Murray W. Enns
- Department of Psychiatry, University of Manitoba, Winnipeg, MN, Canada
| | - Natalie Mota
- Department of Clinical Health Psychology, University of Manitoba, Winnipeg, MN, Canada
| | - Shay-Lee Bolton
- Departments of Community Health Sciences and Psychiatry, University of Manitoba, Winnipeg, MN, Canada
| | | | - Alexandra Heber
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
| | - Linda VanTil
- Veterans Affairs Canada, Charlottetown, PE, Canada
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Landry CA, McCall HC, Beahm JD, Titov N, Dear B, Carleton RN, Hadjistavropoulos HD. Web-Based Mindfulness Meditation as an Adjunct to Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Feasibility Evaluation Study. JMIR Form Res 2024; 8:e54132. [PMID: 38289655 PMCID: PMC10865190 DOI: 10.2196/54132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2023] [Revised: 12/19/2023] [Accepted: 01/10/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND Public safety personnel (PSP) are individuals who work to ensure the safety and security of communities (eg, correctional workers, firefighters, paramedics, and police officers). PSP have a high risk of developing mental disorders and face unique barriers to traditional mental health treatments. The PSP Wellbeing Course is a transdiagnostic, internet-delivered cognitive behavioral therapy (iCBT) course tailored to assist PSP with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). The initial course outcomes are promising, but some clients report some challenges with learning skills and recommend adding additional resources. Mindfulness meditations, which help people to experience the world and their reactions to the world in open and nonjudgmental ways, may complement the existing PSP Wellbeing Course. OBJECTIVE This study aims to examine the feasibility of mindfulness meditations in iCBT tailored for PSP. Information was gathered to evaluate engagement and client experiences with mindfulness meditations, symptom change, and the relationship between mindfulness meditation use and symptom change. METHODS A mixed methods study was conducted on PSP enrolled in the PSP Wellbeing Course who were offered 5 mindfulness meditations during the program (ie, 1/lesson). Clients completed questionnaires on depression, anxiety, PTSD, anger, insomnia, resilience, and mindfulness at pretreatment and at 8 weeks; an 8-week treatment satisfaction questionnaire; and brief weekly measures of mindfulness meditation engagement. We used paired sample t tests (2-tailed) to assess changes in outcomes over time and partial correlations to assess whether mindfulness meditation use predicted outcomes at posttreatment. A total of 12 clients were interviewed about their perceptions of the mindfulness meditations, and interviews were analyzed using directed content analysis. RESULTS Among the 40 clients enrolled, 27 (68%) reported using the mindfulness meditations, practicing for an average of 4.8 (SD 8.1) minutes each week. Most interviewees described the mindfulness meditations as beneficial but also reported challenges, such as discomfort while sitting with their feelings. Clients provided suggestions for better integration of mindfulness into iCBT. Overall, clients who completed the PSP Wellbeing Course with mindfulness meditations experienced statistically significant improvements in symptoms of anxiety (P=.001), depression (P=.001), PTSD (P=.001), and anger (P=.001) but not insomnia (P=.02). Clients also experienced improvements in resilience (P=.01) and mindfulness (P=.001). Self-reported time spent meditating was not associated with changes in symptoms over time. CONCLUSIONS This study provides new insight into the integration of mindfulness meditations with iCBT for PSP. It demonstrates the partial feasibility of adding mindfulness meditations to iCBT, revealing that some, but not all, PSP engaged with the meditations and reported benefits. PSP reported using the mindfulness meditations inconsistently and described challenges with the meditations. Improvements can be made to better integrate mindfulness meditation into iCBT, including offering mindfulness meditation as an optional resource, providing more psychoeducation on managing challenges, and offering shorter meditations.
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Affiliation(s)
- Caeleigh A Landry
- Department of Psychology, University of Regina, Regina, SK, Canada
- PSPNET, University of Regina, Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, SK, Canada
| | - Hugh C McCall
- Department of Psychology, University of Regina, Regina, SK, Canada
- PSPNET, University of Regina, Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, SK, Canada
| | - Janine D Beahm
- Department of Psychology, University of Regina, Regina, SK, Canada
- PSPNET, University of Regina, Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, SK, Canada
| | - Nickolai Titov
- eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - Blake Dear
- eCentreClinic, School of Psychological Sciences, Macquarie University, Sydney, Australia
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, SK, Canada
- PSPNET, University of Regina, Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, SK, Canada
| | - Heather D Hadjistavropoulos
- Department of Psychology, University of Regina, Regina, SK, Canada
- PSPNET, University of Regina, Regina, SK, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, SK, Canada
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Phelps AJ, Madden K, Carleton RN, Johnson L, Carey LB, Mercier JM, Mellor A, Baills J, Forbes D, Devenish-Meares P, Hosseiny F, Dell L. Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members following exposure to Moral Transgression. J Relig Health 2023; 62:3995-4015. [PMID: 37697218 PMCID: PMC10682271 DOI: 10.1007/s10943-023-01908-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/22/2023] [Indexed: 09/13/2023]
Abstract
Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study explores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence-based treatment in collaboration with mental health practitioners.
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Affiliation(s)
- Andrea J Phelps
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia.
| | - Kelsey Madden
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
| | | | - Lucinda Johnson
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
| | - Lindsay B Carey
- School of Psychology and Public Health, La Trobe University, Melbourne, VIC, Australia
| | | | - Andrew Mellor
- National Police Chaplaincy Group, Brisbane, Queensland, Australia
| | - Jeffrey Baills
- National Police Chaplaincy Group, Brisbane, Queensland, Australia
| | - David Forbes
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
| | | | | | - Lisa Dell
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Level 3, 161 Barry Street, Carlton, VIC, 3053, Australia
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Boehme BAE, Shields RE, Carleton RN, Asmundson GJG. Factor structure and factorial invariance of the PTSD checklist for DSM-5 in public safety personnel: Results from a large and diverse sample. Psychol Trauma 2023:2024-21356-001. [PMID: 37917448 DOI: 10.1037/tra0001601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
OBJECTIVE Public safety personnel (PSP; e.g., correctional workers, firefighters, paramedics, and police officers) are frequently exposed to potentially psychologically traumatic events (PPTEs) and report posttraumatic stress disorder (PTSD) difficulties more frequently than the general population. The PTSD checklist for DSM-5 (PCL-5) is a commonly used measure to screen PSP for PTSD. A single previous study assessed PCL-5 factorial invariance among PSP but used a small homogenous sample. The current study evaluated factorial invariance with a large (n = 5,855) and diverse PSP sample. METHOD Multigroup confirmatory factor analyses (mCFAs; n = 98) were conducted using six competing factor models of the PCL-5 across seven PSP sectors, five age groups, and two gender groups. RESULTS The seven-factor hybrid model of PTSD (i.e., reexperiencing, avoidance, negative alterations in cognitions and mood, hyperarousal, intrusion, emotional numbing, dysphoria, dysphoric arousal, anxious arousal, anhedonia, negative affect) produced consistently superior fit across all sectors assessed and produced marginally better absolute values than the six-factor anhedonia model, supporting PCL-5 factorial invariance among PSP. CONCLUSIONS The current study is the first to use a large and diverse PSP sample to assess PCL-5 factorial invariance. The results support the PCL-5 as invariant across PSP sectors, age groups, and men and women. Consistent with other studies, the seven-factor hybrid model of PTSD produced the best fit, followed closely by the six-factor anhedonia model. Future research could use structured clinical interviews to further investigate the factorial structure and invariance of PTSD symptoms among PSPs. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Blake A E Boehme
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
| | - Robyn E Shields
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
| | - R Nicholas Carleton
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
| | - Gordon J G Asmundson
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina
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Heber A, Testa V, Groll D, Ritchie K, Tam-Seto L, Mulligan A, Sullo E, Schick A, Bose E, Jabbari Y, Lopes J, Carleton RN. Glossary of terms: A shared understanding of the common terms used to describe psychological trauma, version 3.0. Health Promot Chronic Dis Prev Can 2023; 43:S1-S999. [PMID: 37991891 DOI: 10.24095/hpcdp.43.10/11.09] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Affiliation(s)
- Alexandra Heber
- Veterans Affairs Canada, Ottawa, Ontario, Canada
- Canadian Institute for Pandemic Health Education and Response (CIPHER), Regina, Saskatchewan, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Valerie Testa
- Centre for Mental Health and Wellbeing, Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, Ontario, Canada
| | - Kimberly Ritchie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Trent/Fleming School of Nursing, Trent University, Peterborough, Ontario, Canada
| | - Linna Tam-Seto
- Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ashlee Mulligan
- Atlas Institute for Veterans and Families, The Royal, Ottawa, Ontario, Canada
| | - Emily Sullo
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Amber Schick
- Canadian Institute for Pandemic Health Education and Response (CIPHER), Regina, Saskatchewan, Canada
| | - Elizabeth Bose
- Canadian Institute for Pandemic Health Education and Response (CIPHER), Regina, Saskatchewan, Canada
| | - Yasaman Jabbari
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - Jillian Lopes
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ontario, Canada
- Department of Psychology, Neuroscience, and Behaviour, McMaster University, Hamilton, Ontario, Canada
| | - R Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, Saskatchewan, Canada
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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10
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Singh J, Carleton RN, Neary JP. Cardiac function and posttraumatic stress disorder: a review of the literature and case report. Health Promot Chronic Dis Prev Can 2023; 43:472-480. [PMID: 37991890 PMCID: PMC10753899 DOI: 10.24095/hpcdp.43.10/11.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
INTRODUCTION Posttraumatic stress disorder (PTSD) can induce an elevation in sympathetic tone; however, research pertaining to the cardiac cycle in patients with PTSD is limited. METHODS A literature review was conducted with PubMed, MEDLINE and Web of Science. Articles discussing changes and associations in echocardiography and PTSD or related symptoms were synthesized for the current review. We have also included data from a case report of a male participant aged 33 years experiencing potentially psychologically traumatic events, who wore a noninvasive cardiac sensor to assess the timing intervals and contractility parameters of the cardiac cycle using seismocardiography. The intervals included systolic time, isovolumic contraction time (IVCT) and isovolumic relaxation time (IVRT). Calculations of systolic (IVCT/systole), diastolic (IVRT/systole) and myocardial [(IVCT+IVRT)/systole] performance indices were completed. RESULTS The review identified 55 articles, 14 of which assessed cardiac function using echocardiography in patients with PTSD symptoms. Cardiac dysfunction varied across studies, with diastolic and systolic impairments found in patients with PTSD. Our case study showed that occupational stress elevated cardiac performance indices, suggesting increased ventricular stress and supporting results in the existing literature. CONCLUSIONS The literature review results suggest that a controlled approach to assessing cardiac function in patients with PTSD is required. The case study results further suggest that acute bouts of stress can alter cardiac function, with potential for sustained occupational stress to induce changes in cardiac function. Cardiac monitoring can be used prospectively to identify changes induced by potentially psychologically traumatic event exposures that can lead to the development of PTSD symptoms.
