Nicholas Carleton

Permanent URI for this collection

Dr. R. Nicholas Carleton, Ph.D., R.D. Psychology
Professor of Psychology,
Department of Psychology,
University of Regina


Recent Submissions

Now showing 1 - 20 of 89
  • ItemOpen Access
    Mental Health Knowledge, Stigma, and Service Use Intentions Among Correctional Workers
    (Canadian Psychological Association, 2023-11-30) Shields, Robyn E.; Ricciardelli, Rosemary; Jamshidi, Laleh; Carleton, R. Nicholas
    Correctional workers are regularly exposed to potentially psychologically traumatic events, which are associated with mental health disorders. Correctional workers report barriers to mental health service use due to difficulties recognizing mental health needs and stigma, leading to compromised mental health. The current study was designed to assess nuances in mental health knowledge, stigma, and service use intentions among correctional workers and differences based on demographic categories and histories of mental health disorders. Participants (n = 878) were correctional workers from Ontario, Canada, who completed the Mental Health Knowledge Scale, the Opening Minds Scale for Workplace Attitudes, and the Mental Health Service Use Questionnaire. There were statistically significant differences on measures of mental health knowledge, stigma, and service use intentions across most demographic categories. There were statistically significant differences on a measure of mental health service use intentions between participants with and without a history of mental health disorders. Mental health knowledge contributed significantly to the variation in service use intentions. The current results provide initial baseline data for correctional workers regarding mental health knowledge, stigma, and service use intentions. The results evidence demographic differences that may help focus training efforts. The results also suggest experiencing mental health disorders may be insufficient to overcome mental health stigma, which means additional individual, organizational, and structural efforts are warranted to increase service use intentions among correctional workers as part of supporting better mental health.
  • ItemOpen Access
    Web-Based Mindfulness Meditation as an Adjunct to Internet-Delivered Cognitive Behavioral Therapy for Public Safety Personnel: Mixed Methods Feasibility Evaluation Study
    (JMIR Publications, 2024-01-30) Landry, Caeleigh A; McCall, Hugh C; Beahm, Janine D; Titov, Nickolai; Dear, Blake; Carleton, R Nicholas; Hadjistavropoulos, Heather D
    Background: Public safety personnel (PSP) are individuals who work to ensure the safety and security of communities (eg, correctional workers, firefighters, paramedics, and police officers). PSP have a high risk of developing mental disorders and face unique barriers to traditional mental health treatments. The PSP Wellbeing Course is a transdiagnostic, internet-delivered cognitive behavioral therapy (iCBT) course tailored to assist PSP with symptoms of depression, anxiety, and posttraumatic stress disorder (PTSD). The initial course outcomes are promising, but some clients report some challenges with learning skills and recommend adding additional resources. Mindfulness meditations, which help people to experience the world and their reactions to the world in open and nonjudgmental ways, may complement the existing PSP Wellbeing Course. Objective: This study aims to examine the feasibility of mindfulness meditations in iCBT tailored for PSP. Information was gathered to evaluate engagement and client experiences with mindfulness meditations, symptom change, and the relationship between mindfulness meditation use and symptom change. Methods: A mixed methods study was conducted on PSP enrolled in the PSP Wellbeing Course who were offered 5 mindfulness meditations during the program (ie, 1/lesson). Clients completed questionnaires on depression, anxiety, PTSD, anger, insomnia, resilience, and mindfulness at pretreatment and at 8 weeks; an 8-week treatment satisfaction questionnaire; and brief weekly measures of mindfulness meditation engagement. We used paired sample t tests (2-tailed) to assess changes in outcomes over time and partial correlations to assess whether mindfulness meditation use predicted outcomes at posttreatment. A total of 12 clients were interviewed about their perceptions of the mindfulness meditations, and interviews were analyzed using directed content analysis. Results: Among the 40 clients enrolled, 27 (68%) reported using the mindfulness meditations, practicing for an average of 4.8 (SD 8.1) minutes each week. Most interviewees described the mindfulness meditations as beneficial but also reported challenges, such as discomfort while sitting with their feelings. Clients provided suggestions for better integration of mindfulness into iCBT. Overall, clients who completed the PSP Wellbeing Course with mindfulness meditations experienced statistically significant improvements in symptoms of anxiety (P=.001), depression (P=.001), PTSD (P=.001), and anger (P=.001) but not insomnia (P=.02). Clients also experienced improvements in resilience (P=.01) and mindfulness (P=.001). Self-reported time spent meditating was not associated with changes in symptoms over time.
