Mindfulness-based Resilience Training Research Articles

A multisite feasibility randomized clinical trial of mindfulness-based resilience training for aggression, stress, and health in law enforcement officers

BackgroundLaw enforcement officers (LEOs) are exposed to significant stressors that can impact their mental health, increasing risk of posttraumatic stress disorder, burnout, at-risk alcohol use, depression, and suicidality. Compromised LEO health can subsequently lead to aggression and excessive use of force. Mindfulness training is a promising approach for high-stress populations and has been shown to be effective in increasing resilience and improving mental health issues common among LEOs.MethodsThis multi-site, randomized, single-blind clinical feasibility trial was intended to establish optimal protocols and procedures for a future full-scale, multi-site trial assessing effects of mindfulness-based resilience training (MBRT) versus an attention control (stress management education [SME]) and a no-intervention control, on physiological, attentional, and psychological indices of stress and mental health. The current study was designed to enhance efficiency of recruitment, engagement and retention; optimize assessment, intervention training and outcome measures; and ensure fidelity to intervention protocols. Responsiveness to change over time was examined to identify the most responsive potential proximate and longer-term assessments of targeted outcomes.ResultsWe observed high feasibility of recruitment and retention, acceptability of MBRT, fidelity to assessment and intervention protocols, and responsiveness to change for a variety of putative physiological and self-report mechanism and outcome measures.ConclusionsResults of this multi-site feasibility trial set the stage for a full-scale, multi-site trial testing the efficacy of MBRT on increasing LEO health and resilience, and on decreasing more distal outcomes of aggression and excessive use of force that would have significant downstream benefits for communities they serve.Trial registrationClinicalTrials.gov, NCT03784846. Registered on December 24th, 2018.

Potential Aetiologies of PTSD and Possible Interventions and Treatment

Passive-traumatic stress disorder is a disorder frequently appeared in the world. The percentage of individuals who have this disorder is specifically high. In this paper, the causes and possible treatment for PTSD is investigated. The cause of PTSD is explored from two dimensions as social and individual angles. Such as personality or growing environment of an individual could be decisive or critical for whether this individual will suffer from PTSD. Potential intervention and treating methods are discussed and concluded from multiple studies reviewed. As an example, Mindfulness-Based Resilience Training (MBRT) could successfully help police officers being more relax and relief from their depression and anxiety in their work. This paper objectives to explore more studies to help scholars to investigate treatment of PTSD. Moreover, this paper could be helpful to other researchers who investigate on similar topic and researching answers. There could be more specific and generalized research made into methods and treatment for PTSD. Overall, there is a bright future for those PTSD patients, more and more treatments and methods will be discovered and found.

A Systematic Review of Positive Psychology Interventions (PPIs) to Improve the Health Behaviours, Psychological Wellbeing and/or Physical Health of Police Staff

This review aimed to assess the use of positive psychology interventions (PPIs), such as using positive mantras, expressive writing, or gratitude diaries, to improve the health behaviours, psychological wellbeing and/or physical health of police staff. The review was registered on PROSPERO before 16 electronic databases were searched for published articles between January 1999 and February 2022. Included studies offered PPIs to improve the physical health (body mass index, blood pressure), psychological well-being (stress, anxiety, mood, emotion, depression, self-efficacy), or health behaviours (physical activity, sitting times, dietary habits, alcohol, or tobacco use) of police staff. The mixed methods appraisal tool (MMAT) was used to assess the risk of bias of included papers. The initial search yielded 4560 results; with 3385 papers remaining after duplicates were removed. Of these, 15 studies were included in the final review. Intervention types included mindfulness-based resilience training (n = 11), physical or wellness practice classes (n = 1), role-play and scenario-based interventions (n = 2) and expressive writing (n = 1). Mindfulness-based interventions improved many psychological wellbeing facets such as anxiety, depression, negative affect and quality of life. Limited improvements were observed for some health behaviours such as alcohol consumption and in self-reported general health. Expressive writing and role-play-based interventions were effective in reducing stress and anxiety, however, improvement in depression scores were inconsistent across studies. Positive psychology interventions are promising to support the health and wellbeing of police staff. Future research should investigate their mechanisms of action to support future innovation in support for police wellbeing.

