Mindful Nonreactivity Moderates the Relationship Between Chronic Stress and Pain Interference in Law Enforcement Officers

Abstract

With high levels of both chronic stress and chronic pain, law enforcement provides a unique population in which to study the potential mitigating impact of cognitive and affective reactivity on the stress–pain link. The primary aim of the present study was to examine the moderating role of mindful nonreactivity in the relationship between chronic stress and pain interference in law enforcement officers (n = 60). A regression analysis was conducted to determine if chronic stress predicted pain interference and, subsequently, to compute an estimate of the interaction effect of the chronic stress and mindful nonreactivity on pain interference. Results demonstrated the overall model was significant, F (3,55) = 5.29, p = .003, R2 = .47. When controlling for mindful nonreactivity, chronic stress significantly predicted pain interference, b = .76, t (55) = 3.40, p = .001, such that every one unit increase in chronic stress was associated with a .76 unit increase in pain interference. Results also demonstrated a significant interaction effect of mindful nonreactivity and chronic stress on pain interference, b = − .04, t (55) = − 2.86, p = .006. The Johnson–Neyman technique was conducted and revealed among individuals with low levels of mindful nonreactivity, chronic stress significantly predicted pain interference. However, for individuals with greater levels of mindful nonreactivity, chronic stress no longer predicted pain interference. Findings contribute to a growing understanding of how mindfulness can mitigate harmful effects of stress.

This is a preview of subscription content, access via your institution.

Fig. 1

References

  1. Abdallah CG, Geha P (2017) Chronic pain and chronic stress: two sides of the same coin? Chronic Stress 1:247054701770476. https://doi.org/10.1177/2470547017704763

    Article  Google Scholar 

  2. Achterstraat P, (2008) Managing injured police: NSW police force. Auditor-General, Ed

  3. Almeida DM, Piazza JR, Stawski RS, Klein LC (2011) Chapter 12 - the speedometer of life: stress, health and aging. In: Schaie KW, Willis SL (eds) Handbook of the psychology of aging, 7th edn. Academic, San Diego, pp 191–206

    Google Scholar 

  4. Amtmann D, Gibran N, Hoffman J, Bombardier C, McMullen K, Carrougher GJ, Johnson K (2017) Pain comparison among traumatic injury groups. Arch Phys Med Rehabil 98(10):e7–e8. https://doi.org/10.1016/j.apmr.2017.08.021

    Article  Google Scholar 

  5. Arial M, Gonik V, Wild P, Danuser B (2010) Association of work related chronic stressors and psychiatric symptoms in a Swiss sample of police officers a cross sectional questionnaire study. (Report). Int Arch Occup Environ Health 83(3):323. https://doi.org/10.1007/s00420-009-0500-z

    Article  PubMed  Google Scholar 

  6. Baer RA (2003) Mindfulness training as a clinical intervention: a conceptual and empirical review. Clin Psychol Sci Pract 10(2):125–143

    Article  Google Scholar 

  7. Baer RA, Krietemeyer J (2006) Overview of mindfulness-and acceptance-based treatment approaches. Mindfulness-based treatment approaches: Clinician’s guide to evidence base and applications, Elseveir Publishing, p 1–27

  8. Benyamina Douma N, Cote C, Lacasse A (2017) Quebec serve and protect low back pain study: a web-based cross-sectional investigation of prevalence and functional impact among police officers. Spine (Phila Pa 1976) 42(19):1485–1493. https://doi.org/10.1097/brs.0000000000002136

    Article  Google Scholar 

  9. Berg AM, Hem E, Lau B, Loeb M, Ekeberg Ø (2003) Suicidal ideation and attempts in Norwegian police. Suicide Life Threat Behav 33(3):302–312. https://doi.org/10.1521/suli.33.3.302.23215

    Article  PubMed  Google Scholar 

  10. Bergman AL, Christopher MS, Bowen S (2016) Changes in facets of mindfulness predict stress and anger outcomes for police officers. Mindfulness 7(4):851–858. https://doi.org/10.1007/s12671-016-0522-z

