Social and Behavioral Sciences Commons^™

Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Schonfeld

Publications and Research

Burnout has elicited growing interest among occupational health specialists in recent decades. Since 2019, the World Health Organization has characterized burnout as a syndrome resulting from chronic, unmanageable workplace stress. Accordingly, three symptoms define the entity: (i) feelings of energy depletion or exhaustion; (ii) increased mental distance from one’s job or feelings of negativism or cynicism towards one’s job; and (iii) a sense of ineffectiveness and lack of accomplishment. We call into question the definition of burnout embodied in the Maslach Burnout Inventory and incorporated into the ICD-11. We draw stakeholders’ attention to the fact that burnout’s symptoms and etiology …

Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout has elicited growing interest among occupational health specialists in recent decades. Since 2019, the World Health Organization has characterized burnout as a syndrome resulting from chronic, unmanageable workplace stress. According to the ICD-11, three symptoms define the entity: feelings of exhaustion, increased mental distance from one’s job, and a sense of ineffectiveness at work, all of which correspond to the structure of the Maslach Burnout Inventory. The ICD-11 includes burnout among the factors that influence health status. This paper calls into question that conceptualization based on a number of lines of evidence. The evidence includes the following: burnout was …

Illness Intrusiveness And Psychosocial Adjustment Among Older Adults With Multimorbidity, Irina Mindlis

Dissertations, Theses, and Capstone Projects

Given the high prevalence of multimorbidity (MM) among older adults and the exponential growth of the older adult U.S. population, identifying factors that can lessen depressive symptoms and improve quality of life (QOL) in this population is timely and important. While it is well established that MM is associated with greater depressive symptoms and poorer QOL (Li et al., 2016; Makovski et al., 2019; Marengoni et al., 2011; Read et al., 2017), the mechanisms underlying these relationships remain understudied. The illness intrusiveness model (Devins et al., 1984) proposes that stressors posed by diseases (disease-related factors) and their treatments (treatment-related factors) …

Burnout And Depression In Teachers And Members Of Other Occupational Groups: A Systematic Review And Meta-Analyses On Potentially Overlapping Conditions, Gail Swingler

Dissertations, Theses, and Capstone Projects

Burnout has long been recognized as a workplace issue among teachers, and other occupational groups. Burnout has potentially been increasing during the Covid-19 pandemic. Researchers tend to regard burnout as a distinct syndrome comprising emotional exhaustion (EE), depersonalization (DP), and reduced personal accomplishment (rPA). Recent evidence suggests that burnout (as a tripartite syndrome) lacks discriminant validity vis-à-vis depression. The overlap between burnout and depression was examined through two meta-analytic studies.

The first study (K = 13) examined the relationship between burnout and depression in teachers with burnout assessed using the MBI. The findings indicated that exhaustion (EE), and depression …

Ssri-Induced Emotional Blunting: A Study Of Cognitive Changes In Pharmaceutically Treated Depression, Carly Tocco

Dissertations, Theses, and Capstone Projects

Objective: In recent years, approximately 12.7% of the American population are on a prescribed antidepressant medication. Selective Serotonin Reuptake Inhibitors (SSRIs) are a widely used pharmacological treatment for depressive and anxiety disorders, primarily due to their tolerance levels, mild side effects in comparison to other antidepressants, and broad range of clinical indications. However, there are still numerous concerns about SSRIs’ ability to improve depressive symptoms without adding side effects such as sexual dysfunction, gastrointestinal upset, and a restricted range of emotions. Although patients typically claim that they have less emotional pain while on SSRIs than they do during a depressive …

Neuroanatomy In Mild Cognitive Impairment: Relationship To Functional Skills, Treatment Expectancy, And Comorbid Depression, Sara Rushia

Dissertations, Theses, and Capstone Projects

Mild cognitive impairment (MCI) is a neurocognitive disorder defined by cognitive decline in older adults. Although MCI has been studied for decades, there remain important areas to be explored in order to adequately characterize aspects of this disorder that provide information valuable for possible interventions and disease progression to dementia, including a better understanding of the neuroanatomical variables relevant to this disorder. Such neuroanatomical variables include cortical thickness, hippocampal volume, and white matter hyperintensities (WMHs). This dissertation consists of three separate studies aimed at addressing gaps in the literature on MCI in relation to brain morphometrics and under-studied characteristics involved …

