First responders call for national strategy to tackle PTSD crisis

A national strategy should include increased funding for psychological care and workers comp’  for first responders.
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Psychiatrist says PTSD treatment for Mounties improving, but not fast enough

‘PTSD is going to be quite widespread within the RCMP and other first-responder organizations’

Help for RCMP officers who struggle with post-traumatic stress disorder is improving, but Mark Johnston is urging the force to move more quickly to implement its 2014 mental health strategy.

Deadly day in Middlesex; First responders will be offered counselling for possible PTSD, OPP say

Emergency workers — including police, paramedics and firefighters — are twice as likely to get post-traumatic stress disorder (PTSD) as anybody else, according to the Tema Conter Memorial Trust, a Toronto-based charity. In recent years, awareness has grown about the mental and emotional toll tragedies can take on rescue workers. This year, Ontario dedicated money and resources to help prevent and reduce PTSD in first responders.

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First Responders Trauma Prevention and Recovery Program is the first of its kind in the world.

Few deal with tragedy and trauma as frequently as first responders. As a result, the incidence of mental illness among emergency personnel is four times the national average in Canada, To help solved this problem Simon Fraser University is launching a new program to help first responders deal with mental health issues.

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Partners’ involvement linked to efficacy of PTSD treatment

A growing body of research shows treating post-traumatic stress is more effective for patients in committed relationships when their partners are deeply involved in the care – the opposite of the usual experience in 22 soldier and veteran suicides examined by The Globe and Mail.

Ottawa Community News

Creating a new standard to help paramedics in need

The Ontario government announced it will invest almost $200,000 to help create a new workplace health and safety standard specific to paramedics. The announcement was made at the Beaver Barraks Paramedic Station on Aug. 10.

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Ontario adds funding to develop mental health standards for paramedics

The Ontario government will direct nearly $200,000 to a program developing a psychological health and wellness standard for paramedics across Canada.

Child and Adolescent Psych Clinics

Substance Abuse and Trauma

Substance use disorders (SUDs) are highly comorbid with posttraumatic stress disor- der (PTSD). The relationship between substance abuse and trauma is complex and bidirectional, with shared social risk factors and biological pathways. Youth with cooc- curring PTSD and SUD often have more severe challenges than teens with either dis- order alone, with treatment needs that may involve multiple community systems. Integrated treatment principles and recommendations are discussed. Two clinical cases are reviewed to illustrate these treatment principles.

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Getting ahead of PTSD in Sudbury

When a dear colleague goes down with a traumatic stress injury, the whole squad suffers. And sadly, those instances of trouble are too common and PTSD has become a familiar acronym for those working as paramedics, police and firefighters.

PubMed logo

Co-morbidity of PTSD and immune system dysfunction: opportunities for treatment

Posttraumatic stress disorder (PTSD) is defined as a psychiatric disorder; however, PTSD co-occurs with multiple somatic manifestations. People living with PTSD commonly manifest dysregulations in the systems that regulate the stress response, including the hypothalamic-pituitary-adrenal (HPA) axis, and development of a pro-inflammatory state. Additionally, somatic autoimmune and inflammatory diseases and disorders have a high rate of co-morbidity with PTSD. Recognition and understanding of the compounding effect that these disease states can have on each other, evidenced from poorer treatment outcomes and accelerated disease progression in patients suffering from co-morbid PTSD and/or other autoimmune and inflammatory diseases, has the potential to lead to additional treatment opportunities.

Experimental Neurology

New translational perspectives for blood-based biomarkers of PTSD: From glucocorticoid to immune mediators of stress susceptibility

Although biological systems have evolved to promote stress-resilience, there is variation in stress-responses. Understanding the biological basis of such individual differences has implications for understanding Posttraumatic Stress Disorder (PTSD) etiology, which is a maladaptive response to trauma occurring only in a subset of vulnerable individuals.

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Posttraumatic Stress Disorder (PTSD)

The Encyclopedia of Mental Disorders defines posttraumatic stress disorder (PTSD) as “a complex disorder in which a person’s memory, emotional responses, intellectual processes, and nervous system have been disrupted by one or more traumatic experiences.” PTSD is classified in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) as a “trauma and stressor-related disorder” and is the only psychiatric diagnosis (along with acute stress disorder) that depends on a factor outside the person—namely, a traumatic stressor that is outside the range of usual experience.

Journal of Child Psychology and Psychiatry logo

The doctor will not see you now: therapist-light therapy for PTSD in children as the way ahead?

Salloum and colleagues have presented data in support of a novel and cost-effective approach to the treatment of PTSD in young children. In this commentary I outline an argument for why their stepped-care model may be an important change to how psychological therapies for trauma- exposed youth are delivered, and propose further caveats that need to be addressed in future research.

