Browsing by Author "R. Nicholas Carleton"

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Open Access
Associations Between Personality and Mental Health Among Royal Canadian Mounted Police Cadets
(Springer Science and Business Media LLC, 2024-01-27) Katie L. Andrews; Laleh Jamshidi; Jolan Nisbet; Tracie O. Afifi; Shannon Sauer-Zavala; Gregory P. Kratzig; Taylor A. Teckchandani; J. Patrick Neary; R. Nicholas Carleton
AbstractRoyal Canadian Mounted Police (RCMP) report frequent exposures to diverse potentially psychological traumatic events (PPTEs) that can lead to symptoms of posttraumatic stress disorder (PTSD) and other mental health disorders. Personality traits may partially inform the substantial mental health challenges reported by serving RCMP. The current study examines associations between HEXACO personality factor and facet-level dimensions and mental health disorders of RCMP cadets starting the Cadet Training Program (CTP). RCMP cadets (n = 772) starting the CTP self-reported sociodemographics, personality, and mental health disorder symptoms. Emotionality was associated with MDD, GAD, and SAD (AORs ranged from 6.23 to 10.22). Extraversion and Agreeableness were inversely associated with MDD, GAD, and SAD (AORs ranged from 0.0159 to 0.43), whereas Openness to Experience was inversely associated with SAD (AOR = 0.36). Several facet-level personality dimensions were associated with mental health disorders. Inconsistent differences were observed between men and women for relationships between personality factors, facets, and positive screenings for mental disorders. The relationship patterns allude to possible risk and resilience factors associated with personality factors and facets. Early training, interventions, and resources tailored to cadet personality factors and facets might reduce risk and bolster mental health resilience.
Open Access
Canadian Provincial and Territorial Correctional Worker Mental Health and Well-Being Study (CWMH): Navigating Practical and Unanticipated Methodological Challenges
(SAGE Publications, 2024-10-08) Rosemary Ricciardelli; Elizabeth Andres; Matthew S. Johnston; Tamara L. Taillieu; Sahar Dorniani; Marina Carbonell; Brittany Bennett; Kadie Hozempa; Ryan Coulling; Marcella Siqueira Cassiano; Tracie O. Afifi; R. Nicholas Carleton
Previous research assessing correctional worker (CW) mental health has seldom assessed for differences based on jurisdiction or diverse occupational categories. The current study was designed to provide a nuanced quantitative examination of mental health disorder prevalence and related problems among CWs and to qualitatively explore the varying social contexts surrounding CW well-being. We reflect on how we overcame unanticipated challenges and disruptions (e.g., technology, COVID-19 pandemic) throughout the design, launch, and analysis of the survey, and illustrate how our national study, driven by a rigorous methodological approach and collaborative research design, builds on the extant CW mental health and wellness literature.
Open Access
Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework
(Elsevier BV, 2024-03) Janine D. Beahm; Hugh C. McCall; R. Nicholas Carleton; Nicholas Jones; Heather D. Hadjistavropoulos
Within Canada, internet-delivered cognitive behavioural therapy (ICBT) has recently been tailored by PSPNET to meet the needs of public safety personnel (PSP) to help address high rates of mental health problems within this population. Perceptions and outcomes of ICBT among PSP are promising, but it remains unknown how PSPNET is perceived by PSP organizational leaders. It is important to assess this gap because these leaders have significant potential to influence the uptake of ICBT. Methods: In the current study, PSP leaders (n = 10) were interviewed to examine their perceptions of PSPNET and opportunities to improve ICBT implementation. The RE-AIM evaluation framework was used to assess PSP leaders' perceptions of PSPNET in terms of reach, effectiveness, adoption, implementation, and maintenance. Results: The results evidenced that leaders perceived PSPNET as effective in reaching and serving PSP and PSP organizations. PSP leaders reported perceiving ICBT as effectively implemented, especially for being freely offered to individual PSP and for improving PSP's access to experienced therapists specifically trained to work with PSP. Participants indicated organizations have promoted and will continue promoting PSPNET longer-term, facilitating adoption and maintenance. Factors perceived as facilitating successful service delivery included building relationships and trust with PSP organizations and general support for PSP leadership mental health initiatives. PSP leaders identified perceived areas for improving ICBT implementation (e.g., ensuring leaders have access to data on PSPNET uptake and outcomes, creating promotional videos, expanding availability of PSPNET to other provinces, offering additional options for receiving therapist support). Implications: Overall, the study provides insights into PSP leaders' perceptions of the implementation of ICBT among PSP and ideas for optimizing implementation efforts.