  • ItemOpen Access
    Measuring moral distress and moral injury: A systematic review and content analysis of existing scales
    (Elsevier BV, 2024-03) Stephanie A. Houle; Natalie Ein; Julia Gervasio; Rachel A. Plouffe; Brett T. Litz; R. Nicholas Carleton; Kevin T. Hansen; Jenny J.W. Liu; Andrea R. Ashbaugh; Walter Callaghan; Megan M. Thompson; Bethany Easterbrook; Lorraine Smith-MacDonald; Sara Rodrigues; Stéphanie A.H. Bélanger; Katherine Bright; Ruth A. Lanius; Clara Baker; William Younger; Suzette Bremault-Phillips; Fardous Hosseiny; J. Don Richardson; Anthony Nazarov
    Background: Moral distress (MD) and moral injury (MI) are related constructs describing the negative conse- quences of morally challenging stressors. Despite growing support for the clinical relevance of these constructs, ongoing challenges regarding measurement quality risk limiting research and clinical advances. This study summarizes the nature, quality, and utility of existing MD and MI scales, and provides recommendations for future use. Method: We identified psychometric studies describing the development or validation of MD or MI scales and extracted information on methodological and psychometric qualities. Content analyses identified specific out- comes measured by each scale. Results: We reviewed 77 studies representing 42 unique scales. The quality of psychometric approaches varied greatly across studies, and most failed to examine convergent and divergent validity. Content analyses indicated most scales measure exposures to potential moral stressors and outcomes together, with relatively few measuring only exposures (n = 3) or outcomes (n = 7). Scales using the term MD typically assess general distress. Scales using the term MI typically assess several specific outcomes.
  • ItemOpen Access
    Examining how organizational leaders perceive internet-delivered cognitive behavioural therapy for public safety personnel using the RE-AIM implementation framework
    (Elsevier BV, 2024-03) Janine D. Beahm; Hugh C. McCall; R. Nicholas Carleton; Nicholas Jones; Heather D. Hadjistavropoulos
    Within Canada, internet-delivered cognitive behavioural therapy (ICBT) has recently been tailored by PSPNET to meet the needs of public safety personnel (PSP) to help address high rates of mental health problems within this population. Perceptions and outcomes of ICBT among PSP are promising, but it remains unknown how PSPNET is perceived by PSP organizational leaders. It is important to assess this gap because these leaders have significant potential to influence the uptake of ICBT. Methods: In the current study, PSP leaders (n = 10) were interviewed to examine their perceptions of PSPNET and opportunities to improve ICBT implementation. The RE-AIM evaluation framework was used to assess PSP leaders' perceptions of PSPNET in terms of reach, effectiveness, adoption, implementation, and maintenance. Results: The results evidenced that leaders perceived PSPNET as effective in reaching and serving PSP and PSP organizations. PSP leaders reported perceiving ICBT as effectively implemented, especially for being freely offered to individual PSP and for improving PSP's access to experienced therapists specifically trained to work with PSP. Participants indicated organizations have promoted and will continue promoting PSPNET longer-term, facilitating adoption and maintenance. Factors perceived as facilitating successful service delivery included building relationships and trust with PSP organizations and general support for PSP leadership mental health initiatives. PSP leaders identified perceived areas for improving ICBT implementation (e.g., ensuring leaders have access to data on PSPNET uptake and outcomes, creating promotional videos, expanding availability of PSPNET to other provinces, offering additional options for receiving therapist support). Implications: Overall, the study provides insights into PSP leaders' perceptions of the implementation of ICBT among PSP and ideas for optimizing implementation efforts.
