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Modern anxiety disorder models implicitly include intolerance of uncertainty (IU) as a critical component for the development and maintenance of these pervasive social and economic concerns. IU represents, at its core, fear of the unknown - a long-recognized, deep-seated fear identified in normative and pathological samples. Indeed, the intrinsic nature of IU can be argued as evolutionarily supported, a notion buttressed by initial biophysiological evidence from uncertainty-related research. Originally thought to be specific to generalized anxiety disorder, recent research has clearly demonstrated that IU is a broad transdiagnostic dispositional risk factor for the development and maintenance of clinically significant anxiety. The available evidence suggests that theorists, researchers and clinicians may benefit from explicitly incorporating IU into models, research designs, case conceptualizations and as a treatment target.

There are growing concerns about the impact of public safety work on the mental health of public safety personnel; as such, we explored systemic and individual factors that might dissuade public safety personnel from seeking care. Public safety personnel barriers to care-seeking include the stigma associated with mental disorders and frequent reports of insufficient access to care. To better understand barriers to care-seeking, we thematically analyzed the optional open-ended final comments provided by over 828 Canadian public safety personnel as part of a larger online survey designed to assess the prevalence of mental disorders among public safety personnel. Our results indicated that systematic processes may have (1) shaped public safety personnel decisions for care-seeking, (2) influenced how care-seekers were viewed by their colleagues, and (3) encouraged under-awareness of personal mental health needs. We described how public safety personnel who do seek care may be viewed by others; in particular, we identified widespread participant suspicion that coworkers who took the time to address their mental health needs were “abusing the system.” We explored what constitutes “abusing the system” and how organizational structures—systematic processes within different public safety organizations—might facilitate such notions of abuse. We found that understaffing may increase scrutiny of injured public safety personnel by those left to manage the additional burden; in addition, cynicism and unacknowledged structural stigma may emerge, preventing the other public safety personnel from identifying their mental health needs and seeking help. Finally, we discuss how system-level stigma can be potentiated by fiscal constraints when public safety personnel take any leave of absence, inadvertently contributing to an organizational culture wherein help-seeking for employment-related mental health concerns becomes unacceptable. Implications for public safety personnel training and future research needs are discussed.

The current study replicated and extended previous studies by examining the mediating and moderating role of rumination in the relationship between intolerance of uncertainty (IU) and depression in a community sample using both cross-sectional (n = 494; 56.9% female) and a two-months longitudinal (n = 321; 48.4% female) designs. Participants in each study were recruited through online crowdsourcing websites and completed study questionnaires. Results from Study 1 suggested that, while rumination did not appear to moderate the relationship between IU and depression, rumination appeared to partially mediates such relationship. Results from Study 2 supported rumination as fully mediating the relationship between IU and depression over two months. The brooding and reflection rumination subtypes exerted a significant indirect, but not moderating, effect on the relationship between IU and depression. Brooding exhibited a stronger mediation effect than did reflection. Overall, current results suggest that high levels of IU fuel the development of depression symptoms over time through engagement in heightened rumination. The IU-depression association appeared fully explained through rumination as it is a passive and contextually-dependent coping response that may enhance individuals' emotion and facilitate the development of depressive symptoms.

Women police officers report elevated symptoms of mental disorders when compared to men police officers. Researchers have indicated that the occupational experience of policing differs greatly among men and women. Indeed, police culture is characterized by hegemonic masculinity, which appears to negatively impact both men and women. The current study examined the contrast between the experiences of men and women police officers. Police officers (n = 17; 9 women) in Saskatchewan participated in semi-structured interviews. Thematic network analysis identified themes related to the experience of policing for both men and women police officers. There were six organizing themes identified in relation to the global theme of Gendered Experiences: (1) Discrimination; (2) Sexual Harassment; (3) Motherhood and Parental Leave; (4) Identity; (5) Stereotypically Feminine Attributes; and (6) Hegemonic Masculinity. Pervasive gender norms appear detrimental for both men and women police officers, as well as the communities they serve. The current results, coupled with the emerging disposition for progress expressed by police services, offer opportunities to develop tailored and focused interventions and policies to support police officers.

