背景:执法人员经常暴露在危险的环境中,令人不安的事件,可以施加严重的压力和长期的心理创伤。因此,警察和其他公共安全人员(PSP)发生创伤后应激性损伤(PTSI)和自主神经系统(ANS)破坏的风险增加。ANS功能可以通过心率(HR)客观和无创地测量,心率变异性(HRV),和呼吸性窦性心律失常(RSA)。旨在在PSP中建立复原力的传统干预措施尚未充分解决导致精神和身体健康状况的生理ANS失调,以及潜在心理创伤后的倦怠和疲劳。
目的:在本研究中,我们将研究基于网络的自主调节训练(AMT)干预对以下结果的功效:(1)减少PTSI的自我报告症状,(2)增强ANS的生理恢复力和健康能力,(3)探索性别和性别如何与心理和生物学PTSI症状的基线差异以及对AMT干预的反应相关。
方法:本研究包括2个阶段。第一阶段涉及基于网络的AMT干预的开发,其中包括1次基线调查措施,6周课程,将HRV生物反馈(HRVBF)培训与元认知技能实践相结合,和1次后续调查措施。阶段2将使用集群随机对照设计来测试AMT对以下post结果的有效性:(1)PTSI和其他健康措施的自我报告症状;(2)健康和弹性的生理指标,包括静息HR,HRV,和RSA;(3)性别和性别对其他结果的影响。参与者将在滚动队列中在加拿大进行为期8周的研究。
结果:该研究于2020年3月获得资助,并于2021年2月获得伦理批准。由于与COVID-19有关的延误,第一阶段于2022年12月完成,第二阶段试点测试于2023年2月开始。实验(AMT)和对照组(仅事后评估)中的10名参与者的队列将继续进行,直到总共250名参与者被测试。所有阶段的数据收集预计将在2025年12月结束,但可能会延长,直到达到预期的样本量。心理和生理数据的定量分析将与专家联合研究者一起进行。
结论:迫切需要为警察和PSP提供有效的训练,以改善身体和心理功能。鉴于这些职业群体中寻求PTSI的帮助减少,AMT是一种有前途的干预措施,可以在家中的隐私中完成。重要的是,AMT是一个新颖的计划,它独特地解决了支持复原力和健康促进的潜在生理机制,并适合PSP的职业需求。
背景:ClinicalTrials.govNCT05521360;https://clinicaltrials.gov/ct2/show/NCT05521360。
■PRR1-10.2196/33492。
BACKGROUND: Law enforcement officers are routinely exposed to hazardous, disturbing events that can impose severe stress and long-term psychological trauma. As a result, police and other public safety personnel (PSP) are at increased risk of developing posttraumatic stress injuries (PTSIs) and disruptions to the autonomic nervous system (ANS). ANS functioning can be objectively and noninvasively measured by heart rate (HR), heart rate variability (HRV), and respiratory sinus arrhythmia (RSA). Traditional interventions aimed at building resilience among PSP have not adequately addressed the physiological ANS dysregulations that lead to mental and physical health conditions, as well as burnout and fatigue following potential psychological trauma.
OBJECTIVE: In this
study, we will investigate the efficacy of a web-based Autonomic Modulation Training (AMT) intervention on the following outcomes: (1) reducing self-reported symptoms of PTSI, (2) strengthening ANS physiological resilience and wellness capacity, and (3) exploring how sex and gender are related to baseline differences in psychological and biological PTSI symptoms and response to the AMT intervention.
METHODS: The
study is comprised of 2 phases. Phase 1 involves the development of the web-based AMT intervention, which includes 1 session of baseline survey measures, 6 weekly sessions that integrate HRV biofeedback (HRVBF) training with meta-cognitive skill practice, and 1 session of follow-up survey measures. Phase 2 will use a cluster randomized control design to test the effectiveness of AMT on the following prepost outcomes: (1) self-report symptoms of PTSI and other wellness measures; (2) physiological indicators of health and resilience including resting HR, HRV, and RSA; and (3) the influence of sex and gender on other outcomes. Participants will be recruited for an 8-week
study across Canada in rolling cohorts.
RESULTS: The
study received grant funding in March 2020 and ethics approval in February 2021. Due to delays related to COVID-19, phase 1 was completed in December 2022, and phase 2 pilot testing began in February 2023. Cohorts of 10 participants in the experimental (AMT) and control (prepost assessment only) groups will continue until a total of 250 participants are tested. Data collection from all phases is expected to conclude in December 2025 but may be extended until the intended sample size is reached. Quantitative analyses of psychological and physiological data will be conducted in conjunction with expert coinvestigators.
CONCLUSIONS: There is an urgent need to provide police and PSP with effective training that improves physical and psychological functioning. Given that help-seeking for PTSI is reduced among these occupational groups, AMT is a promising intervention that can be completed in the privacy of one\'s home. Importantly, AMT is a novel program that uniquely addresses the underlying physiological mechanisms that support resilience and wellness promotion and is tailored to the occupational demands of PSP.
BACKGROUND: ClinicalTrials.gov NCT05521360; https://clinicaltrials.gov/ct2/show/NCT05521360.
UNASSIGNED: PRR1-10.2196/33492.