NL ARMS Netherlands

Can Posttraumatic Stress Disorder Be Prevented?

This chapter gives an insight in the possibilities and limitations of the prevention of Posttraumatic Stress Disorder (PTSD). An elaboration upon the diagnosis, criteria, onset and prevalence demonstrates the enormous impact of PTSD. Prevalence rates vary between countries and with the intensity of missions, but are lower in non-US Western countries. The risk factors for PTSD are well documented, as well as relationships between PTSD and an individual’s psychological, biological, and social functioning.

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The impact of posttraumatic stress disorder on the symptomatology of borderline personality disorder

Previous findings on the impact of co-occurring posttraumatic stress disorder (PTSD) in patients with borderline personality disorder (BPD) have revealed inconsistencies, which may have been related to small sample sizes or differences in the presence of childhood sexual abuse (CSA). In this study, the potentially aggravating impact of PTSD and the role of CSA were examined in a large cohort of BPD patients.

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Humber College School of Health Sciences Is Proud To Offer MANERS Psychological First Aid program In Partnership with Tema Trust

Humber College School of Health Sciences has partnered with Toronto-based charity the Tema Conter Memorial Trust to offer MANERS Psychological First Aid. MANERS is an innovative two-day workshop designed for anyone that deals with trauma or crises.

Canadian Occupational Safety

More boards presuming PTSD caused by work – Canadian Occupational Safety

On April 5, Ontario changed its workers’ compensation system to presume that post-traumatic stress disorder (PTSD) is work-related for individuals in specific occupations. Those occupations include first responders, such as firefighters, paramedics, police officers and emergency medical attendants, as well as certain workers in correctional institutions and secure youth justice facilities. Ontario joins Alberta whose legislation contains a similar presumption and Manitoba whose legislation came into effect Jan.1 but is not limited to a specific occupation. On April 1, New Brunswick’s labour minister introduced a similar bill in the legislature signalling that it will likely move in the same direction.


Mental Health Commission of Canada Webinars for First Responders: Suicide Awareness and Prevention

Mental Health Commission of Canada Webinars for First Responders: Suicide Awareness and Prevention is the first webinar in a series of free webinars related to Mental Health for First Responders.

Join to learn about innovative and effective approaches to suicide prevention.  The guest speaker will provide an overview of the trends and evidence around suicide and first responders. You will get to learn about how education, awareness and training can help increase help-seeking behaviours and build suicide prevention capacity within first responder organizations and the larger community.

PubMed logo

Therapeutic Effects of Extinction Learning as a Model of Exposure Therapy in Rats

Current treatments for stress-related psychiatric disorders, such as depression and PTSD, are inadequate. Cognitive behavioral psychotherapies, including exposure therapy, are an alternative to pharmacotherapy, but the neurobiological mechanisms are unknown. Preclinical models demonstrating therapeutic effects of behavioral interventions are required to investigate such mechanisms. Exposure therapy bears similarity to extinction learning. Thus, we investigated the therapeutic effects of extinction learning as a behavioral intervention to model exposure therapy in rats, testing its effectiveness in reversing chronic stress-induced deficits in cognitive flexibility and coping behavior that resemble dimensions of depression and PTSD.

Journal of Traumatic Stress

The Role of Posttraumatic Growth in a Randomized Controlled Trial of Cognitive–Behavioral Conjoint Therapy for PTSD

Posttraumatic growth (PTG) is defined as a positive psychological change that can emerge following a traumatic life event. Although documented in noninterventional studies of traumatized individuals, there are scant data on the potential for therapy to induce or improve PTG. Thus, the primary goal of this study was to examine changes in PTG in a controlled trial of cognitive–behavioral conjoint therapy for posttraumatic stress disorder versus waitlist (CBCT for PTSD; Monson & Fredman, 2012).

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Gender and Age Differences in Trauma and PTSD Among Dutch Treatment-Seeking Police Officers.

Little is known about how age and gender are associated with posttraumatic stress disorder (PTSD) symptoms and traumatic experiences in treatment-seeking police offers. In this study, we examined 967 diagnostic files of police officers seeking treatment for PTSD.

complementary and alternative medicine for PTSD

Family-Focused Interventions for PTSD

Posttraumatic stress disorder (PTSD) has been shown to have a variety of negative health and mental health effects on those who are afflicted (Kessler et al., 2000), as well as negative effects on relationships with intimate partners and close relatives (Whisman, Sheldon, & Goering, 2000). Families are likely to be impacted by the specific nature of the sustained trauma.

complementary and alternative medicine for PTSD

Recreational Therapy for PTSD

There are currently several interventions for posttraumatic stress disorder (PTSD) that meet the definition of “evidence-based therapies” as outlined by the Institute of Medicine (2012). The current chapter examines one such group of interventions: recreational therapy. Recreational therapy refers to treatments designed to help restore prior levels of functioning resulting from injury or illness, or to promote health and wellness.