Is The Phq-9 A Unidimensional Measure Of Depression? A 58,272-Participant Study, Renzo Bianchi, Jay Verkuilen, Sharon Toker, Irvin Sam Schonfeld, Markus Gerber, Elmar Brähler, Kurt Kroenke

Publications and Research

The PHQ-9 has become a measure of reference in depression research and clinical practice. However, the issue of the PHQ-9’s unidimensionality has not been fully elucidated, and the usability of the PHQ-9’s total score requires clarification. In this study, we examined the dimensionality, scalability, and monotonicity properties of the PHQ-9 as well as the scale’s total-score reliability. We did so based on exploratory structural equation modeling (ESEM) bifactor analysis and Mokken scale analysis (MSA). We relied on a total of 58,272 participants (63% female; Mage = 43, SDage = 13) from 29 samples involving seven different countries (e.g., Germany, the …

Screen Time And The Psychological Well-Being Of U.S. Teenagers: An Exploratory Re-Analysis Of Data From The Youth Risk Behavior Survey, Russell Miller

Dissertations, Theses, and Capstone Projects

Numerous studies, notably secondary analyses of survey data, have examined the possibility of adverse effects from teenagers' use of digital screen-based media--with correspondingly diverse findings. One research group in particular, led by Jean M. Twenge, has been prolific and forceful in associating adolescents’ screen time with reported increases in depression, suicidal ideation, and attempted suicide. Others have pointed to small effect sizes, construct validity issues, and other methodological problems in the Twenge research. However, one characteristic of the group's analyses of survey data, including data from the CDC's Youth Risk Behavior Survey (YRBS), has remained unexplored: the use of metric …

Loneliness, Interpersonal Sensitivity And The Mechanisms Through Which The Dimensions Of Trait Emotional Intelligence May Protect Against Clinical Depression, Eva H. Leighton

Dissertations and Theses

Reducing the prevalence of loneliness and depression are important public health objectives. This dissertation aims to contribute to these objectives by improving our understanding of the relationship between loneliness and depression. Specifically, we assessed three additional constructs known to be strongly associated with loneliness and depression –-perceived social support, emotional intelligence, and interpersonal sensitivity –- with the aim of showing how these three constructs influence the relationship between loneliness and depression. Previous research that jointly examines all five constructs has not been identified by the author in an extensive search of prior literature.

Specifically, this dissertation tested the following hypotheses: …

Being Black & Blue: Sex As A Moderator Between Adverse Childhood Experiences And Depressive Symptoms Among Black Emerging Adults, Wynta C. Alexander

Dissertations and Theses

Adverse Childhood Experiences (ACEs) have been linked to adult mental health consequences (e.g., depressive symptoms). Black people are disproportionately affected by ACEs, and factors related to ethnic subgroups and/or sex may produce differential depressive outcomes. The current study examined the moderating role of sex in the association between adverse childhood experiences and depression symptoms using a life course of health approach among a sample of Black emerging adults. Participants (n = 159) of the current study were Black (e.g., African – American) and Black Caribbean (e.g., Jamaican) undergraduate students (18 – 59 years old; 72.3% female) attending a large, public …

From Burnout To Occupational Depression: Recent Developments In Research On Job-Related Distress And Occupational Health, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Job-related distress has been a focal concern in occupational health science. Job-related distress has a well-documented health-damaging and life-threatening character, not to mention its economic cost. In this article, we review recent developments in research on job-related distress and examine ongoing changes in how job-related distress is conceptualized and assessed. By adopting an approach that is theoretically, empirically, and clinically informed, we demonstrate how the construct of burnout and its measures, long favored in research on job-related distress, have proved to be problematic. We underline a new recommendation for addressing job-related distress within the long-established framework of depression research. In …

Psychiatrist Burnout, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

We critique a paper published by Summers et al. (2020) and papers in general that, because of flawed methods, arrive at exceedingly high estimates of burnout in psychiatrists and other professionals.

