Psychiatry and Psychology Commons^™

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.

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 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 …

Suicide Behavior Among Guyanese Orphans: Identification Of Suicide Risk And Protective Factors In A Low-Middle-Income-Country, Ellen-Ge Denton, George Musa, Christina Hoven

Publications and Research

Objective: Suicide is the leading cause of death among youth in Guyana, a low- and middle-income country (LMIC), which globally ranks first in female adolescent suicides over the last decade. Worldwide, Guyana has experienced the largest increase in youth suicide, despite focused public health efforts to reduce suicide. Further, youth in Guyana, who are clients of the orphanage system and have faced early childhood trauma, may have an additive risk for suicide. Guided by an ideation-to-action theoretical framework for suicide prevention, the goal of the proposed research study is to describe and identify risk and protective factor correlates of …

Mentalized Affectivity: A New Model And Assessment Of Emotion Regulation, David M. Greenberg, Jonela Kolasi, Camilla P. Hegsted, Yoni Berkowitz, Elliot L. Jurist

Publications and Research

Here we introduce a new assessment of emotion regulation called the Mentalized Affectivity Scale (MAS). A large online adult sample (N = 2,840) completed the 60-item MAS along with a battery of psychological measures. Results revealed a robust three-component structure underlying mentalized affectivity, which we labeled: Identifying emotions (the ability to identify emotions and to reflect on the factors that influence them); Processing emotions (the ability to modulate and distinguish complex emotions); and Expressing emotions (the tendency to express emotions outwardly or inwardly). Hierarchical modeling suggested that Processing emotions delineates from Identifying them, and Expressing emotions delineates from Processing them. …

Early And Late Components Of Eeg Delay Activity Correlate Differently With Scene Working Memory Performance, Timothy M. Ellmore, Kenneth Ng, Chelsea P. Reichert

Publications and Research

Sustained and elevated activity during the working memory delay period has long been considered the primary neural correlate for maintaining information over short time intervals. This idea has recently been reinterpreted in light of findings generated from multiple neural recording modalities and levels of analysis. To further investigate the sustained or transient nature of activity, the temporal-spectral evolution (TSE) of delay period activity was examined in humans with high density EEG during performance of a Sternberg working memory paradigm with a relatively long six second delay and with novel scenes as stimuli. Multiple analyses were conducted using different trial window …

Cortical Thickness Abnormalities Within The Salience And Reward Networks In Older Depressed Adults With Apathy, Monique A. Pimontel

Dissertations, Theses, and Capstone Projects

Background and Significance: Apathy is a common comorbidity in late-life depression. Among older depressed adults, apathy is associated with a number of adverse outcomes, including increased disability, comorbid illness, and mortality. The etiological substrates of apathy in late-life depression nonetheless remain poorly understood, and little is known about its optimal treatment. To this end, the aim of the current study was to examine cortical abnormalities within the salience (SN) and reward networks (RN), two brain systems involved in the processing of incentive salience that may underlie the syndrome of apathy in older depressed adults.

Methods: We examined the association between …

A Conceptualization Of The Body In Psychodynamic And Body-Based Psychotherapies: Areas Of Overlap And Possibilities For Integration, Aleksandra Rayska

Dissertations, Theses, and Capstone Projects

The distinction between verbal and nonverbal psychotherapies is clearly visible in theory and clinical practice. Moreover, this duality of approaches promotes a split between the body and the mind, defining them as separate from each other. This dissertation helps bridge the divide between the literature in body-based therapies and verbally-based psychotherapy by (i) exploring the conceptual frame used to understand the body in psychodynamic therapy (ii) identifying the areas of overlap between psychodynamic theory and theories that underlie body-based psychotherapies, and (iii) proposing ways in which psychodynamic and body-based theories can inform one another. A clinical case was used to …

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 …

Respiratory Sinus Arrhythmia Activity Predicts Internalizing And Externalizing Behaviors In Non-Referred Boys, Wei Zhang, Shawn E. Fagan, Yu Gao

Publications and Research

Atypical respiratory sinus arrhythmia (RSA), a biomarker of emotion dysregulation, is associated with both externalizing and internalizing behaviors. In addition, social adversity and gender may moderate this association. In this study, we investigated if RSA (both resting RSA and RSA reactivity in an emotion regulation task) predicts externalizing and/or internalizing behaviors and the extent to which social adversity moderates this relationship. Two hundred and fifty-three children (at Time 1, mean age D 9.05, SD D 0.60, 48% boys) and their caregivers from the community participated in this study. Resting RSA and RSA reactivity were assessed, and caregivers reported children’s externalizing …

Sibrava Studies, Teaches About Stress And Anxiety, Aldemaro Romero Jr.

Publications and Research

“There’s a cliché answer that you get from a lot of folks who say, ‘Well, I’ve always been interested in people,’ and that is true, but for me I always fan- tasized about being a lawyer when I grew up.” This is how Dr. Nicholas Sibrava explains his choice of career. In fact, he envisioned himself in a courtroom, just like in the movies.