complementary and alternative medicine for PTSD

Toward a More Comprehensive Approach to the Management of PTSD

In this volume, after a brief discussion of phenomenology of posttraumatic stress disorder (PTSD), the current guidelines and clinical consensus surrounding treatment, and the limitations of available treatment supported by sufficient evidence necessary to receive endorsement in practice guidelines, we describe emerging treatments that demonstrate varying degrees of promise for relieving the suffering associated with PTSD.

complementary and alternative medicine for PTSD

Resilience Training as a Complementary Treatment for PTSD

Other definitions focus on resilience as a trait (eg, hardiness [Maddi, 2005]) or as an outcome trajectory, such as when individuals respond to a specific traumatic event without symptoms or with symptoms that dissipate quickly (Bonanno, Rennicke, & Dekel, 2005).

complementary and alternative medicine for PTSD

Canines as Assistive Therapy for Treatment of PTSD

Canine-assisted therapies are being used increasingly both by veterans and the civilian community for mental and emotional support. During the past decade, a growing body of scientific research has provided evidence that human–animal interactions can improve social competence and reduce physiological, psychological, and behavioral effects of stress and social isolation.

complementary and alternative medicine for PTSD

Complementary and Alternative Medicine for PTSD

Recognizing the increasing need for more consolidated information on Complementary Alternative Medicine for the treatment of PTSD, Doctors Benedek and Wynn have contributed a ground-breaking and invaluable textbook for scholars and practitioners alike.

complementary and alternative medicine for PTSD

Virtual Reality Exposure Therapy for PTSD

Expert treatment guidelines and consensus statements identified imaginal exposure therapy as a first-line treatment for posttraumatic stress disorder (PTSD) more than a decade ago (Ballenger et al. 2000; Foa et al. 1999; Rothbaum et al. 2000b).

Journal of Clinical Psychology

Journal of Clinical Psychology - Clinical Shame, Dissociation, and Complex PTSD Symptoms in Traumatized Psychiatric and Control Groups: Direct and Indirect Associations With Relationship Distress

Elevated shame and dissociation are common in dissociative identity disorder (DID) and chronic posttraumatic stress disorder (PTSD) and are part of the constellation of symptoms defined as complex PTSD. Previous work examined the relationship between shame, dissociation, and complex PTSD and whether they are associated with intimate relationship anxiety, relationship depression, and fear of relationships. This study investigated these variables in traumatized clinical samples and a nonclinical community group.

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PubMed - Be vigilant for post-traumatic stress reactions

Most people experience at least one potentially traumatic event (PTE) during their life. Many will develop only transient distress and not a psychological illness. Even the most inherently horrific event does not invariably lead to the development of a psychological disorder while an individual with sufficient vulnerability may develop post-traumatic stress disorder (PTSD) after what appears be an event of low magnitude. The diagnosis of PTSD differs fro most psychiatric disorders as it includes an aetiological factor, the traumatic event, as a core criterion. The DSM 5 core symptoms of PTSD are grouped into four key symptom clusters: re-experiencing, avoidance, negative cognitions and mood, and arousal. Symptoms must be present for at least one month and cause functional impairment. PTSD patients can avoid engaging in treatment and assertive follow-up may be necessary.

journal of contextual behavioral science

Journal of Contextual Behavioral Science - Acceptance and Commitment Therapy for Co-Occurring PTSD and Substance Use: A Manual Development Study

We developed an ACT-based manual to treat comorbid PTSD and substance use. A pilot trial with veterans suggested the treatment was feasible and credible. Participants were generally satisfied and offered qualitative feedback. We describe manual revisions aimed at improving treatment retention and impact. Additional strategies for adapting ACT for PTSD/SUD are offered for consideration

Kent University

Kent State University - The Incremental Impact of Trauma-Related Nightmares on PTSD Symptom Severity

Posttraumatic stress disorder (PTSD) often develops following trauma exposure. Sleep disturbances, especially nightmares, are highly comorbid with PTSD and may exacerbate symptoms. The current study examined the relationship between sleep disturbances and PTSD among college students. Results indicated that PTSD-related sleep disturbances, most notably trauma-related nightmares, were associated with PTSD.

Journal of Psychopathology and Behavioral Assessment

Journal of Psychopathology and Behavioral Assessment - The Underlying Role of Negative Affect in the Association between PTSD, Major Depressive Disorder, and Generalized Anxiety Disorder

Clinicians and researchers have found differential diagnosis to be difficult, particularly for conceptually similar disorders. One category of particular interest has been distress or internalizing disorders, theorized to be related via an underlying construct of generalized distress or negative affect. The present study attempted to address the comorbidity of three distress disorders – posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) – using latent analyses by controlling for the variance attributable to negative affect.