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Affiliation(s)
- Jyotpal Singh
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - J Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
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11
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Testa V, Bennett A, Jutai J, Cantor Z, Burke P, McMahon J, Carleton RN, Colman I, Fikretoglu D, Heber A, Leduc S, Heisel MJ, Thavorn K, Corsi DJ, Hatcher S. Applying the Theoretical Domains Framework to identify police, fire, and paramedic preferences for accessing mental health care in a First Responder Operational Stress Injury Clinic: a qualitative study. Health Promot Chronic Dis Prev Can 2023; 43:431-449. [PMID: 37991887 PMCID: PMC10753900 DOI: 10.24095/hpcdp.43.10/11.02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2023]
Abstract
INTRODUCTION First responders and other public safety personnel (PSP; e.g. correctional workers, firefighters, paramedics, police, public safety communicators) are often exposed to events that have the potential to be psychologically traumatizing. Such exposures may contribute to poor mental health outcomes and a greater need to seek mental health care. However, a theoretically driven, structured qualitative study of barriers and facilitators of help-seeking behaviours has not yet been undertaken in this population. This study used the Theoretical Domains Framework (TDF) to identify and better understand critical barriers and facilitators of help-seeking and accessing mental health care for a planned First Responder Operational Stress Injury (OSI) clinic. METHODS We conducted face-to-face, one-on-one semistructured interviews with 24 first responders (11 firefighters, five paramedics, and eight police officers), recruited using purposive and snowball sampling. Interviews were analyzed using deductive content analysis. The TDF guided study design, interview content, data collection, and analysis. RESULTS The most reported barriers included concerns regarding confidentiality, lack of trust, cultural competency of clinicians, lack of clarity about the availability and accessibility of services, and stigma within first responder organizations. Key themes influencing help-seeking were classified into six of the TDF's 14 theoretical domains: environmental context and resources; knowledge; social influences; social/professional role and identity; emotion; and beliefs about consequences. CONCLUSION The results identified key actions that can be utilized to tailor interventions to encourage attendance at a First Responder OSI Clinic. Such approaches include providing transparency around confidentiality, policies to ensure greater cultural competency in all clinic staff, and clear descriptions of how to access care; routinely involving families; and addressing stigma.
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Affiliation(s)
- Valerie Testa
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Alexandria Bennett
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Jeffrey Jutai
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa, Ontario, Canada
- LIFE Research Institute, University of Ottawa, Ottawa, Ontario, Canada
| | - Zachary Cantor
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Ottawa Paramedic Service, City of Ottawa, Ottawa, Ontario, Canada
| | - Peter Burke
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - James McMahon
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, Saskatchewan, Canada
| | - Ian Colman
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Deniz Fikretoglu
- Operational Health and Performance Section, Defence Research and Development Canada, Toronto, Ontario, Canada
| | - Alexandra Heber
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Veterans Affairs Canada, Ottawa, Ontario, Canada
| | - Shannon Leduc
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Ottawa Paramedic Service, City of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Marnin J Heisel
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
- Lawson Health Research Institute, London, Ontario, Canada
| | - Kednapa Thavorn
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- ICES uOttawa, Ottawa, Ontario, Canada
| | - Daniel J Corsi
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, Ontario, Canada
- Better Outcomes Registry & Network Ontario, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Simon Hatcher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Department of Psychiatry, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada
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12
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DeGrace S, Romero-Sanchiz P, Tibbo P, Barrett S, Arenella P, Cosman T, Atasoy P, Cousijn J, Wiers R, Keough MT, Yakovenko I, O'Connor R, Wardell J, Rudnick A, Nicholas Carleton R, Heber A, Stewart SH. Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories? Behav Res Ther 2023; 169:104387. [PMID: 37625353 DOI: 10.1016/j.brat.2023.104387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Revised: 08/16/2023] [Accepted: 08/19/2023] [Indexed: 08/27/2023]
Abstract
Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = .36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = .19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.
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Affiliation(s)
- S DeGrace
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada.
| | - P Romero-Sanchiz
- School of Psychology, University of Sussex Sussex House, Falmer, Brighton, BN1 9RH, United Kingdom
| | - P Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - S Barrett
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - P Arenella
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - T Cosman
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - P Atasoy
- Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - J Cousijn
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - R Wiers
- Universiteit van Amsterdam, Department of Psychology, Nieuwe Achtergracht 129-B, 1018 WT, Amsterdam, Netherlands
| | - M T Keough
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - I Yakovenko
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
| | - R O'Connor
- Concordia University, Department of Psychology, 7141 Sherbrooke West PY-146, Montreal, QC, H4B 1R6, Canada
| | - J Wardell
- York University, Department of Psychology, 4700 Keele St, North York, ON, M3J 1P3, Canada
| | - A Rudnick
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada
| | - R Nicholas Carleton
- University of Regina, Department of Psychology, 3737 Wascana Parkway, Regina, SK, S4S 0A2, Canada
| | - A Heber
- McMaster University, Department of Psychiatry and Behavioural Neurosciences, 100 West 5th Street, Hamilton, ON, Canada
| | - S H Stewart
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J. Lane Memorial Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 1355 Oxford Street, Halifax, NS, B3H 4R2, Canada
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13
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Teckchandani TA, Neary JP, Andrews KL, Maguire KQ, Jamshidi L, Nisbet J, Shields RE, Afifi TO, Sauer-Zavala S, Lix LM, Krakauer RL, Asmundson GJG, Krätzig GP, Carleton RN. Cardioautonomic lability assessed by heart rate variability changes in Royal Canadian Mounted Police cadets during the cadet training program. Front Psychol 2023; 14:1144783. [PMID: 37829079 PMCID: PMC10565660 DOI: 10.3389/fpsyg.2023.1144783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 09/14/2023] [Indexed: 10/14/2023] Open
Abstract
Objective The current study examined variations in cardioautonomic lability during the Royal Canadian Mounted Police (RCMP) Cadet Training Program (CTP) between cadets starting their training who did or did not screen positive for one or more mental health disorders (i.e., posttraumatic stress disorder [PTSD], major depressive disorder [MDD], social anxiety disorder [SAD], generalized anxiety disorder [GAD], panic disorder [PD], alcohol use disorder [AUD]). Methods Electrocardiogram (ECG) signals integrated into Hexoskin garments were used to record ECG and heart rate Over the 26-week CTP. There were 31 heart rate variability (HRV) parameters calculated using Kubios Premium HRV analysis software. Mann-Whitney U-tests were used to perform groupwise comparisons of participant raw values and HRV during the CTP. Results A total of 157 cadets (79% male) were screened for any mental disorder using self-report surveys and then grouped by positive and negative screening. Analyses indicated a statistically significant (p < 0.05) decrease in low frequency (LF): High Frequency (HF) variability during CTP, but only for cadets who endorsed clinically significant anxiety symptoms on the GAD-7 at the start of their training. There were no other statistically significant groupwise differences. Conclusion The results indicate the participants have excellent cardiac health overall and suggest potentially important differences between groups, such that cadets who endorsed clinically significant anxiety symptoms on the GAD-7 showed less variability in the LF:HF ratio over the course of the CTP. The relatively lower variability suggests decreased parasympathetic tone in those without clinically significant anxiety symptoms. The results also have important implications for future investigations of cardioautonomic dysfunction and chronic hypothalamic pituitary adrenal (HPA) axis deviations in policing populations with anxiety disorders; specifically, cardioautonomic inflexibility related to cardiovascular morbidity and mortality. In any case, the current results provide an important baseline for future cardiac research with cadets and serving officers.
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Affiliation(s)
- Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - J. Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Rachel L. Krakauer
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de Recherche et de Traitement en Sécurité Publique (CIPSRT-ICRTSP), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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14
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Ricciardelli R, Mitchell MM, Taillieu T, Cassiano MS, Afifi TO, Carleton RN. Exposures to correctional-specific potentially psychologically traumatic events among Ontario provincial correctional workers. Psychol Trauma 2023; 15:S246-S258. [PMID: 36848056 DOI: 10.1037/tra0001437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/01/2023]
Abstract
OBJECTIVE Correctional work involves exposures to correctional-specific potentially psychologically traumatic events (PPTEs); however, the frequency and impact of such PPTEs on the mental health of correctional workers remain unclear. We analyzed the prevalence and frequency of 13 different occupational-specific PPTE exposures among correctional workers (n = 980; 50.7% female) and estimated associations with mental health symptoms. METHOD The survey data used are from the Provincial Ontario Correctional Worker Mental Health Prevalence Study in Canada. Cross-tabulations, Chi-square tests, ANOVAs, and logistic regression are used to examine the following: (a) the distribution of correctional-specific PPTEs across correctional worker occupational categories; (b) the frequencies of correctional-specific PPTE exposures; and (c) the association between correctional-specific PPTEs and mental disorders. Population-attributable fractions (PAFs) are used to estimate the proportion of mental disorders that may be attributable to PPTE exposures. RESULTS Most correctional workers reported exposures to most types of PPTEs, including being directly threatened or subject to abusive language (94.6%), de-escalating a prison/client in mental health crisis (92.2%), and using force or suit up and resort to "use of force" in a nontraining situation (70.6%). The mean number of lifetime PPTE exposures was 7.79 (SD = 3.33). There were statistically significant differences in PPTE exposure patterns across correctional worker categories. PPTEs were positively associated with mental disorder symptoms for all participants. PAFs indicated that mental disorders among correctional workers could reduce by 66%-80% with the elimination of all PPTEs among correctional workers. CONCLUSIONS Eliminating PPTE exposures is unlikely in the correctional environment; nevertheless, the results indicate that mitigating PPTEs may drastically improve the mental health of correctional workers. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Rosemary Ricciardelli
- School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland
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15
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Andrews KL, Jamshidi L, Nisbet J, Brunet A, Afifi TO, Asmundson GJ, Fletcher AJ, Maguire KQ, Teckchandani TA, Lix L, Sauer-Zavala S, Sareen J, Keane TM, Patrick Neary J, Nicholas Carleton R. Potentially Psychologically Traumatic Event Exposure Histories of new Royal Canadian Mounted Police Cadets. Can J Psychiatry 2023; 68:663-681. [PMID: 36740849 PMCID: PMC10585132 DOI: 10.1177/07067437221149467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Royal Canadian Mounted Police (RCMP) report extremely frequent and varied exposures to potentially psychologically traumatic events (PPTEs). While occupational exposures to PPTEs may be one explanation for the symptoms of mental disorders prevalent among serving RCMP, exposures occurring prior to service may also play a role. The objective of the current study was to provide estimates of lifetime PPTE exposures among RCMP cadets in training and assess for associations with mental disorders or sociodemographic variables. METHODS RCMP cadets (n = 772; 72.0% male) beginning the Cadet Training Program (CTP) completed a survey assessing self-reported PPTE exposures as measured by the Life Events Checklist for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition-Extended. Binomial tests were conducted to compare the current results to previously collected data from the general population, a diverse sample of public safety personnel (PSP) and serving RCMP. RESULTS Cadets reported statistically significantly fewer PPTE exposures for all PPTE types than serving RCMP (all p's < 0.001) and PSP (all p's < 0.001) but more PPTE exposures for all PPTE types than the general population (all p's < 0.001). Cadets also endorsed fewer PPTE types (6.00 ± 4.47) than serving RCMP (11.64 ± 3.40; p < 0.001) and other PSP (11.08 ± 3.23) but more types than the general population (2.31 ± 2.33; p < 0.001). Participants who reported being exposed to any PPTE type reported the exposures occurred 1-5 times (29.1% of participants), 6-10 times (18.3%) or 10 + times (43.1%) before starting the CTP. Several PPTE types were associated with positive screens for one or more mental disorders. There were associations between PPTE types and increased odds of screening positive for post-traumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD) and social anxiety disorder (SAD) (all p's < 0.05). Serious transport accident (11.1%), physical assault (9.5%) and sudden accidental death (8.4%) were the PPTEs most identified as the worst event, and all were associated with positive screens for one or more mental disorders. CONCLUSION The current results provide the first information describing PPTE histories of cadets, evidencing exposure frequencies and types much higher than the general population. PPTE exposures may have contributed to the cadet's vocational choices. The current results support the growing evidence that PPTEs can be associated with diverse mental disorders; however, the results also suggest cadets may be uncommonly resilient, based on how few screened positive for mental disorders, despite reporting higher frequencies of PPTE exposures prior to CTP than the general population.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Alain Brunet
- McGill’s Psychiatry Department, Douglas Institute Research Center, Montreal, QC, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Gordon J.G. Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Amber J. Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | | | - Lisa Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, Kentucky, USA
| | - Jitender Sareen
- Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Terence M. Keane
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System & Boston University School of Medicine, Boston, Massachusetts, USA
| | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - R. Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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16
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Nisbet J, Jamshidi L, Maguire KQ, Afifi TO, Brunet A, Fletcher AJ, Asmundson GJ, Sareen J, Shields RE, Andrews KL, Sauer-Zavala S, Neary JP, Lix L, Stewart SH, Krätzig GP, Carleton RN. Suicidal Ideation, Planning, and Attempts Among new Royal Canadian Mounted Police Cadets. Can J Psychiatry 2023; 68:691-698. [PMID: 36734146 PMCID: PMC10585129 DOI: 10.1177/07067437221149469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
BACKGROUND Royal Canadian Mounted Police (RCMP) report diverse occupational stressors and repeated exposures to potentially psychologically traumatic events, which may increase the odds of screening positive for a mental disorder, and increase the risk of death by suicide. The current study was designed to provide prevalence information regarding suicidal behaviours (i.e., ideation, planning, attempts) and assess for sociodemographic differences among cadets at the start of the RCMP Cadet Training Program (CTP). METHOD Cadets (n = 736, 74.0% male) were administered the structured Mini International Neuropsychiatric Interview by a mental health clinician or a supervised clinical psychologist trainee. The interview includes an assessment of past month suicidal ideation, planning, attempts and lifetime suicide attempts. RESULTS Within 1 month of starting the CTP, a small percentage of cadets reported past month suicidal ideation (1.6%) and no cadets reported any suicidal planning (0%) or attempts (0%). Lifetime suicide attempts were reported by (1.5%) of cadets. CONCLUSIONS The current results provide the first information describing the prevalence of suicidal ideation, planning, and attempts among RCMP cadets starting the CTP. The estimates of suicidal behaviours appear lower than the general population and lower than reports from serving RCMP. Higher prevalence estimates of suicidal behaviours reported by serving RCMP, relative to lower estimates among cadets starting the CTP in the current study, may be related to age, cumulative experiences or protracted exposures to operational and organizational stressors, rather than insufficient screening of recruits.