Is Burnout A Depressive Condition? A 14-Sample Meta-Analytic And Bifactor Analytic Study, Renzo Bianchi, Jay Verkuilen, Irvin S. Schonfeld, Jari J. Hakanen, Markus Jansson-Fröjmark, Guadalupe Manzano-García, Eric Laurent, Laurenz L. Meier

Publications and Research

There is no consensus on whether burnout constitutes a depressive condition or an original entity requiring specific medical and legal recognition. In this study, we examined burnout–depression overlap using 14 samples of individuals from various countries and occupational domains (N = 12,417). Meta-analytically pooled disattenuated correlations indicated (a) that exhaustion—burnout’s core—is more closely associated with depressive symptoms than with the other putative dimensions of burnout (detachment and efficacy) and (b) that the exhaustion–depression association is problematically strong from a discriminant validity standpoint (r = .80). The overlap of burnout’s core dimension with depression was further illuminated in 14 exploratory structural …

The Occupational Depression Inventory: A New Tool For Clinicians And Epidemiologists, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Background: Depressive symptoms induced by insurmountable job stress and sick leave for mental health reasons have become a focal concern among occupational health specialists. The present study introduces the Occupational Depression Inventory (ODI), a measure designed to quantify the severity of work-attributed depressive symptoms and establish provisional diagnoses of job-ascribed depression. The ODI comprises nine symptom items and a subsidiary question assessing turnover intention. Methods: A total of 2254 employed individuals were recruited in the U.S., New Zealand, and France. We examined the psychometric and structural properties of the ODI as well as the nomological network of work-attributed depressive symptoms. …

Memory Bias Toward Emotional Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Lucas M. Bietti, Eric Mayor

Publications and Research

A sample of 1015 educational staff members, exhibiting various levels of burnout and depressive symptoms, underwent a memory test involving incident encoding of positive and negative words and a free recall task. Burnout and depression were each found to be associated with increased recall of negative items and decreased recall of positive items. Results remained statistically significant when controlling for history of depressive disorders. Burnout and depression were not related to mistakes in the reported words, or to the overall number of recalled words. This study suggests that burnout and depression overlap in terms of memory biases toward emotional information.

Does Resilience Moderate The Impact Of Children’S Experiences Of Racial And Ethnic Discrimination On Internalizing Problems?, Dahlia Abbas

Dissertations and Theses

This study’s objectives were to investigate how children’s experiences of discrimination impact the severity of their internalizing symptoms, and whether the relation between discrimination and internalizing symptom severity is moderated by resilience. It was predicted that children who had experienced more discrimination would have more severe internalizing symptoms, especially when they have low levels of resilience. Children [N=20; Mean (SD) age= 11.83 (2.50)] receiving low-cost music lessons in northern Manhattan were recruited into a larger study examining how learning music affects cognitive and emotional development. Children were interviewed in-person about experiences of discrimination because of their race/ethnicity using the Perceptions …

Does Overweight/Obesity Moderate The Association Between Adhd And Internalizing Difficulties In Young Adults?, Breanna Badripersaud

Dissertations and Theses

This study’s objective was to investigate if ADHD symptoms and BMI are associated with internalizing impairments of depression, anxiety, stress and lower self-esteem in college students. It was predicted that higher ADHD symptoms would be associated with elevated depression, anxiety, stress, and low self-esteem, especially if BMI fell in the overweight/obese range. Undergraduate students [N= 580; Mean (SD) age= 20.7 (3.10)] from an urban campus completed an online survey comprising self-report measures of demographics, height/weight, attention and hyperactivity/impulsivity (Barkley Deficits Executive Functioning Scale ADHD- Executive Function Index), depression, anxiety, stress (all using the Depression Anxiety and Stress Scale) and self- …

A Five-Sample Confirmatory Factor Analytic Study Of Burnout-Depression Overlap, Renzo Bianchi, Irvin Sam Schonfeld, Jay Verkuilen

Publications and Research

Objective: It has been asserted that burnout—a condition ascribed to unresolvable job stress—should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined.

