Browsing by Author "Sareen, Jitender"

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Open Access
Anxiety-related psychopathology and chronic pain comorbidity among public safety personnel
(Elsevier, 2018-03-28) Carleton, R. Nicholas; Afifi, Tracie, O; Taillieu, Tamara; Turner, Sarah; El-Gabalawy, Renee; Sareen, Jitender; Asmundson, Gordon
Canadian Public Safety Personnel (PSP; e.g., correctional service officers, dispatchers, firefighters, paramedics, police officers) regularly experience potentially traumatic, painful, and injurious events. Such exposures increase risk for developing mental disorders and chronic pain, which both involve substantial personal and social costs. The interrelationship between mental disorders and chronic pain is well-established, and both can be mutually maintaining; accordingly, understanding the relationship between mental health and chronic pain among PSP is important for improving health care. Unfortunately, the available research on such comorbidity for PSP is sparse. The current study was designed to provide initial estimates of comorbidities between mental disorders and chronic pain across diverse PSP. Participants included 5093 PSP (32% women) in six categories (i.e., Call Center Operators/Dispatchers, Correctional Workers, Firefighters, Municipal/Provincial Police, Paramedics, Royal Canadian Mounted Police) who participated in a large PSP mental health survey. The survey included established self-report measures for mental disorders and chronic pain. In the total sample, 23.1% of respondents self-reported clinically significant comorbid concerns with both mental disorders and chronic pain. The results indicated PSP who reported chronic pain were significantly more likely to screen positive for posttraumatic stress disorder (PTSD), major depressive disorder, generalized anxiety disorder, social anxiety disorder, and alcohol use disorder. There were differences between PSP categories; but, the most consistent indications of comorbidity were for chronic pain, PTSD, and major depressive disorder. Comorbidity between chronic pain and mental disorders among PSP is prevalent. Health care providers should regularly assess PSP for both symptom domains.
Open Access
Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel
(BMC, 2022-12-09) Carleton, R. Nicholas; McCarron, Michelle; Krätzig, Gregory, P.; Sauer-Zavala, Shannon; Neary, Patrick, J.; Lix, Lisa, M.; Fletcher, Amber, J.; Camp II, Ronald, D.; Shields, Robyn, E.; Jamshidi, Laleh; Nisbet, Jolan; Maguire, Kirby, Q.; MacPhee, Renée, S.; Afifi, Tracie, O.; Jones, Nicholas, A.; Martin, Ronald, R.; Sareen, Jitender; Brunet, Alain; Beshai, Shadi; Anderson, Gregory, S.; Cramm, Heidi; MacDermid, Joy, C.; Ricciardelli, Rosemary; Rabbani, Rasheda; Teckchandani, Taylor, A.; Asmundson, Gordon, J. G.
Public safety personnel (PSP; e.g., border services personnel, correctional workers, firefighters, paramedics, police, public safety communicators) are frequently exposed to potentially psychologically traumatic events. Such events contribute to substantial and growing challenges from posttraumatic stress injuries (PTSIs), including but not limited to posttraumatic stress disorder.
Open Access
Child Maltreatment History, Deployment-Related Traumatic Events, and Past 12-Month Cannabis Use Among Veterans in Canada
(Sage, 2023-08-11) Afifi, Tracie O.; Taillieu, Tamara; Salmon, Samantha; Stewart-Tufescu, Ashley; Sareen, Jitender; Enns, Murray W.; Mota, Natalie; Bolton, Shay-Lee; Carleton, R. Nicholas; Heber, Alexandra; VanTil, Linda
Objective Cannabis use among veterans in Canada is an understudied public health priority. The current study examined cannabis use prevalence and the relationships between child maltreatment histories and deployment-related traumatic events (DRTEs) with past 12-month cannabis use including sex differences among Canadian veterans. Method Data were drawn from the 2018 Canadian Armed Forces Members and Veterans Mental Health Follow-up Survey (response rate 68.7%; veterans only n = 1,992). Five child maltreatment types and 9 types of DRTEs were assessed in relation to the past 12-month cannabis use. Results The prevalence of lifetime and past 12-month cannabis use was 49.4% and 16.7%, respectively. Females were less likely than males to report lifetime cannabis use (41.9% vs. 50.4%; odds ratio [OR] 0.71; 95% CI, – 0.59 to 0.86). No sex differences were noted for past 12-month cannabis use (14.1% vs. 17.0%; OR 0.80; 95% CI, 0.60 to 1.07). Physical abuse, sexual abuse, neglect, any child maltreatment, most individual DRTEs, and any DRTE were associated with increased odds of past 12-month cannabis use after adjusting for sociodemographic and military variables. Some models were attenuated and/or nonsignificant after further adjustments for mental disorders and chronic pain conditions. Sex did not statistically significantly moderate these relationships. Cumulative effects of having experienced both child maltreatment and DRTEs compared to DRTEs alone increased the odds of past 12-month cannabis use. Statistically significant interaction effects between child maltreatment history and DRTE on cannabis use were not found. Conclusions Child maltreatment histories and DRTEs increased the likelihood of past 12-month cannabis use among Canadian veterans. A history of child maltreatment, compared to DRTEs, indicated a more robust relationship. Understanding the links between child maltreatment, DRTEs, and cannabis use along with mental disorders and chronic pain conditions is important for developing interventions and improving health outcomes among veterans.
