Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers
Study Details
Study Description
Brief Summary
Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. The proposed study will identify, optimize and refine best clinical and research practices across two sites to ensure success in a future multisite efficacy trial assessing preventative effects of Mindfulness-Based Resilience Training on physiological, behavioral, and psychological outcomes.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
|
N/A |
Detailed Description
Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force. Such dysfunctional stress reactivity can lead to devastating consequences for their community, including unjustified shootings, severe beatings, and fatal chokings. It can also lead to serious consequences for the LEOs, including elevated incidence of post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. A recent meta-analysis of LEO stress reduction programs found little evidence to demonstrate that such approaches are effective, highlighting the urgent need for preventive interventions targeting the stress inherent to policing. Mindfulness training is a promising approach with high-stress populations that has been shown effective in reducing stress and increasing resilience. In a recent pilot feasibility study (R21AT008854), the study team established initial feasibility, acceptability, and adherence to procedures in a single-site RCT assessing Mindfulness-Based Resilience Training (MBRT), a preventive intervention designed to improve LEO mental health and resilience, and reduce aggression and excessive use of force. The R21 data suggest physiological mechanisms and potential clinical benefit in a sample of LEOs. Relative to waitlist control, MBRT participants showed improvements in stress reactivity, aggression, burnout, occupational stress, sleep disturbance, and psychological flexibility. Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of MBRT versus an attention control (Stress Management Education) and a no-intervention control, on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, this study will: a) enhance efficiency of recruitment, engagement and retention; b) optimize lab, assessment, and data management procedures; c) optimize intervention training and ensure fidelity to intervention protocols; and d) assess participant experience and optimize outcome measures across sites. The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience among LEOs, as well as yield significant benefits for communities and residents they serve.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: Mindfulness-Based Resilience Training MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, cognitive behavioral therapy (CBT), and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions. |
Behavioral: Mindfulness-Based Resilience Training
MBRT is an 8-week program combining training in standardized mindfulness practices targeting factors that facilitate resilience, CBT, and psychoeducation. It contains experiential and didactic exercises including body scan, sitting and walking meditation, mindful movement and discussions.
|
| Active Comparator: Stress Management Education SME was designed as an active control condition for other mindfulness-based intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress. |
Behavioral: Stress Management Education
SME was designed as an active control condition for other Mindfulness-Based Intervention trials. SME uses a group-based didactic approach with modules on physiological and dietary effects of stress, time management, sleep physiology and insomnia, nutrition, exercise, stress hardiness, and factors mitigating impacts of stress.
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| No Intervention: No Intervention Control No contact control condition (other than baseline, post, and follow-up assessments) |
Outcome Measures
Primary Outcome Measures
- Change in on the Job Behavioral Use of Force [baseline, 12 month followup]
BlueTeam database of individual-level LEO excessive use of force (i.e., aggressive drawing and discharge of weapons, vehicle rams, illegal takedowns, administrative and citizen complaints)
- Change in Aggression [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Buss-Perry Aggression Questionnaire-Short Form. Scores range from 1-5, with higher scores indicating greater aggression.
Secondary Outcome Measures
- Change in Proinflammatory Cytokine [baseline, post-intervention (8 weeks), 3 month followup]
C-reactive protein
- Change in Proinflammatory Cytokine [baseline, post-intervention (8 weeks), 3 month followup]
interleukin 6
- Change in Proinflammatory Cytokine [baseline, post-intervention (8 weeks), 3 month followup]
interleukin 10
- Change in Proinflammatory Cytokine [baseline, post-intervention (8 weeks), 3 month followup]
tumor necrosis factor-alpha
- Change in Psychological Resilience [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Brief Resilience Scale. Scores range from 1-5, with higher scores indicating greater resilience.
- Change in Alcohol Use [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Patient Reported Outcome Measurement System (PROMIS) Alcohol Use. Scores range from 39-77, with higher scores indicating greater alcohol use.