Methods: Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom–Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)—General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ‐9.

Results: In all five samples, the latent factors pertaining to burnout’s components correlated on average more highly with the latent Depression …

The Epidemiology Of Somatic Depression And Eating Disorders: The Relationship Between Depressive Subtypes And Symptoms Of Disordered Eating, Anita M. Sicignano

Dissertations and Theses

Depression is known to affect females in much greater numbers than males, with about three times as many women having the disorder as men (American Psychiatric Association, 2013). A similar gender disparity can be seen in eating disorders, where up to nine in ten sufferers are female (American Psychiatric Association, 2013). Studies have shown that most of the gender difference in depression occurs as a result of women experiencing a form of depression involving a number of body-centric symptoms, including headaches, weight changes, fatigue, and insomnia, which has been termed “somatic depression” (Silverstein et al., 2013). Some of the symptoms, …

Diet, Inflammation, Gut Microbiome, And Mental Health, Ashley R. Polokowski

Dissertations, Theses, and Capstone Projects

Omega-3 fatty acids (ω-3 FAs) are an essential fatty acid necessary for healthy development in mammals. They possess anti-inflammatory properties and have more recently been shown to impact gut microbiota, both factors hypothesized to be associated with depression and anxiety. Thus, empirical efforts have begun to examine the benefit of ω-3 FAs as a treatment option for various psychological disorders. Although there is evidence that ω-3 FAs have favorable outcomes on depressive symptoms, the relationship between ω-3 FAs and anxiety and the pathways by which ω-3 FAs produce beneficial health effects are poorly understood. Both inflammation and the gut microbiome …

The Impact Of Racial Microaggressions And Major Discriminatory Events On Mental Health, Florence Lui

Dissertations, Theses, and Capstone Projects

The current study, a secondary data analysis, sought to determine the number and nature of latent groups for experiences of spectrum racial discrimination (i.e., both major and microaggressive racial discrimination) in a sample of emerging adults from a people of color (POC)-majority public university setting in the United States, and to understand the role of socio-demographic variables in defining each group. In addition, the study aimed to ascertain the extent to which endorsing spectrum racial discrimination experiences predicted anxiety and/or depression above the effects of general, non-race-related stress. Finally, the analyses gauged the mediating and/or moderating role of coping in …

Clinical Characteristics And Neuroanatomical Predictors Of Acute Antidepressant Outcome For Patients With Comorbid Depression And Mild Cognitive Impairment, Jeffrey N. Motter

Dissertations, Theses, and Capstone Projects

Background: Older adults presenting with both a depressive disorder (DEP) and cognitive impairment (CI) represent a unique, understudied population. The classification of cognitive impairment severity continues to be debated though it has recently been subtyped into late (LMCI) versus early (EMCI) stages. Previous studies have found associations between treatment outcome and both cortical thickness and white matter hyperintensities (WMH), though report inconsistent directionality and affected regions. In this study, we examined baseline clinical characteristics and neuroanatomical features as prognostic indicators for older adults with comorbid DEP and CI participating in an open antidepressant trial. EMCI is hypothesized to have greater …

9/11 Exposure And Parental Monitoring, Heather Zemeck

Theses and Dissertations

This paper investigates the effects of 9/11/01 exposure on parental monitoring, and how depression and anxiety are associated with these effects. This research utilizes data collected from Evacuees, First Responders, and non-exposed Controls. Results revealed moderate 9/11 exposure is associated with increased parental monitoring; while, depression is associated with decreased parental monitoring.

A Program Of Research On Burnout-Depression Overlap, Irvin Sam Schonfeld

Publications and Research

The article describes a program of research aimed at unraveling the nature of the relationship of job-related burnout to depression. The research tends to show that burnout symptoms are depressive symptoms and what is termed a state of burnout often reflects an episode of depression.

