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Burnout Et Dépression, Entre Normal Et Pathologique? Histoire D’Une Différenciation Hasardeuse, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Initial described in the 1970s, the burnout syndrome has been difficult to characterize. It has been difficult to distinguish it from both clinical and subclinical depressive syndromes. In this chapter, we present a logical analysis of the distinction between burnout and depression. We synthesize the results of studies that bear on that distinction. We find that methodological and the historical separation of two lines of research as well as the lack of articulation between dimensional and categorical approaches to psychopathology.

Medication Management In Pediatric Chronic Illness: Should Patient Anxiety Be Considered?, Claire J. Hoogendoorn

Dissertations, Theses, and Capstone Projects

Introduction: There is growing support that psychological symptoms can impact various aspects of disease, well-being, and medical treatment for those with a chronic illness like Crohn’s disease (CD). Yet, almost no studies have examined whether psychological symptoms can influence management or efficacy of patient medication regimens. The aims of this project were to examine whether anxiety predicted pediatric patients’ level of medication management, medication prescription changes, and corticosteroid prescription and duration.

Method: A total of 105 pediatric patients ages 8-18 (M=14.5, SD=2.3) completed a validated anxiety questionnaire during a GI office visit (baseline). Prescribed IBD …

Burnout-Depression Overlap: A Study Of New Zealand Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Mayor, Eric Laurent

Publications and Research

We examined the overlap of burnout with depression in a sample of 184 New Zealand schoolteachers. Burnout and depressive symptoms were strongly correlated with each other (r = .73; disattenuated correlation: .82) and moderately correlated with dysfunctional attitudes, ruminative responses, and pessimistic attributions. All the participants with high frequencies of burnout symptoms were identified as clinically depressed. Suicidal ideation was reported by 36% of those participants. Three groups of teachers emerged from a two-step cluster analysis: “low burnout-depression,” “medium burnout-depression,” and “high burnout-depression.” The correlation between the affective-cognitive and somatic symptoms of depression was similar in strength to the burnout-depression …

Burnout’S Prevalence Estimations: A House Of Cards?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Elmariah et al. (2016) found that 65% of the internal medicine residents who were assessed suffered from burnout. We have 3 concerns about the conclusion. First, the authors used a cutoff score on a burnout measure that is problematic because (a) it is devoid of theoretical or clinical grounding and (b) burnout items were formatted in an unorthodox manner, and (c) including residents who responded "neutral" to a symptom item among those identified as burned out. Second, the authors identified as burned out residents who worked on the night float rotation although the data suggest otherwise. Third information on symptom …

Burnout And Depression In Psychiatric Residents, Irvin Sam Schonfeld, Eric Laurent, Pierre Vandel, Renzo Bianchi

Publications and Research

Kealy et al. (2016) found that 21% of psychiatric residents were suffering symptoms of burnout. A number of problems call that finding into question. First, the writers used a one-item measure to assess burnout. Second, mounting evidence suggests that burnout is a depressive syndrome. Third, unresolvable job stress is related to depression. Given burnout's overlap with depression and the diagnostic blur around burnout, research on the impact of job stress should connect with depression, which is nosologically well characterized and diagnosable using clinically validated instruments.

Burnout Is Associated With A Depressive Cognitive Style, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

We examined whether burnout is associated with a depressive cognitive style, understood as a combination of dysfunctional attitudes, ruminative responses, and pessimistic attributions. A total of 1386 U.S. public school teachers were included—1063 women (M_age: 42.73, SD_age = 11.36) and 323 men (M_age: 44.60, SD_age = 11.42). Burnout was assessed with the Shirom–Melamed Burnout Measure (SMBM). Dysfunctional attitudes were measured with the Dysfunctional Attitude Scale Short Form, ruminative responses with the Ruminative Responses Scale, and pessimistic attributions with the Depressive Attributions Questionnaire. For comparative purposes, depression was assessed using the 9-item depression module of the …

Burnout And Depression: Label-Related Stigma, Help-Seeking, And Syndrome Overlap, Renzo Bianchi, Jay Verkuilen, Romain Brisson, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November–December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and socio-demographic variables. The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited …

Burnout And Depression: Label-Related Stigma, Help-Seeking, And Syndrome Overlap, Renzo Bianchi, Jay Verkuilen, Romain Brisson, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November–December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and sociodemographic variables.The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited stigma scores signaling agreement with the proposed …

Is Burnout Separable From Depression In Cluster Analysis? A Longitudinal Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Purpose: Whether burnout and depression represent distinct pathologies is unclear. The aim of this study was to examine whether burnout and depressive symptoms manifest themselves separately from each other or are so closely intertwined as to reflect the same phenomenon.