Public Safety Personnel (PSP) include border services officers, public safety communications officials, correctional workers, firefighters (career and volunteer), Indigenous emergency managers, operational intelligence personnel, paramedics, police (municipal, provincial, and federal), and search and rescue personnel. PSP are regularly exposed to potentially psychologically traumatic events and recent evidence indicates nearly half may currently screen positive for one or more mental health disorders. There appears to be a long history wherein the challenges faced by PSP have gone relatively unnoticed outside of their own professional communities; however, since 2015 there have been several substantial advancements toward recognizing, researching, and redressing the mental health challenges faced by PSP serving to Canadians. In 2018, the Government of Canada dedicated funding to catalyze the creation of evidence-based solutions through a consortium between the Canadian Institute for Public Safety Research and Treatment (CIPSRT) and the Canadian Institutes of Health Research as part of a national action plan to address posttraumatic stress disorder and other posttraumatic stress injuries. The funding also supported CIPSRT as a national hub for knowledge translation and mobilization efforts informed by an increasingly coordinated national network of academics, researchers, and clinicians, and guided by national PSP leadership. The results support evidence-based solutions (e.g., evidence-based internet-delivered Cognitive Therapy tailored for PSP) that are increasingly deployed across Canada by a growing, diverse, dedicated, and collaborative community. The rapid gains over the past 5 years serve as tangible evidence of reasons to hope for similarly rapid progress in supporting PSP mental health over the next 5 years. Public Significance Statement Public Safety Personnel (PSP; e.g., border services officers, communications officials, correctional workers, firefighters, Indigenous emergency managers, operational intelligence personnel, paramedics, police, and search and rescue personnel) can experience mental health injuries while working to protect Canadians. Recent collaborative efforts have galvanized national attention to better support PSP mental health (e.g., Canada's Action Plan on Post-Traumatic Stress Injuries). The current article chronicles several recent collaborative efforts to better serve the PSP.

BackgroundPublic safety personnel (PSP; e.g., correctional workers and officers, firefighters, paramedics, police officers, public safety communications officials) are regularly exposed to potentially traumatic events and considerable uncertainty as part of their employment. Canadian PSP screen positively for mental disorders at much higher rates than the general population. Intolerance of uncertainty (IU) and anxiety sensitivity (AS) are empirically-supported vulnerability factors associated with the development and maintenance of mental disorders.MethodsThe present study was designed to assess IU and AS across PSP—a population regularly encountering uncertainty—with and without mental disorders (n = 4304; 33.3% women), and across normative clinical, community, and undergraduate samples. Further, the study examined the relationship between IU and AS and mental disorders among PSP.ResultsThere were significant differences across groups on IU and AS scores (ps < .001). All PSP, with and without a positive screen for a mental disorder, reported lower IU and AS than clinical samples; however, PSP without mental disorders reported lower IU and AS than all other groups (ps < .001).ConclusionIncreased resilience or the development of coping skills to manage regular exposures to uncertain threat may help explain why PSP reported low levels of IU and AS despite higher prevalence of mental disorders. Implications for PSP training and treatment are discussed.

The Center for Epidemiologic Studies Depression Scale (CES-D; Radloff, 1977) is a commonly used freely available self-report measure of depressive symptoms. Despite its popularity, several recent investigations have called into question the robustness and suitability of the commonly used 4-factor 20-item CES-D model. The goal of the current study was to address these concerns by confirming the factorial validity of the CES-D. Differential item functioning estimates were used to examine sex biases in item responses, and confirmatory factor analyses were used to assess prior CES-D factor structures and new models heeding current theoretical and empirical considerations. Data used for the analyses included undergraduate (n = 948; 74% women), community (n = 254; 71% women), rehabilitation (n = 522; 53% women), clinical (n =84; 77% women), and National Health and Nutrition Examination Survey (NHANES; n = 2814; 56% women) samples. Differential item functioning identified an item as inflating CES-D scores in women. Comprehensive comparison of the several models supported a novel, psychometrically robust, and unbiased 3-factor 14-item solution, with factors (i.e., negative affect, anhedonia, and somatic symptoms) that are more in line with current diagnostic criteria for depression. Researchers and practitioners may benefit from using the novel factor structure of the CES-D and from being cautious in interpreting results from the originally proposed scale. Comprehensive results, implications, and future research directions are discussed.

The work of public safety personnel (PSP) is inherently moral; however, the ability of PSP to do what is good and right can be impeded and frustrated, leading to moral suffering. Left unresolved, moral suffering may develop into moral injury (MI) and potential psychological harm. The current study was designed to examine if MI is relevant to frontline public safety communicators, firefighters, and paramedics. Semi-structured interviews (n = 3) and focus groups (n = 3) were conducted with 19 participants (public safety communicators (n = 2); paramedics (n = 7); and firefighters (n = 10)). Interviews and focus groups were audio-recorded, transcribed, coded, and constantly compared in accordance with the grounded theory method. A conceptual theory of “frustrating moral expectations” emerged, with participants identifying three interrelated properties as being potentially morally injurious: chronic societal problems, impaired systems, and organizational quagmires. Participants navigated their moral frustrations through both integrative and disintegrative pathways, resulting in either needing to escape their moral suffering or transforming ontologically. The current study results support MI as a relevant concept for frontline PSP. Given the seriousness of PSP leaving their profession or committing suicide to escape moral suffering, the importance of the impact of MI on PSP and public safety organizations cannot be ignored or underestimated. Understanding the similarities and differences of morally injurious exposures of frontline PSP may be critical for determining mental health and resilience strategies that effectively protect PSP.

