Autonomic Modulation Training (AMT)

Research Sponsor: CIHR

Check out more information on our study as listed on the Canadian Institute for Public Safety Research and Treatment website.

Tile title: Autonomic Modulation Training (AMT) for First Responders Exposed to Post-Traumatic Stress Injury (2020-2023)

First responders are exposed to hazardous, disturbing events, resulting in severe stress and trauma. Accumulated stress results in physical and mental health conditions, of which post-traumatic-stress-injuries (PTSI) are central. PTSI is related to reduced occupational performance, absenteeism, and risky behavior, health problems, suffering, and even suicide. However, traditional interventions to build resilience or relieve symptoms of PTSI are focused on addressing cognitive, emotional and behavioural components without addressing underlying neurological and physiological mechanisms that erode resilience, maintain pathology, and often cause symptoms to resurface following treatment.

The objectives of this proposal are to 1). reduce mental health symptoms of PTSI through a biopsychosocial intervention 2). to build wellness capacity (i.e., strengthen biological resilience) among first responders to manage accumulated stress and future exposures to trauma (Arpaia & Andersen, 2019; Andersen et al., 2018). 3). To examine how sex and gender are related to both baseline biological differences PTSI symptomatology and in response to the intervention.

 Biological Resilience: The Missing Piece

Traditional interventions to build resilience or relieve symptoms of PTSI are focused on addressing cognitive, emotional, and behavioural components without addressing underlying neurological and physiological mechanisms. Over time, exposure to chronic stress and trauma lead to a maladaptive rewiring of the autonomic nervous system (ANS) and communications between the ANS, the brainstem and higher brain regions responsible for cognitive processing (e.g., pre-frontal cortex). As a result, research has shown that attempting to teach a person suffering from PTSD only effortful, cognitive strategies, like reappraisal, does not address the underlying physiology that is causing problems. An alternative approach is to assist a person in rewiring their ANS to function adaptively and thus be able to apply cognitive, behavioral and emotion focused strategies when facing future stress.

Recommended reading: for an example of how these processes are particularly relevant to first responders, read this link

Carmichael (2009) Post Traumatic Stress Disorder in Police and Military Personnel: Assessment and Treatment Methods from Psychophysiology and Neuroscience. Biofeedback: Spring 2009, Vol. 37, No. 1, pp. 32-35.

https://doi.org/10.5298/1081-5937-37.1.32

Autonomic Modulation Training (AMT) is tailored to first responders, delivered using leading edge research tools (interactive online platform) and innovative technology (app-based, heart rate variability biofeedback monitors, delivering objective-biological measures to assess changes in psychological and physical wellness and resilience). The interactive, online delivery method addresses the population specific needs of accessibility and stigma reduction (it is not necessary to self-identify publicly). Previous research with police using AMT techniques has garnered high ‘buy-in’ because the intervention is focused on biological change through the use of tangible tools that provide real-time evidence of resilience and health improvement.

In designing the study, we have considered sex as a biological variable and gender as a social determinant of health. Using a pre/post, longitudinal study design, we will assess reductions in PTSI symptoms and increases in resilience using both self-reported and biological measures. This grant will support the development of modular AMT training that is compatible with other learning management systems and can be distributed to interested services across Canada.