Methods: A two-wave longitudinal study involving 627 French schoolteachers (73 % female) was conducted. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire.

Results: Burnout and depressive symptoms clustered both at baseline and follow-up. Cluster membership at time 1 (T1) predicted cases of burnout and depression at time 2 …

Is It Time To Consider The "Burnout Syndrome" A Distinct Illness?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The "burnout syndrome" has been defined as a combination of emotional exhaustion, depersonalization, and reduced personal accomplishment caused by chronic occupational stress. Although there has been increasing medical interest in burnout over the last decades, it is argued in this paper that the syndrome cannot be elevated to the status of diagnostic category, based on (1) an analysis of the genesis of the burnout construct, (2) a review of the latest literature on burnout-depression overlap, (3) a questioning of the three-dimensional structure of the burnout syndrome, and (4) a critical examination of the notion that burnout is singularized by its …

Burnout: Absence Of Binding Diagnostic Criteria Hampers Prevalence Estimates, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Comments on an article by Jef Adriaenssens et al. (see record 2015-00662-015). In a recent review paper, Adriaenssens et al. concluded that about 26% of emergency nurses (EN) suffer from burnout and described their results as alarming. While commentators applaud Adriaenssens et al. efforts to provide a clearer picture of ill-health in EN, they thought that these authors' conclusions were weakened by a fundamental fact, namely, the absence of consensual, clinically valid diagnostic criteria for burnout. Trying to determine the prevalence of a condition that has no binding diagnostic criteria is problematic. Indeed, depending on how researchers decide to …

Interpersonal Rejection Sensitivity Predicts Burnout: A Prospective Study, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

We examined whether interpersonal rejection sensitivity (IRS)—the hallmark of atypical depression – prospectively predicted burnout, controlling for baseline symptoms, history of depressive disorders, antidepressant intake, gender, age, and length of employment (mean between-assessment duration: 21 months; n = 578; 74% female). IRS was related to a 119% increased risk of burnout at follow-up. Three of four burned out participants reported to be affected by IRS, or 2.5 times the rate observed in participants with no (or subthreshold) burnout symptoms. Our study highlights a dispositional factor in burnout’s etiology also known to be a key component of atypical depression’s etiology. The …

Burnout-Depression Overlap: A Review, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout is a form of depression or a distinct phenomenon is an object of controversy. The aim of the present article was to provide an up-to-date review of the literature dedicated to the question of burnout–depression overlap. A systematic literature search was carried out in PubMed, PsycINFO, and IngentaConnect. A total of 92 studies were identified as informing the issue of burnout–depression overlap. The current state of the art suggests that the distinction between burnout and depression is conceptually fragile. It is notably unclear how the state of burnout (i.e., the end stage …

Burnout Does Not Help Predict Depression In French Schoolteachers, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Objectives: Burnout has been viewed as a phase in the development of depression. However, supportive research is scarce. We examined whether burnout predicted depression among French school teachers.

Methods: We conducted a 2-wave, 21-month study involving 627 teachers (73% female) working in French primary and secondary schools. Burnout was assessed with the Maslach Burnout Inventory and depression with the 9-item depression module of the Patient Health Questionnaire (PHQ-9). The PHQ-9 grades depressive symptom severity and provides a provisional diagnosis of major depression. Depression was treated both as a continuous and categorical variable using linear and logistic regression analyses. We controlled …

Predicting Antidepressant Treatment Without Controlling For Depression Is Ill-Advised, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, the link observed by Madsen et al. (2015) between burnout and antidepressant intake may well conceal an expected relationship between depression and antidepressant intake. The impossibility of ruling out this reasonable alternative hypothesis renders the study inconclusive. We recommend that future research on (psychotherapeutic or pharmacologic) treatments for burnout incorporate measures of depression in order to facilitate research advance on burnout's characterization and burnout-depression overlap.