Stress in Policing

Stress in Policing - Policing Disasters, A Conceptual Model and Case Study of Police Resilience

This chapter consists of two sections. Section 1, by John Violanti, describes a case study of resiliency factors among police officers involved in Hurricane Katrina six years post-storm. Section 2, by Douglas Paton, describes (1) developing a model that facilitates learning from experience, (2) anticipating future issues and (3) proactively developing resilience and adaptive capacity in police officers and organizations.

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PubMed - A prospective study of pre-trauma risk factors for post-traumatic stress disorder and depression.

It is unclear which potentially modifiable risk factors best predict post-trauma psychiatric disorders. We aimed to identify pre-trauma risk factors for post-traumatic stress disorder (PTSD) or major depression (MD) that could be targeted with resilience interventions. Method Newly recruited paramedics (n = 453) were assessed for history of mental disorders with structured clinical interviews within the first week of their paramedic training and completed self-report measures to assess hypothesized predictors. Participants were assessed every 4 months for 2 years to identify any episodes of PTSD and MD; 386 paramedics (85.2%) participated in the follow-up interviews.

Experimental Neurology

Experimental Neurology - Neuropeptide Y (NPY) and posttraumatic stress disorder (PTSD): A translational update

Posttraumatic stress disorder (PTSD) is a trauma-evoked syndrome, with variable prevalence within the human population due to individual differences in coping and resiliency. In this review, we discuss evidence supporting the relevance of neuropeptide Y (NPY), a stress regulatory transmitter in PTSD. We consolidate findings from preclinical, clinical, and translational studies of NPY that are of relevance to PTSD with an attempt to provide a current update of this area of research.

Virtual, Augmented and Mixed Reality

Virtual, Augmented and Mixed Reality - Olfactory Stimuli Increase Presence During Simulated Exposure

Exposure therapy (EXP) is an extensively studied and supported treatment for anxiety and trauma-related disorders. EXP works by exposing the patient to the feared object or situation in the absence of danger in order to overcome the related anxiety. Various technologies including head-mounted displays (HMDs), scent machines, and headphones have been used to augment the exposure therapy process by presenting multi-sensory cues (e.g., sights, smells, sounds) to increase the patient’s sense of presence.

European Journal of PsychoTraumatology

European Journal of Psychotraumatology: Erasing Memory Traces of Trauma with Eye Movement Desensitization and Reprocessing Therapy

Eye movement desensitization and reprocessing therapy (EMDR) is by now a well-established treatment for posttraumatic stress disorder (PTSD). There is good evidence for its efficacy and together with trauma-focused cognitive behavioral therapy (TF-CBT) it is considered to be the first-line treatment for PTSD (Bisson, Roberts, Andrew, Cooper, & Lewis, 2013).

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Science Daily - Early screening spots emergency workers at greater risk of mental illness

Emergency services workers who are more likely to suffer episodes of mental ill health later in their careers can be spotted in the first week of training. Researchers wanted to see if they could identify risk factors that made people more likely to suffer post-traumatic stress (PTSD) or major depression (MD) when working in emergency services.

journal of behavior therapy experimental psychiatry

Cognitive restructuring and imagery modification for posttraumatic stress disorder (CRIM-PTSD) - A pilot study

Cognitive restructuring and imagery modification for PTSD (CRIM-PTSD) is a new short intervention. It consists of the cognitive restructuring of core trauma-related dysfunctional beliefs about the self and the use of imagery to encourage more functional beliefs. A randomized controlled trial showed that CRIM was effective for reducing posttraumatic stress disorder (PTSD) in survivors of childhood sexual abuse (CSA) when it focused on the feeling of being contaminated. For this study, CRIM was adapted to treat PTSD symptoms more generally and after various types of trauma by addressing the patients’ negative self-concept.

Psychiatry Research

Psychiatry Research - The Relationship Between Negative Expressivity, Anger, and PTSD Symptom Clusters

More investigation is needed to understand how specific posttraumatic stress disorder (PTSD) symptom clusters relate to the internal experience of anger and overt negative behaviors in response to anger (negative expressivity). We investigated whether anger mediated relations between PTSD symptom clusters and negative expressivity. Multiple regression revealed lower PTSD intrusion symptoms associated with higher levels of negative expressivity. Anger mediated this relationship. Higher avoidance symptoms related to higher negative expressivity. Clinical implications, limitations, and strengths are discussed.

Psychiatry Research

Psychiatry Research - PTSD, food addiction, and disordered eating in a sample of primarily older veterans: The mediating role of emotion regulation

Posttraumatic stress disorder (PTSD) has been associated with eating disorders (EDs) and addictive behaviors, including the relatively new construct food addiction. However, few studies have investigated mechanisms that account for these associations, and men are underrepresented in studies of EDs and food addiction. The results highlight the importance of investigating PTSD as a risk factor for food addiction and ED symptoms and the potential mediating role of emotion regulation in the development of PTSD and EDs in order to identify targets for treatments.