Mindfulness-based resilience training on the psychological well-being of medical students during the COVID-19 pandemic

Background: In recent years, research has witnessed an exciting change toward well-being and health instead of emphasizing disorders and inefficiency. The current study aimed to assess the effect of a mindfulness-based resilience training program on the psychological well-being of medical students during the COVID-19 pandemic. Methods: The current study was quasi-experimental with a control group and a pre/post design. A sample of 30 students was randomly selected from a community of medical students at the Tabriz University of Medical Sciences in the academic year 2021-2022. These students were randomly divided into two groups of 15 participants. The tools used in this research included Ryff’s Psychological Well-Being Questionnaire (PWB-18) and an integrated training program for resilience and mindfulness. Results: The findings showed an integrated training program of resilience and mindfulness positively affected students’ psychological well-being. In addition, this intervention was able to explain 59% of the combined variance of psychological well-being variables. Conclusion: The results of the current study found that an integrated training program of resilience and mindfulness can improve individuals’ psychological well-being during a difficult situation such as the COVID-19 pandemic.

DEcrease STress through RESilience training for Students (DESTRESS) Study: Protocol for a randomized controlled trial nested in a longitudinal observational cohort study

IntroductionChronic stress and burnout are highly prevalent among academically trained healthcare professionals, negatively affecting their well-being and capacity to engage in their work. Resilience to stress develops early in one's career path, hence offering resilience training to university students in these professions is one approach to fostering well-being and mental health. The aim of this study is to assess whether offering mindfulness-based resilience training to university students in healthcare professions reduces their perceived chronic stress. Methods and analysisThe study has a hybrid design combining a longitudinal observational cohort with a nested randomized controlled trial (RCT) with sequential multiple assignment and multistage adaptive interventions while taking participants' preferences into account. All students in healthcare related programmes at the Erasmus University Rotterdam are invited to participate. Within the observational cohort, students with a score of 14 or higher on the Perceived Stress Scale (PSS) are invited to take part in the RCT (n = 706). Eligible participants are randomized to control or active intervention in a ratio of 1:6. Those randomized to the control group and non-randomized participants in the cohort receive passive web-based psychoeducation about chronic stress and burnout through referral to specific websites. Participants randomized to the intervention group receive one of 8 active mindfulness-based interventions. They select a rank order of 4 preferred interventions and are randomized across these with equal probability. Non-response to the intervention is followed by sequential randomized assignment to another intervention, for a total maximum of 3 sequential interventions. All participants receive questionnaires at baseline, before and after each 8-week intervention period, and at 1- and 2-year follow-up. The primary outcome is perceived chronic stress measured with the PSS. Secondary outcomes include mental well-being, burnout, quality of life, healthcare utilization, drug use, bodyweight, mental and physical stress-related symptoms, resilience, and study progress. Ethics and registrationApproval from the Medical Ethics Review Committee was obtained under protocol number MEC-2018-1645. The trial is registered in the Netherlands National Trial Register by registration number NL7623, 22/03/2019, https://www.trialregister.nl/.

The Relationships Between Reduced Alcohol Use and Decreased Burnout Following Mindfulness-Based Resilience Training in Law Enforcement Officers.

