Psychiatry and Psychology Commons^™

Defining Physician Burnout, And Differentiating Between Burnout And Depression—I, Bianchi Renzo, Irvin Sam Schonfeld

Publications and Research

A redefinition of burnout as a depressive condition is called for so that the harmful effects of unresolvable job stress can be more accurately and comprehensively assessed. As research compellingly suggests, reducing the harmful effects of unresolvable job stress to the experience of burnout's dimensions of emotional exhaustion, depersonalization, and reduced personal accomplishment is mistaken in that it denies the depressive core of the syndrome referred to as “burnout.” Replacing the notion of burnout by the concept of job-induced depression would help us be more effective in the management of occupational adversity.

‘Burnout Syndrome’: From Nosological Indeterminacy To Epidemiological Nonsense, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

All in all, Imo’s review is undermined by the very research it relies on. We recommend that researchers interested in burnout begin at the beginning, that is to say, by establishing a reasoned, clinically-founded (differential) diagnosis for their entity of interest. As long as investigators do not complete the required groundwork for establishing a diagnosis and remain unable to distinguish a case of burnout from either a noncase or an existing disorder, conclusions regarding the prevalence of burnout will be nonsense. To close this comment, we note that an immediately available solution for effectively monitoring and protecting physicians’ occupational health …

Do Burnout Researchers Go Around In Circles?, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The incessant reports on the burnout syndrome contrasts sharply with the validity of burnout research. Major problems in the definition and discriminant validity of burnout prevent investigators from getting a clear view of how job stress affects physicians’ health. The inability to distinguish a case of burnout from a non-case is only one of many signs that burnout research is problematic. Burnout researchers should face this reality rather than ignore it.

Biological Research On Burnout-Depression Overlap: Long-Standing Limitations And On-Going Reflections, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this commentary, we discuss seldom-noticed methodological problems affecting biological research on burnout and depression and make recommendations to overcome the limitations of past studies conducted in this area. First, we suggest that identified subtypes of depression (e.g., depression with melancholic features and depression with atypical features) should be taken into account in future biological research on burnout and depression, given that different subtypes of depression have been associated with distinct autonomic and neuroendocrine profiles. Second, we underline that research on burnout-depression overlap is made difficult by the absence of a consensual conceptualization and operationalization of burnout. In order to …

Consequences Of Job Stress For The Psychological Well-Being Of Teachers, Irvin Sam Schonfeld, Renzo Bianchi, Peter Luehring-Jones

Publications and Research

This chapter examines research on the relationship between job stressors and mental health (depressive symptoms, burnout, and mental disorders such as depression) in teachers. Teachers are exposed daily to job stressors (e.g., student disruptiveness) that have been linked to adverse mental health effects. Epidemiologic research indicates that when compared to members of other groups, teachers experience higher rates of mental disorder, although some studies question that conclusion. Large-scale studies indicate when compared to members of other occupational groups, teachers are at higher risk for exposure to workplace violence, with its adverse mental health consequences. Longitudinal research has linked teaching-related stressors …

Overmedicated: Foster Kids In Crisis, Mary E. Wilson

Capstones

Nearly one in four foster children across the county is taking at least one psychotropic medication-- more than four times the rate for all children.

Psychotropic drugs are chemical substances that act primarily upon the central nervous system where they alter brain function, resulting in temporary changes in perception, mood, consciousness and/or behavior.