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Sun Life Financial launches digital assessment for workplace mental health risks

Innovative program could help almost 60 per cent of Canadian workplaces without a mental health strategy

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The Journal for Specialists in Group Work - Exploring the Process: A Narrative Analysis of Group Facilitators’ Reports on Critical Incident Stress Debriefing

Critical incident stress debriefing (CISD) is a psychoeducational group intervention offered after exposure to potentially traumatizing events. This exploratory inquiry examined how mental health and peer facilitators utilized elements of group work practices during CISD interventions. Narratives from 16 mental health and 14 peer facilitators reported how elements of group planning, performing, and processing appear. Important group-process aspects included attention to establishing ground rules and defining boundaries for confidentiality, managing member disclosure, and pacing the process to prevent harm from over-processing the traumatic event. Implications for practice suggest that following best practice guidelines in group work is protective of the CISD process and the participants.

Current Psychiatry Reports

Current Psychiatry Reports - Treating PTSD Within the Context of Heightened Suicide Risk

Because posttraumatic stress disorder (PTSD) is one of the few psychological conditions that predict suicidal behavior among those who think about suicide, many patients with PTSD present clinically with elevated suicide risk. Expert consensus and practice guidelines recommend against trauma-focused treatments for patients with elevated suicide risk, however. Research aimed at understanding the common mechanisms that underlie the association of PTSD and suicide risk has led to several advances in the effective care of suicidal patients diagnosed with PTSD. Based on these results, various combinations and sequences of suicide-focused treatments, risk management procedures, and trauma-focused treatments are implicated.

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Inside Ottawa Valley - PTSD strategy to aid Carleton Place firefighters

The Ocean Wave Fire Company (OWFC) in Carleton Place is putting in place a plan to help prevent or lessen the risk of post-traumatic stress disorder (PTSD) among its firefighters.

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Police Psychology - Mass Casualties

By Gary S. Aumiller, Ph.D.  ABPP

Information on the effects that tragedies such as the recent Orlando night club shooting can have on first responders and what can be done as a police leader or psychologist to help the situation.

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PTSD in first responders focus of July event

The public awareness event, which is put on by the Tema Conter Memorial Trust, will be held in Brantford on Saturday, July 18 at 7 p.m. in The Salvation Army Church, 33 Diana Ave. Brant paramedic Stefanie Miller will be just one of the locals joining in the panel discussion open to everyone.

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Notice of Direction Made Pursuant to Subsection 9.1(1) of the Ministry of Labour Act

Employers are to provide information on their workplace posttraumatic stress disorder prevention plans no later than April 23, 2017, one year from the date of the posting of this notice.

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Police Psychology - Too Much Ugly

By Robin Kroll, PsyD ABPP

Officers spend their careers serving and protecting their communities. As first responders, they make sacrifices that the civilian world may never understand. Forfeiting emotions to be productive on the job is one of the prime sacrifices. It is also the most misunderstood. While withholding feelings is a coping mechanism on the job, it is not a healthy strategy off the job.

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Police Psychology: Police Divorce Part 2 – Hate to Admit

By Gary Aumiller, Ph.D.

As the rest of the regular world, most officers going through a divorce can think of nothing else in that time. They find they have a hard time concentrating and they lose focus easily. Their emotions are on edge, and deep sleep is a sporadic visitor in their life. And it doesn’t have to be that way. This is part 2 of the series on Divorce and how to calm down facing one.


Ottawa braces for budget hangups under PTSD law

The city’s treasurer says it’s ‘impossible to quantify’ how much Ottawa will owe under new legislation that protects first responders suffering from PTSD.

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Reducing the stigma of mental disorders at work: A review of current workplace anti-stigma intervention programs

Stigma has been described as one of the largest barriers for those who have been diagnosed with a mental disorder, with negative consequences impacting all facets of life, including the workplace. Although many population-based anti-stigma initiatives exist, the need for workplace interventions is being recognized, particularly as the financial costs of mental disorders in the workplace mount. Specific workplace-focused programs are emerging to address this need. The present paper describes efforts to reduce the stigma related to mental disorders in the workplace. Following the review, suggestions are made for future workplace anti-stigma interventions, as well as a discussion of considerations for researchers who evaluate such programs.

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Police Psychology: Disabled Police Officer or Scammer? - A personal experience on being ``Disabled in the Line of Duty”

By Sgt. John Rogowski

What is a Disabled Police Officer? He or she is “Lucky,” “A Scammer,” “Faking It,” “Has Hit The Jackpot,” “ Malingering,” “ Making it Worse Than it is,” “Lazy,” “Trying to Get Out of Work,” and the names go on and on…  If you have become permanently “Disabled in The Line of Duty” perhaps you have been called one of these names, or similar ones, to your face.

