Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers

Stress, Psychological Clinical Trial

Official title:

Mindfulness-Based Resilience Training for Aggression, Health, and Stress Among Law Enforcement Officers

Clinical Trial Details — Status: Completed

Administrative data

• NCT number: NCT03784846
• Other study ID #: 1295787-14
• Secondary ID: U01AT009841
• Status: Completed
• Phase: N/A
• Start date: October 1, 2019
• Est. completion date: June 30, 2022

Study information

• Verified date: June 2023
• Source: Pacific University
• Contact: n/a
• Is FDA regulated: No
• Study type: Interventional

Clinical Trial 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.

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.

Recruitment information / eligibility

• Status: Completed
• Enrollment: 109
• Est. completion date: June 30, 2022
• Est. primary completion date: May 17, 2022
• Accepts healthy volunteers: Accepts Healthy Volunteers
• Gender: All
• Age group: 21 Years to 65 Years

Eligibility

Inclusion Criteria:

• be 21-65 years old (age limitations for both police departments),
• demonstrate English fluency,
• be a sworn, full-time, active status law enforcement officer,
• agree to random assignment to condition, and
• be willing to complete assessments at multiple time points and attend intervention groups

Exclusion Criteria:

• previous participation in MBSR, MBRT or a similar mindfulness course,
• score in the severe range on brief screening measures of depression, suicidal ideation, alcohol use, or PTSD, or
• unable or unwilling to give written informed consent.

Related Conditions & MeSH terms

• Aggression
• Stress, Psychological

Intervention

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.
• 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.

Locations

Country	Name	City	State
United States	University of New Mexico	Albuquerque	New Mexico
United States	Pacific University	Forest Grove	Oregon

Sponsors (3)

Lead Sponsor	Collaborator
Pacific University	National Center for Complementary and Integrative Health (NCCIH), National Institutes of Health (NIH)

Country where clinical trial is conducted

United States, 

References & Publications (1)

Christopher M, Bowen S, Witkiewitz K. Mindfulness-based resilience training for aggression, stress and health in law enforcement officers: study protocol for a multisite, randomized, single-blind clinical feasibility trial. Trials. 2020 Feb 28;21(1):236. — View Citation

Outcome

Type	Measure	Description	Time frame	Safety issue
Primary	Change in Aggression	Buss-Perry Aggression Questionnaire-Short Form. Scores range from 1-5, with higher scores indicating greater aggression.	baseline, post-intervention (week 8), 3-month followup, 6-month followup
Secondary	Change in C-reactive Protein	Blood spot analysis of high-sensitivity C-reactive protein.	baseline, post-intervention (8 weeks), 3 month followup
Secondary	Change in Interleukin-6	Blood spot analysis of interleukin-6.	baseline, post-intervention (8 weeks), 3 month followup
Secondary	Change in Interleukin-10	Blood spot analysis of interleukin-10.	baseline, post-intervention (8 weeks), 3 month followup
Secondary	Change in Tumor Necrosis Factor-alpha	Blood spot analysis of tumor necrosis factor-alpha.	baseline, post-intervention (8 weeks), 3 month followup
Secondary	Change in Psychological Resilience	Brief Resilience Scale. Scores range from 1-5, with higher scores indicating greater resilience.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Alcohol Use	Patient Reported Outcome Measurement System (PROMIS) Alcohol Use. Scores range from 39-77, with higher scores indicating greater alcohol use.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Alcohol Use Negative Consequences	Patient Reported Outcome Measurement System (PROMIS) Alcohol Use Negative Consequences.Scores range from 39-77, with higher scores indicating greater alcohol use negative consequences.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Depression	Patient Reported Outcome Measurement System (PROMIS) Depression. Scores range from 38-80, with higher scores indicating more depression.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Suicidal Thinking	Concise Heath Risk Tracking Scale-Self-Report. Scores range from 7-35, with higher scores indicating greater suicidal ideation.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Trauma Symptoms	PTSD Checklist for DSM-5. Scores ranges from 0-80, with higher scores indicating greater PTSD symptoms.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Burnout	Oldenburg Burnout Inventory. Scores range from 1-4, with higher scores indicating greater burnout.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Sustained Attention	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. Increased errors indicates less sustained attention.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Perceived Stress	Perceived Stress Scale-10. Scores range from 0-40, with higher scores indicating greater perceived stress.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Sleep Disturbance	Patient Reported Outcome Measurement System (PROMIS) Sleep Disturbance. Scores range from 32-76, with higher scores indicating greater sleep disturbance.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Self-Compassion	Self-Compassion Scale-Short Form. Scores range from 1-5, with higher scores indicating greater self-compassion.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Mindfulness	Five Facet Mindfulness Questionnaire-Short Form. Scores range from 1-5, with higher scores indicating greater mindfulness.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Change in Interoceptive Awareness	Multidimensional Assessment of Interoceptive Awareness-II. Scores range from 1-6, with higher scores indicating greater interoceptive awareness.	baseline, post-intervention (8 weeks), 3 month followup, 6 month followup
Secondary	Treatment Acceptability	Postcourse satisfaction survey. Scores range from 4-16, with higher scores indicating greater treatment acceptability. Measure only administered to Mindfulness-Based Resilience Training and Stress Management Education arms.	post-intervention (8 weeks)
Secondary	Treatment Compliance	Objective assessment of duration of homework practice. Measure only administered to Mindfulness-Based Resilience Training and Stress Management Education arms.	post-intervention (8 weeks)
Secondary	Treatment Expectancy and Credibility	Expectancy/Credibility Questionnaire. Scale for measuring treatment expectancy and rationale credibility for use in clinical outcome studies. Scores range from 7-21, with higher scores indicating greater expectancy and credibility.	baseline
Secondary	Global Impression of Change	Clinical Global Impressions Scale. Measure of perceived change in functioning as a result of the intervention. Scores range from 3-21, with higher scores indicating a greater impression of change. Measure only administered to Mindfulness-Based Resilience Training and Stress Management Education arms.	post-intervention (8 weeks)