Over the last decade the use of psychotropic medications amongst children has more than doubled. It has yet to be determined what permanent affects such drugs have on children as they age, due to a limited number of studies.

http://marywilson1.wixsite.com/overmedicated

Stimulus Threat And Exposure Context Modulate The Effect Of Mere Exposure On Approach Behaviors, Steven G. Young, Isaiah F. Jones, Heather M. Claypool

Publications and Research

Mere-exposure (ME) research has found that initially neutral objects made familiar are preferred relative to novel objects. Recent work extends these preference judgments into the behavioral domain by illustrating that mere exposure prompts approachoriented behavior toward familiar stimuli. However, no investigations have examined the effect of mere exposure on approach-oriented behavior toward threatening stimuli. The current work examines this issue and also explores how exposure context interacts with stimulus threat to influence behavioral tendencies. In two experiments participants were presented with both mere-exposed and novel stimuli and approach speed was assessed. In the first experiment, when stimulus threat was presented …

Less Citation, Less Dissemination: The Case Of French Psychoanalysis, Rémy Potier, Olivier Putois, Charlotte Dolez, Elliot Jurist

Publications and Research

The future of all publishing is open to question, and this is especially true in the case of psychoanalytic publishing. Stepansky (2009) has explored the future of psychoanalytic publishing with a particular emphasis upon how the digital era has had an impact upon the decline of scholarly publication in the United States. If this trend continues, the survival of contemporary psychoanalytic research will depend upon its capacity to embrace and utilize digital publishing.

Echoing this perspective, we tried to determine whether the seemingly small international visibility of contemporary French psychoanalytic research could be related to its lack of acknowledgment of …

Naïve Beliefs About The Natural World In A Case Of Childhood Onset Amnesia, William Winter

Publications and Research

The individual profiled here (M.S.) suffered an episode of severe oxygen deprivation (anoxia) at the age of eight, damaging memory relevant structures in the mid-temporal lobes, including the hippocampus bilaterally. The resulting anterograde amnesia was characterized by profound deficits in autobiographical memory, but also a compromised ability to acquire new facts and information (semantic memory), resulting in the formation of idiosyncratic and naïve beliefs about the natural world that have persisted into his adult years. This article presents an interview with M.S. in which many of these idiosyncratic beliefs are detailed, and argues that they can be broadly viewed as …

Corned Beef And Karma: A Story About My Volunteering (Reluctantly) To Review For A Journal, Irvin Sam Schonfeld

Publications and Research

No abstract provided.

Object Relations In Children's Projective Testing: Applying The Mutuality Of Autonomy Scale To The Thematic Apperception Test, Lily A. Thom

Dissertations, Theses, and Capstone Projects

Psychodynamic assessment of object relations on projective tests has consistently been shown to contribute to a better understanding of children’s psychological functioning and to guide therapeutic interventions (Tuber, 1992). This research examines the enhanced utility of applying a psychodynamically-derived scale of children’s object relations to a commonly used projective assessment tool, the Thematic Apperception Test (TAT) (Morgan & Murray, 1935; Murray, 1943). The current study investigates the adaptation and application of the Mutuality of Autonomy Scale (MOA) (Urist, 1977; Urist & Shill, 1982), commonly used as a Rorschach Inkblot Method object relations scale, to examine verbal narratives on the TAT. …

Observational Assessment Of Empathy In Parent-Child Verbal Exchanges And Their Influence On Child Behavior, Patty Carambot

Dissertations, Theses, and Capstone Projects

Empathy, the ability to both experientially share in and understand others’ thoughts, behaviors, and feelings, is vital for human adaptation. Deficits in empathy development have implications across the lifespan for the development of prosocial behavior, social functioning, mental health disorders, and risk for antisocial behavior (e.g., Guajardo, Snyder, & Petersen, 2009; Moreno, Klute & Robinson, 2008). In light of these societal and individual burdens, it is imperative to foster and strengthen the development of this ability early in life to prevent or ameliorate such negative outcomes. This type of prevention can take a variety of forms, but parent and child …

The Off-Label Use, Utility And Potential Value Of Tdcs In The Clinical Care Of Particular Neuropsychiatric Conditions, Marom Bikson, Bhaskar Paneri, James Giordano

Publications and Research

No abstract provided.

