Trouble with the curve: the 90-9-1 rule to measure volitional participation inequalities among Royal Canadian Mounted Police cadets during training.

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.

Cardioautonomic lability assessed by heart rate variability changes in Royal Canadian Mounted Police cadets during the cadet training program.

Objective: The current study examined variations in cardioautonomic lability during the Royal Canadian Mounted Police (RCMP) Cadet Training Program (CTP) between cadets starting their training who did or did not screen positive for one or more mental health disorders (i.e., posttraumatic stress disorder [PTSD], major depressive disorder [MDD], social anxiety disorder [SAD], generalized anxiety disorder [GAD], panic disorder [PD], alcohol use disorder [AUD]). Methods: Electrocardiogram (ECG) signals integrated into Hexoskin garments were used to record ECG and heart rate Over the 26-week CTP. There were 31 heart rate variability (HRV) parameters calculated using Kubios Premium HRV analysis software. Mann-Whitney U-tests were used to perform groupwise comparisons of participant raw values and HRV during the CTP. Results: A total of 157 cadets (79% male) were screened for any mental disorder using self-report surveys and then grouped by positive and negative screening. Analyses indicated a statistically significant (p < 0.05) decrease in low frequency (LF): High Frequency (HF) variability during CTP, but only for cadets who endorsed clinically significant anxiety symptoms on the GAD-7 at the start of their training. There were no other statistically significant groupwise differences. Conclusion: The results indicate the participants have excellent cardiac health overall and suggest potentially important differences between groups, such that cadets who endorsed clinically significant anxiety symptoms on the GAD-7 showed less variability in the LF:HF ratio over the course of the CTP. The relatively lower variability suggests decreased parasympathetic tone in those without clinically significant anxiety symptoms. The results also have important implications for future investigations of cardioautonomic dysfunction and chronic hypothalamic pituitary adrenal (HPA) axis deviations in policing populations with anxiety disorders; specifically, cardioautonomic inflexibility related to cardiovascular morbidity and mortality. In any case, the current results provide an important baseline for future cardiac research with cadets and serving officers.

Daily survey participation and positive changes in mental health symptom scores among Royal Canadian Mounted Police Cadets.

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.

Prophylactic relationship between mental health disorder symptoms and physical activity of Royal Canadian Mounted Police Cadets during the cadet training program.

Objective: Royal Canadian Mounted Police report experiencing extremely frequent potentially psychologically traumatic events (PPTE). In a recent study, approximately half of participating RCMP screened positive for one or more mental disorders, which is approximately five times the diagnostic proportion for the general Canadian population. Increased reporting of mental health symptoms been linked to PPTE exposures. Programs promoting physical activity may be useful interventions to supplement or pair with mental health interventions, providing anxiolytic, antidepressant, and stress-buffering effects. The current study was designed to assess the relationship between physical activity behaviors and reported mental health disorder symptoms of cadets during the Royal Mounted Canadian Police (RCMP) Cadet Training Program (CTP). The current study also examined the relationship between exercise and mental health disorder symptoms of cadets during the CTP. Methods: The study included data from 394 cadets (76.1% male). An analysis of variance (ANOVA) and a series of t-tests were used to assess several differences across sociodemographic groups. Bivariate Spearman's Rank correlations were performed between the average number of active calories burned per day, as recorded by Apple Watches, and changes in self-reported mental health disorder symptoms (i.e., Generalized Anxiety Disorder [GAD], Major Depressive Disorder [MDD], Posttraumatic Stress Disorder [PTSD], Social Anxiety Disorder [SAD]. Alcohol Use Disorders [AUD], Panic Disorder [PD]) from pre-training (starting the CTP) to pre-deployment (completing the CTP) 26 weeks later. Results: There were statistically significant correlations between physical activity and self-reported mental health disorder symptom scores during CTP. Cadets who performed more physical activity from pre-training to pre-deployment had statistically significantly greater decreases in symptoms of GAD (ρ = -0.472, p < 0.001), MDD (ρ = -0.307, p < 0.001), PTSD (ρ = -0.343, p < 0.001), and AUD (ρ = -0.085, p < 0.05). There was no statistically significant relationship between physical activity and changes in PD symptoms (ρ = -0.037, p > 0.05). There were also no statistically significant relationships between pre-CTP mental health disorder symptom scores and the volume of physical activity performed during CTP. Conclusion: There was evidence of a significant relationship between reductions in mental health disorder symptom scores and physical activity during the 26-week CTP. The results highlight the role that exercise can play as an important tool for reducing mental health disorder symptoms, considering there was no relationship between pre-CTP baseline mental health scores and physical activity performed during CTP. Further research is needed to understand differences in physical activity behaviours among cadets and serving RCMP.

