Mindfulness-Based Resilience Training for Aggression, Stress and Health in Law Enforcement Officers

项目摘要/摘要 执法人员(Leo)暴露在巨大的压力源之下，增加了他们攻击和过度使用武力的风险。这种功能失调的应激反应会给他们的社区带来毁灭性的后果，包括无理的枪击、严重殴打和致命的窒息。它还会给狮子座带来严重的后果，包括创伤后应激障碍、精疲力竭、酗酒、抑郁和自杀的发生率上升。最近对Leo压力缓解计划进行的一项荟萃分析发现，几乎没有证据表明这种方法是有效的，这突显了针对警务固有压力的预防性干预的迫切需要。正念训练对高压力人群来说是一种很有希望的方法，已经被证明在减轻压力和提高韧性方面有效。我们最近的试验性可行性研究(R21AT008854)确定了单一站点随机对照试验评估基于正念的复原力训练(MBRT)的初步可行性、可接受性和遵守程序，这是一种旨在改善Leo心理健康和复原力、减少攻击性和过度使用武力的预防性干预措施。R21数据提示了LEOS样本的生理机制和潜在的临床益处。与等待名单对照组相比，MBRT参与者在应激反应、攻击性、职业倦怠、职业压力、睡眠障碍和心理灵活性方面表现出改善。这项拟议的研究在两个地点实施，旨在为未来的全面、多地点试验建立最佳方案和程序，以评估MBRT与注意力控制(压力管理教育)和非干预控制对生理、行为和心理结果的影响。为了为未来的临床试验做准备，这项研究将：a)提高招募、参与和保留的效率；b)优化实验室、评估和数据管理程序；c)优化干预培训，确保干预方案的准确性；d)评估参与者的体验，并优化不同地点的结果衡量标准。这一研究的长期目标是开发一种干预措施，减少暴力，提高狮子座人的复原力，并为他们所服务的社区和居民带来显著的好处。

PROJECT ABSTRACT/SUMMARY Law enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force. Such dysfunctional stress reactivity can lead to devastating consequences for their community, including unjustified shootings, severe beatings, and fatal chokings. It can also lead to serious consequences for the LEOs, including elevated incidence of post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. A recent meta-analysis of LEO stress reduction programs found little evidence to demonstrate that such approaches are effective, highlighting the urgent need for preventive interventions targeting the stress inherent to policing. Mindfulness training is a promising approach with high- stress populations that has been shown effective in reducing stress and increasing resilience. Our recent pilot feasibility study (R21AT008854) established initial feasibility, acceptability, and adherence to procedures in a single-site RCT assessing Mindfulness-Based Resilience Training (MBRT), a preventive intervention designed to improve LEO mental health and resilience, and reduce aggression and excessive use of force. The R21 data suggest physiological mechanisms and potential clinical benefit in a sample of LEOs. Relative to waitlist control, MBRT participants showed improvements in stress reactivity, aggression, burnout, occupational stress, sleep disturbance, and psychological flexibility. Implemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of MBRT versus an attention control (Stress Management Education) and a no-intervention control, on physiological, behavioral, and psychological outcomes. To prepare for this future clinical trial, this study will: a) enhance efficiency of recruitment, engagement and retention; b) optimize lab, assessment, and data management procedures; c) optimize intervention training and ensure fidelity to intervention protocols; and d) assess participant experience and optimize outcome measures across sites. The long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience among LEOs, as well as yield significant benefits for communities and residents they serve.