Law enforcement mental health: A systematic review of qualitative research.

The aim of this review was to explore qualitative accounts of law enforcement (LE) officers' personal experiences of mental health, in terms of linguistic descriptions, relationships between occupational experiences and mental health, and challenges to maintaining mental well-being. Using preferred reporting items for systematic reviews and meta-analyses guidelines, 1,876 articles were screened, and 31 studies were included in the current review. A risk of bias assessment was used to assess the study's methodological rigor, and data were extracted to answer three exploratory research questions. Results revealed that LE officers frequently experience occupational stressors and identify different mental health difficulties as a result. Additionally, cultural norms and stigma prevalent in the LE profession were noted to contribute to experiences of mental health and impact LE officers' ability to reach out for help and utilize professional resources. This review suggests that efforts to offer mental health services to LE officers need to prioritize cultural competence, confidentiality, and education to overcome stigma and increase mental health literacy and service use. Stakeholders addressing the LE mental health crisis may find this review useful due to several practical recommendations offered. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Acceptability of exposure-based treatments for PTSD among Latinxs: A mixed-methods study.

OBJECTIVE: Latinx individuals are the largest and fastest growing ethnic group in the United States and are substantially impacted by trauma. Despite the potential benefit that Latinx individuals could experience from existing evidence-based treatments, they demonstrate low service-utilization rates. The current study examined treatment acceptability of exposure-based treatment for PTSD, using mixed methodology. Because exposure-based PTSD treatments were developed through a Western cultural lens, we hypothesized that (a) Latinx individuals would have low rates of treatment acceptability, (b) acculturation would positively predict treatment acceptability, and (c) enculturation would negatively predict treatment acceptability. METHOD: Participants were 95 Latinx individuals. All participants were provided with a vignette depicting a fictional character who underwent exposure therapy for PTSD. A subset of participants completed a semistructured interview assessing their views on exposure-based treatments for PTSD (n = 25), and a subset of participants completed a questionnaire examining treatment acceptability of exposure-based therapy for PTSD (n = 70). RESULTS: Results from the qualitative data revealed that Latinx individuals identified both favorable and negative elements of exposure-based interventions for PTSD. Additionally, we noted that participants had a belief system regarding how they perceived exposure-based treatments to work. Results from the quantitative data indicate that our participants generally found exposure-based therapy to be acceptable and that enculturation (but not acculturation) predicted treatment acceptability. CONCLUSIONS: Because attitudes toward treatment contribute to outcomes, we concluded that the aggravating elements, mitigating factors, and perceived mechanism of change together contribute to Latinx acceptability of exposure-based treatment for PTSD. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Breaking the silence: A qualitative analysis of trauma narratives submitted online by first responders.

OBJECTIVE: Trauma narration is important to PTSD recovery and is widely used in clinical interventions. First responders experience high rates of exposure to trauma yet there are no studies with a primarily first responder population despite that trauma exposure is a chronic and unavoidable aspect of their occupation. The aim of the current study was to qualitatively examine trauma narratives posted online through a supportive website dedicated for first responders. METHOD: 30 trauma narratives of police officers, firefighters, and emergency medical personnel were randomly chosen for inclusion in the study. While some narrative posters remained somewhat anonymous, overall, there was moderate diversity in terms of age, sex, job field, number of years on the job, and the locations of the employer. RESULTS: Online narration offered a less formalized opportunity for self-disclosure that allowed for authenticity, honesty, and vulnerability. Thematic analyses revealed 5 themes: idealization with the job, disillusionment with the job, on the job trauma, trauma sequalae, and coping with trauma. CONCLUSION: Findings suggest that first responders are exposed to trauma on the job that significantly alters their work and home lives. Although they experience psychopathology, and could benefit from formal treatment, their decision to seek treatment is impacted by stigma in the culture. Implications and future directions are discussed regarding the need to improve perceived connectedness and support and reduce stigma in online platforms and within the subculture to encourage healing. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Work-related traumatic stress spillover in first responder families: A systematic review of the literature.

