Impact of Mindfulness Training on Spanish Police Officers' Mental and Emotional Health: a Non-Randomized Pilot Study

A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers

BACKGROUND

Law enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs.

METHODS

This multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes.

RESULTS

We observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures.

CONCLUSIONS

Results of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve.

TRIAL REGISTRATION

ClinicalTrials.gov, NCT03784846 . Registered on December 24th, 2018.

Effectiveness of psychological skills training for police personnel: a meta-analysis

There has been an increasing interest in primary prevention programmes developed to improve police officers' mental health. This meta-analysis synthesised the existing findings on psychological skills training for police personnel including resilience training and mindfulness-based training. Particularly, this study systematically assessed the effectiveness of training programmes on mental health outcomes including resilience, depression, anxiety and perceived stress. A comprehensive search of EBSCO, ProQuest and Web of Science was conducted for studies written in English from 1999 to 2022. Two independent researchers screened 5604 studies. Eligible studies are intervention studies with controlled trials that involved training programmes to improve participants' mental health and reported at least one of the following outcomes: resilience, depression, anxiety and perceived stress. The meta-analysis estimated standardised mean differences (SMDs) for each of the four outcomes. A total of 12 studies, involving 2298 police personnel from 8 countries, met the criteria for inclusion and quality assessment. The training programmes of the eligible studies varied in training approaches, duration, total sessions and follow-up periods. The results suggest that training programmes have a statistically significant moderate effect on depression (SMD=-0.47, 95% CI=-0.73 to -0.22) and anxiety (SMD=-0.40, 95% CI=-0.73 to -0.06), while the effects on resilience (SMD=1.03, 95% CI=-0.36 to 2.41) and perceived stress (SMD=-1.03, 95% CI=-2.15 to 0.08) are not statistically significant. This study highlights the role of primary prevention approaches in supporting officers' mental health by showing that training programmes are effective in mitigating the risk of depression and anxiety.

The Toronto Mindfulness Scale and the State Mindfulness Scale: psychometric properties of the Spanish versions

Objectives

The Toronto Mindfulness Scale (TMS) and the State Mindfulness Scale (SMS) are two relevant self-report measures of state mindfulness. The purpose of this study was to examine the internal structure and to offer evidence of the reliability and validity of the Spanish versions of the TMS and SMS.

Methods

Data from six distinct non-clinical samples in Spain were obtained. They responded to the TMS (n = 119), SMS (n = 223), and measures of trait mindfulness, decentering, non-attachment, depression, anxiety, stress, positive and negative affect, self-criticism, and self-reassurance. The internal structure of the TMS and SMS was analyzed through confirmatory factor analysis. Reliability, construct validity, and sensitivity to change analyses were performed.

Results

The correlated two-factor structure (curiosity and decentering) was the best-fitting model for the TMS (CFI = 0.932; TLI = 0.913; RMSEA = 0.100 [0.077-0.123]; WRMR = 0.908). The bifactor structure (general factor, mindfulness of body, and mindfulness of mind) was the best-fitting model for the SMS (CFI = 0.961; TLI = 0.950; RMSEA = 0.096 [0.086-0.106]; WRMR = 0.993). Adequate reliability was found for both measures. The reliability of the SMS specific factors was very poor when controlling for the general factor. The patterns of correlations were mainly as expected and according to previous literature. The TMS and SMS have been able to detect state mindfulness changes after different meditation practices.

Conclusion

Validity evidence is provided to support the use of the TMS and SMS in Spanish populations, though the reliability of the SMS specific factors merit revision.

The Effectiveness of Mindfulness-Based Interventions for Police Officers' Stress Reduction: a Systematic Review

The profession of a police officer is associated with high levels of stress, which can have harmful consequences for officers' personal lives, the police organisation, and society. This systematic review aims to synthesise recent literature on the effectiveness of mindfulness-based intervention related to stress reduction (MBIs) in a sample of police officers. The search of relevant articles was applied in four databases (SpringerLink, Web of Science, Academic Search Ultimate (EBSCO), and PubMed), using the following inclusion criteria: (1) study involved police officers; (2) study used (quasi)experimental research design; (3) mindfulness-based stress reduction intervention was applied as the main intervention; and (4) study presented pre- and post-intervention measures and quantitative results of stress. The systematic review of eight articles included in the analysis revealed that MBIs were effective in reducing police officers' stress and other stress-related outcomes (sleep problems, post-traumatic stress disorder (PTSD), negative affect, burnout).

Effectiveness of two video-based multicomponent treatments for fibromyalgia: The added value of cognitive restructuring and mindfulness in a three-arm randomised controlled trial

BACKGROUND/OBJECTIVES

The aim of this study was to examine the effectiveness of two video-based multicomponent programs (FIBROWALK) and the Multicomponent Physiotherapy Program (MPP) for patients with fibromyalgia (FM) compared to treatment-as-usual (TAU) only. We posit that FIBROWALK, due to inclusion of specific psychological ingredients (cognitive restructuring and mindfulness), can produce additional clinical benefits when compared to TAU or MPP alone.

METHODS

A total of 330 patients with FM were recruited and randomly allocated (1:1:1) to TAU only, TAU + FIBROWALK, or TAU + MPP. FIBROWALK and MPP consisted of weekly videos on pain neuroscience education, therapeutic exercise and self-management patient education, but only the FIBROWALK intervention provided cognitive restructuring and mindfulness. Both programs were structurally equivalent. Between-group differences in functional impairment, pain, kinesiophobia, anxious-depressive symptoms and physical functioning were evaluated at post-treatment following Intention-To-Treat and complete-case approaches.

RESULTS

Compared to TAU only, individuals in the FIBROWALK arm showed larger improvements in all clinical outcomes; similarly, participants in the MPP program also showed greater improvements in functional impairment, perceived pain, kinesiophobia, depressive symptoms compared to TAU only. The FIBROWALK intervention showed superior effects in improving pain, anxiety and depressive symptoms and physical functioning compared to MPP.

CONCLUSIONS

This RCT supports the short-term effectiveness of the video-based multicomponent programs FIBROWALK and MPP for FM and provides evidence that cognitive-behavioural and mindfulness-based techniques can be clinically useful in the context of physiotherapeutic multicomponent treatment programs.

TRIAL REGISTRATION NUMBER

NCT04571528.