Objective: This study is a secondary analysis of data collected in an earlier clinical trial of mindfulness-based resilience training (MBRT) (ClinicalTrials.gov registration number 02521454), where the MBRT condition demonstrated a significant reduction in self-reported burnout and trend-level reductions in alcohol use in law enforcement officers (LEOs). Given that MBRT is not designed to be a substance use intervention and does not contain explicit substance-related content, this study sought to clarify these findings by exploring whether improved burnout mediates reduced alcohol use. Method: Participants (n = 61) were sworn LEOs (89% male, 85% White, 8% Hispanic/Latinx) recruited from departments in a large urban metro area of the northwestern United States, and were randomized to either MBRT (n = 31) or no intervention control group (n = 30) during the trial. Results: MBRT group assignment predicted reduced burnout (b = 0.43, standard error [SE] = 0.14, p = 0.004), which subsequently predicted reduced alcohol use (b = 1.69, SE = 0.81, p = 0.045). Results suggest that reduced alcohol use was indirectly related to a reduction in burnout post-MBRT. Conclusion: Given that MBRT does not explicitly address substance use, these findings were interpreted to suggest that officers in the training acquired a new set of coping skills to deal with the operational and organizational stressors of police work.

Intensive Mindfulness-based Resilience Training in First Responders: A Pilot Study

first responders offered in a compressed, residential immersion format (MBRT-I). Methods: Participants (N = 31) attended a 2.5-day immersion training to receive training in MBRT-I, with a booster session 30 days later. Self-report data measuring aspects of stress and health were collected at baseline, immediately following MBRT-I training, 30 days after MBRT-I training, and 90 days after MBRT-I training. Results: Participants reported significant improvements in emotional intelligence, emotional regulation, occupational stress, and fatigue (p < .05), with further trends approaching statistical significance regarding perceived stress, anger, and mindfulness. Conclusions: Whereas larger studies with longer follow-up are needed to establish the efficacy of this intervention, preliminary results suggest a compressed-format version of MBRT is (1) feasible, and (2) may be beneficial in reducing stress, anger, and fatigue, and improving likely mediators of positive health outcomes, such as emotional regulation and mindfulness among a broad range of first responders.

Relative Impact of Mindfulness, Self-Compassion, and Psychological Flexibility on Alcohol Use and Burnout Among Law Enforcement Officers.

Objectives: In the present study, we investigated the relative impact of improvements in mindfulness, self-compassion, and psychological flexibility in predicting decreased burnout and alcohol use in a sample of law enforcement officers (LEOs) participating in a mindfulness-based intervention (MBI). Design: This study is a secondary analysis of pre/post data collected as part of a larger randomized controlled trial of mindfulness-based resilience training (MBRT). Subjects: This secondary analysis comprises pre/post data from 28 LEOs recruited from a metropolitan area and its outlying regions in the Pacific Northwest. Intervention: MBRT is a MBI tailored specifically to the culture and needs of LEOs and other first responders. Outcome measures: All included data were obtained through self-report measures. Mindfulness was assessed by the Five Facet Mindfulness Questionnaire-Short Form, self-compassion was assessed by the Self-Compassion Scale-Short Form, psychological flexibility was assessed by the Acceptance and Action Questionnaire-II, alcohol use was measured by the PROMIS® (v1.0) Alcohol Use-Short Form, and burnout was assessed by the Oldenburg Burnout Inventory. Results: In the first regression, only increases in mindfulness significantly predicted decreased postintervention problematic alcohol use. In the second regression, only increases in self-compassion significantly predicted decreased postintervention burnout. Conclusions: This study builds upon a growing body of literature on the relative impact of mindfulness, self-compassion, and psychological flexibility in predicting outcomes among high-stress cohorts. Results suggest that different components of MBIs may be emphasized to achieve unique benefits. The Clinical Trial Registration number for the parent study is NCT02521454.