It also explains why this native of Cleveland, Ohio obtained a bachelor’s degree in both criminology and psychology. The psychology part crept up on him while taking some psych courses. “Somewhere along the way I flip-flopped …

Quantifying Cerebral Contributions To Pain Beyond Nociception, Choong-Wan Woo, Liane Schmidt, Anjali Krishnan, Marieke Jempa, Mathieu Roy, Martin A. Lindquist, Lauren Y. Atlas, Tor D. Wager

Publications and Research

Cerebral processes contribute to pain beyond the level of nociceptive input and mediate psychological and behavioural influences. However, cerebral contributions beyond nociception are not yet well characterized, leading to a predominant focus on nociception when studying pain and developing interventions. Here we use functional magnetic resonance imaging combined with machine learning to develop a multivariate pattern signature—termed the stimulus intensity independent pain signature-1 (SIIPS1)—that predicts pain above and beyond nociceptive input in four training data sets (Studies 1–4, N¼137). The SIIPS1 includes patterns of activity in nucleus accumbens, lateral prefrontal and parahippocampal cortices, and other regions. In cross-validated analyses of …

The Relationship Between Clinical Teaching Effectiveness And Emotional Intelligence In Clinical Nurse Faculty In Pre-Licensure Baccalaureate Programs In New York State, Caroline K. Mosca

Dissertations, Theses, and Capstone Projects

It is important to evaluate the Clinical Teaching Effectiveness (CTE) of nurse faculty because clinical teaching is one of the most effective pedagogies in nursing education (Billings & Halstead, 2012). However, clinical faculty must be able to manage effectively the stressors of the clinical setting, where lessons can be unpredictable and the environment is often laden with intense emotion (Gerolamo & Roemer, 2011; Ondrejka, 2013; Roberts, Chrisman, & Flowers, 2013). Emotional Intelligence (EI) may facilitate CTE because higher EI has been associated with improved management of stress in both nursing and the general workplace (Goleman, 1995; Görgens-Ekermans & Brand, 2012; …

Weight Loss Maintenance: Women's Experience During Perimenopause, Karren B. Liebert

Dissertations, Theses, and Capstone Projects

Women’s health may be at risk during middle age, a time when women in the United States often gain weight. Being overweight or obese during perimenopause increases a woman’s vulnerability to disabling health sequela in later life, such as cardiovascular disease, diabetes, depression and osteoarthritis, all of which increase morbidity, mortality, health care costs and decrease quality of life. Stigma and discrimination related to overweight and obesity are associated with delay and avoidance of health care, and with poorer quality health care. Weight loss often is followed by weight regain within three to five years. This qualitative study was designed …

Persistent Amygdala Novelty Response Is Associated With Less Anterior Cingulum Integrity In Trauma-Exposed Women, Seungyeon A. Yoon, Mariann R. Weierich

Publications and Research

Objectives: We investigated the potential role of cingulum and uncinate fasciculus integrity in trauma-related neural hypervigilance, indexed by less discrimination between amygdala activation to novel and familiar affective images.

Participants: 22 women (mean age 21.7 ± 3.9 years) with a history of trauma, and 20 no-trauma controls (mean age 21.9 ± 4.8 years).

Measures: Trauma exposure and trauma-related symptoms were assessed during structured clinical interview. White matter integrity in the anterior cingulum, parahippocampal cingulum, and uncinate fasciculus was measured using diffusion weighted imaging. Amygdala response to novel and familiar affective scenes was measured with functional magnetic resonance imaging.

Results: Trauma-exposed …

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 Or Depression: Both Individual And Social Issue, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended in our that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. The phenomena of interest (burnout or depression) should not be confused with the perspectives (individual or social) adopted to elucidate those phenomena. Both burnout and depression are best explained through the interaction of social or external conditions with individual or internal dispositions.

Consumers, Clergy, And Clinicians In Collaboration: Ongoing Implementation And Evaluation Of A Mental Wellness Program, Glen Milstein, Dennis Middel, Adriana Espinosa

Publications and Research

As a foundation of most cultures, with roots in persons’ early development, religion can be a source of hope as well as denigration. Some religious institutions have made attempts to help persons with mental health problems, and some mental health professionals have sought to engage religion resources. These programs have rarely been sustained. In 2008, the Mental Health Center of Denver (MHCD) developed a program to assess the utility of religion resources within mental health care. In response to positive feedback, MHCD appointed a director of Faith and Spiritual Wellness who facilitates community outreach to faith communities and spiritual integration …

Editorial: Depression, Burnout, And Other Mood Disorders: Interdisciplinary Approaches, Eric Laurent, Bianchi Renzo, Irvin Sam Schonfeld, Pierre Vandel

Publications and Research

Various perspectives on mood disorders and psychopathology are brought into perspective. The paper underlines (i) an interdisciplinary perspective and a complexity-oriented approach and (ii) an interest in both basic problems in science and potential far-reaching consequences of research applications.