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Affiliation(s)
- Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment – Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina, Regina, Saskatchewan, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment – Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina, Regina, Saskatchewan, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment – Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina, Regina, Saskatchewan, Canada
| | - Tracie O. Afifi
- Max Rady College of Medicine, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alain Brunet
- Research Centre of the Douglas Mental Health University Institute, McGill University, Montreal, Quebec, Canada
| | - Amber J. Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Gordon J.G. Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Jitender Sareen
- Max Rady College of Medicine, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment – Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina, Regina, Saskatchewan, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment – Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina, Regina, Saskatchewan, Canada
| | | | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Lisa Lix
- Max Rady College of Medicine, Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Sherry H. Stewart
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Gregory P. Krätzig
- Research and Strategic Partnerships, RCMP Depot Division, Regina, Saskatchewan, Canada
| | - R. Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, 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. Can J Psychiatry 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] [What about the content of this article? (0)] [Affiliation(s)] [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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18
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McCall H, Dear BF, Landry C, Beahm JD, Gregory J, Titov N, Carleton RN, Hadjistavropoulos HD. Internet-delivered cognitive behavioural therapy for symptoms of PTSD among public safety personnel: Initial outcomes of an open cohort preference trial of transdiagnostic and disorder-specific therapy. Internet Interv 2023; 33:100656. [PMID: 37609530 PMCID: PMC10440509 DOI: 10.1016/j.invent.2023.100656] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 07/27/2023] [Accepted: 08/07/2023] [Indexed: 08/24/2023] Open
Abstract
Public safety personnel (PSP) face high rates of mental health problems and many barriers to care. Initial outcomes of transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) tailored for PSP are promising, but prior research has not evaluated outcomes of PTSD-specific ICBT among PSP or PSP's preferences for transdiagnostic or PTSD-specific ICBT. The current paper presents the initial outcomes (N = 150) of a mixed-methods observational study designed to (a) investigate preferences for transdiagnostic or PTSD-specific ICBT among PSP with elevated symptoms of PTSD and/or a primary concern with PTSD symptoms and (b) explore potential differences in client engagement, satisfaction, and symptom changes between the two forms of ICBT. PSP completed questionnaires before and after their preferred ICBT program. Mixed-methods analyses included generalized estimating equations, descriptive statistics, and inductive conventional qualitative content analysis. More clients (n = 85; 57 %) selected transdiagnostic ICBT than PTSD-specific ICBT (n = 65; 43 %), but the difference in the number of clients who selected each course was not statistically significant. Clients in both ICBT programs reported similar and favorable treatment satisfaction (e.g., 98 % would recommend the course to a friend), treatment engagement (i.e., 69 % accessed at least four of the five lessons), and pre-post improvement in symptoms (e.g., Hedges' g = 0.81 for reduction in PTSD symptom). Transdiagnostic ICBT resulted in greater reductions in symptoms of panic disorder than PTSD-specific ICBT. Qualitative analyses showed similarities across the ICBT programs in client feedback. The current study provides further evidence supporting the use and outcomes of ICBT for PSP in both transdiagnostic and disorder-specific formats. Implications for the literatures on PSP mental health and ICBT, as well as practical recommendations, are discussed.
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Affiliation(s)
- Hugh McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Blake F. Dear
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
- eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - Caeleigh Landry
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Julia Gregory
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nickolai Titov
- School of Psychological Sciences, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
- eCentreClinic, Macquarie University, Balaclava Rd, Macquarie Park, NSW 2109, Australia
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), 2 Research Drive, Regina, SK S4T 2P7, Canada
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19
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Jones C, Juby B, Spencer S, Smith-MacDonald L, O’Greysik E, Vincent M, Mooney C, Bright KS, Sevigny PR, Burback L, Greenshaw A, Carleton RN, Savage R, Hayward J, Zhang Y, Cao B, Brémault-Phillips S. "Collapsing into Darkness": An Exploratory Qualitative Thematic Analysis of the Experience of Workplace Reintegration among Nurses with Operational Stress Injuries. Int J Environ Res Public Health 2023; 20:6664. [PMID: 37681804 PMCID: PMC10487705 DOI: 10.3390/ijerph20176664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2023] [Revised: 08/13/2023] [Accepted: 08/23/2023] [Indexed: 09/09/2023]
Abstract
BACKGROUND Nurses are engaged in an unpredictable and dynamic work environment where they are exposed to events that may cause or contribute to physical and/or psychological injuries. Operational stress injury (OSI) may lead to an extended time away from work or nurses leaving the profession altogether. A deliberate focus on the workplace reintegration phase of the mental health recovery process may lead to the increased retention of nurses in their profession. Prior to the creation and implementation of potential solutions to address workplace reintegration, it is imperative to explore the experiences and perceptions of nurses affected by OSI. This qualitative study aims to investigate the experiences and perceptions of nurses (N = 7) employed within a Canadian provincial healthcare system who have attempted workplace reintegration after being off of work with an OSI. METHODS Nurses were recruited via social media, unit emails, and word of mouth. Data were collected through recorded semi-structured interviews conducted over videoconferencing. Once transcribed, the data were thematically analyzed using an inductive approach. RESULTS The resulting themes included (1) heroes to zeros, (2) changing the status quo, (3) connection is key, and (4) post-traumatic growth: advocacy and altruism. Study participants indicated both that nursing culture and a cumulation of events contributed to a need for a leave of absence from work and that a formalized process was desired by nurses to assist in returning to work. CONCLUSIONS The development, implementation, and exploration of innovative policies, procedures, and initiatives to bridge the gap from clinical interventions to workplace reintegration are needed for nurses experiencing OSI. Further research is also needed regarding mental health impacts and appropriate resources to support nurses in their workplace reintegration process after experiencing psychological and/or physical injury.
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Affiliation(s)
- Chelsea Jones
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
| | - Brenda Juby
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
| | - Shaylee Spencer
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
| | - Lorraine Smith-MacDonald
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- St. Stephen’s College, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Elly O’Greysik
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Faculty of Nursing, MacEwan University, Edmonton, AB T5J 2P2, Canada
| | - Michelle Vincent
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
| | | | - Katherine S. Bright
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Faculty of Nursing, University of Calgary, Calgary, AB T2N 4V8, Canada
- School of Nursing and Midwifery, Faculty of Health, Community and Education, Mount Royal University, Calgary, AB T3E 6K6, Canada
| | - Phillip R. Sevigny
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Faculty of Education, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Lisa Burback
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Andrew Greenshaw
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
- Canadian Institute for Public Safety Research and Treatment, Regina, SK S4S 0A2, Canada
| | - Raymond Savage
- Royal Canadian Mounted Police, Edmonton, AB T5G 2T4, Canada
| | - Jake Hayward
- Department of Emergency Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Yanbo Zhang
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Alberta Health Services, Edmonton, AB T5J 3E4, Canada
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Bo Cao
- Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB T6G 2R3, Canada
| | - Suzette Brémault-Phillips
- Heroes in Mind, Advocacy and Research Consortium, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada (S.B.-P.)
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta, Edmonton, AB T6G 2R3, Canada
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Shields RE, Teckchandani TA, Asmundson GJG, Nisbet J, Krakauer RL, Andrews KL, Maguire KQ, Jamshidi L, Afifi TO, Lix LM, Brunet A, Sauer-Zavala S, Krätzig GP, Neary JP, Sareen J, Carleton RN. Daily survey participation and positive changes in mental health symptom scores among Royal Canadian Mounted Police Cadets. Front Psychol 2023; 14:1145194. [PMID: 37599763 PMCID: PMC10437217 DOI: 10.3389/fpsyg.2023.1145194] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 02/24/2023] [Indexed: 08/22/2023] Open
Abstract
Introduction Royal Canadian Mounted Police (RCMP) officers self-report high levels of mental health disorder symptoms, such as alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Participation in regular mental health monitoring has been associated with improved mental health disorder symptom reporting and may provide an accessible tool to support RCMP mental health. The current study assessed relationships between self-reported mental health disorder symptoms and the completion of daily surveys (i.e., daily mental health disorder symptom monitoring) by RCMP cadets during the Cadet Training Program (CTP). Methods Participants were RCMP cadets (n = 394; 76.1% men) in the Standard Training Program who completed the 26-week CTP and daily self-monitoring surveys, as well as full mental health assessments at pre-training (i.e., starting the CTP) and pre-deployment (i.e., ~2 weeks prior to deployment to the field). Symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder were assessed. Changes in mental health disorder symptom reporting from pre-training to pre-deployment were calculated. Spearman's rank correlations were estimated for number of daily surveys completed and change in mental health disorder symptom scores between pre-training and pre-deployment. Results There were statistically significant inverse relationships between number of daily surveys completed and number of mental health disorder symptoms reported; specifically, cadets who completed more daily surveys during CTP reported fewer symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Conclusion An inverse correlation between number of daily surveys completed and mental health disorder symptom scores indicated that participation in daily mental health monitoring was associated with improvements in self-reported mental health disorder symptoms between pre-training and pre-deployment. Regular self-monitoring of mental health disorder symptoms may help to mitigate mental health challenges among RCMP cadets and officers.