OBJECTIVE: The aim of the current review was to examine the impact of trauma exposure on first responder families, particularly, in terms of their relationships, family roles and obligations, and engagement in risk factors. METHOD: Using the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRIMSA) guidelines, 3,213 articles were screened, and 16 studies met inclusion for the current review. A risk of bias assessment was conducted to determine the methodological rigor of included studies and data was extracted to highlight the research questions, targeted populations, study design, measurement instruments, and outcomes of the included studies. RESULTS: The majority of research questions were asked to understand the experience of being a spouse to a first responder and to identify the stressors, supports, and resources of first responders and their families. Additionally, studies in this area were determined to be conducted primarily with spouses or partners of first responders, utilizing predominantley cross-sectional methodologies and measurement instruments with good psychometric properties. CONCLUSIONS: A discussion of the limitations and gaps in the literature was included and generally highlighted a lack of diversity in sample demographic characteristics and study design. Five concrete recommendations for future research were made to address limitations and strengthen research in this area. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

¡No me duele cuando me deprimo!: An Examination of Ethnic Differences in Depression Symptoms Among Latinx and Non-Latinx Primary Care Patients.

The research on ethnic differences in prevalence rates of depression is mixed. Additionally, culture has been hypothesized to impact symptom manifestation. The purpose of this study was to examine prevalence rates of depression among Spanish-speaking Latinx and non-Latinx White (NLW) primary care patients and explore ethnic differences in how depression symptoms manifest. Participants were 240 primary care patients who completed a demographic questionnaire and the Beck Depression-Inventory-2 (BDI-II). Latinx primary care patients had lower prevalence rates of depressive symptoms and less severe depressive symptoms than NLW primary care patients. Holding total BDI-II score constant, Latinxs also endorse pessimism, past failures, feelings of being punished, agitation, and problems with sleeping less than their NLW counterparts. This study adds support to research that indicates that Latinxs have lower rates of depression than NLWs and suggests that Latinxs are not more likely to endorse somatic complaints.

Culturally sensitive clinical practices: A mixed methods study.

The purpose of this mixed methods study was to discover if and how clinicians integrate cultural factors into treatment, what specific 'culturally sensitive' practices clinicians utilize, and who clinicians use these practices with. In Study 1(N = 9) qualitative interviews were conducted with psychologists who shared information about the culturally sensitive clinical practices that they utilize. Based on the results from Study 1, a survey was created for Study 2 and completed by 142 psychologists. There were three overriding conceptual themes that were generated from the analysis of the data regarding how clinicians provide culturally sensitive psychological services and what specific culturally sensitive clinical practices clinicians use when working with clients. It was evident from the data that the delivery of culturally sensitive services was best conceptualized as a process. The process began with being aware that cultural factors existed. This awareness led to the development of hypotheses, which guided the assessment process. Based on the results of the assessment process clinicians then tailored the services they provided to the unique characteristics of their clients. The quantitative results from Study 2 indicate that that the qualitative results from Study 1 are generalizable to a larger sample of psychologists. Results from Study 2 also indicated that the vast majority of participants indicated that they engaged in culturally sensitive clinical practices regardless of client minority-status. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Minority Participation in Randomized Controlled Trials for Prolonged Exposure Therapy: A Systematic Review of the Literature.

Per the most recent census, non-Latinx White individuals comprise the majority of the U.S. population (76.6%); Latinx individuals make up 18.3% of the total U.S. population, followed by African Americans (13.4%) and Asians (5.9%). Given the high prevalence rates of posttraumatic stress disorder (PTSD) observed across many ethnoracial minority groups in the United States, the fact that PTSD presentation may vary across culture, and the National Institute of Health's mandates for the inclusion of women and minorities in clinical outcome research, the aim of the present systematic review was to examine minority inclusion in clinical outcome research for PTSD. Our review focused exclusively on one empirically supported treatment: prolonged exposure therapy (PE); we identified 38 studies that met the inclusion criteria. Apart from African Americans, who were overrepresented in 21 studies (inclusion rate range: 13.5%-73.9%), ethnoracial minority inclusion in RCTs examining PE was low. More specifically, across included studies that reported ethnoracial minority data, 58.9% of participants were White, 31.1% were African American, 4.9% were Latinx, 0.6% were Asian American or Pacific Islander, and 4.7% reported race as "other." Inclusion rates for ethnoracial minorities appeared to increase across time, and recruitment strategies did not appear to be associated with increased ethnoracial minority participation in RCTs for PE.