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Are you at risk of suffering from PTSD?

New legislation across the country is prompting questions about PTSD, what exactly the definition should be, and its real impact on front-line responders.

First Reference

After the accident - Pitfalls to avoid for employers after workplace accidents #learnthelatest

The obligations on employers, constructors and other workplace stakeholders once a workplace accident occurs are heavy. The Occupational Health and Safety Act (the “Act”) requires that these parties take positive actions immediately from the time that an accident occurs. These actions can have important implications for later legal proceedings. Failing to comply with these obligations is itself a breach of the Act and can lead to legal liability distinct from and in addition to any liability flowing from the accident.

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Police Psychology: Motivation - Back to the Basics

By Lt. James Kieran

Different generations are motivated differently due to different frames of reference.  While it is essential to understand the differences in the people that you lead, there are far more similarities then you may think.  The basics still remain the same.

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The Family Journal - The Phenomenological Experience of First Responder Spouses

In this phenomenological study, the essence of being a first responder spouse was described through the lived experiences of the participants. The objective of this phenomenological study was to answer the question, “What is the experience of being the spouse of a first responder?” The qualitative results identified significant barriers and stressors that exist within the first responder family system and implications for clinical practice with this population.

Clinical Psychological Science

Clinical Psychological Science - Emotion Regulatory Flexibility Sheds Light on the Elusive Relationship Between Repeated Traumatic Exposure and Posttraumatic Stress Disorder Symptoms

Conventional wisdom suggests that repeated traumatic exposure should strongly relate to increased posttraumatic stress disorder (PTSD) symptoms. However, research with first responders, who are repeatedly exposed to traumatic events, finds inconsistent links to PTSD. A total of 69 firefighters with differing duty-related traumatic-exposure were tested on an innovative performance-based regulatory choice flexibility paradigm and evaluated for PTSD symptoms using clinical interviews.

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Clinical Psychology Review - Treating posttraumatic stress disorder in first responders: A systematic review

First responders are generally considered to be at greater risk for full or partial posttraumatic stress disorder (PTSD) than most other occupations because their duties routinely entail confrontation with traumatic stressors. These critical incidents typically involve exposure to life threat, either directly or as a witness. There is a substantial literature that has examined the risk factors, symptom presentation, course, and comorbidities of PTSD in this population. However, to our knowledge, there are no systematic reviews of treatment studies for first responders. We conducted a systematic review of the PTSD treatment literature (English and non-English) in order to evaluate such treatment proposals based on what is known about treating PTSD in first responders.

Journal of Community Psychology

The Journal of Community Psychology - The relation of perceived and received social support to mental health among first responders: a meta-analytic review

There are plenty of theories that may support the protective role of social support in the aftermath of potentially traumatic events. This meta-analytic review examined the role of received and perceived social support in promoting mental health among first responders.
Psychiatric Quarterly

Psychiatric Quarterly - Treating Psychological Trauma in First Responders: A Multi-Modal Paradigm

Responding to critical incidents may result in 5.9–22 % of first responders developing psychological trauma and posttraumatic stress disorder. These impacts may be physical, mental, and/or behavioral. This population remains at risk, given the daily occurrence of critical incidents. Given the multiplicity of impacts from psychological trauma and the inadequacies of responder treatment intervention research thus far, this paper proposes a paradigmatic shift from single/double treatment interventions to a multi-modal approach to first responder victim needs. A conceptual framework based on psychological trauma is presented and possible multi-modal interventions selected from the limited, extant first responder research are utilized to illustrate how the approach would work and to encourage clinical and experimental research into first responder treatment needs.

American Journal of Industrial Medicine

American Journal of Industrial Medicine - Chronic Probable PTSD in Police Responders inthe World Trade Center Health Registry Ten toEleven Years After 9/11

Police responders to the WTC attacks continue to bear a high mental health burden. Improved early access to mental health treatment for police exposed to disasters may be needed.  Police enrollees without pre-9/11 PTSD were studied. Probable PTSD was assessed by Posttraumatic Stress Check List (PCL). Risk factors for chronic, new onset or resolved PTSD were assessed using multinomial logistic regression.
Psychological Medicine

Psychological Medicine - DSM-IV post-traumatic stress disorder among World Trade Center responders 11–13 years after the disaster of 11 September 2001 (9/11)

This study examines the extent of DSM-IV PTSD 11–13 years after the disaster in WTC responders, its symptom profiles and trajectories, and associations of active, remitted and partial PTSD with exposures, physical health and psychosocial well-being.