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Affiliation(s)
- Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Rachel L. Krakauer
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- 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
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Alain Brunet
- McGill’s Psychiatry Department and Douglas Institute Research Center, Montréal, QC, Canada
| | | | | | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Jitender Sareen
- Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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21
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Olthuis JV, Kaltenbach E, Giberson E, Saryeddine T, Asmundson GJG, Carleton RN, Cramm H, Crombach A, Devlin J, Mack J, Lingley-Pottie P, Rao S, Sullivan M, Wozney L, McGrath PJ. Paraprofessional delivery of online narrative exposure therapy for firefighters. J Trauma Stress 2023; 36:772-784. [PMID: 37291963 DOI: 10.1002/jts.22941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/21/2023] [Accepted: 04/08/2023] [Indexed: 06/10/2023]
Abstract
Firefighters are at increased risk for developing posttraumatic stress disorder (PTSD) and face numerous barriers to accessing mental health care. Innovative ways to increase access to evidence-based interventions are needed. This study was a case series testing the acceptability, feasibility, and preliminary effectiveness of a paraprofessional-delivered, virtual narrative exposure therapy (eNET) intervention for PTSD. Participants were 21 firefighters who met the criteria for clinical or subclinical probable PTSD and completed 10-12 sessions of eNET via videoconference. Participants completed self-report measures pre- and postintervention and at 2- and 6-month follow-ups as well as a postintervention qualitative interview. Paired samples t tests evidenced statistically significant decreases in PTSD, anxiety, and depressive symptom severity and functional impairment from pre- to postintervention, ds = 1.08-1.33, and in PTSD and anxiety symptom severity and functional impairment from preintervention to 6-month follow-up, ds = 0.69-1.10. The average PTSD symptom severity score fell from above to below the clinical cutoff for probable PTSD at postintervention and follow-ups. Qualitative interviews indicated that paraprofessionals were considered central to participants' success and experience with the intervention. No adverse events or safety concerns were raised. This study is an important step in demonstrating that appropriately trained and supervised paraprofessionals can effectively deliver eNET to firefighters with PTSD.
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Affiliation(s)
- Janine V Olthuis
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | | | - Emma Giberson
- Department of Psychology, University of New Brunswick, Fredericton, New Brunswick, Canada
| | - Tina Saryeddine
- Canadian Association of Fire Chiefs, Ottawa, Ontario, Canada
- Telfer School of Management, University of Ottawa, Ottawa, Ontario, Canada
| | | | - R Nicholas Carleton
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, Ontario, Canada
| | - Anselm Crombach
- Department of Psychology, Universität des Saarlandes, Saarbrücken, Germany
| | - Julie Devlin
- Conservation and Protection, Fisheries and Oceans Canada, Ottawa, Ontario, Canada
| | - Jeff Mack
- Fredericton Fire Department, Fredericton, New Brunswick, Canada
| | - Patricia Lingley-Pottie
- IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sanjay Rao
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michael Sullivan
- Department of Psychology, McGill University, Montreal, Québec, Canada
| | - Lori Wozney
- IWK Health Centre, Halifax, Nova Scotia, Canada
| | - Patrick J McGrath
- IWK Health Centre, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
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22
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Teckchandani T, Krakauer RL, Andrews KL, Neary JP, Nisbet J, Shields RE, Maguire KQ, Jamshidi L, Afifi TO, Lix LM, Sauer-Zavala S, Asmundson GJG, Krätzig GP, Carleton RN. Prophylactic relationship between mental health disorder symptoms and physical activity of Royal Canadian Mounted Police Cadets during the cadet training program. Front Psychol 2023; 14:1145184. [PMID: 37260953 PMCID: PMC10229095 DOI: 10.3389/fpsyg.2023.1145184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Accepted: 04/24/2023] [Indexed: 06/02/2023] Open
Abstract
Objective Royal Canadian Mounted Police report experiencing extremely frequent potentially psychologically traumatic events (PPTE). In a recent study, approximately half of participating RCMP screened positive for one or more mental disorders, which is approximately five times the diagnostic proportion for the general Canadian population. Increased reporting of mental health symptoms been linked to PPTE exposures. Programs promoting physical activity may be useful interventions to supplement or pair with mental health interventions, providing anxiolytic, antidepressant, and stress-buffering effects. The current study was designed to assess the relationship between physical activity behaviors and reported mental health disorder symptoms of cadets during the Royal Mounted Canadian Police (RCMP) Cadet Training Program (CTP). The current study also examined the relationship between exercise and mental health disorder symptoms of cadets during the CTP. Methods The study included data from 394 cadets (76.1% male). An analysis of variance (ANOVA) and a series of t-tests were used to assess several differences across sociodemographic groups. Bivariate Spearman's Rank correlations were performed between the average number of active calories burned per day, as recorded by Apple Watches, and changes in self-reported mental health disorder symptoms (i.e., Generalized Anxiety Disorder [GAD], Major Depressive Disorder [MDD], Posttraumatic Stress Disorder [PTSD], Social Anxiety Disorder [SAD]. Alcohol Use Disorders [AUD], Panic Disorder [PD]) from pre-training (starting the CTP) to pre-deployment (completing the CTP) 26 weeks later. Results There were statistically significant correlations between physical activity and self-reported mental health disorder symptom scores during CTP. Cadets who performed more physical activity from pre-training to pre-deployment had statistically significantly greater decreases in symptoms of GAD (ρ = -0.472, p < 0.001), MDD (ρ = -0.307, p < 0.001), PTSD (ρ = -0.343, p < 0.001), and AUD (ρ = -0.085, p < 0.05). There was no statistically significant relationship between physical activity and changes in PD symptoms (ρ = -0.037, p > 0.05). There were also no statistically significant relationships between pre-CTP mental health disorder symptom scores and the volume of physical activity performed during CTP. Conclusion There was evidence of a significant relationship between reductions in mental health disorder symptom scores and physical activity during the 26-week CTP. The results highlight the role that exercise can play as an important tool for reducing mental health disorder symptoms, considering there was no relationship between pre-CTP baseline mental health scores and physical activity performed during CTP. Further research is needed to understand differences in physical activity behaviours among cadets and serving RCMP.
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Affiliation(s)
- Taylor Teckchandani
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Rachel L. Krakauer
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - J. Patrick Neary
- Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Lisa M. Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | | | - Gordon J. G. Asmundson
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Anxiety and Illness Behaviours Lab, Department of Psychology, University of Regina, Regina, SK, Canada
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Khoury JMB, Jamshidi L, Shields RE, Nisbet J, Afifi TO, Fletcher AJ, Stewart SH, Asmundson GJG, Sauer-Zavala S, Krätzig GP, Carleton RN. Putative risk and resiliency factors among Royal Canadian Mounted Police cadets. Front Psychol 2023; 14:1048573. [PMID: 37008880 PMCID: PMC10053504 DOI: 10.3389/fpsyg.2023.1048573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 02/20/2023] [Indexed: 03/17/2023] Open
Abstract
ObjectiveMental health disorders are prevalent among active-duty Royal Canadian Mounted Police (RCMP) officers. The current study was designed to assess whether RCMP cadets commencing the Cadet Training Program are inherently at greater risk of developing mental health challenges by statistically comparing cadet putative risk and resiliency scores to scores from young adult populations. The study was also designed to assess for sociodemographic differences in putative risk and resiliency variables among RCMP cadets in order to facilitate future comparisons.MethodsCadets (n = 772; 72.2% men) completed self-report measures of several putative risk variables (i.e., anxiety sensitivity, fear of negative evaluation, pain anxiety, illness and injury sensitivity, intolerance of uncertainty, and state anger) and resiliency. Scores were statistically compared to samples from Canadian, American, Australian, and European young adult populations.ResultsCadets had statistically significantly lower scores on all putative risk variables and statistically significantly higher resiliency scores compared to the young adult populations. In the cadet sample, there were statistically significant differences in putative risk and resiliency variables across gender and sex.ConclusionCadets’ significantly lower scores on putative risk variables and higher scores on resiliency suggest that they may be psychologically strong; as such, it may be that the nature of police work, as opposed to inherent individual differences in risk and resiliency, accounts for active-duty RCMP officers’ comparatively higher prevalence of mental health disorders over time.Clinical Trial Registration: ClinicalTrials.gov, Identifier NCT05527509.
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Affiliation(s)
- Juliana M. B. Khoury
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Sociology and Social Studies, University of Regina, Regina, SK, Canada
| | - Amber J. Fletcher
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Sherry H. Stewart
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | | | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY, United States
| | | | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment-Institut Canadien de recherche et de traitement en sécurité publique (CIPSRT-ICRTSP), University of Regina/Université de Regina, Regina, SK, Canada
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
- *Correspondence: R. Nicholas Carleton,
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Nisbet J, Jamshidi L, Andrews KL, Stewart SH, Shields RE, Teckchandani TA, Maguire KQ, Carleton RN. Mental health and social support among Royal Canadian Mounted Police cadets. Front Psychol 2023; 14:1092334. [PMID: 36860784 PMCID: PMC9969355 DOI: 10.3389/fpsyg.2023.1092334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Accepted: 01/19/2023] [Indexed: 02/15/2023] Open
Abstract
Introduction Certain populations, such as public safety personnel (PSP), experience frequent exposures to potentially psychologically traumatic events and other occupational stressors, increasing their risk for mental health challenges. Social support has been evidenced as a protective factor for mental health. However, research examining perceived social support and its associations with symptoms related to mental disorders among PSP recruits is limited. Methods RCMP cadets (n = 765, 72% male) completed self-report surveys assessing: sociodemographic information, social support, and symptoms related to posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Results The results indicated statistically significant associations between higher social support and decreased odds of positive screens for generalized anxiety disorder, social anxiety disorder, and panic disorder (i.e., significant Adjusted Odds Ratios = 0.90 to 0.95). Discussion Cadets' perceived levels of social support are comparable to the Canadian general population and higher than serving RCMP. Social support appears to offer a protective element against anxiety-related disorders among participating cadets. Reductions in perceived levels of social support may be a function of RCMP service. Factors contributing to decreased levels of perceived social support should be considered.
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Affiliation(s)
- Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada,*Correspondence: Jolan Nisbet, ✉
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada
| | - Sherry H. Stewart
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada,Department of Psychology and Neuroscience, Dalhousie University, Halifax, NS, Canada,Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Robyn E. Shields
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada,Anxiety and Illness Behavior Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada
| | - Kirby Q. Maguire
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada
| | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK, Canada,Anxiety and Illness Behavior Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
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Andrews KL, Jamshidi L, Shields RE, Teckchandani TA, Afifi TO, Fletcher AJ, Sauer-Zavala S, Brunet A, Krätzig GP, Carleton RN. Examining mental health knowledge, stigma, and service use intentions among Royal Canadian Mounted Police cadets. Front Psychol 2023; 14:1123361. [PMID: 37205089 PMCID: PMC10187145 DOI: 10.3389/fpsyg.2023.1123361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 04/06/2023] [Indexed: 05/21/2023] Open
Abstract
Background Royal Canadian Mounted Police (RCMP) officers experience an elevated risk for mental health disorders due to inherent work-related exposures to potentially psychologically traumatic events and occupational stressors. RCMP officers also report high levels of stigma and low levels of intentions to seek mental health services. In contrast, very little is known about the levels of mental health knowledge and stigma of RCMP cadets starting the Cadet Training Program (CTP). The current study was designed to: (1) obtain baseline levels of mental health knowledge, stigma against peers in the workplace, and service use intentions in RCMP cadets; (2) determine the relationship among mental health knowledge, stigma against peers in the workplace, and service use intentions among RCMP cadets; (3) examine differences across sociodemographic characteristics; and (4) compare cadets to a sample of previously surveyed serving RCMP. Methods Participants were RCMP cadets (n = 772) starting the 26-week CTP. Cadets completed questionnaires assessing mental health knowledge, stigma against coworkers with mental health challenges, and mental health service use intentions. Results RCMP cadets reported statistically significantly lower levels of mental health knowledge (d = 0.233) and stigma (d = 0.127), and higher service use intentions (d = 0.148) than serving RCMP (all ps < 0.001). Female cadets reported statistically significantly higher scores on mental health knowledge and service use and lower scores on stigma compared to male cadets. Mental health knowledge and service use intentions were statistically significantly positively associated. For the total sample, stigma was inversely statistically significantly associated with mental health knowledge and service use intentions. Conclusion The current results indicate that higher levels of mental health knowledge were associated with lower stigma and higher intention to use professional mental health services. Differences between cadets and serving RCMP highlight the need for regular ongoing training starting from the CTP, designed to reduce stigma and increase mental health knowledge. Differences between male and female cadets suggest differential barriers to help-seeking behaviors. The current results provide a baseline to monitor cadet mental health knowledge and service use intentions and stigma as they progress throughout their careers.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
- *Correspondence: Katie L. Andrews,
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Robyn E. Shields
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
| | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, Canada
| | - Amber J. Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, SK, Canada
| | - Shannon Sauer-Zavala
- Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY, United States
| | - Alain Brunet
- McGill’s Psychiatry Department and Douglas Institute Research Center, Verdun, QC, Canada
| | - Gregory P. Krätzig
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK, Canada
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Teale Sapach MJN, Carleton RN. Self-compassion training for individuals with social anxiety disorder: a preliminary randomized controlled trial. Cogn Behav Ther 2023; 52:18-37. [PMID: 36254613 DOI: 10.1080/16506073.2022.2130820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
Self-compassion is the ability to offer oneself kindness and compassion in response to failure, suffering, or insecurity. Learning how to be self-compassionate through self-compassion training appears effective for improving psychological well-being in community samples and promising for clinical populations. The current randomized controlled trial was designed to (a) examine the effectiveness of a self-guided self-compassion training program; and (b) determine whether self-compassion training can help mitigate social anxiety disorder (SAD) symptoms. Adults with SAD (n = 63; Mage = 34.3, SD = 11.4; 67.8% female; 84.7% Caucasian) were randomized to a waitlist control condition, a self-guided self-compassion training condition, or a self-guided applied relaxation training condition for six weeks. Outcome measures of SAD symptoms and self-compassion were completed pre-, mid-, and post-treatment, as well as at 3-months follow-up. Multilevel linear modelling results suggested the self-compassion training program was statistically superior at improving outcome measures relative to the waitlist control condition (ps < .05; η2ps = .12-.33), but not relative to the applied relaxation training condition (ps > .05; η2ps = .01-.05). Self-compassion training produced greater clinically significant gains in self-compassion and reductions in fear of self-compassion compared to both the waitlist condition and applied relaxation training. The current trial provides preliminary evidence for the effectiveness of a self-help self-compassion training program and provides evidence that self-compassion training may be beneficial for managing clinically significant SAD symptoms.
