The human in the uniform LEPH 2018 - Toronto

What is the goal of this session? Reflection on: How to investigate resilience? How could our research improve police work? Background MSc Neurobiology Lecturer Police Leadership PhD Candidate – neurobiology of resilience Intro: background in neurobiology #LEPH2018 - Toronto - @teunpieter

Resilience individual: three perspectives the ability to function successfully under challenging circumstances Functioning successfully: spirit (spirituality) Ability to function: body (physiological) Functioning under challenging circumstances: mind (psychological) #LEPH2018 - Toronto - @teunpieter

Human performance individual group organisation #LEPH2018 - Toronto - @teunpieter

Hunting for an explanatory mechanism Homeostasis Remaining the same (Cannon, 1929) Function integrity of a dynamic, open and composed whole in interaction with a continouisly changing context (Smit, 2018) In practice: Focus on skills Instrumental approach When confronted with ‘the unusual’, climate moves from ‘identity and meaning’ to ‘behaviour and skills’. The human body is made up of a vast number of individual cells, each of which contains tiny structures with specific functions. Each cell is surrounded by a membrane and the cells work together in groups. Together they form different types of tissue and, at the next level, the tissues make up individual organs. Cells (and the tissues and organs that they make up) have a natural tendency to seek equilibrium. This happens automatically and is known as homeostasis (Cannon, 1929). The word homeostasis comes from Greek and its literal meaning is ‘remaining the same’. The human body seeks to keep its internal environment, inside the body, in a healthy state of equilibrium. However, this occurs in an environment that is naturally constantly changing. Yet in spite of these external changes, the body seeks to maintain similar conditions – temperature, moisture levels and so on. This is important in order for cells to continue functioning properly (Pocock, Richards & Richards, 2013). Connections within the body facilitate this process: tissues and organs communicate with each other via the nervous system (by means of neurotransmitters) and the blood (by means of hormones). This is the basis for the entire system of the human body, from the beating of the heart to the functioning of the immune system (Andersson & Tracey, 2012) and maintaining a steady body weight (Vianna & Coppari, 2011). #LEPH2018 - Toronto - @teunpieter

Levels of learning (Bateson) anxiety #LEPH2018 - Toronto - @teunpieter

Examples Training Mental Strength Inspire Resilience Scale Group resilience Moral resilience Personal challenges: Focus on craftmanship – not gadgets or pathology Connection between physical, mental and other kind of indicators #LEPH2018 - Toronto - @teunpieter

Key elements of stressor Unpredictable Uncertainty ‘I have had a great many troubles in my life. And most never happened…’ Mark Twain #LEPH2018 - Toronto - @teunpieter

Acute stress-response en coördination Optimal stressor-aimed orchestration of organ and tissue functions. The brain coördinates the different responses. Goal is to adaptively cope with the stressor. #LEPH2018 - Toronto - @teunpieter

#LEPH2018 - Toronto - @teunpieter

Next step Self-reported and biological markers of resilience (cross-sectional analysis) Relationship of IRS scores with biological markers of resilience, e.g., MR haplotype and other genotypes Performance of Inspire Resilience Scale as selection aid (longitudinal analysis) Predictive validity of psychological and biological markers of resilience. Why biomarkers? During a stressful encounter, cortisol activates the mineralocorticoid receptor (MR) in limbic brain circuits that governs response selection based on retrieval of previous experiences. In a healthy organism, the situation is correctly appraised and the most appropriate response is selected based on previous experiences. Meanwhile, stress-induced cortisol levels increase and activate the second cortisol receptor type, the glucocorticoid receptor (GR), which promotes memory storage of the stressful experience and the selected coping style in preparation of future encounters. The MR and GR work in complementary fashion to enable the appropriate  response to a stressful environment, to promote adaptation and to facilitate recovery. Both receptors need to operate in the right balance to maintain healthy and for optimal resilience.   Supporting the importance of the MR in health and disease, MR expression in limbic brain structures is decreased during chronic stress and depression, whereas MR activity is increased by antidepressant treatment. Such increased MR expression is associated with suppression of cortisol secretion, promotion of slow wave sleep, together with increased cognitive performance and reduced anxiety. We discovered three common and functional sets of single-nucleotide polymorphisms (haplotypes) in the human MR gene based on rs5522 and rs2070951. Testing in a laboratory setting in vitro disclosed differences in activity of the three MR-haplotypes. Haplotype 2 was (frequency 35%) found most active, followed by haplotype 1(frequency 50%) , while haplotype 3 (frequency 12 %). was least active. Using these human MR-gene variants we tested several human cohorts and found haplotype 2 to be associated with a more dynamic cortisol response, increased optimism, less rumination, less burn-out and less risk for depression. Importantly, the effect of the haplotype is most prominent in an interaction with early life adversity (trauma), while gender effect were often observed Denken kost veel energie Geen stress: amygdala – hippocampus (denken) Stress amygdala – striatum (doen) Optimisme-gen – type-2-receptor (MR) - Sneller terug in gewoontes Optimistisch, weerbaar tegen chronische stress Stress: hippocampus en pfc krimpen, amy groeit Bij verrassing meer dopamine Hippocampus: adreslabel op herinnering Amygdala: emotioneel label #LEPH2018 - Toronto - @teunpieter