In the current study, we quantified the mean stress levels of 43 occupational stressors for 868 Correctional Workers (CWs) and analyzed the relationships between occupational stressors, exposure to potentially psychologically traumatic events (PPTEs), and mental health disorders. Our findings emphasize the importance of the occupational environment in relation to CW mental health and indicate that occupational stressors (e.g., staff shortages, inconsistent leadership style, bureaucratic red tape) are more salient contributors to CW mental health than exposure to PPTEs. Finding strategies to ameliorate staff shortages, improve leadership style and communication, and support CWs to maintain physical, mental, and social well-being would be interventions tied to significant organizational and operational stressors within the current study.

Substantial media attention has focused on suicide among Canadian Public Safety Personnel (PSP; e.g., correctional workers, dispatchers, firefighters, paramedics, police). The attention has raised significant concerns about the mental health impact of public safety service, as well as interest in the correlates for risk of suicide. There have only been two published studies assessing lifetime suicidal behaviors among Canadian PSP. The current study was designed to assess past-year and lifetime suicidal ideation, plans, and attempts amongst a large diverse sample of Canadian PSP. Estimates of suicidal ideation, plans, and attempts were derived from self-reported data from a nationally administered online survey. Participants included 5,148 PSP (33.4% women) grouped into six categories (i.e., Call Centre Operators/Dispatchers, Correctional Workers, Firefighters, Municipal/Provincial Police, Paramedics, Royal Canadian Mounted Police). Substantial proportions of participants reported past-year and lifetime suicidal ideation (10.1%, 27.8%), planning (4.1%, 13.3%), or attempts (0.4%, 4.6%). Women reported significantly more lifetime suicidal behaviors than men (ORs = 1.15 to 2.62). Significant differences were identified across PSP categories in reports of past-year and lifetime suicidal behaviors. The proportion of Canadian PSP reporting past-year and lifetime suicidal behaviors was substantial. The estimates for lifetime suicidal behaviors appear consistent with or higher than previously published international PSP estimates, and higher than reports from the general population. Municipal/Provincial Police reported the lowest frequency for past-year and lifetime suicidal behaviors, whereas Correctional Workers and Paramedics reported the highest. The results provide initial evidence that substantial portions of diverse Canadian PSP experience suicidal behaviors, therein warranting additional resources and research. Le nombre de suicides survenus parmi les membres du personnel de la sécurité publique (PSP) au Canada (PSP : les travailleurs de services correctionnels, répartiteurs, pompiers, ambulanciers et policiers) a fait l'objet d'une importante attention médiatique. Cette attention a suscité des préoccupations importantes concernant l'impact de la santé mentale du service de la sécurité publique, ainsi qu'un intérêt au niveau des corrélations avec les risques de suicide. Il n'y a eu que deux études publiées sur les comportements suicidaires au long d'une vie parmi les membres du personnel de la sécurité publique au Canada. L'étude actuelle a été conçue pour évaluer le nombre d'idées, de projets et de tentatives de suicide au cours de la dernière année et pendant toute une vie parmi un large échantillon diversifié de membres du personnel de sécurité publique canadien. Les estimations d'idées, de projets et de tentatives de suicide ont été calculées à partir de données autodéclarées provenant d'une enquête nationale effectuée en ligne. Les participants comprenaient 5 148 membres du PSP (dont 33,4% de femmes) regroupés en six catégories (c.-à-d. opérateurs/répartiteurs de centre d'appels, travailleurs de services correctionnels, pompiers, policiers municipaux et provinciaux, ambulanciers et agents de la Gendarmerie royale du Canada). D'importantes proportions de participants ont déclaré avoir été victimes d'idées suicidaires (10,1 %, 27,8 %), de projets suicidaires (4,1 %, 13,3 %) ou de tentatives suicidaires (0,4 %, 4,6 %). Les femmes ont signalé un nombre significativement plus élevé de comportements suicidaires au long de leur vie que les hommes (rapport des cotes = 1,15 à 2,62). Des différences significatives ont été relevées entre les différentes catégories de membres du PSP en ce qui a trait aux déclarations de comportements suicidaires au cours de la dernière année et tout au long d'une vie. La proportion de membres du PSP canadien ayant déclaré avoir été victime de comportements suicidaires au cours de la dernière année ou au long de leur vie était considérable. Les estimations de comportements suicidaires au long d'une vie semblent être cohérentes avec les estimations de PSP internationales publiées précédemment et plus élevées que les déclarations de la population générale. Les policier municipaux/provinciaux ont connu la plus basse fréquence de comportements suicidaires au cours de la dernière année et au long de leur vie alors que les travailleurs des services correctionnels et les ambulanciers ont connu la fréquence la plus haute. Ces résultats apportent des premières preuves à l'effet que des portions importantes de membres divers du PSP canadien affichent des comportements suicidaires, justifiant la nécessité de ressources et de recherches supplémentaires.