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Carleton RN, McCarron M, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Camp RD, Shields RE, Jamshidi L, Nisbet J, Maguire KQ, MacPhee RS, Afifi TO, Jones NA, Martin RR, Sareen J, Brunet A, Beshai S, Anderson GS, Cramm H, MacDermid JC, Ricciardelli R, Rabbani R, Teckchandani TA, Asmundson GJG. Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel. BMC Psychol 2022; 10:295. [PMID: 36494748 PMCID: PMC9733219 DOI: 10.1186/s40359-022-00989-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/13/2022] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder. METHODS The current protocol paper describes the PSP PTSI Study (i.e., design, measures, materials, hypotheses, planned analyses, expected implications, and limitations), which was originally designed to evaluate an evidence-informed, proactive system of mental health assessment and training among Royal Canadian Mounted Police for delivery among diverse PSP (i.e., firefighters, municipal police, paramedics, public safety communicators). Specifically, the PSP PTSI Study will: (1) adapt, implement, and assess the impact of a system for ongoing (i.e., annual, monthly, daily) evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; and, (4) assess the impact of providing diverse PSP with a tailored version of the Emotional Resilience Skills Training originally developed for the Royal Canadian Mounted Police in mitigating PTSIs based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. Participants are assessed pre- and post-training, and then at a follow-up 1-year after training. The assessments include clinical interviews, self-report surveys including brief daily and monthly assessments, and daily biometric data. The current protocol paper also describes participant recruitment and developments to date. DISCUSSION The PSP PTSI Study is an opportunity to implement, test, and improve a set of evidence-based tools and training as part of an evidence-informed solution to protect PSP mental health. The current protocol paper provides details to inform and support translation of the PSP PTSI Study results as well as informing and supporting replication efforts by other researchers. TRIAL REGISTRATION Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered. TRIAL REGISTRATION ClinicalTrials.gov, NCT05530642. Registered 1 September 2022-Retrospectively registered. The subsequent PSP PTSI Study results are expected to benefit the mental health of all participants and, ultimately, all PSP.
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Affiliation(s)
- R. Nicholas Carleton
- grid.57926.3f0000 0004 1936 9131Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Michelle McCarron
- grid.412733.00000 0004 0480 4970Research Department, Saskatchewan Health Authority, Regina, SK S4S 0A5 Canada
| | - Gregory P. Krätzig
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Shannon Sauer-Zavala
- grid.266539.d0000 0004 1936 8438Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY 40506 USA
| | - J. Patrick Neary
- grid.57926.3f0000 0004 1936 9131Faculty of Kinesiology and Health Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Lisa M. Lix
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3 Canada
| | - Amber J. Fletcher
- grid.57926.3f0000 0004 1936 9131Department of Sociology and Social Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald D. Camp
- grid.266876.b0000 0001 2156 9982Faculty of Business and Economics, University of Northern British Columbia, Prince George, BC V2N 4Z9 Canada
| | - Robyn E. Shields
- grid.57926.3f0000 0004 1936 9131University of Regina, Regina, SK S4S 0A2 Canada
| | - Laleh Jamshidi
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jolan Nisbet
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Kirby Q. Maguire
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Renée S. MacPhee
- grid.268252.90000 0001 1958 9263Department of Kinesiology and Physical Education, Wilfrid Laurier University, Waterloo, ON N2L 3C5 Canada
| | - Tracie O. Afifi
- grid.21613.370000 0004 1936 9609Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Nicholas A. Jones
- grid.57926.3f0000 0004 1936 9131Department of Justice Studies, University of Regina, Regina, SK S4S 0A2 Canada
| | - Ronald R. Martin
- grid.57926.3f0000 0004 1936 9131Faculty of Education, University of Regina, Regina, SK S4S 0A2 Canada
| | - Jitender Sareen
- grid.21613.370000 0004 1936 9609Department of Psychiatry, Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W5 Canada
| | - Alain Brunet
- grid.459278.50000 0004 4910 4652McGill’s Psychiatry Department and Douglas Institute Research Center, 6875 Lasalle Boulevard, Verdun, QC H4H 1R3 Canada
| | - Shadi Beshai
- grid.57926.3f0000 0004 1936 9131Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gregory S. Anderson
- grid.265014.40000 0000 9945 2031Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8 Canada
| | - Heidi Cramm
- grid.410356.50000 0004 1936 8331School of Rehabilitation Therapy, Faculty of Health Sciences, Queen’s University, Kingston, ON K7L 3N6 Canada
| | - Joy C. MacDermid
- grid.39381.300000 0004 1936 8884School of Physiotherapy, Western University, London, ON N6A 3K7 Canada
| | - Rosemary Ricciardelli
- grid.25055.370000 0000 9130 6822School of Maritime Studies, Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3 Canada
| | - Rasheda Rabbani
- grid.21613.370000 0004 1936 9609George & Fay Yee Centre for Healthcare Innovation, Community Health Sciences, Max Rady College of Medicine, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Canada
| | - Taylor A. Teckchandani
- grid.57926.3f0000 0004 1936 9131Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, SK S4S 0A2 Canada
| | - Gordon J. G. Asmundson
- grid.57926.3f0000 0004 1936 9131Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, SK S4S 0A2 Canada
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Andrews KL, Jamshidi L, Nisbet J, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Assessing the Relative Impact of Diverse Stressors among Canadian Coast Guard and Conservation and Protection Officers. Int J Environ Res Public Health 2022; 19:16396. [PMID: 36554280 PMCID: PMC9778725 DOI: 10.3390/ijerph192416396] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 12/01/2022] [Accepted: 12/03/2022] [Indexed: 06/17/2023]
Abstract
Public Safety Personnel (PSP), including members of the Canadian Coast Guard (CCG) and Conservation and Protection (C&P) officers, are regularly exposed to potentially psychologically traumatic events (PPTEs) and other occupational stressors (organizational and operational stressors). The current study quantified occupational stressors among CCG and C&P and assessed relationships with PPTEs and mental health disorders. Participants (n = 341; 58.4% male) completed an online survey assessing self-reported occupational stressors, PPTEs, and mental health disorder symptoms. CCG and C&P Officers reported significantly lower mean overall and item-level organizational and operational stress scores compared to other Canadian PSP. Mean operational stress scores were statistically significantly associated with increased odds of screening positive for all mental disorders and organizational stress scores were statistically significantly associated with increased odds of screening positive for all mental disorders except social anxiety disorder. Participants reported several item-level occupational stressors associated with screening positive for posttraumatic stress disorder, general anxiety disorder, major depressive disorder, social anxiety disorder, panic disorder, and alcohol use disorder, even after accounting for diverse PPTE exposures. Exposure to PPTEs may be a regular part of employment for CCG and C&P PSP; however, bureaucratic red tape, staff shortages, excessive administrative duties, physical conditioning, healthy eating, and fatigue are occupational stressors that appear significantly related to mental health. Ongoing mental health efforts are needed to mitigate and manage the impact of occupational stressors among CCG and C&P.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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Nisbet J, Jamshidi L, Andrews KL, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Suicidal Ideation, Planning, and Attempts among Canadian Coast Guard and Conservation and Protection Officers. Int J Environ Res Public Health 2022; 19:ijerph192316318. [PMID: 36498388 PMCID: PMC9736749 DOI: 10.3390/ijerph192316318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 12/01/2022] [Accepted: 12/02/2022] [Indexed: 05/17/2023]
Abstract
The current study provides estimates of suicidal ideation, planning, and attempts among Canadian Coast Guard personnel and Canadian Conservation and Protection Officers. Participants (n = 385; 59% men) completed a self-report survey that collected past-year and lifetime estimates of suicidal ideation, planning, attempts, sociodemographic information, and symptoms related to mental health disorders. Within the sample, participants reported lifetime suicidal ideation (25.7%), planning (10.9%), and attempts (5.5%). Participants reported past-year suicidal ideation (7.5%), planning (2.1%), and the percentage of attempts was too marginal to report due to ethical considerations. Canadian Coast Guard personnel and Conservation and Protection Officers reported higher percentages of past-year and lifetime suicidal ideation, planning, and attempts than the Canadian general population, but the percentages reported are comparable to other Canadian PSP sectors. No statistically significant results were observed for the sociodemographic covariates within the past-year, whereas, statistically significant results were observed for the lifetime sociodemographic covariates of age, province of residence, and previous work experience. There were statistically significant associations between past-year suicidal ideation and positive screens for major depressive disorder (MDD) and general anxiety disorder (GAD); as well, past-year suicidal planning was associated with social anxiety disorder (SAD). There were also statistically significant associations between lifetime suicidal ideation, planning, and attempts and positive screens for posttraumatic stress disorder (PTSD), MDD, and SAD. Lifetime suicidal ideation and planning were associated with panic disorder (PD). The current estimates provide valuable information for clinicians and stakeholders involved in prevention programs, treatment, or future research.
