Medicine and Health Sciences Commons^™

The Relationship Between Traumatic Brain Injuries, Impulsivity, And Crime, Brian Ramanauskas

Student Theses

The rate of traumatic brain injuries (TBIs) are increasing each year, impacting an estimated 1.4 million Americans. After further investigation, researchers have concluded that 8.5% of the general public sustains at least one TBI, whereas this number ranges from 25% to 87% in criminal populations. In the literature, impulsivity is frequently described as poorly conceived, prematurely expressed, or inappropriate behaviors. Additionally, poor impulse control has been shown to significantly impact the likelihood of criminal activity, increasing the rate of recidivism. The current study examined an archival dataset of 95 incarcerated individuals from a private correctional facility in a large mid-Atlantic …

Mechanisms Of Value-Biased Prioritization In Fast Sensorimotor Decision Making, Kivilcim Afacan-Seref

Dissertations and Theses

In dynamic environments, split-second sensorimotor decisions must be prioritized according to potential payoffs to maximize overall rewards. The impact of relative value on deliberative perceptual judgments has been examined extensively, but relatively little is known about value-biasing mechanisms in the common situation where physical evidence is strong but the time to act is severely limited. This research examines the behavioral and electrophysiological indices of how value biases split-second perceptual decisions and the possible mechanisms underlying the process. In prominent decision models, a noisy but statistically stationary representation of sensory evidence is integrated over time to an action-triggering bound, and value-biases …

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 Development Of Face Morphing Task To Assess Self Other Differentiation, Esen Karan

Dissertations, Theses, and Capstone Projects

Self-Other Differentiation (SOD) refers to a developmental process of acquiring a consolidated, integrated, and individuated sense of self. SOD develops at a) perceptual (e.g., facial perception) and b) representational (e.g., traits, mental states, and beliefs) levels. Impairments in representational SOD (R-SOD) are associated with many forms of psychopathology, particularly borderline personality disorder (BPD) and narcissistic personality disorder (NPD). Few studies to date have examined the perceptual aspects of SOD (P-SOD), which are hypothesized to develop from infancy onwards in tandem and in interaction with R-SOD. Given that the human face is one of the key characteristics that humans use to …

Does Ethnic Identity, In-Group Preference, And Acculturation Protect Latinas With A History Of Interpersonal Trauma From Developing Symptoms Of Ptsd?, Evelyn M. Ramirez

Dissertations, Theses, and Capstone Projects

Previous research suggests ethnic identity, a sense of belonging to a particular cultural group, may be protective against symptoms of post-traumatic stress disorder (PTSD). However, the role of ethnic identity, in-group preference (i.e., an individual’s preference for interactions with members of their own ethnic group) and acculturation (i.e., the level of comfort with the mainstream culture) have not been investigated as protective factors for Latinas with a history of interpersonal and sexual trauma. In this study, ethnic identity, in-group preference and acculturation were assessed via self-report on the Scale of Ethnic Experience in two samples of undergraduate Latina and non-Latina …

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 …

The Social Cost Of Pain: Rejection Sensitivity, Social Rejection, And Cannabis Use In Young Adults, Naomi Dambreville

Dissertations, Theses, and Capstone Projects

Cannabis has been implicated in relieving distress and social pain, an important area of research in young adult samples, given the saliency of peer and social networks to addiction. Cannabis, via opioid pathways, has been shown to reduce, or potentially buffer, the effects of social pain and rejection. Thus, cannabis may be protective against the painful feelings of social stress, particularly for heavier or more frequent users. However, findings are not wholly positive, as other research indicates cannabis may blunt affective responses and impair social processing. The effects of cannabis use in young adults are understudied, as well as its …

Electroencephalographic Asymmetry, Emotion Regulation, And Their Relationships With Depression Risk, Aliza Jacob

Dissertations, Theses, and Capstone Projects

Background: Research investigating patterns of electroencephalographic (EEG) brain asymmetry aids our understanding of neural systems involved in the processing of emotion, motivation, and psychopathology. Withdrawal-motivated negative emotions characteristic of depression are associated with relative right prefrontal cortex (PFC) activity, whereas approach- motivated positive emotions are associated with relative left PFC activity. Styles of emotion regulation (ER), or modulation of the intensity and duration of emotional responses, are also associated with presence (e.g., suppression, or maladaptive ER) versus absence (e.g., cognitive reappraisal, or adaptive ER) of depression vulnerability. Most PFC asymmetry studies of emotion, depression, and/or ER rely upon EEG recorded …