- Change in Alcohol Use Negative Consequences [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Patient Reported Outcome Measurement System (PROMIS) Alcohol Use Negative Consequences.Scores range from 39-77, with higher scores indicating greater alcohol use negative consequences.
- Change in Depression [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Patient Reported Outcome Measurement System (PROMIS) Depression. Scores range from 38-80, with higher scores indicating more depression.
- Change in Suicidal Thinking [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Concise Heath Risk Tracking Scale-Self-Report. Scores range from 7-35, with higher scores indicating greater suicidal ideation.
- Change in Trauma Symptoms [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
PTSD Checklist for DSM-5. Scores ranges from 0-80, with higher scores indicating greater PTSD symptoms.
- Change in Burnout [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Oldenburg Burnout Inventory. Scores range from 1-4, with higher scores indicating greater burnout.
- Change in Sustained Attention [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Sustained Attention to Response Task. A computer-based go/no-go task that requires participants to withhold behavioral response to a single, infrequent target presented amongst a background of frequent non-targets.
- Change in Perceived Stress [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Perceived Stress Scale-10. Scores range from 0-40, with higher scores indicating greater perceived stress.
- Change in Sleep Disturbance [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Patient Reported Outcome Measurement System (PROMIS) Sleep Disturbance. Scores range from 32-76, with higher scores indicating greater sleep disturbance.
- Change in Self-Compassion [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Self-Compassion Scale-Short Form. Scores range from 12-60, with higher scores indicating greater self-compassion.
- Change in Mindfulness [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Five Facet Mindfulness Questionnaire-Short Form. Each FFMQ-SF facet has five items (except for non-reactivity, which has 4 items) resulting in a 24-item scale. Each facet ranges from 5-25 (4-20 for non-reactivity), higher scores indicate greater mindfulness.
- Change in Interoceptive Awareness [baseline, post-intervention (8 weeks), 3 month followup, 6 month followup]
Multidimensional Assessment of Interoceptive Awareness-II. Scores range from 0-185, with higher scores indicating greater interoceptive awareness.
- Treatment Acceptability [post-intervention (8 weeks)]
Postcourse satisfaction survey. Scores range from 0-24, with higher scores indicating greater treatment acceptability.
- Treatment Compliance [post-intervention (8 weeks)]
iMINDr app. Objective assessment of type, frequency and duration of homework practice.
- Assessment Acceptability [post-intervention (8 weeks)]
Acceptability of self-report questionnaires. Four item measure of acceptability of assessment procedures. Scores range from 0-12, with higher scores indicating greater acceptability of assessment procedures.
- Treatment Expectancy and Credibility [baseline]
Expectancy/Credibility Questionnaire. Scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. Scores range from 8-24, with higher scores indicating greater expectancy and credibility.
- Global Impression of Change [post-intervention (8 weeks)]
Clinical Global Impressions Scale. Single-item, 7-point measure of perceived change in functioning as a result of the intervention. Scores range from 0-7, with higher scores indicating a greater impression of change.
Eligibility Criteria
Criteria
Inclusion Criteria:
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be 21-65 years old (age limitations for both police departments),
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demonstrate English fluency,
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be a sworn, full-time, active status law enforcement officer,
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agree to random assignment to condition, and
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be willing to complete assessments at multiple time points and attend intervention groups
Exclusion Criteria:
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previous participation in MBSR, MBRT or a similar mindfulness course,
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score in the severe range on brief screening measures of depression, suicidal ideation, alcohol use, or PTSD, or
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unable or unwilling to give written informed consent.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University of New Mexico | Albuquerque | New Mexico | United States | 87106 |
| 2 | Pacific University | Forest Grove | Oregon | United States | 97116 |
Sponsors and Collaborators
- Pacific University
- National Institutes of Health (NIH)
- National Center for Complementary and Integrative Health (NCCIH)
Investigators
None specified.Study Documents (Full-Text)
More Information
Publications
None provided.- 1295787-14
- U01AT009841