Practicing Patienthood Online: Social Media, Chronic Illness, And Lay Expertise, Collette Sosnowy

Publications and Research

The use of digital technologies and social media by people with serious illness to find, share, and create health information is much celebrated but rarely critiqued. Proponents laud “Health 2.0” as transforming health care practice and empowering patients. Critics, however, argue that a discourse of developing lay expertise online masks the disciplinary practices of the neoliberal state’s emphasis on individual responsibility. Notably, the perspectives of people who are engaging with social media related to their health and illness are under-represented in this debate. This research examines the experiences and perspectives of women who blog about their lives with Multiple Sclerosis …

Is Burnout A Depressive Disorder? A Reexamination With Special Focus On Atypical Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Whether burnout and depression cover the same psychopathology remains to be elucidated. To date, subtypes of depression have been overlooked in research on the burnout–depression overlap. Our aim was to estimate the prevalence of depressive disorders in workers with burnout while examining the overlap of burnout with the atypical subtype of depression. The present study included 5,575 schoolteachers (mean age = 41 years; 78% female). Burnout was assessed with the Maslach Burnout Inventory. Depression was measured with the 9-item depression scale of the Patient Health Questionnaire (PHQ-9). Atypical features of depression were examined using a dedicated module, referenced to …

Strengths And Limitations Of Qualitative Approaches To Research In Occupational Health Psychology, Irvin Sam Schonfeld, Joseph J. Mazzola

Publications and Research

Like all research methods, qualitative methods have strengths and limitations. This chapter describes seven strengths and five limitations. With an understanding of their strengths and limitations and how to minimize and/or balance them, occupational health psychology (OHP) researchers can benefit from qualitative methods. It is important to understand that qualitative findings do not establish generalizable cause-effect relations. However, qualitative methods can help an OHP researcher develop a theory of causality and derive hypotheses related to the theory and, thus, motivate quantitatively organized research designed to test the hypotheses. The challenge for the OHP researcher is to be mindful of what …

The Effect Of Weight Loss On Changes In Health-Related Quality Of Life Among Overweight And Obese Women With Urinary Incontinence, Angela Marinilli Pinto, Leslee L. Subak, Sanae Nakagawa, Eric Vittinghoff, Rena R. Wing, John W. Kusek, William H. Herman, Delia Smith West, Miriam Kuppermann

Publications and Research

OBJECTIVE: To estimate the effect of change in weight and change in urinary incontinence (UI) frequency on changes in preference-based measures of health-related quality of life (HRQL) among overweight and obese women with UI participating in a weight loss trial.

METHODS: We conducted a longitudinal cohort analysis of 338 overweight and obese women with UI enrolled in a randomized clinical trial comparing a behavioral weight loss intervention to an educational control condition. At baseline, 6, and 18 months, health utilities were estimated using the Health Utilities Index Mark 3 (HUI3), a transformation of the SF-36 to the preference-based SF-6D, and …

School-Based Screening To Identify At-Risk Students Not Already Known To School Professionals: The Columbia Suicide Screen, Michelle A. Scott, Holly C. Wilcox, Irvin Sam Schonfeld, Mark Davies, Roger C. Hicks, J. Blake Turner, David Shaffer

Publications and Research

Objectives.Wesought todeterminethedegreeofoverlapbetweenstudents identified through school-based suicide screening and those thought to be at risk by school administrative and clinical professionals. Methods. Students from7 high schools in theNewYorkmetropolitan area completed the Columbia Suicide Screen; 489 of the 1729 students screened had positive results. The clinical status of 641 students (73% of those who had screened positive and 23%of thosewho had screened negative) was assessedwithmodules from the Diagnostic Interview Schedule for Children. School professionals nominated by their principal and unaware of students’ screening and diagnostic status were asked to indicate whether they were concerned about the emotional well-being of each participating student. …

Behavioral Approaches To Weight Control: A Review Of Current Research, Angela Marinilli Pinto, Jessica Gokee-Larose, Rena R. Wing

Publications and Research

Weight management is a salient issue for women. Studies of behavioral, pharmacological and surgical interventions indicate that women comprise the majority of patients presenting for weight-loss treatment. In this review we discuss the health impact of obesity for women, review behavioral treatments for adult overweight and obesity, and address topics of particular relevance for women, including concerns that weight-loss treatment may precipitate the development of eating pathology, as well as time periods of high risk for weight gain such as pregnancy and menopause.