Mindfulness In Medicine: Modified Mindfulness-Based Stress Reduction (Mbsr) Program Among Future Doctors, Virtue Sankoh

Dissertations, Theses, and Capstone Projects

Medical trainees are at particular risk for stress-related illness, including mental health problems such as suicidal ideation, substance abuse, and mood disorders. A vast literature on mindfulness-based stress reduction (MBSR), consisting of mindfulness education and structured meditative practices, has consistently demonstrated that MBSR and related mindfulness-based interventions improve mental and physical health, as well as one’s overall sense of well-being. Moreover, theorists and researchers have begun to suggest further that mindfulness plays a particular role in social cognition, or social-emotional learning. Medical schools have long been interested in ways to improve the “soft skills” related to interpersonal connectedness that are …

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 …

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 …

Response To "From A Polemic Paradox To A Proper Perspective Of Job Burnout And Job Satisfaction, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Juárez García and colleagues considered that “part of the conceptual and empirical problem of burnout is that many researchers force it into a biomedical disease model despite its being a psychosocial one.” Problematically, these authors’ scholastic argument a priori excludes biological or bodily factors from psychological conceptualizations. Scientists usually face considerable difficulties when trying to describe complex processes. If the understanding of biological processes sheds light on the complex processes that bear on burnout, then there is no reason to exclude research on those processes.

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.

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 …

Casualties Of Racism: Racial And Ethnic Discrimination And Suicidal Thoughts And Behaviors Among Racial And Ethnic Minority Emerging Adults, Lillian Anais Polanco

Dissertations, Theses, and Capstone Projects

The evidence demonstrating that experiences of racial/ethnic discrimination is detrimental to the mental health of racial/ethnic minority youth is unequivocal. What remains unclear, however, is whether racial/ethnic discrimination increases vulnerability for suicidal thoughts and behaviors in particular, and if so, what are the underlying mechanisms to explain this relation. Drawing upon the Race-based Traumatic Stress Theory (Carter, 2007), which suggests that some individuals may experience racial/ethnic discrimination as a traumatic stressor, and thus, eliciting a traumatic stress response, the present study examined posttraumatic stress reactions (i.e., posttraumatic stress, depression, dissociation, stress sensitivity) as mediators in the relation between racial/ethnic discrimination …

Underlying Contribution Of Executive Functioning To Cognition And Academic Achievement In Individuals With Dystrophinopathy, Robert Fee

Dissertations, Theses, and Capstone Projects

Dystrophinopathy is a genetic disorder that results in the lack of or abnormal expression of the protein dystrophin. It is a disorder that alters cell structure and function, impacts the developing brain and brain function, presents with multi-domain cognitive deficits, and influences both mood and behavior. Cognitive impairments appear to be more localized to specific areas of functioning rather than a global deficit; however, deficits have been identified across multiple cognitive domains including language and aspects of executive functioning. A careful examination of the cognitive phenotype and its association to mutations affecting CNS isoforms is necessary to clarify the neuropsychological …

Linking Hostile/Helpless Maternal Representations In Pregnancy And Later Child Protection Involvement: A Pilot Study, Madeleine Terry

Dissertations, Theses, and Capstone Projects

The present pilot study examined whether there are reliable indices in the narratives of pregnant women that can be used to identify child abuse and neglect potential before the birth of the child. The Hostile/Helpless (HH) Classification system (Lyons-Ruth et al., 1995-2005), which detects mental states associated with trauma, disturbances in early attachment, and severe pathology, was adapted for use with the Pregnancy Interview (PI), a semi-structured clinical interview (Slade, 2003) that assesses a woman's emotional experience of pregnancy, and quality of her developing relationship with her baby. The study sample was drawn from a replication study of the Minding …

What’S Your Story? Assessing Childhood Maltreatment Using The Thematic Apperception Test In An Adult Inpatient Population., Thachell C. Tanis