Somatic And Vicarious Pain Are Represented By Dissociable Multivariate Brain Patterns, Anjali Krishnan, Choong-Wan Woo, Luke J. Chang, Luka Ruzic, Xiaosi Gu, Marina Lopez-Sola, Philip L. Jackson, Jesus Pujol, Jin Fan, Tor D. Wager

Publications and Research

Understanding how humans represent others’ pain is critical for understanding pro-social behavior. ‘Shared experience’ theories propose common brain representations for somatic and vicarious pain, but other evidence suggests that specialized circuits are required to experience others’ suffering. Combining functional neuroimaging with multivariate pattern analyses, we identified dissociable patterns that predicted somatic (high versus low: 100%) and vicarious (high versus low: 100%) pain intensity in out-of-sample individuals. Critically, each pattern was at chance in predicting the other experience, demonstrating separate modifiability of both patterns. Somatotopy (upper versus lower limb: 93% accuracy for both conditions) was also distinct, located in somatosensory versus …

Psychological And Psychiatric Comorbidities Associated With Tinnitus: A Systematic Review, Shanna Hymowitz

Dissertations, Theses, and Capstone Projects

The purpose of this systematic literature review was to examine the current literature evidence pertaining to the relationship between tinnitus and psychological and psychiatric comorbidities. Literature was found discussing the prevalence of tinnitus with psychological and psychiatric comorbidities, differences in self-reports, and whether the perception of tinnitus is aided with the use of psychological counseling and psychotropic medications. Relative search strings applied to Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline Complete, and PubMed identified studies to be included in this review. (Will put total amount of studies found once collected). An assessment of all research literature found …

Becoming Serpent: Mapping Coils Of Paranoia In A Neocolonial Security State, Rachel J. Liebert

Dissertations, Theses, and Capstone Projects

What follows is a feminist, decolonial experiment to map the un/settling circulation of paranoia – how it is done, what it does, what it could do – within contemporary conditions of US white supremacy. Drawing on participant observation, interviewing, scientific artifacts, reflexive journaling, and a public art project, I enter white supremacy through a burgeoning form of pre-emptive psy to capture ‘the prodrome’ – a stage-cum-population-cum-figure at the center of a transnational program of research to identify and intervene on ‘pre-psychosis’. I argue that this nascent, contested, and accelerating movement is enacting a contemporary transition from …

Neuroanatomical Alterations In High-Functioning Adults With Autism Spectrum Disorder, Tehila Eilam-Stock, Tingting Wu, Alfredo Spagna, Laura J. Egan, Jin Fan

Publications and Research

Autism spectrum disorder (ASD) is a pervasive neurodevelopmental condition, affecting cognition and behavior throughout the life span. With recent advances in neuroimaging techniques and analytical approaches, a considerable effort has been directed toward identifying the neuroanatomical underpinnings of ASD. While gray-matter abnormalities have been found throughout cortical, subcortical, and cerebellar regions of affected individuals, there is currently little consistency across findings, partly due to small sample-sizes and great heterogeneity among participants in previous studies. Here, we report voxel-based morphometry of structural magnetic resonance images in a relatively large sample of high-functioning adults with ASD (n = 66) and matched …

Science, Symptoms, And Support Groups:Adhd In The American Cultural Context, Kealy D. Fallon

Theses and Dissertations

This thesis is a cultural analysis of the behaviorally- and psychiatrically-defined disorder ADHD, socio-historically contextualizing it in the United States and exploring ethnographically how people affected by it talk about and organize their experience of its symptoms.