    Article  Google Scholar 

  11. Bishop SR, Lau M, Shapiro S, Carlson L, Anderson ND, Carmody J, Devins G (2004) Mindfulness: A proposed operational definition. Clin Psychol Sci Pract 11(3):230–241

  12. Bohlmeijer E, ten Klooster PM, Fledderus M, Veehof M, Baer R (2011) Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form. Assessment 18(3):308–320. https://doi.org/10.1177/1073191111408231

    Article  PubMed  Google Scholar 

  13. Bonneau J, Brown J (1995) Physical ability, fitness and police work. J Clin Forensic Med 2(3):157–164. https://doi.org/10.1016/1353-1131(95)90085-3

    Article  PubMed  Google Scholar 

  14. Bränström R, Duncan LG, Moskowitz JT (2011) The association between dispositional mindfulness, psychological well-being, and perceived health in a Swedish population-based sample. Br J Health Psychol 16(2):300–316. https://doi.org/10.1348/135910710X501683

    Article  PubMed  PubMed Central  Google Scholar 

  15. Brosschot JF, Verkuil B, Thayer JF (2010) Conscious and unconscious perseverative cognition: is a large part of prolonged physiological activity due to unconscious stress? J Psychosom Res 69(4):407–416. https://doi.org/10.1016/j.jpsychores.2010.02.002

    Article  PubMed  Google Scholar 

  16. Brown KW, Ryan RM, Creswell JD (2007) Mindfulness: theoretical foundations and evidence for its salutary effects. Psychol Inq 18(4):211–237

    Article  Google Scholar 

  17. Brydon L, Walker C, Wawrzyniak A, Whitehead D, Okamura H, Yajima J, Tsuda A, Steptoe A (2009) Synergistic effects of psychological and immune stressors on inflammatory cytokine and sickness responses in humans. Brain Behav Immun 23(2):217–224. https://doi.org/10.1016/j.bbi.2008.09.007

    Article  PubMed  PubMed Central  Google Scholar 

  18. Burns J, Quartana P, Gilliam W, Matsuura J, Nappi C, Wolfe B (2012) Suppression of anger and subsequent pain intensity and behavior among chronic low back pain patients: the role of symptom-specific physiological reactivity. J Behav Med 35(1):103–114. https://doi.org/10.1007/s10865-011-9347-3

    Article  PubMed  Google Scholar 

  19. Cella D, Riley W, Stone A, Rothrock N, Reeve B, Yount S et al (2010) The Patient-Reported Outcomes Measurement Information System (PROMIS) developed and tested its first wave of adult self-reported health outcome item banks: 2005-2008. J Clin Epidemiol 63(11):1179–1194. https://doi.org/10.1016/j.jclinepi.2010.04.011

    Article  PubMed  PubMed Central  Google Scholar 

  20. Chiesa A, Serretti A (2009) Mindfulness-based stress reduction for stress management in healthy people: a review and meta-analysis. J Altern Complement Med 15(5):593–600. https://doi.org/10.1089/acm.2008.0495

    Article  PubMed  Google Scholar 

  21. Christopher MS, Hunsinger M, Goerling LRJ, Bowen S, Rogers BS, Gross CR, Dapolonia E & Pruessner JC (2018) Mindfulness-based resilience training to reduce health risk, stress reactivity, and aggression among law enforcement officers: a feasibility and preliminary efficacy trial. Psychiatry Res 264:104–115

  22. Christopher MS, Goerling RJ, Rogers BS, Hunsinger M, Baron G, Bergman AL, Zava DT (2015) A pilot study evaluating the effectiveness of a mindfulness-based intervention on cortisol awakening response and health outcomes among law enforcement officers. J Police Crim Psychol 1–14

  23. Colgan DD, Klee D, Memmott T, Proulx J, Oken B (2018) Perceived stress mediates the relationship between mindfulness and negative affect variability: a randomized controlled trial among middle-aged to older adults. Stress Health 35(1):89–97

  24. Consedine NS, Butler HF (2014) Mindfulness, health symptoms and healthcare utilization: active facets and possible affective mediators. Psychol Health Med 19(4):392. https://doi.org/10.1080/13548506.2013.824596