Dissertations, Theses, and Capstone Projects

There is a robust evidence that childhood maltreatment contributes to the development of adult psychopathology (Brown & Anderson, 1991; Johnson, Cohen, Brown, Smailes, & Bernstein 1999; Johnson, Smailes, Cohen, Brown, & Bernstein, 2000; Ruggiero et al., 1999). However, the identification of childhood maltreatment remains a methodological problem that results in inconsistencies in the reported incidence and psychological sequelae of maltreatment. A primary method for identifying histories of childhood maltreatment among adults is retrospective self-report measures which are susceptible to multiple biases (Briere, 1992; Cicchetti & Rizley, 1981; Shaffer, Huston, & Egeland, 2008). This present study suggests that childhood maltreatment can …

An Analysis Of Self-Reported Suicide Attempts And Ideation In A National Sample Of Incarcerated Sex Offenders, Kseniya Katsman

Student Theses

Suicide is the leading cause of preventable death in US jails and prisons, with rates three to nine times higher than those of the general population. Although suicide in correctional settings has been recognized as a serious problem, the research on suicide among incarcerated individuals remains limited. While the majority of suicide risk factors may be common across all offender types, sex offenders may be at a particularly elevated risk. Specifically, sex offenders have been found to report high rates of hopelessness and depressive mood, which are known predictors of suicidal behavior, and approximately 14% of incarcerated sex offenders have …

Interpretation Bias Toward Ambiguous Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Jay Verkuilen, Chantal Berna

Publications and Research

Burnout has been defined as a job-related syndrome combining pervasive fatigue and loss of motivation. In recent years, evidence has mounted that burnout may reflect a depressive condition. In this study, we expanded on past investigations of burnout-depression overlap by focusing on interpretation biases toward ambiguous information among the two entities. We conducted a web-based study involving 1056 participants (83% female; mean age: 42.87). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure and depressive symptoms with the PHQ-9. The Ambiguous Scenarios Test (AST), a measure of interpretation bias validated among dysphoric individuals, was the outcome of interest. The AST …

What Is The Difference Between Depression And Burnout? An Ongoing Debate, Irvin Sam Schonfeld, Renzo Bianchi, Stefano Palazzi

Publications and Research

Il burnout è concepito come una sindrome che si sviluppa in risposta a condizioni di lavoro cronicamente avverse. Si ritiene che il burnout comporti esaurimento emotivo, depersonalizzazione e riduzione della realizzazione personale. Storicamente, tuttavia, il burnout è stato difficile da separare dalla depressione. In effetti, i sintomi del burnout coincidono con i sintomi della depressione. L'evidenza della validità discriminante del burnout nei confronti della depressione è debole, sia a livello empirico sia a livello teorico. L'esaurimento emotivo, il nucleo del burnout, riflette una combinazione di umore depresso e affaticamento / perdita di energia e si correla molto bene con altri …

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …

A Neglected Problem In Burnout Research, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Although we share with Eckleberry-Hunt et al. (2018) some of their criticisms regarding the problematic conceptualization of burnout, we are perplexed by the authors’ silence regarding burnout–depression overlap, which is arguably the most troubling problem attached to the burnout construct. The extensive research suggests that burnout reflects a combination of depressive responses. The emotional exhaustion component of burnout involves fatigue and depressed mood, two diagnostic criteria for depressive disorders. Maslach et al. (2001) wrote that there is “a predominance of dysphoric symptoms” in burnout. Depersonalization symptoms are commonly found in depressed individuals. Diminished personal accomplishment reflects well-known depressive manifestations of …

Burnout Research: Eyes Wide Shut, Irvin Sam Schonfeld, Eric Laurent, Renzo Bianchi

Publications and Research

In a study published in a recent issue of Critical Care Medicine, Colville and Smith (2017) found modest overlap between burnout and depression and assumed that burnout and depression are distinct entities. For four reasons, we think that the study is seriously flawed. First, Colville and Smith assessed burnout symptoms with an abbreviated version of the Maslach Burnout Inventory (MBI), the psychometric properties of which are unclear. Second, they used clinically and theoretically arbitrary cutoff scores for categorizing burnout, a modus operandi that, unfortunately, has become commonplace in studies of medical professionals. Third, participants could be categorized as “burned out” …