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Affiliation(s)
- Jolan Nisbet
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
- Correspondence:
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Katie L. Andrews
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, Saint John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Dean Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute for Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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Andrews KL, Jamshidi L, Nisbet J, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Mental Health Training, Attitudes toward Support, and Screening Positive for Mental Disorders among Canadian Coast Guard and Conservation and Protection Officers. Int J Environ Res Public Health 2022; 19:15734. [PMID: 36497809 PMCID: PMC9739214 DOI: 10.3390/ijerph192315734] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2022] [Revised: 11/22/2022] [Accepted: 11/24/2022] [Indexed: 06/17/2023]
Abstract
Public Safety Personnel (PSP) including members of the Canadian Coast Guard (CCG) and Conservation and Protection (C&P) officers, are regularly exposed to potentially psychologically traumatic events (PPTEs) and other occupational stressors. Several mental health training programs (e.g., critical incident stress management [CISM], critical incident stress debriefing [CISD], peer support, mental health first aid, Road to Mental Readiness [R2MR]) exist as efforts to minimize the impact of exposures. To help inform on the impact of several categories of mental health training programs (i.e., CISM, CISD, mental health first aid, Peer Support, R2MR) for improving attitudes toward support and willingness to access supports among CCG and C&P officers, the current study assessed CCG and C&P Officers perceptions of access to professional (i.e., physicians, psychologists, psychiatrists, employee assistance programs, chaplains) and non-professional (i.e., spouse, friends, colleagues, leadership) support, and associations between training and mental health. Participants (n = 341; 58.4% male) completed an online survey assessing perceptions of support, experience with mental health training and symptoms of mental health disorders. CCG and C&P Officers reported access to professional and non-professional support; however, most indicated they would first access a spouse (73.8%), a friend (64.7%), or a physician (52.9%). Many participants would never, or only as a last resort, access other professional supports (24.0% to 47.9%), a CCG or C&P colleague (67.5%), or their leadership (75.7%). Participants who received any mental health training reported a lower prevalence of positive screens for all mental health disorders compared to those who did not received training; but no statistically significant associations were observed between mental health training categories and decreased odds for screening positive for mental disorders. The current results suggest that the mental health training categories yield comparable results; nevertheless, further research is needed to assess the shared and unique content across each training program. The results highlight the need to increase willingness to access professional and non-professional support among CCG and C&P Officers. Revisions to training programs for leadership and colleagues to reduce stigma around mental health challenges and support for PSP spouses, friends, and physicians may be beneficial.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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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] [What about the content of this article? (0)] [Affiliation(s)] [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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Andrews KL, Jamshidi L, Nisbet J, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Mental Health Disorder Symptoms among Canadian Coast Guard and Conservation and Protection Officers. Int J Environ Res Public Health 2022; 19:ijerph192315696. [PMID: 36497767 PMCID: PMC9741097 DOI: 10.3390/ijerph192315696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2022] [Revised: 11/18/2022] [Accepted: 11/21/2022] [Indexed: 05/16/2023]
Abstract
Canadian public safety personnel (PSP) screen positive for one or more mental health disorders, based on self-reported symptoms, at a prevalence much greater (i.e., 44.5%) than the diagnostic prevalence for the general public (10.1%). Potentially psychologically traumatic event (PPTE) exposures and occupational stressors increase the risks of developing symptoms of mental health disorders. The current study was designed to estimate the mental health disorder symptoms among Canadian Coast Guard (CCG) and Conservation and Protection (C&P) Officers. The participants (n = 412; 56.1% male, 37.4% female) completed an online survey assessing their current mental health disorder symptoms using screening measures and sociodemographic information. The participants screened positive for one or more current mental health disorders (42.0%; e.g., post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, alcohol use disorder) more frequently than in the general population diagnostic prevalence (10.1%; p < 0.001). The current results provide the first information describing the prevalence of current mental health disorder symptoms and subsequent positive screenings of CCG and C&P Officers. The results evidence a higher prevalence of positive screenings for mental health disorders than in the general population, and differences among the disorder-screening prevalence relative to other Canadian PSP. The current results provide insightful information into the mental health challenges facing CCG and C&P PSP and inform efforts to mitigate and manage PTSI among PSP. Ongoing efforts are needed to protect CCG and C&P Officers' mental health by mitigating the impacts of risk factors and operational and organizational stressors through interventions and training, thus reducing the prevalence of occupational stress injuries.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
- Correspondence:
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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Andrews KL, Jamshidi L, Nisbet J, Teckchandani TA, Price JAB, Ricciardelli R, Anderson GS, Carleton RN. Exposures to Potentially Psychologically Traumatic Events among Canadian Coast Guard and Conservation and Protection Officers. Int J Environ Res Public Health 2022; 19:ijerph192215116. [PMID: 36429829 PMCID: PMC9690280 DOI: 10.3390/ijerph192215116] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 11/11/2022] [Accepted: 11/13/2022] [Indexed: 05/28/2023]
Abstract
Canadian Public Safety Personnel (PSP) (i.e., municipal/provincial police, firefighters, paramedics, Royal Canadian Mounted Police, correctional workers, dispatchers) report frequent and varied exposures to potentially psychologically traumatic events (PPTEs). Exposure to PPTEs may be one explanation for the symptoms of mental health disorders prevalent among PSP. The objective of the current study was to provide estimates of lifetime PPTE exposures among Canadian Coast Guard (CCG) and Conservation and Protection (C&P) Officers and to assess for associations between PPTEs, mental health disorders, and sociodemographic variables. Participants (n = 412; 55.3% male, 37.4% female) completed an online survey assessing self-reported PPTE exposures and self-reported symptoms of mental health disorders. Participants reported higher frequencies of lifetime exposures to PPTEs than the general population (all ps < 0.001) but lower frequencies than other Canadian PSP (p < 0.5). Several PPTE types were associated with increased odds of positive screens for posttraumatic stress disorder, major depressive disorder, general anxiety disorder, social anxiety disorder, panic disorder, and alcohol use disorder (all ps < 0.05). Experiencing a serious transportation accident (77.4%), a serious accident at work, home, or during recreational activity (69.7%), and physical assault (69.4%) were among the PPTEs most frequently reported by participants. The current results provide the first known information describing PPTE exposures of CCG and C&P members, supporting the growing evidence that PPTEs are more frequent and varied among PSP and can be associated with diverse mental health disorders.
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Affiliation(s)
- Katie L. Andrews
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Laleh Jamshidi
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jolan Nisbet
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Taylor A. Teckchandani
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Jill A. B. Price
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
| | - Rosemary Ricciardelli
- Fisheries and Marine Institute, Memorial University of Newfoundland, St. John’s, NL A1C 5R3, Canada
| | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada
| | - R. Nicholas Carleton
- Canadian Institute of Public Safety Research and Treatment (CIPSRT), University of Regina, Regina, SK S4S 0A2, Canada
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Giesbrecht CJ, Jamshidi L, LaVallie C, Sasakamoose J, Nicholas Carleton R. Assessing the Efficacy of a Cultural and Artistic Intervention for Indigenous Women Who Have Experienced Intimate Partner Violence. Violence Against Women 2022; 28:3375-3399. [PMID: 34870521 DOI: 10.1177/10778012211058220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
nato' we ho win is a trauma-and-violence-informed artistic and cultural intervention for Indigenous women who have experienced intimate partner violence. The results of this study provide evidence that engagement in nato' we ho win had a positive impact on participants' well-being. Participants completed self-report questionnaires at intake, post-intervention, and at one-year follow-up. Multilevel modeling analyses assessed for within-participant changes over time. There was a statistically significant increase in participants' self-reported sense of resilience (p < 0.001), personal agency, connectedness, and post-traumatic growth (ps < 0.05). There were statistically significant decreases in participants' self-reported anxiety and depression (ps < 0.01) from intake to one-year follow-up.
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Affiliation(s)
- Crystal J Giesbrecht
- Provincial Association of Transition Houses and Services of Saskatchewan (PATHS), Regina, Saskatchewan, Canada
| | | | - Carrie LaVallie
- 7231First Nations University of Canada, Prince Albert, Saskatchewan, Canada
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35
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Stelnicki AM, Jamshidi L, Taillieu TL, Carleton RN, Afifi TO. Mental Health and Well-Being among Children of Public Safety Personnel in Canada. Int J Environ Res Public Health 2022; 19:14030. [PMID: 36360909 PMCID: PMC9654265 DOI: 10.3390/ijerph192114030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Revised: 10/19/2022] [Accepted: 10/24/2022] [Indexed: 06/16/2023]
Abstract
Public safety personnel (PSP) often experience stress due to their occupational demands that affect the family environment (e.g., work-family conflict, marital breakdown, disruption to home routines, and holidays). A substantial base of research has focused on the impact of PSP work on the marital relationship, but fewer studies have focused specifically on children's functioning within PSP families. The current study investigated mental health, well-being, and functioning among children of PSP in Canada, as reported by PSP. Data were collected between 2016 and 2017 as part of a large pan-Canadian study of PSP. Participants (n = 2092; 72.5% women) were PSP parents who responded to questions about their 4- to 17-year-old children. Overall, a substantial proportion of PSP parents reported their children have at least some difficulties with sadness (15.4%), worries and fear (22.0%), disobedience or anger (22.0%), attention (21.0%), and friendships (11.4%). Firefighters reported the fewest problems among their children compared to other PSP groups. Almost 40% of participants indicated that their child's problems were related to their work as a PSP. The results highlight the need to find ways to identify children that are struggling and provide support to those families. Organizations and PSP leadership should develop and prioritize efforts to support families of PSP members, with the likely outcome of enhancing PSP member well-being.
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Affiliation(s)
| | - Laleh Jamshidi
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Tamara L. Taillieu
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
| | | | - Tracie O. Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada
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36
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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. Int J Environ Res 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] [What about the content of this article? (0)] [Affiliation(s)] [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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37
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Boehme BAE, Shields RE, Asmundson GJG, Szeto ACH, Dobson KS, Carleton RN. A short version of the Opening Minds Scale–Workplace Attitudes: Factor structure and factorial validity in a sample of Canadian public safety personnel. Canadian Journal of Behavioural Science / Revue canadienne des sciences du comportement 2022. [DOI: 10.1037/cbs0000350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Easterbrook B, Ricciardelli R, Sanger BD, Mitchell MM, McKinnon MC, Carleton RN. Longitudinal study of Canadian correctional workers' wellbeing, organizations, roles and knowledge (CCWORK): Baseline demographics and prevalence of mental health disorders. Front Psychiatry 2022; 13:874997. [PMID: 36032233 PMCID: PMC9411959 DOI: 10.3389/fpsyt.2022.874997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Researchers and practitioners have begun to recognize and empirically examine the mental health challenges facing public safety personnel (PSP). Empirical results from longitudinal data collection among PSP remains extremely scant, particularly for institutional correctional workers. We designed the current study to assess the mental health of Correctional Service of Canada (CSC) correctional officer recruits (CORs) across time to help clarify potential challenges to or protective factors for mental health across correctional officer (CO) careers. Methods The current study uses data from the Canadian Correctional Workers' Wellbeing, Organizations, Roles, and Knowledge (CCWORK) study. The study uses a longitudinal design with self-report surveys administered online prior to CORs beginning the CSC Correctional Training Program. Initial baseline survey data were used to assess demographic information and mental health symptoms endorsed at the outset of the training program. Results Participating CORs (n = 265; 40% female; age = 32.8, SD = 9.1) began training between August 2018 and July 2021. Participants were less likely to screen positive for one or more current mental health disorders (i.e., 4.9%) than previously published rates for serving correctional officers (i.e., 54.6%), including reporting lower rates of posttraumatic stress disorder (i.e., 2.4 vs. 29.1%) and major depressive disorder (i.e., 1.9 vs. 31.1%). Conclusion/Impact Prevalence of positive screens for current mental health disorders in CORs appears lower than for the general population, and significantly lower than for serving correctional officers. The current results suggest an important causal relationship may exist between correctional work and detrimental mental health outcomes. Maintaining the mental health of correctional officers may require institutionally-supported proactive and responsive multimodal activities.