Mindfulness-based resilience training for aggression, stress and health in law enforcement officers: study protocol for a multisite, randomized, single-blind clinical feasibility trial

BackgroundLaw enforcement officers (LEOs) are exposed to significant stressors, elevating their risk for aggression and excessive use of force, as well as mental health consequences, including post-traumatic stress disorder, burnout, alcohol misuse, depression, and suicide. Mindfulness training is a promising approach with high-stress populations that has been shown effective for increasing resilience and improving negative mental health outcomes common among LEOs.MethodImplemented at two sites, the proposed study is designed to establish optimal protocols and procedures for a future full-scale, multisite trial assessing effects of mindfulness-based resilience training 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, the current study is designed to: enhance efficiency of recruitment, engagement, and retention; optimize laboratory, assessment, and data management procedures; optimize intervention training and ensure fidelity to intervention protocols; and assess participant experience and optimize outcome measures across two sites. Herein, we describe the protocol and methodology of this multisite, randomized, single-blind clinical feasibility trial.DiscussionThe long-term objective of this line of research is to develop an intervention that will reduce violence and increase resilience and mental health among LEOs, as well as yield significant benefits for the communities and residents they serve.Trial registrationClinicalTrials.gov, NCT03784846. Registered on 24 December 2018.

Differential impact of mindfulness practices on aggression among law enforcement officers.

Home-based mindfulness practice is a common component of formal mindfulness training (MT) protocols. Obtaining objective data from home-based mindfulness practice is challenging. Interpreting associations between home-based mindfulness practice and clinically impactful outcomes is complicated given the variability in recommendations in length, frequency, and type of practice. In this exploratory study, adherence to home-based practices of Mindfulness-Based Resilience Training (MBRT) was studied in order to evaluate associations with clinical outcomes. Home practices from 24 (92% male, non-Hispanic white, aged M = 43.20 years) law enforcement officers (LEOs) from the urban Pacific Northwest enrolled in a feasibility and efficacy trial of MBRT were studied using an objective tracking device and self-report data. Outcomes included adherence to home-based mindfulness practices and self-reported aggression. Participants completed 59.12% of the frequency amount of practice assigned in the MBRT curriculum. Frequency of practice was associated with decreased aggression, adjusted R 2 = .41, F(3,23) = 6.14, p = .004. Duration of practice also predicted decreased aggression, adjusted R 2 = .33, F(3,23) = 4.76, p = .011. Home-based MBRT practices for LEOs, even at low rates of adherence, may reduce aggression. MTs may show beneficial effects for other populations presented with challenges to engage in regular MT practices.

Mindfulness Training, Implicit Bias, and Force Response Decision-making.

The goal of this study was to assess the preliminary efficacy of a Mindfulness-Based Training (Mindfulness-based Resilience Training; MBRT) in improving weapon identification among Law Enforcement Officers (LEOs). Participants (N = 61) were randomly assigned to either MBRT or a no-intervention control group (NIC). A self-report questionnaire assessing mindfulness and a computerized measure assessing implicit stereotype reliance were administered at baseline, post-training, and three months following intervention completion. We also collected information about meditation practice outside of the training for LEOs in the MBRT group. Inferential analyses yielded improvements in mindfulness in the MBRT group compared to NIC. Analyses did not provide evidence for implicit stereotype reliance at baseline and therefore did not yield a significant impact of MBRT versus NIC on implicit stereotype reliance, ps > .05; however, participants across both conditions exerted more control when responding to Black male targets compared to White male targets, F(1,74) = 3.98, p = .05, 95% CI [-.05, -.01], d = .36. Our results do not provide evidence for the impact of MBRT on weapon identification, but do suggest that LEOs exerted more effort when responding to images of Black males compared to White males. We discuss recommendations for future clinical trials assessing implicit stereotype reliance, viz., that researchers utilize measures more sensitive to a wider range of LEO samples and with higher ecological validity, and we discuss potential reasons why our results do not align with past research.

A Qualitative Investigation of the Experience of Mindfulness Training among Police Officers.

