Browsing by Author "Stewart, Sherry H."

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    Do trauma cue exposure and/or PTSD symptom severity intensify selective approach bias toward cannabis cues in regular cannabis users with trauma histories?
    (Elsevier, 2023-08-21) DeGrace, S.; Romero Sanchiz, P.; Tibbo, P.; Barrett, S.; Arenella, P.; Cosman, T.; Atasoy, P.; Cousijn, J.; Wiers, R.; Keough, M.T.; Yakovenko, I.; O'Connor, R.; Wardell, J.; Rudnick, A.; Carleton, R. Nicholas; Heber, Alexandra; Stewart, Sherry H.
    Trauma cue-elicited activation of automatic cannabis-related cognitive biases are theorized to contribute to comorbid posttraumatic stress disorder and cannabis use disorder. This phenomenon can be studied experimentally by combining the trauma cue reactivity paradigm (CRP) with cannabis-related cognitive processing tasks. In this study, we used a computerized cannabis approach-avoidance task (AAT) to assess automatic cannabis (vs. neutral) approach bias following personalized trauma (vs. neutral) CRP exposure. We hypothesized that selective cannabis (vs. neutral) approach biases on the AAT would be larger among participants with higher PTSD symptom severity, particularly following trauma (vs. neutral) cue exposure. We used a within-subjects experimental design with a continuous between-subjects moderator (PTSD symptom severity). Participants were exposed to both a trauma and neutral CRP in random order, completing a cannabis AAT (cannabis vs. neutral stimuli) following each cue exposure. Current cannabis users with histories of psychological trauma (n = 50; 34% male; mean age = 37.8 years) described their most traumatic lifetime event, and a similarly-detailed neutral event, according to an established interview protocol that served as the CRP. As hypothesized, an AAT stimulus type x PTSD symptom severity interaction emerged (p = .042) with approach bias greater to cannabis than neutral stimuli for participants with higher (p = .006), but not lower (p = 0.36), PTSD symptom severity. Contrasting expectations, the stimulus type x PTSD symptoms effect was not intensified by trauma cue exposure (p = 0.19). Selective cannabis approach bias may be chronically activated in cannabis users with higher PTSD symptom severity and may serve as an automatic cognitive mechanism to help explain PTSD-CUD co-morbidity.
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    Mental Disorder Symptoms among Public Safety Personnel in Canada
    (SAGE Publications, 2017-08-28) Carleton, R. Nicholas; Afifi, Tracie O.; Turner, Sarah; Taillieu, Tamara L.; Duranceau, Sophie; LeBouthillier, Daniel, M.; Sareen, Jitender; Ricciardelli, Rosemary; MacPhee, Renée, S.; Groll, Dianne; Hozempa, Kadie; Brunet, Alain; Weekes, John R.; Griffiths, Curt T.; Abrams, Kelly J.; Jones, Nicholas A.; Beshai, Shadi; Cramm, Heidi; Dobson, Keith S.; Hatcher, Simon; Keane, Terence M.; Stewart, Sherry H.; Asmundson, Gordon J.G.
    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.
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    Mental health disorder symptom changes among public safety personnel after emotional resilience skills training.
    (Elsevier Inc., 2025-02-05) Carleton, R. Nicholas; Sauer-Zavala, Shannon; Teckchandani, Taylor A.; Maguire, Kirby Q.; Jamshidi, Laleh; Shields, Robyn, E.; Afifi, Tracie O.; Nisbet, Jolan; Andrews, Katie L.; Stewart, Sherry H.; Fletcher, Amber J.; Martin, R; MacPhee, Renée, S.; MacDermid, J.C.; Keane, Terence M.; Brunet, Alain; McCarron, Michelle C. E.; Lix, Lisa M.; Jones, N.A.; Krätzig, Gregory P.; Neary, J. Patrick; Anderson, Gregory S.; Ricciardelli, Rosemary; Cramm, Heidi; Sareen, Jitender; Asmundson, Gordon J.G.
    Public safety personnel (PSP) are frequently exposed to psychologically traumatic events. The exposures potentiate posttraumatic stress injuries (PTSIs), including posttraumatic stress disorder (PTSD). The Royal Canadian Mounted Police (RCMP) Protocol was designed to mitigate PTSIs using ongoing monitoring and PSP-delivered Emotional Resilience Skills Training (ERST) based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. The current study pilot-tested ERST effectiveness among diverse PSP.
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    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.
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    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 J.G.; Sareen, Jitender; Shields, Robyn, E.; Andrews, Katie L.; Sauer-Zavala, Shannon; Neary, J. Patrick; Lix, Lisa M.; 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)
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    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) Teckchandani, Taylor A.; Shields, Robyn, E.; Andrews, Katie L.; Maguire, Kirby Q.; Jamshidi, Laleh; Nisbet, Jolan; Afifi, Tracie O.; Lix, Lisa M.; Stewart, Sherry H.; Sauer-Zavala, Shannon; Krakauer, Rachel L.; Neary, J. Patrick; Krätzig, Gregory P.; Carleton, R. Nicholas
    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.