Open Access
Measuring moral distress and moral injury: A systematic review and content analysis of existing scales
(Elsevier BV, 2024-03) Stephanie A. Houle; Natalie Ein; Julia Gervasio; Rachel A. Plouffe; Brett T. Litz; R. Nicholas Carleton; Kevin T. Hansen; Jenny J.W. Liu; Andrea R. Ashbaugh; Walter Callaghan; Megan M. Thompson; Bethany Easterbrook; Lorraine Smith-MacDonald; Sara Rodrigues; Stéphanie A.H. Bélanger; Katherine Bright; Ruth A. Lanius; Clara Baker; William Younger; Suzette Bremault-Phillips; Fardous Hosseiny; J. Don Richardson; Anthony Nazarov
Background: Moral distress (MD) and moral injury (MI) are related constructs describing the negative conse- quences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use. Method: We identified psychometric studies describing the development or validation of MD or MI scales and extracted information on methodological and psychometric qualities. Content analyses identified specific out- comes measured by each scale. Results: We reviewed 77 studies representing 42 unique scales. The quality of psychometric approaches varied greatly across studies, and most failed to examine convergent and divergent validity. Content analyses indicated most scales measure exposures to potential moral stressors and outcomes together, with relatively few measuring only exposures (n = 3) or outcomes (n = 7). Scales using the term MD typically assess general distress. Scales using the term MI typically assess several specific outcomes.
Open Access
Outcomes of transdiagnostic internet-delivered cognitive behavioural therapy tailored to public safety personnel: A longitudinal observational study
(Elsevier BV, 2024-06) Heather D. Hadjistavropoulos; Hugh C. McCall; Blake F. Dear; Janine D. Beahm; R. Nicholas Carleton; Nickolai Titov
First responders and other public safety personnel (PSP) experience high rates of mental health problems and face barriers to accessing mental healthcare. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment for various mental health concerns. Canadian PSP report favorable attitudes toward ICBT, and preliminary outcomes demonstrate that they benefit from it. Expanding on this research, the current study consisted of a longitudinal observational study of 560 Canadian PSP who participated in ICBT. It was designed to assess the longer term effectiveness of ICBT and moderators of outcomes by gender, linguistic and occupational group, and years of occupational experience. We evaluated symptom change at 8, 26, and 52 weeks post-enrollment, and results among PSP who had elevated clinical scores, showed large reductions (Hedges’ g) in symptoms of depression (g = 1.3), anxiety (g =1.48), posttraumatic stress (g =1.24), panic (g =1.19), and anger (g =1.07) and moderate reductions in symptoms of social anxiety (g =.48–.56). Moderator analyses revealed modest differences in pre-treatment symptoms among certain groups but no group differences in symptom change over time. Clients showed good completion of treatment materials and reported high treatment satisfaction. The results suggest further study of ICBT tailored to PSP is warranted, including evaluating ICBT tailored for PSP in other countries.
Open Access
Perspectives and Experiences of Public Safety Personnel Engaged in a Peer-Led Workplace Reintegration Program Post Critical Incident or Operational Stress Injury: A Qualitative Thematic Analysis
(MDPI AG, 2024-07-19) Chelsea Jones; Shaylee Spencer; Elly O’Greysik; Lorraine Smith-MacDonald; Katherine S. Bright; Amy J. Beck; R. Nicholas Carleton; Lisa Burback; Andrew Greenshaw; Yanbo Zhang; Phillip R. Sevigny; Jake Hayward; Bo Cao; Suzette Brémault-Phillips
Introduction: Public safety personnel (PSP) experience operational stress injuries (OSIs), which can put them at increased risk of experiencing mental health and functional challenges. Such challenges can result in PSP needing to take time away from the workplace. An unsuccessful workplace reintegration process may contribute to further personal challenges for PSP and their families as well as staffing shortages that adversely affect PSP organizations. The Canadian Workplace Reintegration Program (RP) has seen a global scale and spread in recent years. However, there remains a lack of evidence-based literature on this topic and the RP specifically. The current qualitative study was designed to explore the perspectives of PSP who had engaged in a Workplace RP due to experiencing a potentially psychologically injurious event or OSI. Methods: A qualitative thematic analysis analyzed interview data from 26 PSP who completed the RP. The researchers identified five themes: (1) the impact of stigma on service engagement; (2) the importance of short-term critical incident (STCI) program; (3) strengths of RP; (4) barriers and areas of improvement for the RP; and (5) support outside the RP. Discussion: Preliminary results were favorable, but further research is needed to address the effectiveness, efficacy, and utility of the RP. Conclusion: By addressing workplace reintegration through innovation and research, future initiatives and RP iterations can provide the best possible service and support to PSP and their communities.