The primary objective of this study was to qualitatively assess the experience of mindfulness-based resilience training (MBRT) among police officers. MBRT is an 8-week intervention designed to enhance police officer resilience in the context of acute and chronic stressors inherent to policing. MBRT has demonstrated preliminary efficacy in decreasing aggression, burnout, alcohol use, sleep disturbance, and improving cortisol reactivity, psychological flexibility, and non-reactivity. Participants (n = 5) were police officers who completed an individual semi-structured interview post-MBRT. A coding schema was developed to identify and categorize participant responses, and then applied the final coding framework to all participant interviews. Results revealed perceived improvements in intrapersonal and interpersonal functioning, benefits of MBRT, and strategies for overcoming potential barriers to mindfulness practice. These preliminary qualitative results are consistent with quantitative psychological and physiological MBRT outcomes and provide further support for MBRT feasibility and acceptability.

Resilience@Work Mindfulness Program: Results From a Cluster Randomized Controlled Trial With First Responders.

BackgroundA growing body of research suggests that resilience training can play a pivotal role in creating mentally healthy workplaces, particularly with regard to protecting the long-term well-being of workers. Emerging research describes positive outcomes from various types of resilience training programs (RTPs) among different occupational groups. One specific group of workers that may benefit from this form of proactive resilience training is first responders. Given the nature of their work, first responders are frequently exposed to stressful circumstances and potentially traumatic events, which may impact their overall resilience and well-being over time.ObjectiveThis study aimed to examine whether a mindfulness-based RTP (the Resilience@Work [RAW] Mindfulness Program) delivered via the internet can effectively enhance resilience among a group of high-risk workers.MethodsWe conducted a cluster randomized controlled trial (RCT) comprising 24 Primary Fire and Rescue and Hazmat stations within New South Wales. Overall, 12 stations were assigned to the 6-session RAW Mindfulness Program and 12 stations were assigned to the control condition. A total of 143 active full-time firefighters enrolled in the study. Questionnaires were administered at baseline, immediately post training, and at 6-month follow-up. Measurements examined change in both adaptive and bounce-back resilience as well as several secondary outcomes examining resilience resources and acceptance and mindfulness skills.ResultsMixed-model repeated measures analysis found that the overall test of group-by-time interaction was significant (P=.008), with the intervention group increasing in adaptive resilience over time. However, no significant differences were found between the intervention group and the control group in terms of change in bounce-back resilience (P=.09). At 6-month follow-up, the group receiving the RAW intervention had an average increase in their resilience score of 1.3, equating to a moderate-to-large effect size compared with the control group of 0.73 (95% CI 0.38-1.06). Per-protocol analysis found that compared with the control group, the greatest improvements in adaptive resilience were observed among those who completed most of the RAW program, that is, 5 to 6 sessions (P=.002).ConclusionsThe results of this RCT suggest that mindfulness-based resilience training delivered in an internet format can create improvements in adaptive resilience and related resources among high-risk workers, such as first responders. Despite a number of limitations, the results of this study suggest that the RAW Mindfulness Program is an effective, scalable, and practical means of delivering online resilience training in high-risk workplace settings. To the best of our knowledge, this is the first time a mindfulness-based RTP delivered entirely via the internet has been tested in the workplace.Trial RegistrationAustralian New Zealand Clinical Trials Registry ACTRN12615000574549; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=368296 (Archived by WebCite at http://www.webcitation.org/75w4xtrpw).

Mindfulness-Based Resilience Training in the Workplace: Pilot Study of the Internet-Based Resilience@Work (RAW) Mindfulness Program.