    Article  PubMed  Google Scholar 

  25. Consedine NS, Magai C, Bonanno GAJROGP (2002) Moderators of the emotion inhibition-health relationship: a review and research agenda. 6(2):204

  26. Creswell JD, Pacilio LE, Lindsay EK, Brown KW (2014) Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology 44:1–12. https://doi.org/10.1016/j.psyneuen.2014.02.007

    Article  PubMed  Google Scholar 

  27. Davidson RJ, McEwen BS (2012) Social influences on neuroplasticity: stress and interventions to promote well-being. Nat Neurosci 15(5):689–695. https://doi.org/10.1038/nn.3093

    Article  PubMed  PubMed Central  Google Scholar 

  28. Davis MC, Zautra AJ, Wolf LD, Tennen H, Yeung EW (2015) Mindfulness and cognitive-behavioral interventions for chronic pain: differential effects on daily pain reactivity and stress reactivity. J Consult Clin Psychol 83(1):24–35. https://doi.org/10.1037/a0038200

    Article  PubMed  Google Scholar 

  29. Ehlert U, Gaab J, Heinrichs M (2001) Psychoneuroendocrinological contributions to the etiology of depression, posttraumatic stress disorder, and stress-related bodily disorders: the role of the hypothalamus–pituitary–adrenal axis. Biol Psychol 57(1):141–152. https://doi.org/10.1016/S0301-0511(01)00092-8

    Article  PubMed  Google Scholar 

  30. Epel ES, Crosswell AD, Mayer SE, Prather AA, Slavich GM, Puterman E, Mendes WB (2018) More than a feeling: a unified view of stress measurement for population science. Front Neuroendocrinol 49:146–169

    Article  Google Scholar 

  31. Filtness AJ, Mitsopoulos-Rubens E, Rudin-Brown CM (2014) Police officer in-vehicle discomfort: appointments carriage method and vehicle seat features. Appl Ergon 45(4):1247–1256. https://doi.org/10.1016/j.apergo.2014.03.002

    Article  PubMed  Google Scholar 

  32. Franke DW, Collins AS, Hinz NP (1998) Cardiovascular disease morbidity in an Iowa law enforcement cohort, compared with the general Iowa population. J Occup Environ Med 40(5):441–444. https://doi.org/10.1097/00043764-199805000-00006

    Article  PubMed  Google Scholar 

  33. Fries E, Hesse J, Hellhammer J, Hellhammer DH (2005) A new view on hypocortisolism. Psychoneuroendocrinology 30(10):1010–1016. https://doi.org/10.1016/j.psyneuen.2005.04.006

    Article  PubMed  Google Scholar 

  34. Garland EL, Howard MO (2013) Mindfulness-oriented recovery enhancement reduces pain attentional bias in chronic pain patients. Psychother Psychosom 82(5):311–318. https://doi.org/10.1159/000348868

    Article  PubMed  Google Scholar 

  35. Garland E, Gaylord S, Palsson O, Faurot K, Douglas Mann J, Whitehead W (2012) Therapeutic mechanisms of a mindfulness-based treatment for IBS: effects on visceral sensitivity, catastrophizing, and affective processing of pain sensations. J Behav Med 35(6):591–602. https://doi.org/10.1007/s10865-011-9391-z

    Article  PubMed  Google Scholar 

  36. Grabovac AD, Lau MA, Willett BR (2011) Mechanisms of mindfulness: a Buddhist psychological model. Mindfulness 2(3):154–166

    Article  Google Scholar 

  37. Gyi DE, Porter JM (1998) Musculoskeletal problems and driving in police officers. Occup Med (Lond) 48(3):153–160

    Article  Google Scholar 

  38. Hall GB, Dollard MF, Tuckey MR, Winefield AH, Thompson BM (2010) Job demands, work-family conflict, and emotional exhaustion in police officers: a longitudinal test of competing theories. (Report). J Occup Organ Psychol 83(1):237

    Article  Google Scholar 

  39. Hannibal KE, Bishop MD (2014) Chronic stress, cortisol dysfunction, and pain: a psychoneuroendocrine rationale for stress management in pain rehabilitation. Phys Ther 94(12):1816–1825. https://doi.org/10.2522/ptj.20130597

