Carleton R N, Sauer-Zavala S, Teckchandani T A, Maguire K Q, Jamshidi L, Shields R E, Afifi T O, Nisbet J, Andrews K L, Stewart S H, Fletcher A J, Martin R, MacPhee R S, MacDermid J C, Keane T M, Brunet A, McCarron M, Lix L M, Jones N A, Krätzig G P, Neary J P, Anderson G, Ricciardelli R, Cramm H, Sareen J, Asmundson G J G
Department of Psychology, University of Regina, Regina, SK S4S 0A2, Canada.
Treatment Innovation for Psychological Services Research Program, Department of Psychology, University of Kentucky, Lexington, KY 40506, USA.
Compr Psychiatry. 2025 Apr;138:152580. doi: 10.1016/j.comppsych.2025.152580. Epub 2025 Feb 5.
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.
A 16-month longitudinal design engaged serving PSP (n = 119; 34 % female; firefighters, municipal police, paramedics, public safety communicators) who completed PSP-delivered ERST. Participants were assessed for symptoms of PTSIs, including but not limited to PTSD, at pre- and post-training, and 1-year follow-up using self-report measures and clinical interviews.
There were reductions in self-report and clinical diagnostic interview positive screens for PTSD and other PTSI from pre- to post-training (ps < 0.05), with mental health sustained or improved at 1-year follow-up. Improvements were observed among firefighters (Cohen's d = 0.40 to 0.71), police (Cohen's d = 0.28 to 0.38), paramedics (Cohen's d = 0.20 to 0.56), and communicators (Cohen's d = 0.05 to 0.14).
Ongoing monitoring and PSP-delivered ERST, can produce small to large mental health improvements among diverse PSP, or mitigate PSP mental health challenges, with variations influenced by pre-training factors and organizational supports. ERST replication and extension research appears warranted.
Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022 - Prospectively registered.
ClinicalTrials.gov, NCT05530642.
公共安全人员（PSP）经常暴露于心理创伤事件中。这些暴露会加剧创伤后应激损伤（PTSI），包括创伤后应激障碍（PTSD）。加拿大皇家骑警（RCMP）协议旨在通过持续监测和基于情绪障碍跨诊断治疗统一协议的由PSP提供的情绪恢复力技能培训（ERST）来减轻PTSI。本研究对不同PSP群体中ERST的有效性进行了试点测试。
采用为期16个月的纵向设计，纳入在职PSP（n = 119；34%为女性；消防员、市警察、护理人员、公共安全通信员），他们完成了由PSP提供的ERST。在训练前、训练后以及1年随访时，使用自我报告量表和临床访谈对参与者进行PTSI症状评估，包括但不限于PTSD。
从训练前到训练后，PTSD和其他PTSI的自我报告及临床诊断访谈阳性筛查结果有所减少（p < 0.05），在1年随访时心理健康状况得以维持或改善。在消防员（科恩d值 = 0.40至0.71）、警察（科恩d值 = 0.28至0.38）、护理人员（科恩d值 = 0.20至0.56）和通信员（科恩d值 = 0.05至0.14）中均观察到了改善。
持续监测和由PSP提供的ERST可以使不同PSP群体的心理健康状况得到小到显著的改善，或减轻PSP的心理健康挑战，其变化受训练前因素和组织支持的影响。ERST的重复和扩展研究似乎很有必要。
假设注册：aspredicted.org，#90136。2022年3月7日注册——前瞻性注册。
ClinicalTrials.gov，NCT05530642。