On The Depressive Nature Of The “Burnout Syndrome”: A Clarification, Renzo Bianchi, Irvin Sam Schonfeld, Pierre Vandel, Eric Laurent

Publications and Research

Key theoretical arguments and empirical findings converge to suggest that the burnout construct captures a depressive phenomenon. The reluctance to consider burnout a depressive condition may be due to (a) a neglect of the stress–depression relationship and (b) a difficulty coordinating dimensional and categorical approaches to psychopathology in burnout research. The dimensions and categories constitute two ways of describing (psychopathological) phenomena. Thus, dimensions and categories should be heuristically combined rather than opposed: burnout and depression can be studied both as ‘‘processes’’ or ‘‘end-states’’. Clarifying what burnout actually is matters in terms of conceptual parsimony, theoretical integration, nosological consistency, interventional effectiveness, …

Physician Burnout Is Better Conceptualised As Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Ronald Epstein and Michael Privitera reported that burnout affects more than half of practising physicians. The authors additionally warned against confusing burnout with depression. For two reasons we are concerned with the validity of these conclusions. First, there is now robust evidence that burnout is a depressive condition. Second, the published estimates of burnout’s prevalence rely on clinically groundless criteria, cobbled together without any rationale.

Training Pharmacists In The Stage-Of-Change Model Of Smoking Cessation And Motivational Interviewing: A Randomized Controlled Trial, Pasquale Caponnetto, Jennifer Dipiazza, Maria Rosaria Aiello, Riccardo Polosa

Publications and Research

This study evaluated the effect of training pharmacists in the stage-of-change model for smoking cessation and motivational interviewing on smoking cessation outcomes. A training based on the stage-of-change model for smoking cessation and motivational interviewing was introduced to pharmacists. Pharmacists were randomly assigned to the intervention or control group. The control group attended a 3-hour training session, whereas the intervention group also attended a further 6-hour training session. At week 24, 12.2 percent of the smokers quit smoking in the intervention group, whereas 1.6 percent of the smokers quit smoking in the control group. The findings of this study showed …

On Parsimony And Tautology In The Study Of Acute Coronary Syndrome, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In a recent study, Zhang et al. concluded that burnout was associated with poor physical function and low quality of life after acute coronary syndrome (ACS). In our estimation, the authors' study has at least two unnoticed, though major, methodological limitations: not controlling for depression and using a burnout scale that is a questionable choice.

Burnout Symptoms: Depressive Manifestations Under Psychosocial Labels?, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

It can be concluded that burnout symptoms represent depressive symptoms under nonmedical labels. Our analysis supports the view that burnout is synonymous with depression and constitutes a roadblock to transdisciplinary communication.

Burnout And The Hypothalamic-Pituitary-Thyroid Axis: A Methodological Comment, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Because (a) burnout overlaps with depression and (b) depression has been associated with altered functioning of the hypothalamic-pituitary-thyroid axis changes in the activity of the HPT axis can be expected in burnout. Most probably, Guo et al.’s (2017) results are flawed by a severe form of the “healthy worker effect.”

Burnout Or Depression: Both Individual And Social Issue, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In view of the profound problems attached to the construct of burnout, we recommended that occupational health specialists focus on (job-related) depression rather than burnout to help workers more effectively. Epstein and Privitera (April 8, 1398) rejected our recommendation on the grounds that burnout is not a “purely individual syndrome”. Problematically, Epstein and Privitera attributed to us an idea that is not ours. In these authors’ view, equating burnout with depression is synonymous with mistakenly individualising a social problem. For two reasons, the argument that depression cannot replace burnout because burnout is a social problem whereas depression is an individual …

On The Overlap Of Vital Exhaustion And Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Our reexamination of the symptoms and main measure of vital exhasution (VE) suggests that the overlap of VE with depression has been problematically underestimated due to inconsistent comparisons and blindness to definitional similarities. In our view, the case of VE is emblematic of a trend toward construct proliferation. Many ‘‘new’’ constructs are introduced in the literature precipitously, with insufficient examination of their added value, and based on ‘‘linguistic contortions’’ and anecdotal evidence rather than robust empirical findings and sound theorizing. Such constructs are often ‘‘distinguished’’ from existing ones on the basis of specious arguments and missing-the-point conclusions. This is for …

Vital Exhaustion, Burnout, And Other Avatars Of Depression, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In our view, there is a worrying tendency in psychology and medicine to let proliferate “depression-like” constructs—a transgression of the scientific canon of parsimony. The problem is not limited to vital exhaustion (VE). Burnout, a condition akin to VE, has been shown to problematically overlap with depression. Compassion fatigue, a condition that shows particularly blurred definitional contours, is also uncomfortably close to depressive symptomatology. The construct of neurasthenia may be part of this confusing trend as well, although neurasthenia has been elevated to the status of nosological category in the ICD. Construct proliferation jeopardizes knowledge growth by undermining theory building …