Burnout: Moving Beyond The Status Quo, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

Burnout has been defined as a job-induced syndrome combining emotional exhaustion, depersonalization/cynicism, and a sense of reduced personal accomplishment. In this article, we expand on past analyses of burnout by reviewing key, yet overlooked, problems affecting the construct. We concomitantly examine the implications of these problems for the overall validity of burnout research. Our work shows that burnout research is undermined by 4 main problems. First, what constitutes a case of burnout is unclear. Second, the basic conceptualization and operationalization of burnout are ill aligned. Third, burnout is unlikely to be the specifically job-induced syndrome it has been posited to …

The Trouble With Burnout: An Update On Burnout-Depression Overlap, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Reducing depression to its clinical stage—to a nosological category—is unwarranted when examining the burnout-depression distinction. Recent factor analytic studies of burnout and depression measures indicate that the discriminant validity of the burnout construct is not satisfactory. Exhaustion—the core and only consensual characteristic of burnout—has been repeatedly found to correlate more strongly with depression (including anhedonia and depressed mood) than with the two other components of burnout (cynicism and professional inefficacy).

Inquiry Into The Correlation Between Burnout And Depression, Irvin Sam Schonfeld, Jay Verkuilen, Renzo Bianchi

Publications and Research

The extent to which burnout refers to anything other than a depressive condition remains an object of controversy among occupational health specialists. In three studies conducted in two different countries and two different languages, we investigated the discriminant validity of burnout scales by evaluating the magnitude of the correlation between (latent) burnout and (latent) depression. In Study 1 (N = 911), burnout was assessed with the Maslach Burnout Inventory–General Survey’s Exhaustion subscale and depression with the depression module of the Patient Health Questionnaire (PHQ). In Study 2 (N = 1,386), the Shirom–Melamed Burnout Measure was used to assess burnout and …

An Exploratory Structural Equation Modeling Bi-Factor Analytic Approach To Uncovering What Burnout, Depression, And Anxiety Scales Measure, Irvin Sam Schonfeld, Jay Verkuilen, Renzo Bianchi

Publications and Research

In this study, we addressed the ongoing debate about what burnout and depression scales measure by conducting an exploratory structural equation modeling (ESEM) bifactor analysis. A sample of 734 U.S. teachers completed a survey that included the Center for Epidemiologic Studies Depression scale (CES-D-10), the depression module of the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), and the Maslach Burnout Inventory (MBI), which contains emotional exhaustion (EE), depersonalization (DP), and (diminished) personal accomplishment (PA) subscales. Job adversity and workplace support were additionally measured for the purpose of a nomological network analysis. EE, burnout’s core, was more highly …

Suicide Watch: How Netflix Landed On A Cultural Landmine, Shabnaj Chowdhury

Capstones

Following the premiere of the television series “13 Reasons Why” in 2017, Netflix stepped squarely on a cultural landmine, stirring controversy over its graphic depiction of teen suicide.

According to media experts, showing a teenager kill themselves on television was completely unprecedented. Mental health experts say the act has significant consequences for “at risk” audience members, or people who were already experiencing suicidal thoughts before watching the show. It is proven that entertainment, and television specifically, can strongly influence audience behaviors and thoughts.

Suicide is one of the only causes of deaths that’s on the rise in the United States, …

Threat-Related Attentional Bias In Relation To Anxiety And Depressive Symptoms In The General Population: The Potential Role Of Sex Effects, Beril Yaffe

Dissertations, Theses, and Capstone Projects

Heightened sensitivity to relevant environmental stimuli (attentional bias) has been observed in relation to clinical and non-clinical anxiety and depression symptoms. While depression symptoms are associated with sensitivity to disorder and self-relevant words, hypervigilance to threatening stimuli is observed in relation to anxiety symptoms. Furthermore, attentional bias has been shown to play an important role in the development and maintenance of depressive and anxiety disorders. Accordingly, a large body of literature has examined threat-related attentional bias in relation to symptoms of anxiety and depression. However, several methodological inconsistencies exist across studies, including variability in definitions of threat, lack of consideration …