Religious Involvement And Psychological Stress As Predictors Of Dental Health, Yung Y. Chen, Anty Lam

Publications and Research

Religious involvement has been linked to many indicators of health, including longevity. Previous research has identified psychological stress as a possible mediator for the positive effects of religion on health. Fewer studies have investigated the potential relationship between these psychosocial factors and dental health. This study examined religious involvement, stress, and dental health in a community sample. Participants included 150 community residents who received dental care as part of the study. Results indicated a significant positive association between religiousness and dental health, and a negative association between stress and dental health. These findings encourage further research on religion, stress, and …

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’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 …

On The Dead End Of Current Research On Burnout's Prevalence, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

Dimou et al. (2016) concluded that >50% of surgeons experience burnout. For three reasons, we think that such conclusions are unwarranted. First, there are no consensual or binding diagnostic criteria for burnout. Second, recent research (e.g., Bianchi, Schonfeld, & Laurent, 2015) suggests that burnout is actually a depressive syndrome. Finally, we note that researchers’ recommendations about stress-reducing organizational changes often remain incantatory because they insufficiently consider the economic issues and macrosocial power relationships that can hamper the recommendations’ implementation. Current practices in burnout research have led to an accumulation of results, the clinical meaning of which is obscure.

Brief Optogenetic Inhibition Of Dopamine Neurons Mimics Endogenous Negative Reward Prediction Errors, Chun Yun Chang, Guillem R. Esber, Yasmin Marrero-Garcia, Hau-Jie Yau, Antonello Bonci, Geoffrey Schoenbaum

Publications and Research

No abstract provided.

Re: "Job Strain And The Cortisol Diurnal Cycle In Mesa: Accounting For Between- And Within-Day Variability, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Rudolph et al. (2016) examined the association between job strain and cortisol profile. Several potential confounders were considered, including sociodemographic characteristics, income-wealth index, financial strain, physical health, physical activity, and medication use. No relationship between job strain and the cortisol awakening response was observed. We have 4 comments on the methods used in the study. First, although the authors related the modifications in cortisol profiles to job strain, they did not assess and statistically control for a number of nonoccupational strain factors (e.g., family- or couple-related chronic stress). Second, depressive symptoms and disorders were not considered in the study. Depression …

Job Stress, Inflammation, And Atherosclerosis: A Reflection, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Stress in general has been associated with inflammation and atherosclerosis (Sapolsky, 2004; Slavich and Irwin, 2014). The accumulation of inadequately controlled studies has become a concern (Bianchi, 2016; Schonfeld & Bianchi, 2016). Stronger efforts should be made to take into account both empirically identified and theoretically likely confounders in this research field. Assessing the contribution of job-related factors to given outcomes without simultaneously considering the role of relevant non-job factors is unwarranted. Results from inadequately controlled studies can lead to our making ineffective, or even counter-productive, decisions in terms of public health policies.

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 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: Two Entities Or One, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

Objectives: The purpose of this study was to examine the overlap in burnout and depression. Method: The sample comprised 1,386 schoolteachers (mean age = 43; mean years taught = 15; 77% women) from 18 different U.S. states. We assessed burnout, using the Shirom-Melamed Burnout Measure, and depression, using the depression module of the Patient Health Questionnaire. Results: Treated dimensionally, burnout and depressive symptoms were strongly correlated (.77; disattenuated correlation, .84). Burnout and depressive symptoms were similarly correlated with each of 3 stress-related factors, stressful life events, job adversity, and workplace support. In categorical analyses, 86% of the teachers identified as …

Burnout In Firefighters: A Word On Methodology, Irvin Sam Schonfeld, Renzo Bianchi

Publications and Research

At least three methodological problems affect the study by Katsavouni et al. (2016). First, there are currently no diagnostic criteria for burnout, neither in the DSM-5, nor in the ICD-10. Second, one extremely important variable was omitted from this study of firefighters, namely, depression. Third, the authors did not control for relevant nonoccupational factors such as stressors occurring outside of work.

The “Burnout” Construct: An Inhibitor Of Public Health Action?, Bianchi Renzo, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

The prevention and treatment of the “burnout syndrome” within the critical care community is an important objective of the Moss et al. Burnout in the occupational area is based on the idea that burnout is especially common in individuals who care for critically ill patients. We think that the authors’ observations and recommendations are diminished by the fact that studies of burnout’s prevalence are methodologically problematic. The current definition and use of the burnout construct may in fact be detrimental to public health decision making.