Corticosteroid receptors / Hippocampus Why biomarkers? Mineralocorticoid receptor high affinity almost always occupied Glucocorticoid receptor lower affinity occupied after stress Corticosteroid receptors / Hippocampus Mineralocorticoid Receptors Glucocorticoid receptors #LEPH2018 - Toronto - @teunpieter

Why biomarkers? Cortisol Mineralocorticoid receptor (MR) Response selection Glucocortoid receptor (GR) Memory storage Preparation future encouters MR and GR need to operate in the right balance to maintain healthy and for optimal resilience. Why biomarkers? During a stressful encounter, cortisol activates the mineralocorticoid receptor (MR) in limbic brain circuits that governs response selection based on retrieval of previous experiences. In a healthy organism, the situation is correctly appraised and the most appropriate response is selected based on previous experiences. Meanwhile, stress-induced cortisol levels increase and activate the second cortisol receptor type, the glucocorticoid receptor (GR), which promotes memory storage of the stressful experience and the selected coping style in preparation of future encounters. The MR and GR work in complementary fashion to enable the appropriate  response to a stressful environment, to promote adaptation and to facilitate recovery. Both receptors need to operate in the right balance to maintain healthy and for optimal resilience.   Supporting the importance of the MR in health and disease, MR expression in limbic brain structures is decreased during chronic stress and depression, whereas MR activity is increased by antidepressant treatment. Such increased MR expression is associated with suppression of cortisol secretion, promotion of slow wave sleep, together with increased cognitive performance and reduced anxiety. We discovered three common and functional sets of single-nucleotide polymorphisms (haplotypes) in the human MR gene based on rs5522 and rs2070951. Testing in a laboratory setting in vitro disclosed differences in activity of the three MR-haplotypes. Haplotype 2 was (frequency 35%) found most active, followed by haplotype 1(frequency 50%) , while haplotype 3 (frequency 12 %). was least active. Using these human MR-gene variants we tested several human cohorts and found haplotype 2 to be associated with a more dynamic cortisol response, increased optimism, less rumination, less burn-out and less risk for depression. Importantly, the effect of the haplotype is most prominent in an interaction with early life adversity (trauma), while gender effect were often observed Denken kost veel energie Geen stress: amygdala – hippocampus (denken) Stress amygdala – striatum (doen) Optimisme-gen – type-2-receptor (MR) - Sneller terug in gewoontes Optimistisch, weerbaar tegen chronische stress Stress: hippocampus en pfc krimpen, amy groeit Bij verrassing meer dopamine Hippocampus: adreslabel op herinnering Amygdala: emotioneel label #LEPH2018 - Toronto - @teunpieter

Glucocorticoid and mineralocorticoid receptor distribution GR MR #LEPH2018 - Toronto - @teunpieter