Mental Health of Royal Canadian Mounted Police at the Start of the Cadet Training Program.

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.

Mental health and social support among Royal Canadian Mounted Police cadets.

Introduction: Certain populations, such as public safety personnel (PSP), experience frequent exposures to potentially psychologically traumatic events and other occupational stressors, increasing their risk for mental health challenges. Social support has been evidenced as a protective factor for mental health. However, research examining perceived social support and its associations with symptoms related to mental disorders among PSP recruits is limited. Methods: RCMP cadets (n = 765, 72% male) completed self-report surveys assessing: sociodemographic information, social support, and symptoms related to posttraumatic stress disorder, major depressive disorder, generalized anxiety disorder, social anxiety disorder, panic disorder, and alcohol use disorder. Results: The results indicated statistically significant associations between higher social support and decreased odds of positive screens for generalized anxiety disorder, social anxiety disorder, and panic disorder (i.e., significant Adjusted Odds Ratios = 0.90 to 0.95). Discussion: Cadets' perceived levels of social support are comparable to the Canadian general population and higher than serving RCMP. Social support appears to offer a protective element against anxiety-related disorders among participating cadets. Reductions in perceived levels of social support may be a function of RCMP service. Factors contributing to decreased levels of perceived social support should be considered.

Potentially Psychologically Traumatic Event Exposure Histories of new Royal Canadian Mounted Police Cadets.

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.

Suicidal Ideation, Planning, and Attempts Among new Royal Canadian Mounted Police Cadets.

BACKGROUND: 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). METHOD: Cadets (n = 736, 74.0% male) were administered the structured Mini International Neuropsychiatric Interview by a mental health clinician or a supervised clinical psychologist trainee. The interview includes an assessment of past month suicidal ideation, planning, attempts and lifetime suicide attempts. RESULTS: Within 1 month of starting the CTP, a small percentage of cadets reported past month suicidal ideation (1.6%) and no cadets reported any suicidal planning (0%) or attempts (0%). Lifetime suicide attempts were reported by (1.5%) of cadets. CONCLUSIONS: The current results provide the first information describing the prevalence of suicidal ideation, planning, and attempts among RCMP cadets starting the CTP. The estimates of suicidal behaviours appear lower than the general population and lower than reports from serving RCMP. Higher prevalence estimates of suicidal behaviours reported by serving RCMP, relative to lower estimates among cadets starting the CTP in the current study, may be related to age, cumulative experiences or protracted exposures to operational and organizational stressors, rather than insufficient screening of recruits.

Assessing the impact of the Royal Canadian Mounted Police (RCMP) protocol and Emotional Resilience Skills Training (ERST) among diverse public safety personnel.