BackgroundThe impact of mental illness on society is far reaching and has been identified as the leading cause of sickness absence and work disability in most developed countries. By developing evidence-based solutions that are practical, affordable, and accessible, there is potential to deliver substantial economic benefits while improving the lives of individual workers. Academic and industry groups are now responding to this public health issue. A key focus is on developing practical solutions that enhance the mental health and psychological resilience of workers. A growing body of research suggests resilience training may play a pivotal role in the realm of public health and prevention, particularly with regards to protecting the long-term well-being of workers.ObjectiveOur aim is to examine whether a mindfulness-based resilience-training program delivered via the internet is feasible and engaging to a group of high-risk workers. Additionally, we aim to measure the effect of the Resilience@Work Resilience@Work Mindfulness program on measures of resilience and related skills.MethodsThe current pilot study recruited 29 full-time firefighters. Participants were enrolled in the 6-session internet-based resilience-training program and were administered questionnaires prior to training and directly after the program ended. Measurements examined program feasibility, psychological resilience, experiential avoidance, and thought entanglement.ResultsParticipants reported greater levels of resilience after Resilience@Work training compared to baseline, with a mean increase in their overall resilience score of 1.5 (95% CI -0.25 to 3.18, t14=1.84, P=.09). Compared to baseline, participants also reported lower levels of psychological inflexibility and experiential avoidance following training, with a mean decrease of -1.8 (95% CI -3.78 to 0.20, t13=-1.94, P=.07). With regards to cognitive fusion (thought entanglement), paired-samples t tests revealed a trend towards reduction in mean scores post training (P=.12).ConclusionsThis pilot study of the Resilience@Work program suggests that a mindfulness-based resilience program delivered via the Internet is feasible in a high-risk workplace setting. In addition, the firefighters using the program showed a trend toward increased resilience and psychological flexibility. Despite a number of limitations, the results of this pilot study provide some valuable insights into what form of resilience training may be viable in occupational settings particularly among those considered high risk, such as emergency workers. To the best of our knowledge, this is the first time a mindfulness-based resilience-training program delivered wholly via the internet has been tested in the workplace.

Mindfulness-based resilience training to reduce health risk, stress reactivity, and aggression among law enforcement officers: A feasibility and preliminary efficacy trial

The primary objective of this study was to assess feasibility and gather preliminary outcome data on Mindfulness-Based Resilience Training (MBRT) for law enforcement officers. Participants (n = 61) were randomized to either an 8-week MBRT course or a no intervention control group. Self-report and physiological data were collected at baseline, post-training, and three months following intervention completion. Attendance, adherence, post-training participant feedback, and interventionist fidelity to protocol all demonstrated feasibility of MBRT for law enforcement officers. Compared to no intervention controls, MBRT participants experienced greater reductions in salivary cortisol, self-reported aggression, organizational stress, burnout, sleep disturbance, and reported increases in psychological flexibility and non-reactivity at post-training; however, group differences were not maintained at three-month follow-up. This initial randomized trial suggests MBRT is a feasible intervention. Outcome data suggest MBRT targets key physiological, psychological, and health risk factors in law enforcement officers, consistent with the potential to improve officer health and public safety. However, follow-up training or “booster” sessions may be needed to maintain training gains. A fully powered longitudinal randomized trial is warranted.

ROLE OF RESILIENCE IN MINDFULNESS TRAINING FOR FIRST RESPONDERS.

First responders are exposed to critical incidents and chronic stressors that contribute to a higher prevalence of negative health outcomes compared to other occupations. Psychological resilience, a learnable process of positive adaptation to stress, has been identified as a protective factor against the negative impact of burnout. Mindfulness-Based Resilience Training (MBRT) is a preventive intervention tailored for first responders to reduce negative health outcomes, such as burnout. This study is a secondary analysis of law enforcement and firefighters samples to examine the mechanistic role of psychological resilience on burnout. Results indicated that changes in resilience partially mediated the relationship between mindfulness and burnout, and that increased mindfulness was related to increased resilience (b = .41, SE = .11, p < .01), which in turn was related to decreased burnout (b = -.25, SE = .12, p = .03). The bootstrapped confidence interval of the indirect effect did not contain zero [95% CI; -.27, -.01], providing evidence for mediation. Limitations and implications are discussed.

A resilience intervention involving mindfulness training for transplant patients and their caregivers.

