Ignite Creation Date:
2024-05-06 @ 6:03 PM
Last Modification Date:
2024-10-26 @ 2:40 PM
Study NCT ID:
NCT05521360
Status:
RECRUITING
Last Update Posted:
2023-11-30
First Post:
2021-09-09
Brief Title:
Autonomic Modulation Training for Police Exposed to Post-Traumatic Stress Injuries
Sponsor:
University of Toronto
Organization:
University of Toronto
Study Overview
Official Title:
Autonomic Modulation Training A Biological Approach to Building Resilience and Wellness Capacity Among Police Exposed to Post-Traumatic Stress Injuries PTSI
Status:
RECRUITING
Status Verified Date:
2023-11
Last Known Status:
None
Delayed Posting:
No
If Stopped, Why?:
Not Stopped
Has Expanded Access:
False
If Expanded Access, NCT#:
N/A
Has Expanded Access, NCT# Status:
N/A
Acronym:
AMT
Brief Summary:
Police officers are exposed to hazardous disturbing events that impose stress and long-term trauma Upwards of 15-26 of public safety personnel PSP report one or more mental health symptoms Accumulated stress and posttraumatic stress injuries PTSI result in chronic physical and mental health disorders including anxiety depression substance abuse and cardiovascular disease PTSI are related to reduced occupational performance absenteeism and risky behaviour with implications for both police and public safety Recent empirical evidence and government reports highlight a mental health and suicide crisis among various PSP sectors in Canada Prior research forms an urgent call for evidence-based programs that build resilience and wellness capacity to prevent PTSI symptoms before they manifest as severe chronic diagnosable disorders The current study addresses the limited effectiveness issues associated with existing interventions for PTSI among PSP and also considers sex and gender as central determinants of health
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
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:
Hypotheses
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 Occupationaloperational 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 eg high and low frequency HRV LFHF 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 ie 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
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 Occupationaloperational 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 eg high and low frequency HRV LFHF 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 ie 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
Study Oversight
Has Oversight DMC:
None
Is a FDA Regulated Drug?:
False
Is a FDA Regulated Device?:
False
Is an Unapproved Device?:
None
Is a PPSD?:
None
Is a US Export?:
None
Is an FDA AA801 Violation?:
None
Secondary IDs
| Secondary ID | Type | Domain | Link |
|---|---|---|---|
| 39478 | OTHER | University of Toronto Research Ethics Board | None |