Bullying, Depression, And Suicidality In Adolescents, Anat Brunstein-Klomek, Frank Marrocco, Marjorie Kleinman, Irvin Sam Schonfeld, Madelyn S. Gould

Publications and Research

Objective: To assess the association between bullying behavior and depression, suicidal ideation, and suicide attempts among adolescents. Method: A self-report survey was completed by 9th- through 12th-grade students (n = 2342) in six New York State high schools from 2002 through 2004. Regression analyses were conducted to examine the association between being victimized and bullying others with depression, ideation, and attempts. Results: Approximately 9% of the sample reported being victimized frequently, and 13% reported bullying others frequently. Frequent exposure to victimization or bullying others was related to high risks of depression, ideation, and suicide attempts compared with adolescents not involved …

Stress In 1st-Year Women Teachers: The Context Of Social Support And Coping, Irvin Sam Schonfeld

Publications and Research

The effects of adverse work environments were examined in the context of other risk/protective factors in this extension of a short-term longitudinal study involving 184 newly appointed women teachers. Regression analyses revealed that, adjusting for preemployment levels of the outcomes and negative affectivity, social support and adversity in the fall work environment were among the factors that affected spring depressive symptoms, self-esteem, job satisfaction, and motivation to teach. Support from nonwork sources was directly related to future improved symptom levels and self-esteem; supervisor and colleague support were directly related to future job satisfaction. Effects of occupational coping, professional …

Relation Of Negative Affectivity To Self-Reports Of Job Stressors And Psychological Outcomes, Irvin Sam Schonfeld

Publications and Research

A total of 250 new women teachers participated in a longitudinal study of the influence of negative affectivity (NA) on the relation of self-report work-environment measures to psychological outcomes. Three "neutrally worded" work-environment measures were specially constructed to minimize confounding with NA. The work-environment measures were moderately related to postemployment depressive symptoms, job satisfaction, and, among Whites but not among a principally Black and Hispanic subsample, motivation. Correlation and regression coefficients were largely unchanged when the preemployment psychophysiologic symptoms scale and the Center for Epidemiologic Studies-Depression Scale (L. S. Radloff, 1977), factors that tap NA, were controlled. Findings suggest NA …

Methodological Issues In Occupational-Stress Research: Research In One Occupational Group And Its Wider Applications, Irvin Sam Schonfeld, Jaesoon Rhee, Fang Xia

Publications and Research

The chapter addresses a number of important methodologic issues that are relevant to occupational-stress researchers. The issues addressed have arisen in the context of an ongoing research program involving cross-sectional and longitudinal studies of stress in teachers; the issues, however, apply to occupational research in general. The first issue involves measurement strategies required in operationalizing the stress process. The focal concern is the reduction of confounding in measures of the work environment. The second issue encompasses the question of whether to sample new or veteran workers. The third issue applies to types of job stressors. The chapter describes a …

Assessing Stress In Teachers: Depressive Symptoms Scales And Neutral Self-Reports Of The Work Environment, Irvin Sam Schonfeld

Publications and Research

The focal interest of this chapter on teacher stress is methodologic. The chapter enumerates a number of defects in existing measures of job stress in teachers and, concomitantly, other helping professionals. Alternative ways of measuring stress in teachers are suggested and evaluated. The use of depressive symptom scales in concert with more 'objective' measures of the work environment is discussed. An application of the proposed alternative measurement strategy is described. The wider utility of the measurement strategy is briefly described.

Dimensions Of Functional Social Support And Psychological Symptoms, Irvin Sam Schonfeld

Publications and Research

In the summer following graduation a sample of 125 female college graduates (mean age = 28) completed Cohen & Wills' ISEL (1985) which includes scales measuring four social support functions: belonging (social companionship), appraisal (availability of confidants), tangible (instrumental), and self-esteem support. In the summer and fall subject status on two outcome scales was ascertained: the Psychophysiologic Symptom Scale and the Center for Epidemiologic Studies Depression Scale (CES-D). Reliability of the difference scores suggested that the ISEL scales do not measure entirely different constructs and the ISEL Self-esteem Scale is operationally redundant with the Rosenberg Self-esteem scale and the CES-D. …