  • ItemOpen Access
    Associations Between Personality and Mental Health Among Royal Canadian Mounted Police Cadets
    (Springer Science and Business Media LLC, 2024-01-27) Katie L. Andrews; Laleh Jamshidi; Jolan Nisbet; Tracie O. Afifi; Shannon Sauer-Zavala; Gregory P. Kratzig; Taylor A. Teckchandani; J. Patrick Neary; R. Nicholas Carleton
    AbstractRoyal Canadian Mounted Police (RCMP) report frequent exposures to diverse potentially psychological traumatic events (PPTEs) that can lead to symptoms of posttraumatic stress disorder (PTSD) and other mental health disorders. Personality traits may partially inform the substantial mental health challenges reported by serving RCMP. The current study examines associations between HEXACO personality factor and facet-level dimensions and mental health disorders of RCMP cadets starting the Cadet Training Program (CTP). RCMP cadets (n = 772) starting the CTP self-reported sociodemographics, personality, and mental health disorder symptoms. Emotionality was associated with MDD, GAD, and SAD (AORs ranged from 6.23 to 10.22). Extraversion and Agreeableness were inversely associated with MDD, GAD, and SAD (AORs ranged from 0.0159 to 0.43), whereas Openness to Experience was inversely associated with SAD (AOR = 0.36). Several facet-level personality dimensions were associated with mental health disorders. Inconsistent differences were observed between men and women for relationships between personality factors, facets, and positive screenings for mental disorders. The relationship patterns allude to possible risk and resilience factors associated with personality factors and facets. Early training, interventions, and resources tailored to cadet personality factors and facets might reduce risk and bolster mental health resilience.
  • ItemOpen Access
    Towards a Holistic Model of Care for Moral Injury: An Australian and New Zealand Investigation into the Role of Police Chaplains in Supporting Police Members following exposure to Moral Transgression
    (Springer, 2023-09-11) Phelps, Andrea J.; Madden, Kelsey; Carleton, R. Nicholas; Johnson, Lucinda; Carey, Lindsay B.; Mercier, Jean-Michel; Mellor, Andrew; Baills, Jeffrey; Forbes, David; Devenish-Meares, Peter; Hosseiny, Fardous; Dell, Lisa
    Police members can be exposed to morally transgressive events with potential for lasting psychosocial and spiritual harm. Through interviews with police members and police chaplains across Australia and New Zealand, this qualitative study ex- plores the current role that police chaplains play in supporting members exposed to morally transgressive events. The availability of chaplains across police services and the close alignment between the support they offer, and the support sought by police, indicates they have an important role. However, a holistic approach should also consider organizational factors, the role of leaders, and access to evidence- based treatment in collaboration with mental health practitioners.
  • ItemOpen Access
    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, MT; Yakovenko, I.; O'Connor, R.; Wardell, J.; Rudnick, A.; Carleton, R. Nicholas; Heber, A.; Stewart, SH
    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.
  • ItemOpen Access
    Internet-delivered cognitive behavioural therapy for symptoms of PTSD among public safety personnel: Initial outcomes of an open cohort preference trial of transdiagnostic and disorder-specific therapy
    (Elsevier, 2023-09-09) McCall, Hugh; Dear, Blake, F.; Landry, Caeleigh; Beahm, Janine D.; Gregory, Julia; Titov, Nickolai; Carleton, R. Nicholas; Hadjistavropoulos, Heather D.
    Public safety personnel (PSP) face high rates of mental health problems and many barriers to care. Initial outcomes of transdiagnostic internet-delivered cognitive behavioural therapy (ICBT) tailored for PSP are promising, but prior research has not evaluated outcomes of PTSD-specific ICBT among PSP or PSP's preferences for transdiagnostic or PTSD-specific ICBT. The current paper presents the initial outcomes (N = 150) of a mixed-methods observational study designed to (a) investigate preferences for transdiagnostic or PTSD-specific ICBT among PSP with elevated symptoms of PTSD and/or a primary concern with PTSD symptoms and (b) explore potential differences in client engagement, satisfaction, and symptom changes between the two forms of ICBT. PSP completed questionnaires before and after their preferred ICBT program. Mixed-methods analyses included generalized estimating equations, descriptive statistics, and inductive conventional qualitative content analysis. More clients (n = 85; 57 %) selected transdiagnostic ICBT than PTSD-specific ICBT (n = 65; 43 %), but the difference in the number of clients who selected each course was not statistically significant. Clients in both ICBT programs reported similar and favorable treatment satisfaction (e.g., 98 % would recommend the course to a friend), treatment engagement (i.e., 69 % accessed at least four of the five lessons), and pre-post improvement in symptoms (e.g., Hedges' g = 0.81 for reduction in PTSD symptom). Transdiagnostic ICBT resulted in greater reductions in symptoms of panic disorder than PTSD-specific ICBT. Qualitative analyses showed similarities across the ICBT programs in client feedback. The current study provides further evidence supporting the use and outcomes of ICBT for PSP in both transdiagnostic and disorder-specific formats. Implications for the literatures on PSP mental health and ICBT, as well as practical recommendations, are discussed.
