Autonomic Modulation Training for Police Exposed to Post-Traumatic Stress Injuries
NCT ID: NCT05521360
Last Updated: 2023-11-30
Study Results
The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.
Basic Information
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RECRUITING
NA
250 participants
INTERVENTIONAL
2023-01-30
2026-04-30
Brief Summary
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Advances in physiology and neuroscience demonstrate that resilience is maintained by the healthy functioning of psychophysiological systems within the body. Objective biological measures have shown that chronic stress and trauma disrupt both psychological and physiological functioning, eroding resilience and reducing wellness capacity. Traditional interventions to build resilience among PSP have not adequately addressed the physiological underpinnings that lead to mental and physical health conditions, as well as burnout and fatigue following trauma. Together with previous empirical research lead by the NPA, the current proposal addresses this gap in PSP intervention research by employing Autonomic Modulation Training (AMT), a biological approach to building resilience and wellness capacity among PSP exposed to PTSI. Prior research shows that core AMT techniques effectively reduce psychophysiological stress and mental health symptoms in clinical and non-clinical populations. Further, research has shown that AMT techniques improve police health and occupational performance when completed during scenario-based, in-person training.
The aim of the proposed study is to test if a web-based delivery of AMT for police officers can build resilience and wellness capacity, and reduce symptoms of PTSI with similar effectiveness as in-person training. An additional novel scientific contribution of the current proposal includes an examination of sex and gender in baseline biological presentation of PTSI among police, and in response to a resilience building intervention.
Detailed Description
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Self-reported PTSI symptoms and resilience
H1. Symptoms of PTSI will be significantly reduced following completion of the AMT intervention, as measured by the Personal Health Questionnaire (PHQ-8), General Anxiety Disorder Scale (GAD-7), Depression, Anxiety, and Stress Scale (DASS), PTSD checklist (PCL-5), Copenhagen Burnout Inventory (CBI), Perceived Stress Scale (PSS), Alcohol Use Disorder Identification Test (AUDIT). Occupational/operational stress exposure will be measured by the Police Stress Questionnaire (PSQ) to account for possible exposures to stress and potentially traumatic events over the course of the intervention. Self-reported and COVID related stress will also be evaluated.
H2. Functional wellness capacity and resilience will be significantly improved following completion of the AMT intervention, as measured by the Brief COPE, Resilience Scale for Adults (RSA-33), and Brief Resilience Scale (BRS), White Bear Suppression Inventory (WBSI), Perseverative Thinking Questionnaire (PTQ), Ultra-Brief Penn State Worry Questionnaire (UB-PSWQ), Ultra-Brief Rumination Response Styles (UB-RRS), Good Health Practices Scale (GHPS).
H3. Sex and gender differences in PTSI will be observed at baseline and post-intervention assessment. We expect that females will report more symptoms of PTSI and lower resilience at baseline, and a greater reduction of PTSI symptoms and greater increase in resilience at follow-up than males. Gender role stress, discrimination, and harassment will be explored as moderators of PTSI symptoms at baseline and in response to the AMT intervention. Sex is measured by self-reported sex at birth, gender discrimination is measured by Workplace Gender Discrimination Scale (WGDS) and harassment is measured by the Gender Experiences Questionnaire (GEQ).
Objective biological indicators of PTSI symptoms and resilience
H4. Resting HRV will significantly increase following completion of the AMT intervention. Changes in resting HRV will be measured by time and frequency domain parameters based on data collected from the wearable HR monitors (e.g., high and low frequency HRV, LF/HF ratio, and the root mean square of successive differences (RMSSD) as recommended in the standards of practice for HRV analysis.
H5. RSA will significantly increase following completion of the AMT intervention. RSA is measured by obtaining the respiratory frequency. Greater power at the respiratory frequency indicates a higher level of RSA and will be analyzed using the gold standard HRV analysis program, Kubios.
H6. Recovery from acute stress will significantly improve following completion of the AMT intervention. Acute stress will be induced by completion of the online Paced Auditory Serial Addition Test (PASAT) and the Stroop Emotion Face Interference Task. Acute stress recovery will be assessed via a time domain measure of HRV (RMSSD).
H7. Based on inconsistencies in the extant literature, we will conduct exploratory analyses of any potential sex and gender differences in HRV, RSA, and acute stress recovery at baseline and post-intervention assessments. Although we expect to see improvements in self-reported and objective measures of PTSI and resilience overall (i.e., independent of sex and gender), we hypothesize that gender role stress and gender discrimination will moderate these effects. Further, it is possible that the magnitude of post-intervention changes is greater among women given the additional burden of exposure to a hyper-masculinized working environment. Because AMT provides tools for effective stress management, women may find more benefit from the intervention in managing the wider array of sociocultural stressors they experience compared to males.
Conditions
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Keywords
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Study Design
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RANDOMIZED
PARALLEL
PREVENTION
SINGLE
Study Groups
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Experimental
Participants randomized to the experimental group will complete baseline assessments, the 6 week AMT treatment online and then complete the follow up assessment (8 weeks total)
Autonomic Modulation Training
AMT is a six week online behavioral intervention comprised of two components. The first component is an adapted (to online format) version of an established and publicly available HRVBF protocol (Lehrer et al, 2013, Biofeedback).The second is the integration of meta-cognitive coping skills and autonomic modulation breathing techniques into the HRVBF protocol (Arpaia \& Andersen, 2019 Frontiers in Psychiatry; Andersen, Arpaia \& Gustafsberg, 2021 Int J Emerg Ment Health and Human Resilience).
Control
Participants randomized to the control group will be matched to the experimental group on demographic and outcome measures. Control participants will take the baseline assessments, will wait 7 weeks and take the follow-up assessment (8 weeks total). Control group participants are able to enrol in the AMT intervention at the end of their wait-list control period.
No interventions assigned to this group
Interventions
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Autonomic Modulation Training
AMT is a six week online behavioral intervention comprised of two components. The first component is an adapted (to online format) version of an established and publicly available HRVBF protocol (Lehrer et al, 2013, Biofeedback).The second is the integration of meta-cognitive coping skills and autonomic modulation breathing techniques into the HRVBF protocol (Arpaia \& Andersen, 2019 Frontiers in Psychiatry; Andersen, Arpaia \& Gustafsberg, 2021 Int J Emerg Ment Health and Human Resilience).
Other Intervention Names
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Eligibility Criteria
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Inclusion Criteria
* Must be fluent in English.
Exclusion Criteria
* Officers that do not have weekly access to a personal computer to complete the online AMT intervention
18 Years
ALL
Yes
Sponsors
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Canadian Institutes of Health Research (CIHR)
OTHER_GOV
University of Toronto
OTHER
Responsible Party
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Judith Andersen
Principal Investigator
Principal Investigators
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Judith P Andersen, PhD
Role: PRINCIPAL_INVESTIGATOR
University of Toronto
Locations
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University of Toronto Mississauga
Mississauga, Ontario, Canada
Countries
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Central Contacts
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Facility Contacts
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Judith P Andersen, PhD
Role: primary
References
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Andersen JP, Di Nota PM, Alavi N, Anderson G, Bennell C, McGregor C, Ricciardelli R, Scott SC, Shipley P, Vincent ML. A Biological Approach to Building Resilience and Wellness Capacity Among Police Exposed to Posttraumatic Stress Injuries: Protocol for a Randomized Controlled Trial. JMIR Res Protoc. 2023 May 24;12:e33492. doi: 10.2196/33492.
Other Identifiers
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39478
Identifier Type: OTHER
Identifier Source: secondary_id
CIHR Grant#433650
Identifier Type: -
Identifier Source: org_study_id