Solid organ and stem cell transplant patients and their caregivers report a substantial level of distress. Mindfulness-based stress reduction has been shown to alleviate distress associated with transplant, but there is limited experience in this population with other mindfulness-based interventions, or with combined transplant patient and caregiver interventions. We evaluated a novel, 6-week mindfulness-based resilience training (MBRT) class for transplant patients and their caregivers that incorporates mindfulness practice, yoga, and neuroscience of stress and resilience. Thirty-one heart, liver, kidney/pancreas, and stem cell transplant patients and 18 caregivers at Mayo Clinic in Arizona participated. Measures of stress, resilience, depression, anxiety, health-related quality of life, positive and negative affect, and sleep were completed at baseline, 6weeks, and 3months postintervention. At 6weeks and 3months, patients demonstrated significant (P<.005) improvements from baseline in measures of perceived stress, depression, anxiety, and negative affect. Quality-of-life mental component (P=.006) and positive affect (P=.02) also improved at follow-up. Most participants adhered to the program, were satisfied with class length and frequency, and reported improved well-being as a result of the class. MBRT holds promise as an intervention to enhance resilience and manage stress for transplant patients and their caregivers.

Stress and burnout in residents: impact of mindfulness-based resilience training.

Background and objectiveStress and burnout impact resident physicians. This prospective study tests the hypothesis that a mindfulness-based resilience intervention would decrease stress and burnout in residents.MethodsResident physicians from the Departments of Family Medicine, Psychiatry, and Anesthesia at Duke University, Durham, NC, USA, participated in two or three 1-hour sessions of mindfulness-based resilience activities, which introduced mindful-awareness and included practical exercises for nurturing resilience. Anonymous surveys were distributed before (completed by 47 residents) and after the intervention (both completed by 30 residents); a follow-up survey was distributed 1 month later (seven residents completed all three surveys). The survey included the Depression Anxiety Stress Scale, 21-question version (DASS-21), the Oldenburg Burnout Inventory, the Mindful Attention Awareness Scale, and ten questions from the Cognitive Failures Questionnaire.ResultsAt baseline, most residents’ scores were in the normal range with respect to stress; however, female residents had higher DASS-21 scores than male residents (31.7, females vs 18.4, males; P=0.002). Most residents’ burnout scores were in the abnormal range, both with respect to exhaustion (38/47 residents, subscore ≥2.25) and disengagement (37/47 residents, subscore ≥2.1). Higher perceived levels of stress correlated with the instruments. Analysis of the surveys before and after the intervention showed no significant short-term change in stress, burnout, mindful-awareness, or cognitive failure. There was a trend for females and post-medical school graduate year 1 and 2 (PGY1 and PGY2) residents to have a reduction in DASS-21 scores after intervention. There was also a trend of reduced stress and burnout in residents who perceived higher stress.ConclusionResidents who are female, PGY1 and PGY2, and who perceive residency to be stressful may benefit most from a mindfulness-based resilience intervention.

A Pilot Study Evaluating the Effectiveness of a Mindfulness-Based Intervention on Cortisol Awakening Response and Health Outcomes among Law Enforcement Officers

As first responders who are frequently exposed to job-related trauma, police officers are at an elevated risk of adverse mental and physical health outcomes. Evidence-based approaches to stress reduction are sorely needed to address the complex variety of problems that police officers face. In this pilot study we examined the feasibility and preliminary effectiveness of a mindfulness-based intervention designed to address police officer stress. A total of 43 police officers completed an 8-week Mindfulness-Based Resilience Training (MBRT) program, which was designed to improve mindfulness, resilience, stress, health outcomes, and emotional functioning. Using multilevel models we found significant improvement in self-reported mindfulness, resilience, police and perceived stress, burnout, emotional intelligence, difficulties with emotion regulation, mental health, physical health, anger, fatigue, and sleep disturbance. Although there were no significant pre-to-post-MBRT changes in cortisol awakening response (CAR), while controlling for pre-MBRT increase area under the curve (AUCI), change in mental health was a significant predictor of post-AUCI. Implications of these findings and areas for future research are discussed.