    Article  PubMed  PubMed Central  Google Scholar 

  40. Hayes A (2012) PROCESS: A versatile computational tool for observed variable mediation, moderation, and conditional process modeling. Retrieved from http://www.afhayes.com/public/process2012.pdf. Accessed 9/2/2017

  41. Hayes SC, Wilson KG (2003) Mindfulness: method and process. Clin Psychol Sci Pract 10(2):161–165

    Article  Google Scholar 

  42. Holmes MWR, McKinnon CD, Dickerson CR, Callaghan JP (2013) The effects of police duty belt and seat design changes on lumbar spine posture, driver contact pressure and discomfort. Ergonomics 56(1):126–136. https://doi.org/10.1080/00140139.2012.739206

    Article  PubMed  Google Scholar 

  43. Juniper B, White N, Bellamy P (2010) A new approach to evaluating the well-being of police. Occup Med (Lond) 60(7):560–565. https://doi.org/10.1093/occmed/kqq130

    Article  Google Scholar 

  44. Kabat-Zinn J (1990) Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. Delta Publishing, Brooklyn

    Google Scholar 

  45. Kaplan JB, Bergman AL, Christopher M, Bowen S, Hunsinger M (2017) Role of resilience in mindfulness training for first responders. Mindfulness 8:1–8. https://doi.org/10.1007/s12671-017-0713-2

    Article  Google Scholar 

  46. Keng SL, Smoski MJ, Robins CJ (2011) Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev 31(6):1041–1056. https://doi.org/10.1016/j.cpr.2011.04.006

    Article  PubMed  PubMed Central  Google Scholar 

  47. Kessler RC, Walters EE (1998) Epidemiology of DSM-III-R major depression and minor depression among adolescents and young adults in the national comorbidity survey. Depress Anxiety 7(1):3–14. https://doi.org/10.1002/(SICI)1520-6394(1998)7:1<3::AID-DA2>3.0.CO;2-F

    Article  PubMed  Google Scholar 

  48. Kröll C, Doebler P, Nüesch S (2017) Meta-analytic evidence of the effectiveness of stress management at work. Eur J Work Organ Psy 26(5):677–693. https://doi.org/10.1080/1359432X.2017.1347157

    Article  Google Scholar 

  49. Lazarus RS (2006) Stress and emotion: a new synthesis. Springer Publishing Company, New York

    Google Scholar 

  50. Lazarus RS, & Folkman S (1984). Stress, appraisal, and coping. Springer publishing company

  51. Lovallo RW, Gerin RW (2003) Psychophysiological reactivity: mechanisms and pathways to cardiovascular disease. Psychosom Med 65(1):36–45. https://doi.org/10.1097/01.PSY.0000033128.44101.C1

    Article  PubMed  Google Scholar 

  52. Marks ADG, Sobanski DJ, Hine DW (2010) Do dispositional rumination and/or mindfulness moderate the relationship between life hassles and psychological dysfunction in adolescents? Aust N Z J Psychiatry 44(9):831–838. https://doi.org/10.3109/00048674.2010.487478

    Article  PubMed  Google Scholar 

  53. Marmar C, McCaslin S, Metzler T, Best S, Weiss D, Fagan J, … Neylan T (2006) Predictors of posttraumatic stress in police and other first responders. Ann N Y Acad Sci, 1071(1):1–18

  54. McCreary DR, Thompson MM (2006) Development of two reliable and valid measures of stressors in policing: the operational and organizational police stress questionnaires. Int J Stress Manag 13(4):494–518. https://doi.org/10.1037/1072-5245.13.4.494

    Article  Google Scholar 

  55. Morash M, Kwak D-H, Hoffman V, Lee CH, Cho SH, Moon B (2008) Stressors, coping resources and strategies, and police stress in South Korea. J Crim Just 36(3):231–239. https://doi.org/10.1016/j.jcrimjus.2008.04.010

    Article  Google Scholar 

  56. Nabeel I, Baker BA, McGrail MP Jr, Flottemesch TJ (2007) Correlation between physical activity, fitness, and musculoskeletal injuries in police officers. Minn Med 90(9):40–43