On The “Bubble” Of Burnout's Prevalence Estimates, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi, Laura Hawryluck, Peter G. Brindley

Publications and Research

Hawryluck and Brindley (2018) addressed the issue of burnout—a syndrome thought to be induced by job stress—among critical care medicine (CCM) practitioners. Although we agree that the practice of CCM can be stressful, relying on burnout as an indicator of the practitioners’ response to occupational adversity is unwarranted. Despite its popularity, burnout remains poorly defined. Disconcertingly, investigators have widely relied on the Maslach Burnout Inventory (MBI) for “diagnosing” burnout in spite of the fact that the MBI is not a diagnostic instrument.Experiencing fatigue or distancing oneself from one’ work—what burnout is about—is not necessarily a sign of ill-being in itself. …

Is A Meta-Analytic Approach To Burnout’S Prevalence Timely?, Eric Laurent, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Cañadas‐De la Fuente et al. performed a meta‐analysis of the prevalence of emotional exhaustion, depersonalization, and diminished personal accomplishment—the three definitional components of the burnout syndrome—among nursing professionals working in oncology units. All in all, their meta‐analysis was inconclusive because of the very state of burnout research. Because there is mounting evidence that burnout is a depressive condition, we recommend that investigators focus on depression, rather than burnout, in occupational health research and practice.

Burnout-Depression Overlap: Nomological Network Examination And Factor-Analytic Approach, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout has been defined as a condition in which individuals are left exhausted by a long-term confrontation with unmanageable job stressors. The question of whether burnout reflects anything other than depressive responses to unresolvable stress remains an object of debate. In this 911-participant study (83% female; mean age: 42.36), we further addressed the issue of burnout-depression overlap. Burnout was assessed with the exhaustion subscale of the Maslach Burnout Inventory-General Survey (MBI-GS) and depression with the PHQ-8. The relationships of burnout and depression with three jobrelated variables – illegitimate work tasks, work-nonwork interference, and job satisfaction – and three “context-free” variables …

When We Say 'Physician Burnout,' We Really Mean Depression, Irvin Sam Schonfeld

Publications and Research

There has been controversy regarding the extent to which burnout overlaps depression. I enumerate eight reasons explaining to why depression is at the heart of burnout. Some of these reasons pertain to the highly similar work-related causes of burnout and depression, burnout adherents' faulty categorical and dimensional conceptualizations of burnout and depression, problematically high correlations between emotional exhaustion (the core of burnout) and depressive symptoms, research on physicians and dentists that underline burnout-depression overlap, and the problem of alexithymia being similarly related to burnout and depression. Suggestions for addressing the problem of burnout-depression among physicians are presented.

Burnout And Depressive Symptoms Are Not Primarily Linked To Perceived Organizational Problems, Renzo Bianchi, Eric Mayor, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this 257-participant study (76% female; mean age: 44.84), we examined two ideas that are widespread among burnout researchers: (a) the idea that burnout is primarily related to occupational-level factors; and (b) the idea that burnout should be considered a sentinel indicator in research on negative occupational outcomes. We investigated the links between burnout and a series of generic and work-related variables, namely, depressive symptoms, neuroticism, extraversion, effort-reward imbalance in the job (ERI), social support at work (SSW), and turnover intention. Burnout was assessed with the Shirom-Melamed Burnout Measure, depressive symptoms with the PHQ-9, neuroticism and extraversion with the NEO-Five …

Women’S Sexual Fantasies In Context: The Emotional Content Of Sexual Fantasies, Psychological And Interpersonal Distress, And Satisfaction In Romantic Relationships, Sarah Constantine

Dissertations, Theses, and Capstone Projects

Background: Psychoanalytic thinkers propose that aspects of an individual’s sexual fantasies are related to her psychological and interpersonal functioning. The present study aims to elucidate the significance of sexual fantasies with respect to women’s emotional and interpersonal lives. The study evaluated a model, which hypothesized that internal representations of self and others (e.g. attachment security, maturity of object relations) along with psychological and interpersonal factors would predict both the emotional content (guilt, fear, affection) of written sexual fantasy narratives, and overall romantic satisfaction in heterosexual women. Methods: Five hundred and thirty four women completed self-report questionnaires online. Subsequently, the sexual …