Open Access
Chronic pain among public safety personnel in Canada
(Taylor and Francis Group, 2017-12-18) Carleton, R. Nicholas; Afifi, Tracie, O.; Turner, Sarah; Taillieu, Tamara; El-Gabalawy, Renée; Sareen, Jitender; Asmundson, Gordon, J. G.
Chronic pain is highly prevalent in the general population and may be even higheramong public safety personnel (PSP; e.g., correctional officers, dispatchers, firefighters, paramedics,police). Comprehensive data on chronic pain among diverse Canadian PSP are relatively sparse.Aims: The current study was designed to provide initial estimates of chronic pain frequencyand severity among Canadian PSP.
Open Access
Comorbidity of Posttraumatic Stress Disorder and Social Anxiety Disorder: Implications for Diagnosis and Treatment
(Faculty of Graduate Studies and Research, University of Regina, 2016-12) McMillan, Katherine; Asmundson, Gordon; Martin, Ronald; Sareen, Jitender; Wright, Kristi; Hadjistavropoulos, Heather; Keane, Terrence
Posttraumatic stress disorder (PTSD) and social anxiety disorder (SAD) demonstrate a high degree of comorbidity. Indeed, rates of past-year SAD among individuals with PTSD have been shown to range from 14.8 to 46.0% within treatment-seeking and veteran samples (Collimore, Carleton, Hofmann, & Asmundson, 2010). Although PTSD and SAD are individually associated with negative mental health outcomes, preliminary data suggests that the co-occurrence of these disorders can result in a significant increase in distress and impairment beyond the impact of either disorder alone (Zayfert, DeViva, Hofmann, 2005). Despite accumulating evidence that PTSD and SAD frequently co-occur, and growing interest into the nature and correlates of these disorders, little is known about the nature of this association. Contemporary research has largely been conducted using treatment-seeking or veteran samples which may not generalize to the population as a whole. In addition, studies of the impact of trauma type have largely focused on the impact of sexual abuse, ignoring large variability in the experience of trauma. Large-scale epidemiological studies are needed to fill existing gaps in the literature and to clarify the nature of this association within a representative sample of the general population. As such, the current dissertation examined the relationship between PTSD and SAD using Wave 2 of the National Epidemiological Survey of Alcohol and Related Conditions, a large, nationally-representative survey of American adults. A series of three thematically related studies were conducted in order to explore the nature and correlates of these frequently comorbid disorders. Study one examined patterns of trauma exposure among those with comorbid DSM-IV PTSD and SAD (PTSD-SAD). Compared to those with PTSD alone (PTSD-no SAD) or SAD alone (SAD-no PTSD), those in the comorbid PTSD-SAD group were significantly more likely to report specific types of traumas from within the assaultive violence, childhood maltreatment, or other shocking events categories. Associations between PTSD-SAD comorbidity and childhood maltreatment were significant for females only. Study two examined the impact of PTSD-SAD comorbidity on PTSD symptom expression. Compared to those with PTSD-no SAD, those with comorbid SAD demonstrated elevated rates of specific PTSD symptoms within each criterion cluster, suggesting that the presence of SAD is associated with differences in the expression of PTSD symptoms. Multiple between sex differences were noted. Finally, study three examined the impact of PTSD-SAD comorbidity on SF-12 quality of life indicators and lifetime suicide attempts. Those in the comorbid PTSD-SAD group demonstrated an elevated risk of lifetime suicide attempts and lower levels of physical and mental quality of life compared to those with PTSD-no SAD and SAD-no PTSD. Results demonstrate the adverse impact of PTSD-SAD comorbidity on psychosocial functioning and provide indicators to enhance differential diagnosis and treatment planning.