BACKGROUND: 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. METHODS: The current protocol paper describes the PSP PTSI Study (i.e., design, measures, materials, hypotheses, planned analyses, expected implications, and limitations), which was originally designed to evaluate an evidence-informed, proactive system of mental health assessment and training among Royal Canadian Mounted Police for delivery among diverse PSP (i.e., firefighters, municipal police, paramedics, public safety communicators). Specifically, the PSP PTSI Study will: (1) adapt, implement, and assess the impact of a system for ongoing (i.e., annual, monthly, daily) evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; and, (4) assess the impact of providing diverse PSP with a tailored version of the Emotional Resilience Skills Training originally developed for the Royal Canadian Mounted Police in mitigating PTSIs based on the Unified Protocol for the Transdiagnostic Treatment of Emotional Disorders. Participants are assessed pre- and post-training, and then at a follow-up 1-year after training. The assessments include clinical interviews, self-report surveys including brief daily and monthly assessments, and daily biometric data. The current protocol paper also describes participant recruitment and developments to date. DISCUSSION: The PSP PTSI Study is an opportunity to implement, test, and improve a set of evidence-based tools and training as part of an evidence-informed solution to protect PSP mental health. The current protocol paper provides details to inform and support translation of the PSP PTSI Study results as well as informing and supporting replication efforts by other researchers. TRIAL REGISTRATION: Hypotheses Registration: aspredicted.org, #90136. Registered 7 March 2022-Prospectively registered. TRIAL REGISTRATION: ClinicalTrials.gov, NCT05530642. Registered 1 September 2022-Retrospectively registered. The subsequent PSP PTSI Study results are expected to benefit the mental health of all participants and, ultimately, all PSP.

The Royal Canadian Mounted Police (RCMP) Study: protocol for a prospective investigation of mental health risk and resilience factors. / Étude de la Gendarmerie royale du Canada : protocole d'enquête prospective sur les facteurs de risque et de résilience en matière de santé mentale.

The Royal Canadian Mounted Police (RCMP), like all public safety personnel (PSP), are frequently exposed to potentially psychologically traumatic events that contribute to posttraumatic stress injuries (PTSI). Addressing PTSI is impeded by the limited available research. In this protocol paper, we describe the RCMP Study, part of the concerted efforts by the RCMP to reduce PTSI by improving access to evidence-based assessments, treatments and training as well as participant recruitment and RCMP Study developments to date. The RCMP Study has been designed to (1) develop, deploy and assess the impact of a system for ongoing annual, monthly and daily evidence-based assessments; (2) evaluate associations between demographic variables and PTSI; (3) longitudinally assess individual differences associated with PTSI; (4) augment the RCMP Cadet Training Program with skills to proactively mitigate PTSI; and (5) assess the impact of the augmented training condition (ATC) versus the standard training condition (STC). Participants in the STC (n = 480) and ATC (n = 480) are assessed before and after training and annually for 5 years on their deployment date; they also complete brief monthly and daily surveys. The RCMP Study results are expected to benefit the mental health of all participants, RCMP and PSP by reducing PTSI among all who serve.

Research is limited on how to mitigate posttraumatic stress injuries (PTSIs) among Royal Canadian Mounted Police (RCMP) who are exposed to potentially psychologically traumatic events. The RCMP Study has been designed to develop, deploy and assess the impact of skills taught to proactively mitigate PTSI. RCMP cadets recruited into the study to receive the augmented training are assessed before and after training and annually for 5 years on their deployment date. The RCMP Study results are expected to benefit the mental health of study participants, RCMP and other public safety personnel by mitigating PTSI among all who serve.

On dispose de peu de recherches sur les moyens d'atténuer les blessures de stress post­traumatique chez les membres de la Gendarmerie royale du Canada (GRC) qui sont exposés à des événements potentiellement traumatiques sur le plan psychologique. L'étude de la GRC a été conçue pour mettre au point des compétences permettant d'atténuer de façon proactive les blessures de stress post­traumatique, pour intégrer ces compétences à la formation offerte aux cadets et pour en évaluer les effets. Les cadets de la GRC recrutés dans le cadre de l'étude en vue de suivre une formation renforcée sont évalués avant et après la formation ainsi que chaque année pendant cinq ans à compter de la date de leur déploiement. Les résultats de l'étude de la GRC devraient être bénéfiques pour la santé mentale des participants de l'étude, pour la GRC et pour les autres membres du personnel de la sécurité publique, en contribuant à atténuer les blessures de stress post­traumatique de tous ceux qui sont au service de la population.

What does evolutionary theory add to stereotype theory in the explanation of attractiveness bias?

Maestripieri et al. seem to put forth an argument in which they become vulnerable to some of the same criticisms that they level against stereotype theory As a result, the explanatory utility of their account of attractiveness bias comes into question, and it is unclear whether it offers anything superior to stereotype theory in conceptual soundness.