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Affiliation(s)
- Bethany Easterbrook
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
- MacDonald Franklin Operational Stress Injury Research Centre, London, ON, Canada
| | - Rosemary Ricciardelli
- School of Maritime Studies, Fisheries and Marine Institute, Memorial University, St. John's, NL, Canada
| | - Brahm D. Sanger
- Department of Psychology, Neuroscience and Behaviour, McMaster University, Hamilton, ON, Canada
- Homewood Research Institute, Guelph, ON, Canada
| | - Meghan M. Mitchell
- Department of Criminal Justice, University of North Dakota, Grand Forks, ND, United States
| | - Margaret C. McKinnon
- Homewood Research Institute, Guelph, ON, Canada
- St. Joseph's Healthcare Hamilton, Hamilton, ON, Canada
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, ON, Canada
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Carleton RN, Krätzig GP, Sauer-Zavala S, Neary JP, Lix LM, Fletcher AJ, Afifi TO, Brunet A, Martin R, Hamelin KS, Teckchandani TA, Jamshidi L, Maguire KQ, Gerhard D, McCarron M, Hoeber O, Jones NA, Stewart SH, Keane TM, Sareen J, Dobson K, Asmundson GJG. The Royal Canadian Mounted Police (RCMP) Study: protocol for a prospective investigation of mental health risk and resilience factors. Health Promot Chronic Dis Prev Can 2022; 42:319-333. [PMID: 35993603 PMCID: PMC9514212 DOI: 10.24095/hpcdp.42.8.02] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
The Royal Canadian Mounted Police (RCMP), like all public safety personnel (PSP), are frequently exposed to potentially psychologically traumatic events that contribute to posttraumatic stress injuries (PTSI). Addressing PTSI is impeded by the limited available research. In this protocol paper, we describe the RCMP Study, part of the concerted efforts by the RCMP to reduce PTSI by improving access to evidence-based assessments, treatments and training as well as participant recruitment and RCMP Study developments to date. The RCMP Study has been designed to (1) develop, deploy and assess the impact of a system for ongoing annual, monthly and daily evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; (4) augment the RCMP Cadet Training Program with skills to proactively mitigate PTSI; and (5) assess the impact of the augmented training condition (ATC) versus the standard training condition (STC). Participants in the STC (n = 480) and ATC (n = 480) are assessed before and after training and annually for 5 years on their deployment date; they also complete brief monthly and daily surveys. The RCMP Study results are expected to benefit the mental health of all participants, RCMP and PSP by reducing PTSI among all who serve.
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Affiliation(s)
- R Nicholas Carleton
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Gregory P Krätzig
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Shannon Sauer-Zavala
- Department of Psychology, University of Kentucky, Lexington, Kentucky, United States of America
| | - J Patrick Neary
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Amber J Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Tracie O Afifi
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Alain Brunet
- Department of Psychiatry and Douglas Institute Research Centre, McGill University, Verdun, Quebec, Canada
| | - Ron Martin
- Faculty of Education, University of Regina, Regina, Saskatchewan, Canada
| | | | - Taylor A Teckchandani
- Faculty of Kinesiology & Health Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Laleh Jamshidi
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, Saskatchewan, Canada
| | - Kirby Q Maguire
- Canadian Institute for Public Safety Research and Treatment, University of Regina, Regina, Saskatchewan, Canada
| | - David Gerhard
- Department of Computer Science, University of Regina, Regina, Saskatchewan, Canada
| | | | - Orland Hoeber
- Department of Computer Science, University of Regina, Regina, Saskatchewan, Canada
| | - Nicholas A Jones
- Department of Justice Studies, University of Regina, Regina, Saskatchewan, Canada
| | - Sherry H Stewart
- Mood, Anxiety, and Addiction Comorbidity (MAAC) Lab, Departments of Psychiatry and Psychology & Neuroscience, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Terence M Keane
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System & Boston University School of Medicine, Boston, Massachusetts, United States of America
| | - Jitender Sareen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Keith Dobson
- Department of Psychology, University of Calgary, Calgary, Alberta, Canada
| | - Gordon J G Asmundson
- Anxiety and Illness Behaviours Laboratory, Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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Jones KA, Freijah I, Carey L, Carleton RN, Devenish-Meares P, Dell L, Rodrigues S, Madden K, Johnson L, Hosseiny F, Phelps AJ. Correction to: Moral Injury, Chaplaincy and Mental Health Provider Approaches to Treatment: A Scoping Review. J Relig Health 2022; 61:2632-2633. [PMID: 35429280 PMCID: PMC9142428 DOI: 10.1007/s10943-022-01560-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Affiliation(s)
- Kimberley A Jones
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Isabella Freijah
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Lindsay Carey
- Department of Public Health, La Trobe University, Melbourne, Australia
| | | | - Peter Devenish-Meares
- Graduate School of Business, Queensland University of Technology, Brisbane, Australia
| | - Lisa Dell
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Sara Rodrigues
- Canadian Centre of Excellence On Post-Traumatic Stress Disorder (PTSD) and Related Mental Health Conditions, Ottawa, Canada
| | - Kelsey Madden
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Lucinda Johnson
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Fardous Hosseiny
- Canadian Centre of Excellence On Post-Traumatic Stress Disorder (PTSD) and Related Mental Health Conditions, Ottawa, Canada
| | - Andrea J Phelps
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia.
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Abstract
OBJECTIVE We examined the prevalence ofmental health disorders and suicidal behaviors (ideation, planning, and attempts) among a sample of provincial correctional workers in Manitoba. METHODS Self-reported mental health data from a survey on correctional worker mental health and well-being were analyzed for 491 correctional workers. RESULTS Over half (57%) of respondents screened positive for mental health disorder, most commonly major depressive disorder, and over one-third of respondents (37%) screened positive for more than one disorder. Positive mental health screens for all mental health disorders were associated with statistically significantly increased odds of lifetime suicidal ideation, and positive screens for most disorders were associated with past year suicidal ideation. CONCLUSIONS Relative to other public safety personnel and the general public, correctional workers appear have a higher prevalence of mental health disorders and suicidal behaviors. The association between positive screens for mental health disorders and suicidal behaviors highlights the vulnerability of correctional workers in regards to mental well-being.
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Affiliation(s)
- Rosemary Ricciardelli
- From the Memorial University of Newfoundland and Labrador, St. John's, Newfoundland (Dr Ricciardelli, Dr McKendy); University of Regina, Regina, Saskatchewan (Dr Jamshidi, Dr Carleton), Canada
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Ramadan ZF, Angehrn A, Stelnicki AM, Fletcher AJ, Krätzig GP, Hadjistavropoulos H, Carleton RN. Public safety personnel, personality, and gender. Personality and Individual Differences 2022. [DOI: 10.1016/j.paid.2022.111583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Price JAB, Landry CA, Sych J, McNeill M, Stelnicki AM, Asmundson AJN, Carleton RN. Assessing the Perceptions and Impact of Critical Incident Stress Management Peer Support among Firefighters and Paramedics in Canada. Int J Environ Res Public Health 2022; 19:ijerph19094976. [PMID: 35564374 PMCID: PMC9100761 DOI: 10.3390/ijerph19094976] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/05/2022] [Accepted: 04/14/2022] [Indexed: 02/05/2023]
Abstract
Relative to the general population, public safety personnel (PSP) appear at an increased risk of developing mental health challenges as a result of repeated exposure to potentially psychologically traumatic events (PPTEs). To help mitigate the impact of PPTEs on PSP mental health, many PSP agencies have implemented diverse peer support despite limited empirical evidence. The current study was designed to expand the empirical evidence surrounding peer support by investigating one of the most widely used and structured peer support resources: Critical Incident Stress Management (CISM). Specifically, the current study with integrated firefighters and paramedics assessed (a) the prevalence of mental disorders; (b) perceptions of high fidelity CISM peer support; and (c) the comparative associations of CISM with high fidelity (n = 91) versus unknown fidelity (n = 60) versus no CISM (n = 64) and mental health. Results indicated that (a) mental disorders are prevalent among PSP irrespective of gender, age, and years of service; (b) participants perceived CISM peer support as offering beneficial and valuable tools (e.g., skills and coping strategies); and (c) high fidelity CISM environments offer some mental health benefits to individuals who screen positive for alcohol use disorder and generalized anxiety disorder. Overall, the current study offers novel information that can inform future directions for evidence-based peer support and policy decisions designed to support the mental health of PSP.
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Affiliation(s)
- Jill A. B. Price
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (C.A.L.); (A.M.S.); (R.N.C.)
- Correspondence:
| | - Caeleigh A. Landry
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (C.A.L.); (A.M.S.); (R.N.C.)
| | - Jeff Sych
- Sych & Associates Psychological Services, Edmonton, AB T5M 2P6, Canada; (J.S.); (M.M.)
| | - Malcolm McNeill
- Sych & Associates Psychological Services, Edmonton, AB T5M 2P6, Canada; (J.S.); (M.M.)
| | - Andrea M. Stelnicki
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (C.A.L.); (A.M.S.); (R.N.C.)
| | | | - R. Nicholas Carleton
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (C.A.L.); (A.M.S.); (R.N.C.)
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44
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Price JAB, Ogunade AO, Fletcher AJ, Ricciardelli R, Anderson GS, Cramm H, Carleton RN. Peer Support for Public Safety Personnel in Canada: Towards a Typology. Int J Environ Res Public Health 2022; 19:ijerph19095013. [PMID: 35564405 PMCID: PMC9104081 DOI: 10.3390/ijerph19095013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Revised: 04/14/2022] [Accepted: 04/18/2022] [Indexed: 11/16/2022]
Abstract
Public safety personnel (PSP) are frequently exposed to potentially psychologically traumatic events (PPTEs) which can impact mental health. To help mitigate the negative effects of PPTEs, PSP commonly rely on peer support. Peer support generally refers to a wide variety of mental health resources that offer social or emotional assistance to a peer, and in some cases professional assistance. Despite the use of and demand for peer support, there is relatively little empirical evidence regarding effectiveness. The evidence gaps regarding peer support effectiveness may be due, in part, to inadequate guidelines and standards of practice that are publicly supported by a consensus among peer support providers. The current study was designed to explore the current conceptualization and implementation of peer support among Canadian PSP using a document analysis. The results indicate that peer support can be conceptualized via three models (i.e., peer-enabled, peer-led, peer-partnership) and implemented via two delivery methods (i.e., program, service). The research team proposed a novel diagram towards a typology of peer support to highlight the diversity in peer support conceptualization and implementation and provide a foundation for the development of mutually agreed-upon language and a shared framework. Overall, the current study can help inform peer support resources within and beyond PSP communities.
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Affiliation(s)
- Jill A. B. Price
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (A.O.O.); (R.N.C.)
- Correspondence:
| | - Adeyemi O. Ogunade
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (A.O.O.); (R.N.C.)
| | - Amber J. Fletcher
- Department of Sociology and Social Studies, University of Regina, Regina, SK S4S 0A2, Canada;
| | | | - Gregory S. Anderson
- Faculty of Science, Thompson Rivers University, Kamloops, BC V2C 0C8, Canada;
| | - Heidi Cramm
- School of Rehabilitation Therapy, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada; (A.O.O.); (R.N.C.)
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Jones KA, Freijah I, Carey L, Carleton RN, Devenish-Meares P, Dell L, Rodrigues S, Madden K, Johnson L, Hosseiny F, Phelps AJ. Moral Injury, Chaplaincy and Mental Health Provider Approaches to Treatment: A Scoping Review. J Relig Health 2022; 61:1051-1094. [PMID: 35290554 PMCID: PMC8922078 DOI: 10.1007/s10943-022-01534-4] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/14/2022] [Indexed: 06/14/2023]
Abstract
The aim of this research was to describe the evidence examining the approaches taken by mental health providers (MHPs) and chaplains to address symptoms related to moral injury (MI) or exposure to potentially morally injurious events (PMIEs). This research also considers the implications for a holistic approach to address symptoms related to MI that combines mental health and chaplaincy work. A scoping review of literature was conducted using Medline, PsycINFO, Embase, Central Register of Controlled Trials, Proquest, Philosphers Index, CINAHL, SocINDEX, Academic Search Complete, Web of Science and Scopus databases using search terms related to MI and chaplaincy approaches or psychological approaches to MI. The search identified 35 eligible studies: 26 quantitative studies and nine qualitative studies. Most quantitative studies (n = 33) were conducted in military samples. The studies examined interventions delivered by chaplains (n = 5), MHPs (n = 23) and combined approaches (n = 7). Most studies used symptoms of post-traumatic stress disorder (PTSD) and/or depression as primary outcomes. Various approaches to addressing MI have been reported in the literature, including MHP, chaplaincy and combined approaches, however, there is currently limited evidence to support the effectiveness of any approach. There is a need for high quality empirical studies assessing the effectiveness of interventions designed to address MI-related symptoms. Outcome measures should include the breadth of psychosocial and spiritual impacts of MI if we are to establish the benefits of MHP and chaplaincy approaches and the potential incremental value of combining both approaches into a holistic model of care.