Anxiety Disorders

Journal of Anxiety Disorders - Characteristics of the traumatic stressors experienced by rural first responders

First responders routinely experience work-related events that meet the definition of a traumatic stressor. Despite the high exposure to traumatic events, prevalence rates of posttraumatic stress disorder (PTSD) are relatively low. This discrepancy points to the potential value of identifying factors that distinguish those traumatic stressors that produce ongoing traumatic stress symptoms from those that do not. The present study surveyed 181 first responders from rural settings. A repeated-measures design was used to compare characteristics of traumatic stressors that were or were not associated with ongoing PTSD symptoms.

Psychiatry Research

A systematic review of probable posttraumatic stress disorder in first responders following man-made mass violence

The current study was a systematic review examining probable posttraumatic stress disorder (PTSD) in first responders following man-made mass violence. A systematic literature search yielded 20 studies that fit the inclusion criteria. The prevalence rates of probable PTSD across all 20 studies ranged from 1.3% to 22.0%. This paper is meant to serve as a call for additional research and to encourage more breadth in the specific incidents that are examined.

Occupational Medicine Oxford Press Logo

Occupational Medicine - The relationship between burnout, PTSD symptoms and injuries in firefighters

Firefighters participate in activities with intense physical and psychological stress. The occupational obligations may be responsible for the psychological and musculoskeletal problems experienced by firefighters. Early recognition and response to psychosomatic issues in firefighters is of high importance.

Scandinavian Journal of Trauma, Resuscitation & Emergency Medicine

Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine: Exposure and posttraumatic stress symptoms among first responders working in proximity to the terror sites in Norway on July 22, 2011 – a cross-sectional study

Norway experienced two terror attacks on July 22, 2011. A car bomb exploded in the Oslo government district killing eight people. Shortly after, 69 adolescents gathered at a political youth camp were shot and killed at Utøya Island. First responders were exposed to multiple risk factors for the development of posttraumatic stress symptoms (PTSS).

Journal of Nervous and Mental Disease logo

Journal of Nervous & Mental Disease - Sudden Gains and Deteriorations in the Treatment of Posttraumatic Stress Disorder in World Trade Center Responders

This study sought to examine the prevalence of sudden gains and deteriorations (i.e., symptom reduction/improvement during treatment) and their influence on treatment outcomes among World Trade Center responders with probable posttraumatic stress disorder. Thirty-six outpatient clients received at least three sessions of integrative psychotherapy, which included elements of psychodynamic and cognitive-behavioral therapy approaches, under routine clinical conditions.

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Clinical Psychology Review - A systematic review of suicidal thoughts and behaviors among police officers, firefighters, EMTs, and paramedics

First responders—police officers, firefighters, emergency medical technicians (EMTs), and paramedics—experience significant job-related stressors and exposures that may confer increased risk for mental health morbidities (e.g., posttraumatic stress disorder [PTSD], suicidal thoughts and behaviors) and hastened mortality (e.g., death by suicide). Inherent in these occupations, however, are also factors (e.g., camaraderie, pre-enlistment screening) that may inoculate against the development or maintenance of psychiatric conditions.

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International Paramedic Practice -The impact of post-traumatic stress on first responders: analysis of cortisol, anxiety, depression, sleep impairment and pain

First responders are an often ignored group facing emotional and physical stress that is similar to that of law enforcement personnel and military veterans. Fifty first responder employees were invited to participate in the study, of which 34 completed the following psychological and biological measures. A substantial portion of first responders met criteria for PTSD and anxiety. Assessing the impact of these conditions may best be achieved through physical health measures (cortisol, BMI, heart rate) in addition to psychometric screening tools (PCL, CESD, STICSA).

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CNW - Ontario Shores partners with OPG to deliver mental health first aid to employees

In the heart of National Mental Health Week, Ontario Power Generation (OPG) and Ontario Shores Centre for Mental Health Sciences (Ontario Shores) have announced an agreement to provide mental health training to the energy provider’s employees.

The agreement supports the training of up to 2,000 OPG employees in Mental Health First Aid (MHFA), a certificate program managed in this country by the Mental Health Commission of Canada.

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OHSCanada - Out of the Shadows

The passing of legislation presuming that post-traumatic stress disorder among Ontario’s first responders is work-related points to a growing recognition across Canada that occupational injuries are not just physical.