The Behavioral Model of Health: Education, Behavioral Health Factors, and Stigma as Predictors of Help-Seeking Attitudes.

Per the behavioral model of health, help-seeking attitudes (and even behavioral health service use) are a function of predisposing and enabling individual characteristics (e.g. demographic characteristics, health beliefs), as well as contextual characteristics (resources, social structures such as education etc.). While researchers have examined how demographic (gender and ethnicity) and socioeconomic (education and income) characteristics, psychological factors, and internal barriers relate to help-seeking attitudes, the majority of these works have investigated how different variables independently act on help-seeking attitudes in lieu of more comprehensively investigating how they operate in tandem. The purpose of the current study was to examine how demographic (gender and ethnicity) and socioeconomic (education and income) characteristics, behavioral health factors, and internal barriers relate to help-seeking attitudes in a diverse sample of primary care patients. We also sought to examine differences in demographic and socioeconomic characteristics in mental health literacy, stigma, and help-seeking attitudes. Participants were 286 primary care patients. Results from this study indicate that a combination of socioeconomic characteristics (i.e. education), behavioral health factors (level of distress and history of behavioral health service utilization), and internal barriers (personal stigma) predicted help-seeking attitudes among primary care patients. There was an inverse relationship between education and personal stigma and help-seeking attitudes such that higher levels of education and higher levels of personal stigma were associated with more negative help-seeking attitudes.

Latinos, anxiety, and cognitive behavioral therapy: a systematic review

This systematic review examined intervention studies that used Cognitive Behavioral Therapy (CBT) to treat anxiety among Latinos. PsychINFO, Social Work Abstracts, PubMed, and Medline were searched for manuscripts published between January 1995 through July 2016 as part of a registered review protocol (PROSPERO) following PRISMA guidelines. Studies were included if they were an intervention study that used CBT to treat anxiety in predominately U.S. Latino adult samples. Risk of bias was assessed using two National Heart, Lung, and Blood Institute quality assessment tools. Overall, 4 studies met inclusion criteria. Results supported CBT interventions to be efficacious for Latinos with anxiety and CBT interventions with cultural adaptations to address some barriers to treatment. Limitations and implications of these results are discussed

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Prevalence of Interpersonal Violence Among Latinas: A Systematic Review.

Violence against women continues to be a great concern in today's society. In the United States, women experience high rates of interpersonal violence throughout their lifetime. Among Latinas, interpersonal violence is also highly prevalent however the wide variation of interpersonal prevalence rates among Latinas is problematic. The aims of this systematic review of the literature were to (1) document the prevalence rates of violence among Latinas, (2) determine the types of violence that Latinas are most impacted by, and (3) assess the prevalence rates of interpersonal across Latina subethnicities. The research was based on seven databases including PsycArticles, PsycCRITIQUES, PsycINFO, ScienceDirect, Social Services Abstracts, Social Work Abstracts, and PubMED for articles published from January 2007 up to July 2017. The following key words were used in the search: (Latinas OR Latinos OR Hispanics) AND (victim OR victimization) AND (domestic violence OR intimate partner violence OR Interpersonal Violence). We identified 41 articles in our search that reported rates of interpersonal violence which ranged from 1% to 83% with intimate partner violence and domestic violence being the most prevalent. Interpersonal violence was found to be more prevalent among individuals who identified as Mexican. Based on the findings, it is clear that efforts should be focused on conducting a lager national survey of interpersonal violence among Latinas. It would need to include subethnicity, immigration status, and type of abuse experienced and possibly add socioeconomic factors.

The evolving definition of cultural competency: a mixed methods study

This research established a definition of cultural competency from the perspective of the psychologists using mixed methodology. In Study 1 (N= 9) participants were interviewed and asked how they conceptualize cultural competency; three emergent themes were identified: awareness, knowledge, and skills. Based on the results from Study 1, a survey was created for Study 2 and completed by psychologists (N= 142). Results from a confirmatory factor analysis did not support cultural competency as a 3-dimensional construct. A post-hoc exploratory factor analysis suggested that cultural competency is best conceptualized as a 2-dimensional construct consisting of knowledge/awareness and skills. Results suggest that the knowledge needed to work with diverse populations is more than simply knowing about the major cultural groups in the United States; a more sophisticated level of knowledge is needed as there are many cultures and sub-cultures

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