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Affiliation(s)
- Kimberley A Jones
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Isabella Freijah
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Lindsay Carey
- Department of Public Health, La Trobe University, Melbourne, Australia
| | | | - Peter Devenish-Meares
- Graduate School of Business, Queensland University of Technology, Brisbane, Australia
| | - Lisa Dell
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Sara Rodrigues
- Canadian Centre of Excellence on Post-Traumatic Stress Disorder (PTSD) and Related Mental Health Conditions, Ottawa, Canada
| | - Kelsey Madden
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Lucinda Johnson
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia
| | - Fardous Hosseiny
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Andrea J Phelps
- Phoenix Australia - Centre for Posttraumatic Mental Health, Department of Psychiatry, University of Melbourne, Carlton, VIC, 3053, Australia.
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46
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Ricciardelli R, Tamara T, Mitchell MM, Groll D, Afifi T, Nicholas Carleton R. Exposures to Potentially Psychologically Traumatic Events Among Provincial Correctional Workers in Ontario, Canada. Violence Vict 2022; 37:77-100. [PMID: 35165161 DOI: 10.1891/vv-d-21-00009] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
We know little about potentially psychologically traumatic events (PPTE) exposures among provincial correctional workers in diverse occupational positions and even less regarding how exposure to events are associated with mental health disorders. We designed the current study to unpack and quantify estimates of the frequencies that correctional workers, across occupational roles, experience exposure to diverse incidents. We categorized 1,338 of our 1,487 participants into six occupational categories and our measures included established self-report items measuring PPTE exposure and mental disorder symptoms. Almost all correctional workers reported exposures to most PPTE types. Correctional workers collectively report exposures to physical assault (90.2%) and sudden violent death (81.8%), with many (3.1%-46%) reporting 11+ exposures (M = 10.01, SD = 4.29). We found significant differences in exposure patterns across correctional worker categories; specifically, we found a higher prevalence of exposure to toxic substances, physical assault, assault with a weapon, severe human suffering, sudden accidental or sudden violent death, among those working in institutional correctional services (e.g., governance, correctional officers). PPTE exposure and all assessed mental health disorder symptom profiles were closely related, as correctional workers report high exposure to PPTE. Population attributable fractions indicated that the burden of mental disorders among provincial correction workers might be reduced by between 38%-70% if PPTE exposures were eliminated from the population. We conclude with recommendations for mental health related policies, such as investing in peer and psychologically support, as well as interventions for exposure to PPTE and readiness to inform strategies for employee mental health and well-being.
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47
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Cramm H, Richmond R, Jamshidi L, Edgelow M, Groll D, Ricciardelli R, MacDermid JC, Keiley M, Carleton RN. Mental Health of Canadian Firefighters: The Impact of Sleep. Int J Environ Res Public Health 2021; 18:ijerph182413256. [PMID: 34948864 PMCID: PMC8701315 DOI: 10.3390/ijerph182413256] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 12/08/2021] [Accepted: 12/09/2021] [Indexed: 12/25/2022]
Abstract
Volunteer and career firefighters are at risk of major depressive disorders, posttraumatic stress disorder (PTSD), alcohol use disorder, and other mental health disorders due to the demanding and unpredictable nature of their employment. The mental health risks are exacerbated by the need to work extended hours, night shifts, and/or rotating schedules, or the competing demands of other employment, especially in volunteer firefighters. The mental health disorders and risk factors interact with altered sleeping patterns. In the current study, we examined volunteer and career firefighters regarding the association between mental health and sleep, drawing from a national Canadian mental health survey of 1217 firefighters. Most (69%) of the firefighters reported less than ideal sleep quality and 21% screened positive for clinical insomnia, with no significant difference between volunteer and career subgroups. Firefighters with insomnia had higher odds ratios (OR) and frequencies for PTSD (OR = 4.98), generalized anxiety disorder (OR = 7.15), panic disorder (OR = 6.88), social phobia (OR = 4.98), and major depressive disorder (OR = 7.91), than firefighters without insomnia. The burden of sleep disorders and their association with mental health disorders suggests that sleep should be considered in health monitoring and self-management, environmental design, fire service work-organization policies, and health programming.
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Affiliation(s)
- Heidi Cramm
- School of Rehabilitation Therapy, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Rachel Richmond
- School of Rehabilitation Therapy, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Laleh Jamshidi
- Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada
| | - Megan Edgelow
- School of Rehabilitation Therapy, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Dianne Groll
- Department of Psychiatry, Queen's University, Kingston, ON K7L 3N6, Canada
| | - Rose Ricciardelli
- Department of Sociology, Memorial University of Newfoundland, St. John's, NL A1C 5S7, Canada
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McCall HC, Landry CA, Ogunade A, Carleton RN, Hadjistavropoulos HD. Why Do Public Safety Personnel Seek Tailored Internet-Delivered Cognitive Behavioural Therapy? An Observational Study of Treatment-Seekers. Int J Environ Res Public Health 2021; 18:ijerph182211972. [PMID: 34831728 PMCID: PMC8619750 DOI: 10.3390/ijerph182211972] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/19/2021] [Revised: 11/10/2021] [Accepted: 11/13/2021] [Indexed: 11/16/2022]
Abstract
First responders and other public safety personnel (PSP) experience elevated rates of mental disorders and face unique barriers to care. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment that has demonstrated good treatment outcomes when tailored specifically for PSP. However, little is known about how PSP come to seek ICBT. A deeper understanding of why PSP seek ICBT can inform efforts to tailor and disseminate ICBT and other treatments to PSP. The present study was designed to (1) explore the demographic and clinical characteristics, motivations, and past treatments of PSP seeking ICBT, (2) learn how PSP first learned about ICBT, and (3) understand how PSP perceive ICBT. To address these objectives, we examined responses to online screening questionnaires among PSP (N = 259) who signed up for an ICBT program tailored for PSP. The results indicate that most of our sample experienced clinically significant symptoms of multiple mental disorders, had received prior mental disorder diagnoses and treatments, heard about ICBT from a work-related source, reported positive perceptions of ICBT, and sought ICBT to learn skills to manage their own symptoms of mental disorders. The insights gleaned through this study have important implications for ICBT researchers and others involved in the development, delivery, evaluation, and funding of mental healthcare services for PSP.
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Affiliation(s)
- Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Caeleigh A. Landry
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Adeyemi Ogunade
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada; (H.C.M.); (C.A.L.); (R.N.C.)
- PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada;
- Correspondence:
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49
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Beahm JD, McCall HC, Carleton RN, Titov N, Dear B, Hadjistavropoulos HD. Insights into internet-delivered cognitive behavioural therapy for public safety personnel: Exploration of client experiences during and after treatment. Internet Interv 2021; 26:100481. [PMID: 34815951 PMCID: PMC8593259 DOI: 10.1016/j.invent.2021.100481] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Revised: 11/01/2021] [Accepted: 11/09/2021] [Indexed: 12/26/2022] Open
Abstract
Canadian public safety personnel (PSP) experience high rates of mental health problems and barriers to receiving care. Internet-delivered cognitive behavioural therapy (ICBT) may help reduce barriers to care; however, there is no literature involving qualitative analyses of client feedback to describe PSP experiences with ICBT. Identifying these experiences is important because it can inform future use of ICBT with this group that has unique needs. The current study was designed to explore how clients (N = 82) experienced ICBT that had been tailored to meet their needs; specifically, the study assessed their perceptions of program impacts, what clients found helpful, and client suggestions for improvements. The ICBT course included five core lessons, client stories, and nine initial additional resources, as well as flexible frequencies (optional, once weekly, or twice weekly) and durations (8 to 16 weeks) of therapist support. A qualitative reliability thematic analysis was used to analyze client communications and feedback. Responses to a Treatment Satisfaction Questionnaire administered at eight weeks post-enrollment were available for 57 clients. Client emails with therapists were also examined among all clients, including an additional 25 clients who did not complete the Treatment Satisfaction Questionnaire. Themes identified in the qualitative analyses were related to: reported impacts and hindering events, helpful and challenging course skills and content, helpful aspects of the course, and areas for improvement. Clients who completed the Treatment Satisfaction Questionnaire and those who did not reported beneficial impacts from the program, with the most commonly endorsed themes being skill development and normalizing mental health issues. Hindering events were experienced by both groups and included timeline challenges, technology challenges, and negative effects. Comments from both groups suggested that clients had more success than challenges when practicing the skills. Thought challenging was the skill most frequently identified as helpful. Clients described many aspects of the program as helpful with the most frequently endorsed themes being the course format and content, the flexible nature of the course, access to additional materials and case stories, and therapist assistance. Clients also provided suggestions for improving the course (e.g., case stories, additional resources, timelines audio and videos). Overall, client communications suggest that ICBT is accepted and perceived as beneficial among PSP. These results informed rapid improvements to the ICBT program tailored for PSP and may inform others seeking to provide digital mental health services to PSP.
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Affiliation(s)
- Janine D. Beahm
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada,PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Hugh C. McCall
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada,PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - R. Nicholas Carleton
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada,PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada
| | - Nick Titov
- Department of Psychology, Macquarie University, Sydney, Australia,eCentreClinic, Macquarie University, Sydney, Australia
| | - Blake Dear
- Department of Psychology, Macquarie University, Sydney, Australia,eCentreClinic, Macquarie University, Sydney, Australia
| | - Heather D. Hadjistavropoulos
- Department of Psychology, University of Regina, 3737 Wascana Pkwy, Regina, SK S4S 0A2, Canada,PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada,Corresponding author at: PSPNET, University of Regina, 2 Research Drive, Regina, SK S4T 2P7, Canada.
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50
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Konyk K, Ricciardelli R, Taillieu T, Afifi TO, Groll D, Carleton RN. Assessing Relative Stressors and Mental Disorders among Canadian Provincial Correctional Workers. Int J Environ Res Public Health 2021; 18:10018. [PMID: 34639320 PMCID: PMC8508585 DOI: 10.3390/ijerph181910018] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/13/2021] [Revised: 09/08/2021] [Accepted: 09/14/2021] [Indexed: 12/03/2022]
Abstract
In the current study, we quantified the mean stress levels of 43 occupational stressors for 868 Correctional Workers (CWs) and analyzed the relationships between occupational stressors, exposure to potentially psychologically traumatic events (PPTEs), and mental health disorders. Our findings emphasize the importance of the occupational environment in relation to CW mental health and indicate that occupational stressors (e.g., staff shortages, inconsistent leadership style, bureaucratic red tape) are more salient contributors to CW mental health than exposure to PPTEs. Finding strategies to ameliorate staff shortages, improve leadership style and communication, and support CWs to maintain physical, mental, and social well-being would be interventions tied to significant organizational and operational stressors within the current study.
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Affiliation(s)
- Katy Konyk
- School of Social Work, McGill University, Montreal, QC H3A 1E3, Canada;
| | - Rosemary Ricciardelli
- Department of Sociology, Memorial University of Newfoundland, St. John’s, NL A1C 5S7, Canada
| | - Tamara Taillieu
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada; (T.T.); (T.O.A.)
| | - Tracie O. Afifi
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, MB R3E 0W3, Canada; (T.T.); (T.O.A.)
| | - Dianne Groll
- Departments of Psychiatry and Psychology, Queen’s University, Kingston, ON K7L 3N6, Canada;
| | - R. Nicholas Carleton
- Department of Psychology, Anxiety and Illness Behaviours Laboratory, University of Regina, Regina, SK S4S 0A2, Canada;
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