    PubMed  Google Scholar 

  57. Neylan TC, Metzler TJ, Best SR, Weiss DS, Fagan JA, Liberman A, Rogers C, Vedantham K, Brunet A, Lipsey TL, Marmar CR (2002) Critical incident exposure and sleep quality in police officers. Psychosom Med 64(2):345–352

    Article  Google Scholar 

  58. Nolen-Hoeksema S, Wisco BE, Lyubomirsky S (2008) Rethinking rumination. Perspect Psychol Sci 3(5):400–424. https://doi.org/10.1111/j.1745-6924.2008.00088.x

    Article  PubMed  Google Scholar 

  59. Ormel J, Jeronimus BF, Kotov R, Riese H, Bos EH, Hankin B, Rosmalen JGM, Oldehinkel AJ (2013) Neuroticism and common mental disorders: meaning and utility of a complex relationship. Clin Psychol Rev 33(5):686–697. https://doi.org/10.1016/j.cpr.2013.04.003

    Article  PubMed  PubMed Central  Google Scholar 

  60. Pascoe MC, Thompson DR, Jenkins ZM, Ski CF (2017) Mindfulness mediates the physiological markers of stress: systematic review and meta-analysis. J Psychiatr Res 95:156–178. https://doi.org/10.1016/j.jpsychires.2017.08.004

    Article  PubMed  Google Scholar 

  61. Proulx J, Klee D, Oken BS (2017) Do psychosocial predictors affect the following days’ cortisol awakening response? Expanding the temporal frame with which to explore morning cortisol. Stress 20(4):398–403. https://doi.org/10.1080/10253890.2017.1346076

    Article  PubMed  PubMed Central  Google Scholar 

  62. Quartana PJ, Buenaver LF, Edwards RR, Klick B, Haythornthwaite JA, Smith MT (2010) Pain catastrophizing and salivary cortisol responses to laboratory pain testing in temporomandibular disorder and healthy participants. J Pain 11(2):186–194. https://doi.org/10.1016/j.jpain.2009.07.008

    Article  PubMed  Google Scholar 

  63. Ramstrand N, Larsen LB (2012) Musculoskeletal injuries in the workplace: perceptions of Swedish police. Int J Police Sci Manag 14(4):334–342. https://doi.org/10.1350/ijps.2012.14.4.293

    Article  Google Scholar 

  64. Ramstrand N, Larsen LBJIJOPS, Management (2012) Musculoskeletal injuries in the workplace: perceptions of Swedish police 14(4):334–342

  65. Ramstrand N, Zügner R, Larsen LB, Tranberg R (2016) Evaluation of load carriage systems used by active duty police officers: relative effects on walking patterns and perceived comfort. Appl Ergon 53(Part A):36–43. https://doi.org/10.1016/j.apergo.2015.08.007

    Article  PubMed  Google Scholar 

  66. Rodriguez-Raecke R, Niemeier A, Ihle K, Ruether W, May A (2009) Brain gray matter decrease in chronic pain is the consequence and not the cause of pain. J Neurosci 29(44):13746–13750

    Article  Google Scholar 

  67. Schroeder DA, Stephens E, Colgan D, Hunsinger M, Rubin D, Christopher MS (2018) A brief mindfulness-based intervention for primary care physicians: a pilot randomized controlled trial. Am J Lifestyle Med 12(1):83–91. https://doi.org/10.1177/1559827616629121

    Article  PubMed  Google Scholar 

  68. Seminowicz DA, Wideman TH, Naso L, Hatami-Khoroushahi Z, Fallatah S, Ware MA, Jarzem P, Bushnell MC, Shir Y, Ouellet JA, Stone LS (2011) Effective treatment of chronic low back pain in humans reverses abnormal brain anatomy and function. J Neurosci 31(20):7540–7550. https://doi.org/10.1523/jneurosci.5280-10.2011

    Article  PubMed  PubMed Central  Google Scholar 

  69. Shane JM (2010) Organizational stressors and police performance. J Crim Just 38(4):807–818. https://doi.org/10.1016/j.jcrimjus.2010.05.008