  • ItemOpen 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.
  • ItemOpen 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.
  • ItemOpen Access
    Understanding PTSD among correctional workers in Manitoba, Canada: Key considerations of social variables
    (Wiley, 2023-06) McKendy, Laura; Taillieu, Tamara; Johnston, Matthew, S.; Ricciardelli, Rosemary; Ricciardelli, R. Nicholas
    Mounting evidence highlights the high prevalence of posttraumatic stress disorder (PTSD) among correctional workers. The current analysis draws on survey response data to present a social profile of correctional workers in the province of Manitoba (n = 580), Canada, who screened positive for PTSD (n = 196). We examined demographic information, professional history information, and adverse work exposure experiences, as well as treatment and support patterns. The analysis was not intended to identify correlates of PTSD development among correctional workers, but did identify the characteristics, professional and personal situations, and treatment experiences of correctional workers who screened positive for PTSD. The results highlight the multidimensional nature of work stressors, the pronounced problem of work–life conflict, and variations in seeking supports and treatments. Generally, participants screening positive for PTSD reported higher exposure to potentially psychologically traumatic events, higher environmental or occupational stressors at work, and many had prior work experience as public safety personnel. Correctional workers who screened positive for PTSD appeared more likely to access mental health supports. Promoting proactive support seeking for mental health treatment may help to mitigate the severity, frequency, stigma, and length of mental health challenges among correctional workers.
  • ItemOpen Access
    Paraprofessional delivery of online narrative exposure therapy for firefighters
    (Wiley, 2023-06-08) Olthuis, Janine V.; Kaltenbach, Elisa; Giberson, Emma; Saryeddine, Tina; Asmundson, Gordon J. G.; Carleton, R. Nicholas; Cramm, Heidi; Crombach, Anselm; Devlin, Julie; Mack, Jeff; Lingley-Pottie, Patricia; Rao, Sanjay; Sullivan, Michael; Wozney, Lori; McGrath, Patrick J.
    Firefighters are at increased risk for developing posttraumatic stress disorder (PTSD) and face numerous barriers to accessing mental health care. Innovative ways to increase access to evidence-based interventions are needed. This study was a case series testing the acceptability, feasibility, and preliminary effectiveness of a paraprofessional-delivered, virtual narrative exposure therapy (eNET) intervention for PTSD. Participants were 21 firefighters who met the criteria for clinical or subclinical probable PTSD and completed 10–12 sessions of eNET via videoconference. Participants completed self-report measures pre- and postintervention and at 2- and 6-month follow-ups as well as a postintervention qualitative interview. Paired samples t tests evidenced statistically significant decreases in PTSD, anxiety, and depressive symptom severity and functional impairment from pre- to postintervention, ds = 1.08–1.33, and in PTSD and anxiety symptom severity and functional impairment from preintervention to 6-month follow-up, ds = 0.69–1.10. The average PTSD symptom severity score fell from above to below the clinical cutoff for probable PTSD at postintervention and follow-ups. Qualitative interviews indicated that paraprofessionals were considered central to participants’ success and experience with the intervention. No adverse events or safety concerns were raised. This study is an important step in demonstrating that appropriately trained and supervised paraprofessionals can effectively deliver eNET to firefighters with PTSD.
  • ItemOpen Access
    Provincial Correctional Service Workers: The Prevalence of Mental Disorders
    (Multidisciplinary Digital Publishing Institute, 2020-03-25) Carleton, R. Nicholas; Ricciardelli, Rosemary; Taillieu, Tamara; Mitchell, Meghan M.; Andres, Elizabeth; Afifi, Tracie O.