Open Access
Daily survey participation and positive changes in mental health symptom scores among Royal Canadian Mounted Police Cadets
(Frontiers, 2023-08-04) Shields, Robyn E.; Teckchandani, Taylor A.; Asmundson, Gordon J. G.; Nisbet, Jolan; Krakauer, Rachel L.; Andrews, Katie L.; Maguire, Kirby Q.; Jamshidi, Laleh; Afifi, Tracie O.; Lix, Lisa M.; Brunet, Alain; Sauer-Zavala, Shannon; Krätzig, Gregory P.; Neary, J. Patrick; Sareen, Jitender; Carleton, R. Nicholas
Introduction: Royal Canadian Mounted Police (RCMP) officers self-report high levels of mental health disorder symptoms, such as alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Participation in regular mental health monitoring has been associated with improved mental health disorder symptom reporting and may provide an accessible tool to support RCMP mental health. The current study assessed relationships between self-reported mental health disorder symptoms and the completion of daily surveys (i.e., daily mental health disorder symptom monitoring) by RCMP cadets during the Cadet Training Program (CTP). Methods: Participants were RCMP cadets (n = 394; 76.1% men) in the Standard Training Program who completed the 26-week CTP and daily self-monitoring surveys, as well as full mental health assessments at pre-training (i.e., starting the CTP) and pre-deployment (i.e., ~2 weeks prior to deployment to the field). Symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder were assessed. Changes in mental health disorder symptom reporting from pre-training to pre-deployment were calculated. Spearman’s rank correlations were estimated for number of daily surveys completed and change in mental health disorder symptom scores between pre-training and pre-deployment. Results: There were statistically significant inverse relationships between number of daily surveys completed and number of mental health disorder symptoms reported; specifically, cadets who completed more daily surveys during CTP reported fewer symptoms of alcohol use disorder, generalized anxiety disorder, major depressive disorder, panic disorder, and posttraumatic stress disorder. Conclusion: An inverse correlation between number of daily surveys completed and mental health disorder symptom scores indicated that participation in daily mental health monitoring was associated with improvements in self-reported mental health disorder symptoms between pre-training and pre-deployment. Regular self-monitoring of mental health disorder symptoms may help to mitigate mental health challenges among RCMP cadets and officers.
Open Access
Mental Disorder Symptoms among Public Safety Personnel in Canada
(SAGE Publications, 2017-08-28) Carleton, R. Nicholas; Afifi, Tracie, O; Turner, Sarah; Taillieu, Tamara; Duranceau, Sophie; LeBouthillier, Daniel, M.; Sareen, Jitender; Ricciardelli, Rosemary; MacPhee, Renee; Groll, Dianne; Hozempa, Kadie; Brunet, Alain; Weekes, John, R.; Griffiths, Curt, T.; Abrams, Kelly, J.; Jones, Nicholas, A.; Beshai, Shadi; Cramm, Heidi, A.; Dobson, Keith, S.; Hatcher, Simon; Keane, Terence, M.; Stewart, Sherry, H.; Asmundson, Gordon
Canadian public safety personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police officers) are exposed to potentially traumatic events as a function of their work. Such exposures contribute to the risk of developing clinically significant symptoms related to mental disorders. The current study was designed to provide estimates of mental disorder symptom frequencies and severities for Canadian PSP.
Open Access
Mental Health of Royal Canadian Mounted Police at the Start of the Cadet Training Program
(SAGE Publications, 2023-05-02) Carleton, R. Nicholas; Jamshidi, Laleh; Maguire, Kirby Q.; Lix, Lisa M.; Stewart, Sherry H.; Afifi, Tracie O.; Sareen, Jitender; Andrews, Katie L.; Jones, Nicholas A.; Nisbet, Jolan; Sauer-Zavala, Shannon; Neary, J. Patrick; Brunet, Alain; Krätzig, Gregory P.; Fletcher, Amber J.; Teckchandani, Taylor A.; Keane, Terence M.; Asmundson, Gordon J.G.
Objective Serving Royal Canadian Mounted Police (RCMP) have screened positive for one or more mental disorders based on self-reported symptoms with substantial prevalence (i.e., 50.2%). Mental health challenges for military and paramilitary populations have historically been attributed to insufficient recruit screening; however, cadet mental health when starting the Cadet Training Program (CTP) was unknown. Our objective was to estimate RCMP Cadet mental health when starting the CTP and test for sociodemographic differences. Method Cadets starting the CTP completed a survey assessing self-reported mental health symptoms (n = 772, 72.0% male) and a clinical interview (n = 736, 74.4% male) with a clinician or supervised trainee using the Mini-International Neuropsychiatric Interview to assess current and past mental health. Results The percentage of participants screening positive for one or more current mental disorders based on self-reported symptoms (15.0%) was higher than the diagnostic prevalence for the general population (10.1%); however, based on clinical interviews, participants were less likely to screen positive for any current mental disorder (6.3%) than the general population. Participants were also less likely to screen positive for any past mental disorder based on self-report (3.9%) and clinical interviews (12.5%) than the general population (33.1%). Females were more likely to score higher than males (all ps<.01; Cohen's ds .23 to .32) on several self-report mental disorder symptom measures. Conclusions The current results are the first to describe RCMP cadet mental health when starting the CTP. The data evidenced a lower prevalence of anxiety, depressive, and trauma-related mental disorders than the general population based on clinical interviews, contrasting notions that more rigorous mental health screening would reduce the high prevalence of mental disorders among serving RCMP. Instead, protecting RCMP mental health may require ongoing efforts to mitigate operational and organizational stressors.