    Article  Google Scholar 

  70. Sorrells S, Caso J, Munhoz CD, Sapolsky RM (2009) The stressed CNS: when glucocorticoids aggravate inflammation. Neuron 64(1):33–39. https://doi.org/10.1016/j.neuron.2009.09.032

    Article  PubMed  PubMed Central  Google Scholar 

  71. Steglitz J, Buscemi J, Ferguson M (2012) The future of pain research, education, and treatment: a summary of the IOM report “Relieving pain in America: a blueprint for transforming prevention, care, education, and research”. Transl Behav Med 2(1):6–8. https://doi.org/10.1007/s13142-012-0110-2

    Article  PubMed  PubMed Central  Google Scholar 

  72. Tak LM, Rosmalen JGJJOPR (2010) Dysfunction of stress responsive systems as a risk factor for functional somatic syndromes. J Psychosom Res 68(5):461–468

    Article  Google Scholar 

  73. Tsigos C, Chrousos GP (2002) Hypothalamic-pituitary-adrenal axis, neuroendocrine factors and stress. J Psychosom Res 53(4):865–871. https://doi.org/10.1016/S0022-3999(02)00429-4

    Article  PubMed  Google Scholar 

  74. van Gelderen B, Heuven E, van Veldhoven M, Zeelenberg M, Croon M (2007) Psychological strain and emotional labor among police-officers: a diary study. J Vocat Behav 71(3):446–459. https://doi.org/10.1016/j.jvb.2007.09.001

    Article  Google Scholar 

  75. Veehof MM, Oskam MJ, Schreurs KM, Bohlmeijer ET (2011) Acceptance-based interventions for the treatment of chronic pain: a systematic review and meta-analysis. Pain 152(3):533–542. https://doi.org/10.1016/j.pain.2010.11.002

    Article  PubMed  Google Scholar 

  76. Violanti JM, Burchfiel CM, Miller DB, Andrew ME, Dorn J, Wactawski-Wende J et al (2006) The Buffalo Cardio-Metabolic Occupational Police Stress (BCOPS) pilot study: methods and participant characteristics. Ann Epidemiol 16(2):148–156. https://doi.org/10.1016/j.annepidem.2005.07.054

    Article  PubMed  Google Scholar 

  77. Violanti JM, Fekedulegn D, Andrew ME, Charles LE, Hartley TA, Burchfiel CM (2011) Adiposity in policing: mental health consequences. Int J Emerg Ment Health 13(4):257–266

    PubMed  Google Scholar 

  78. Zimmaro L, Salmon P, Naidu H, Rowe J, Phillips K, Rebholz W et al (2016) Association of dispositional mindfulness with stress, cortisol, and well-being among university undergraduate students. Mindfulness 7(4):874–885. https://doi.org/10.1007/s12671-016-0526-8

    Article  Google Scholar 

Download references

Acknowledgments

The authors would like to acknowledge Brant Rodgers, Lieutenant Richard Goerling, and the many law enforcement officers who made this study possible.

Funding

Research reported in this publication was supported by the National Center for Complementary & Integrative Health of the National Institutes of Health under Award Numbers T32AT002688 and K24AT005121.

Author information

Affiliations

Authors

Corresponding author

Correspondence to Dana Dharmakaya Colgan.

Ethics declarations

This manuscript has not been previously published and is not under consideration in the same or substantially similar form in any other peer-reviewed media. All authors listed have contributed sufficiently to the project to be included as authors, and all those who are qualified to be authors are listed in the author byline. To the best of our knowledge, no conflict of interest, financial, or other exists. The parent study was approved by Pacific University IRB and all participants provided informed consent prior to assessments.

Disclaimer

The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Colgan, D.D., Eddy, A., Bowen, S. et al. Mindful Nonreactivity Moderates the Relationship Between Chronic Stress and Pain Interference in Law Enforcement Officers. J Police Crim Psych 36, 56–62 (2021). https://doi.org/10.1007/s11896-019-09336-3

Download citation

Keywords

  • Pain
  • Stress
  • Pain interference
  • Mindfulness
  • Law enforcement