    Correctional service employees in Ontario, Canada (n = 1487) began an online survey available from 2017 to 2018 designed to assess the prevalence and correlates of mental health challenges. Participants who provided data for the current study (n = 1032) included provincial staff working in institutional wellness (e.g., nurses) (n = 71), training (e.g., program officers) (n = 26), governance (e.g., superintendents) (n = 82), correctional officers (n = 553), administration (e.g., record keeping) (n = 25 ), and probation officers (n = 144, parole officers). Correctional officers, workers in institutional administration and governance positions, and probation officers reported elevated risk for mental disorders, most notably posttraumatic stress disorder (PTSD) and major depressive disorder. Among institutional correctional staff, 61.0% of governance employees, 59.0% of correctional officers, 43.7% of wellness staff, 50.0% of training staff, and 52.0% of administrative staff screened positive for one or more mental disorders. In addition, 63.2% of probation officers screened positive for one or more mental disorders. Women working as correctional officers were more likely to screen positive than men (p < 0.05). Across all correctional occupational categories positive screens for each disorder were: 30.7% for PTSD, 37.0% for major depressive disorder, 30.5% for generalized anxiety disorder, and 58.2% for one or more mental disorders. Participants between ages 40 and 49 years, working in institutional governance, as an institutional correctional officer, or as a probational officer, separated or divorced, were all factors associated (p < 0.05) with screening positive for one or more mental disorders. The prevalence of mental health challenges for provincial correctional workers appears to be higher than federal correctional workers in Canada and further supports the need for evidence-based mental health solutions.
  • ItemOpen Access
    Why Do Public Safety Personnel Seek Tailored Internet-Delivered Cognitive Behavioural Therapy? An Observational Study of Treatment-Seekers
    (Multidisciplinary Digital Publishing Institute, 2021-11-15) McCall, Hugh C.; Landry, Caeleigh A.; Ogunade, Adeyemi; Carleton, R. Nicholas; Hadjistavropoulos, Heather, D.
    First responders and other public safety personnel (PSP) experience elevated rates of mental disorders and face unique barriers to care. Internet-delivered cognitive behavioural therapy (ICBT) is an effective and accessible treatment that has demonstrated good treatment outcomes when tailored specifically for PSP. However, little is known about how PSP come to seek ICBT. A deeper understanding of why PSP seek ICBT can inform efforts to tailor and disseminate ICBT and other treatments to PSP. The present study was designed to (1) explore the demographic and clinical characteristics, motivations, and past treatments of PSP seeking ICBT, (2) learn how PSP first learned about ICBT, and (3) understand how PSP perceive ICBT. To address these objectives, we examined responses to online screening questionnaires among PSP (N = 259) who signed up for an ICBT program tailored for PSP. The results indicate that most of our sample experienced clinically significant symptoms of multiple mental disorders, had received prior mental disorder diagnoses and treatments, heard about ICBT from a work-related source, reported positive perceptions of ICBT, and sought ICBT to learn skills to manage their own symptoms of mental disorders. The insights gleaned through this study have important implications for ICBT researchers and others involved in the development, delivery, evaluation, and funding of mental healthcare services for PSP.
  • ItemOpen 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.
  • ItemOpen 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.
  • ItemOpen Access
    CV Carleton 2023_May_25
    (2023-05-25) Carleton, R. Nicholas
  • ItemOpen Access
    CV Carleton 2023_April_2
    (2023-04-02) Carleton, R. Nicholas
  • ItemOpen Access
    Exploring item order in anxiety-related constructs: Practical impacts of serial position
    (2012-04) Carleton, R. Nicholas; Thibodeau, Michel, A.; Osborn, Jason, A.; Asmundson, Gordon, J. G.
    The present study was designed to test for item order effects by measuring four distinct constructs that contribute substantively to anxiety-related psychopathology (i.e., anxiety sensitivity, fear of negative evaluation, injury/illness sensitivity, and intolerance of uncertainty). Participants (n = 999; 71% women) were randomly assigned to complete measures for each construct presented in one of two modalities: (a) items presented cohesively as measures or (b) items presented randomly interspersed with one another. The results suggested that item order had a relatively small impact on item endorsement, response patterns, and reliabilities. The small impact was such that item order appears unlikely to influence clinical decisions related to these measures. These findings not only have implications for these and other similar measures, but further inform a long-standing debate about whether item grouping is a substantial concern in measurement.
  • ItemOpen 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.