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      Mindfulness Training Improves Quality of Life and Reduces Depression and Anxiety Symptoms Among Police Officers: Results From the POLICE Study—A Multicenter Randomized Controlled Trial


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          Background: Police officers' high-stress levels and its deleterious consequences are raising awareness to an epidemic of mental health problems and quality of life (QoL) impairment. There is a growing evidence that mindfulness-based interventions are efficacious to promote mental health and well-being among high-stress occupations.

          Methods: The POLICE study is a multicenter randomized controlled trial (RCT) with three assessment points (baseline, post-intervention, and 6-month follow-up) where police officers were randomized to mindfulness-based health promotion (MBHP) ( n = 88) or a waiting list ( n = 82). This article focuses on QoL, depression and anxiety symptoms, and religiosity outcomes. Mechanisms of change and MBHP feasibility were evaluated.

          Results: Significant group × time interaction was found for QoL, depression and anxiety symptoms, and non-organizational religiosity. Between-group analysis showed that MBHP group exhibited greater improvements in QoL, and depression and anxiety symptoms at both post-intervention (QoL d = 0.69 to 1.01; depression d = 0.97; anxiety d = 0.73) and 6-month follow-up (QoL d = 0.41 to 0.74; depression d = 0.60; anxiety d = 0.51), in addition to increasing non-organizational religiosity at post-intervention ( d = 0.31). Changes on self-compassion mediated the relationship between group and pre-to-post changes for all QoL domains and facets. Group effect on QoL overall health facet at post-intervention was moderated by mindfulness trait and spirituality changes.

          Conclusion: MBHP is feasible and efficacious to improve QoL, and depression and anxiety symptoms among Brazilian officers. Results were maintained after 6 months. MBHP increased non-organizational religiosity, although the effect was not sustained 6 months later. To our knowledge, this is the first mindfulness-based intervention RCT to empirically demonstrate these effects among police officers. Self-compassion, mindfulness trait, and spirituality mechanisms of change are examined.

          Clinical Trial Registration: www.ClinicalTrials.gov. identifier: NCT03114605.

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          Most cited references163

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          SPIRIT 2013 statement: defining standard protocol items for clinical trials.

          The protocol of a clinical trial serves as the foundation for study planning, conduct, reporting, and appraisal. However, trial protocols and existing protocol guidelines vary greatly in content and quality. This article describes the systematic development and scope of SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) 2013, a guideline for the minimum content of a clinical trial protocol.The 33-item SPIRIT checklist applies to protocols for all clinical trials and focuses on content rather than format. The checklist recommends a full description of what is planned; it does not prescribe how to design or conduct a trial. By providing guidance for key content, the SPIRIT recommendations aim to facilitate the drafting of high-quality protocols. Adherence to SPIRIT would also enhance the transparency and completeness of trial protocols for the benefit of investigators, trial participants, patients, sponsors, funders, research ethics committees or institutional review boards, peer reviewers, journals, trial registries, policymakers, regulators, and other key stakeholders.
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            SPSS and SAS procedures for estimating indirect effects in simple mediation models

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              The benefits of being present: Mindfulness and its role in psychological well-being.

              Mindfulness is an attribute of consciousness long believed to promote well-being. This research provides a theoretical and empirical examination of the role of mindfulness in psychological well-being. The development and psychometric properties of the dispositional Mindful Attention Awareness Scale (MAAS) are described. Correlational, quasi-experimental, and laboratory studies then show that the MAAS measures a unique quality of consciousness that is related to a variety of well-being constructs, that differentiates mindfulness practitioners from others, and that is associated with enhanced self-awareness. An experience-sampling study shows that both dispositional and state mindfulness predict self-regulated behavior and positive emotional states. Finally, a clinical intervention study with cancer patients demonstrates that increases in mindfulness over time relate to declines in mood disturbance and stress.

                Author and article information

                Front Psychiatry
                Front Psychiatry
                Front. Psychiatry
                Frontiers in Psychiatry
                Frontiers Media S.A.
                26 February 2021
                : 12
                : 624876
                [1] 1Postgraduate Program in Psychiatry and Behavioral Sciences, Federal University of Rio Grande do Sul (UFRGS) , Porto Alegre, Brazil
                [2] 2Department of Psychiatry, Hospital de Clínicas de Porto Alegre , Porto Alegre, Brazil
                [3] 3Innovations and Interventions for Quality of Life Research Group , Porto Alegre, Brazil
                [4] 4Clinical Research Center, Hospital de Clínicas de Porto Alegre , Porto Alegre, Brazil
                [5] 5Department of Psychiatry, Harvard Medical School , Boston, MA, United States
                [6] 6Cambridge Health Alliance, Center for Mindfulness and Compassion , Cambridge, MA, United States
                [7] 7Mente Aberta, Brazilian Center for Mindfulness and Health Promotion, Department of Preventive Medicine, Federal University of São Paulo (UNIFESP) , São Paulo, Brazil
                [8] 8Department of Psychology and Sociology, University of Zaragoza , Huesca, Spain
                [9] 9Grupo de Investigación en Salud Mental en Atención Primaria, Miguel Servet University Hospital , Zaragoza, Spain
                Author notes

                Edited by: Angela Fang, University of Washington, United States

                Reviewed by: Sverre Urnes Johnson, University of Oslo, Norway; Bassam Khoury, Harvard University, United States

                *Correspondence: Marcelo Trombka marcelotrombka@ 123456gmail.com

                This article was submitted to Psychological Therapies, a section of the journal Frontiers in Psychiatry

                Copyright © 2021 Trombka, Demarzo, Campos, Antonio, Cicuto, Walcher, García-Campayo, Schuman-Olivier and Rocha.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

                : 01 November 2020
                : 21 January 2021
                Page count
                Figures: 2, Tables: 4, Equations: 0, References: 170, Pages: 16, Words: 12697
                Clinical Trial

                Clinical Psychology & Psychiatry
                mindfulness,police officer,quality of life,depression,anxiety,religiosity,well-being,self-compassion


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