Why biomarkers? Decreased MR expression in limbic brain structures Chronic stress Depression Increased MR expression Promotion slow wave sleep Increased cognitive performance Reduced anxiety Why biomarkers? During a stressful encounter, cortisol activates the mineralocorticoid receptor (MR) in limbic brain circuits that governs response selection based on retrieval of previous experiences. In a healthy organism, the situation is correctly appraised and the most appropriate response is selected based on previous experiences. Meanwhile, stress-induced cortisol levels increase and activate the second cortisol receptor type, the glucocorticoid receptor (GR), which promotes memory storage of the stressful experience and the selected coping style in preparation of future encounters. The MR and GR work in complementary fashion to enable the appropriate  response to a stressful environment, to promote adaptation and to facilitate recovery. Both receptors need to operate in the right balance to maintain healthy and for optimal resilience.   Supporting the importance of the MR in health and disease, MR expression in limbic brain structures is decreased during chronic stress and depression, whereas MR activity is increased by antidepressant treatment. Such increased MR expression is associated with suppression of cortisol secretion, promotion of slow wave sleep, together with increased cognitive performance and reduced anxiety. We discovered three common and functional sets of single-nucleotide polymorphisms (haplotypes) in the human MR gene based on rs5522 and rs2070951. Testing in a laboratory setting in vitro disclosed differences in activity of the three MR-haplotypes. Haplotype 2 was (frequency 35%) found most active, followed by haplotype 1(frequency 50%) , while haplotype 3 (frequency 12 %). was least active. Using these human MR-gene variants we tested several human cohorts and found haplotype 2 to be associated with a more dynamic cortisol response, increased optimism, less rumination, less burn-out and less risk for depression. Importantly, the effect of the haplotype is most prominent in an interaction with early life adversity (trauma), while gender effect were often observed Denken kost veel energie Geen stress: amygdala – hippocampus (denken) Stress amygdala – striatum (doen) Optimisme-gen – type-2-receptor (MR) - Sneller terug in gewoontes Optimistisch, weerbaar tegen chronische stress Stress: hippocampus en pfc krimpen, amy groeit Bij verrassing meer dopamine Hippocampus: adreslabel op herinnering Amygdala: emotioneel label #LEPH2018 - Toronto - @teunpieter

Why biomarkers? MR-haplotype 2 associated with more dynamic cortisol response increased optimism less rumination less burn-out less risk for depression Why biomarkers? During a stressful encounter, cortisol activates the mineralocorticoid receptor (MR) in limbic brain circuits that governs response selection based on retrieval of previous experiences. In a healthy organism, the situation is correctly appraised and the most appropriate response is selected based on previous experiences. Meanwhile, stress-induced cortisol levels increase and activate the second cortisol receptor type, the glucocorticoid receptor (GR), which promotes memory storage of the stressful experience and the selected coping style in preparation of future encounters. The MR and GR work in complementary fashion to enable the appropriate  response to a stressful environment, to promote adaptation and to facilitate recovery. Both receptors need to operate in the right balance to maintain healthy and for optimal resilience.   Supporting the importance of the MR in health and disease, MR expression in limbic brain structures is decreased during chronic stress and depression, whereas MR activity is increased by antidepressant treatment. Such increased MR expression is associated with suppression of cortisol secretion, promotion of slow wave sleep, together with increased cognitive performance and reduced anxiety. We discovered three common and functional sets of single-nucleotide polymorphisms (haplotypes) in the human MR gene based on rs5522 and rs2070951. Testing in a laboratory setting in vitro disclosed differences in activity of the three MR-haplotypes. Haplotype 2 was (frequency 35%) found most active, followed by haplotype 1(frequency 50%) , while haplotype 3 (frequency 12 %). was least active. Using these human MR-gene variants we tested several human cohorts and found haplotype 2 to be associated with a more dynamic cortisol response, increased optimism, less rumination, less burn-out and less risk for depression. Importantly, the effect of the haplotype is most prominent in an interaction with early life adversity (trauma), while gender effect were often observed Denken kost veel energie Geen stress: amygdala – hippocampus (denken) Stress amygdala – striatum (doen) Optimisme-gen – type-2-receptor (MR) - Sneller terug in gewoontes Optimistisch, weerbaar tegen chronische stress Stress: hippocampus en pfc krimpen, amy groeit Bij verrassing meer dopamine Hippocampus: adreslabel op herinnering Amygdala: emotioneel label #LEPH2018 - Toronto - @teunpieter

Questions Contrast: ambition (resilient police officers) vs. underlyning pattern (surviving in an environment filled with anxiety) #LEPH2018 - Toronto - @teunpieter

Thank you for your attention! Resilience Investigated On human processes in police work www.politieacademie.nl/weerbaarheidonderzocht Stories of resilience Resilience in the practice of police work www.politieacademie.nl/veerkrachtigeverhalen Contact teun-pieter.de.snoo@politieacademie.nl www.linkedin.com/in/teunpieter #LEPH2018 - Toronto - @teunpieter

Further reading #LEPH2018 - Toronto - @teunpieter