Open Access
Prevalence of Current Chronic Pain in Royal Canadian Mounted Police Cadets
(Informa UK Limited, 2024-05-12) Robyn E. Shields; Taylor A. Teckchandani; Katie L. Andrews; Billea Ahlgrim; Danielle M. Caissie; Chet C. Hembroff; Jolan Nisbet; Gordon J. G. Asmundson; Gregory P. Krätzig; R. Nicholas Carleton
Background: Nearly half of active duty Royal Canadian Mounted Police (RCMP) officers (i.e., 43%) report experiencing current chronic pain (i.e., pain lasting longer than 3 months). Most RCMP officers (i.e., 91%) who report chronic pain indicate that the pain started after working as RCMP officers. Baseline data on chronic pain prevalence among RCMP cadets has not been available. Aims: The current study was designed to provide cross-sectional estimates of chronic pain prevalence among RCMP cadets starting the Cadet Training Program and to assess for sociodemographic differences among participants. Methods: The RCMP Study uses a longitudinal prospective sequential experimental cohort design to create a clustered randomized trial that engages individual participants for 5.5 years. The current manuscript provides cross- sectional associations between chronic pain prevalence and sociodemographic characteristics. Participants were RCMP cadets (n=770) starting the Cadet Training Program. Location, intensity (i.e., on a 0-10 scale, and days per week experienced), and duration (i.e., number of months) of chronic pain was reported. Differences across sociodemographic characteristics were examined. Results: Few RCMP cadets reported experiencing chronic pain (i.e., 10%); lower back pain was rated as the most severe in terms of intensity and duration, and second most frequently reported in number of days experienced per week. Prevalence of chronic pain was lower among RCMP cadets than RCMP officers. Conclusions: Chronic pain prevalence among active duty RCMP officers may result from or be moderated by operational duties, as well as routine aging. Future researchers could examine ways to mitigate chronic pain development during RCMP officer careers.
Open Access
Sleep quality and mental disorder symptoms among correctional workers in Ontario, Canada
(Springer Science and Business Media LLC, 2024-06-28) Rosemary Ricciardelli; Tamara L. Taillieu; Megan McElheran; Heidi Cramm; Harsha Ajith; Matthew S. Johnston; R. Nicholas Carleton
Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.
Open Access
Trouble with the curve: the 90–9-1 rule to measure volitional participation inequalities among Royal Canadian Mounted Police cadets during training
(Frontiers Media SA, 2024-05-28) Taylor A. Teckchandani; Robyn E. Shields; Katie L. Andrews; Kirby Q. Maguire; Laleh Jamshidi; Jolan Nisbet; Tracie O. Afifi; Lisa M. Lix; Sherry H. Stewart; Shannon Sauer-Zavala; Rachel L. Krakauer; J. Patrick Neary; Gregory P. Krätzig; R. Nicholas Carleton
Objective: The Royal Canadian Mounted Police (RCMP) Study includes longitudinal multimodal assessments of RCMP cadets from pre-training (i.e., starting the Cadet Training Program [CTP]) to post-deployment and for five years thereafter. The data allow for investigating the multidimensionality of volitional participation in digital health data collection frameworks within serial data collection platforms and the impact of participation inequalities by classifying cadets using the 90–9-1 rule. By classifying cadets as Lurkers, Contributors, and Superusers formally described by the 90–9-1 rule, where 90% of actors do not participate, 9% seldom contribute, and 1% contribute substantially allows for the assessing of relationships between participation inequalities in self-monitoring behaviors as well as whether mental health disorder symptoms at pre-training (i.e., starting the CTP) were associated with subsequent participation. Methods: Participants were asked to complete a Full Assessment prior to their training at CTP, as well as short daily surveys throughout their training. Participation frequency was described using a process where participants were rank ordered by the number of daily surveys completed and classified into one of three categories. Full assessment surveys completed prior to their training at CTP included screening tools for generalized anxiety disorder (GAD), major depressive disorder (MDD), posttraumatic stress disorder (PTSD), alcohol use disorder (AUD), and panic disorder (PD). The Kruskal-Wallis H test was used to assess differences in participation rates between mental health disorder symptom screening groups for each measure at pre-training, and Spearman’s Rho was used to test for associations amongst self-reported Full Assessment screening tool responses and the number of daily surveys completed during CTP. Results: There were 18557 daily survey records collected from 772 participants. The rank-ordering of cadets by the number of daily surveys completed produced three categories in line with the 90–9-1 rule: Superusers who were the top 1% of cadets (n=8) and produced 6.4% of all recordings; Contributors who were the next 9% of cadets (n=68) and produced 49.2% of the recordings; and Lurkers who were the next 90% of cadets (n=695) and produced 44.4% of daily survey recordings. Lurkers had the largest proportion of positive screens for self-reported mental health disorders at pre-training. Conclusion: The creation of highly individualized, population-based mental health injury programs has been limited by an incomplete understanding of the causal relationships between protective factors and mental health. Disproportionate rates of disengagement from persons who screen positive for mental health disorders further compounds the difficulty in understanding the relationships between training programs and mental health. The current results suggest persons with mental health challenges may be less likely to engage in some forms of proactive mental health training. The current results also provide useful information about participation, adherence, and engagement that can be used to inform evidence-based paradigm shifts in health-related data collection in occupational populations.