Open Access
Potentially Psychologically Traumatic Event Exposure Histories of new Royal Canadian Mounted Police Cadets
(SAGE Publications, 2023-02-05) Andrews, Katie L.; Jamshidi, Laleh; Nisbet, Jolan; Brunet, Alain; Afifi, Tracie O.; Asmundson, Gordon J.G.; Fletcher, Amber J.; Maguire, Kirby Q.; Teckchandani, Taylor A.; Lix, Lisa; Sauer-Zavala, Shannon; Sareen, Jitender; Keane, Terence M.; Neary, J. Patrick; Carleton, R. Nicholas
Objective Royal Canadian Mounted Police (RCMP) report extremely frequent and varied exposures to potentially psychologically traumatic events (PPTEs). While occupational exposures to PPTEs may be one explanation for the symptoms of mental disorders prevalent among serving RCMP, exposures occurring prior to service may also play a role. The objective of the current study was to provide estimates of lifetime PPTE exposures among RCMP cadets in training and assess for associations with mental disorders or sociodemographic variables. Methods RCMP cadets (n = 772; 72.0% male) beginning the Cadet Training Program (CTP) completed a survey assessing self-reported PPTE exposures as measured by the Life Events Checklist for the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition-Extended. Binomial tests were conducted to compare the current results to previously collected data from the general population, a diverse sample of public safety personnel (PSP) and serving RCMP. Results Cadets reported statistically significantly fewer PPTE exposures for all PPTE types than serving RCMP (all p’s < 0.001) and PSP (all p’s < 0.001) but more PPTE exposures for all PPTE types than the general population (all p’s < 0.001). Cadets also endorsed fewer PPTE types (6.00 ± 4.47) than serving RCMP (11.64 ± 3.40; p < 0.001) and other PSP (11.08 ± 3.23) but more types than the general population (2.31 ± 2.33; p < 0.001). Participants who reported being exposed to any PPTE type reported the exposures occurred 1–5 times (29.1% of participants), 6–10 times (18.3%) or 10 + times (43.1%) before starting the CTP. Several PPTE types were associated with positive screens for one or more mental disorders. There were associations between PPTE types and increased odds of screening positive for post-traumatic stress disorder (PTSD), major depressive disorder (MDD), generalized anxiety disorder (GAD) and social anxiety disorder (SAD) (all p’s < 0.05). Serious transport accident (11.1%), physical assault (9.5%) and sudden accidental death (8.4%) were the PPTEs most identified as the worst event, and all were associated with positive screens for one or more mental disorders. Conclusion The current results provide the first information describing PPTE histories of cadets, evidencing exposure frequencies and types much higher than the general population. PPTE exposures may have contributed to the cadet's vocational choices. The current results support the growing evidence that PPTEs can be associated with diverse mental disorders; however, the results also suggest cadets may be uncommonly resilient, based on how few screened positive for mental disorders, despite reporting higher frequencies of PPTE exposures prior to CTP than the general population.
Open Access
Suicidal Ideation, Planning, and Attempts Among new Royal Canadian Mounted Police Cadets
(SAGE Publications, 2023-02-03) Nisbet, Jolan; Jamshidi, Laleh; Maguire, Kirby, Q; Afifi, Tracie, O; Brunet, Alain; Fletcher, Amber, J.; Asmundson, Gordon; Sareen, Jitender; Shields, Robyn, E.; Andrews, Katie, L.; Sauer-Zavala, Shannon; Neary, J. Patrick; Lix, Lisa; Stewart, Sherry, H.; Krätzig, Gregory, P.; Carleton, R. Nicholas
Royal Canadian Mounted Police (RCMP) report diverse occupational stressors and repeated exposures to potentially psychologically traumatic events, which may increase the odds of screening positive for a mental disorder, and increase the risk of death by suicide. The current study was designed to provide prevalence information regarding suicidal behaviours (i.e., ideation, planning, attempts) and assess for sociodemographic differences among cadets at the start of the RCMP Cadet Training Program (CTP)