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EMSWORLD - Canadian Agency Tackles PTSD Head On With Peer Support Program

In response to its paramedics’ emotional trauma, the YRPS launched a Peer Support Team. Comprised of 20 York Region paramedics trained in psychological first aid, these paramedics provide traumatized EMS practitioners with someone they can reach out to for help.

nhmrc ASD & PTSD

NHMRC - Australian Guidelines for the Treatment of Adults with Acute Stress Disorder and Posttraumatic Stress Disorder

Acute stress disorder (ASD) and posttraumatic stress disorder (PTSD) are psychological reactions that develop in some people following the experience of traumatic events such as major disaster, war, sexual or physical assault, motor vehicle accidents, and torture. Exposure to a traumatic event is not an uncommon experience. Large community surveys in Australia and overseas reveal that 50–65 per cent of people report at least one traumatic event in their lives. The volume of research studies on the treatment of ASD and PTSD published over the past decade, and the emerging consensus from those studies, warrants the development of clinical practice guidelines. The guidelines were developed in accord with National Health and Medical Research Council guideline development requirements, by a working party comprising key trauma experts from throughout Australia, in consultation with a multidisciplinary panel comprising representatives of the range of health professionals involved in the care of people with ASD and PTSD, and service users.

Expert Guidelines

Diagnosis and treatment of post-traumatic stress disorder in emergency service workers

Emergency workers perform a vital role in our society. They protect the rule of law, ensure our safety and provide assistance in emergencies. Surveys consistently show that emergency workers are one of the most valued and trusted occupational groups. However, there is increasing realisation that emergency work can come at a cost. Large numbers of emergency workers report ongoing psychological consequences from exposure to trauma, most notably post-traumatic stress disorder (PTSD). This guideline helps emergency workers and their clinicians as they work together towards recovery.

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Mental Health and Mental Illness In The Workplace: Diagnostic and Treatment Issues

Mental health, mental illness and stress-related disability are especially ill-defined, complex and controversial issues when considered in the context of the workplace. Currently, a knowledge gap exists between mental health professionals and employers regarding symptom-based models of illness and function based models of work performance. As a result, psychiatric disorders affecting workers are under-identified and under-treated and likely result in unmitigated impairment and disability. The authors examine several conceptual models for workplace mental illness across medical and psychological disciplines and propose a unifying construct. The utility of the existing screening methods for common workplace illnesses and their potential application are reviewed. The challenges of diagnosis and effective treatment of workplace mental illness are highlighted within an “occupational mental health system” with suggestions for future research directions.

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Mental health problems are a serious issue in our society. The Qualaxia Network supports effective actions that promote mental health, prevention and treatments for common mental disorders.

Qualaxia is a network of researchers, experts, decision-makers, managers and clinicians. The network’s goal is making documents believed to be particularly important on the subject of public mental health easily accessible.

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EENet Connect

This community has been created to bring together stakeholders from the mental health and addictions system in Ontario. To join EENet Connect, sign up below. Members will receive a weekly email about activity in the community and email alerts as new content is posted.

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Evidence Exchange Network for Mental Health and Addictions (EeNet)

Evidence Exchange Network is a knowledge exchange network that brings together mental health and addition stakeholders from across Ontario.  It lists current researchers in the area of mental health and their area of focus. The site also includes webinars based on research in this area.


CAMH - PTSD in the First Responder World

There has been increasing media coverage about PTSD over the past several years, particularly with the number of Canadian and US soldiers returning from the Middle East reporting high levels of psychological distress. Highly-respected Canadians such as Lieutenant General Romeo Dallaire and Lieutenant Colonel Stéphane Grenier have courageously opened up about their own battles with PTSD. PTSD however, is not a new concept.

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Global News - Edmonton artist who battles depression uses camera to put a face to mental illness

A local photographer is turning her lens on a subject she feels needs to be in the spotlight. As Su-Ling Goh reports, she’s focusing on the faces of mental illness with a cool exhibit that’s being sponsored by the Canadian Mental Health Association.

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Mississauga firefighters first in Ontario to receive new mental-health training

Firefighters in Mississauga are the first in the province to benefit from a new program that aims to help first responders cope with the impact of post-traumatic stress disorder. The Road to Mental Readiness (R2MR) program held its first training session with firefighters learning how to recognize signs of mental-health issues and work-related stress in themselves and their colleagues.


TEDxMSVU - Police Mental Health: from self-improvement to community improvement by Jean-Michel Blais

Jean-Michel Blais, Chief of Halifax Regional Police, describes the experiences that led him be diagnosed with PTSD and how the daily management of his condition has led him to be a better leader, which is helping to change the attitude and culture of his police force. Jean-Michel (J.M.) Blais was a member of the Royal Canadian Mounted Police for 25 years. In 2008, he was assigned to the United Nations Stabilization Mission in Haiti as Deputy Police Commissioner in charge of over 1,700 international police officers. Chief Blais was also dispatched to provide aid following the devastating earthquake that hit Haiti in 2010. He is a committed community member and has been decorated with medals by both the UN and the Government of Canada.

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TVO: Rescuing the Rescuers

While others run away from sirens, police officers, paramedics and firefighters are expected to run towards them. Their constant experience with emergency and trauma makes them more likely to develop post-traumatic stress disorder. First responders and a psychologist join The Agenda to discuss PTSD, workplace culture and the impact of proposed legislation currently being debated at Queen’s Park.