Browsing by Author "Lix, Lisa M."

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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, J. Patrick; Lix, Lisa M.; Fletcher, Amber J.; Camp, 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
A controlled investigation of continuing pain education for long-term care staff
(Hindawi, 2013) Ghandehari, Omeed, O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P.; Dal Bello-Haas, Vanina; Malloy, David C.; Martin, Ronald, R.; Rahaman, Omar; Zwakhale, Sandra, M.G.; Carleton, R. Nicholas; Hunter, Paulette V.; Lix, Lisa M.
The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors.OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff.METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies.RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants.CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers.
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 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.
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 M.; 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
Royal Canadian Mounted Police cadets’ exposure to potentially psychologically traumatic events during the Cadet Training Program
(Wiley, 2024-12-20) Andrews, Katie L.; Maguire, Kirby Q.; Jamshidi, Laleh; Afifi, Tracie O.; Nisbet, Jolan; Shields, Robyn, E.; Teckchandani, Taylor A.; Asmundson, Gordon J.G.; Brunet, Alain; Lix, Lisa M.; Sauer-Zavala, Shannon; Sareen, Jitender; Keane, Terence M.; Neary, J. Patrick; Carleton, R. Nicholas
Lifetime exposures to potentially psychologically traumatic events (PPTEs) among Royal Canadian Mounted Police (RCMP) cadets starting the Cadet Training Program (CTP) appear lower than exposures reported by serving RCMP, but the prevalence of PPTE exposures during the CTP remains unknown. The current study assessed PPTE exposures during the CTP and examined associations with mental disorders among RCMP cadets. Participants were cadets (n = 449, 24.7% women) from the larger RCMP Longitudinal Study who self-reported critical incidents, PPTE exposures, and mental health disorder symptoms at pretraining and predeployment. Most participants reported no exposures to a PPTE (n = 374, 83.3%) during the CTP. Participants who reported any PPTE exposure (n = 75, 16.7%; i.e., direct or indirect) most commonly reported serious transport accidents, physical assault, and sudden accidental death. The most common direct PPTEs (i.e., “happened to me”) during the CTP were physical assault (n = 13), other unwanted or uncomfortable sexual experience (n = 11), and serious transportation accident (n = 8). The total number of PPTE types reported at predeployment was associated with increased odds of screening positive for any mental health disorder, aOR = 1.22, 95% CI [1.01, 1.49], p = .049, and positively associated with mental health disorder symptoms, ps < .001. These results provide the first assessment of PPTE exposure among RCMP cadets during the CTP, indicating that 16.7% of cadets experience PPTEs directly or indirectly. The PPTEs reported by cadets may help inform additional opportunities to further increase safety during training.
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 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)
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) 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.