Psychiatry and Psychology Commons^™

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.

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.

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.

An Examination Of The Relationship Between Childhood Abuse, Anger And Violent Behavior Among A Sample Of Sex Offenders, Stephanie R. Ramirez, Elizabeth L. Jeglic, Cynthia Calkins

Publications and Research

Background: Increasing attention has focused on the emotional dysregulation that can result from adverse childhood experiences among those who commit sexually violent crimes. While studies confirm a relationship between child maltreatment and anger the research is limited and it is unclear how anger and child maltreatment effect the use of violence during the commission of the sex crime.

Methods: This study examined the relationship between childhood maltreatment, anger and violent behavior by reviewing the records of 571 adult male offenders convicted of sexual assault or child molestation. The aims of the present study were to 1) examine differences in anger …

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 …

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 …

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 …

Role Of Home Environment, Parental Care, Parents’ Personality And Their Relationship To Adolescent Mental Health, Sibnath Deb, Kevin Mcgirr, Banhisikah Bhattacharya, Jiandong Sun

Publications and Research

The study examined relationships among home environment, parents’ personality and mental health of adolescents with a focus on adjustment, anxiety, self-concept and self-confidence. A group of 370 adolescents were interviewed using a semi-structured questionnaire and three psychological tests; subjects were selected following a two-stage sampling technique. Participation of the adolescent students in the study was voluntary. Results indicate that parental care was associated with high self-confidence while parental pressure associated with high anxiety. Fathers’ “friendliness” associated with low emotional adjustment and high self-concept while mothers’ short-temper associated with high anxiety. Disturbed families contributed to adolescent anxiety, inability to share personal …

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 …

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.

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 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 …

A Qualitative Study Of Stress In Individuals Self-Employed In Solo Businesses, Irvin Sam Schonfeld, Joseph J. Mazzola

Publications and Research

This qualitative study involved 54 individuals who were self-employed in a variety of solo businesses. All participants were administered a semistructured interview that inquired into various aspects of their work experience with the data subject to reliability and validity checks. The study identified stressful incidents, coping strategies, and emotional strains arising from those stressful incidents. Uncertainty about income was a common background stressor. Recent specific stressors included dramatic slowdowns in business, reputational threat, betrayal, unreasonable customers, and medical problems. Commonly occurring strains included apprehension/anxiety, frustration, anger, and sadness/depression. The self-employed used problem-focused coping much more often than emotion-focused coping. We …

Increasing Maternal Or Post-Weaning Folic Acid Alters Gene Expression And Moderately Changes Behavior In The Offspring, Subit Barua, Kathryn K. Chadman, Salomon Kuizon, Diego Buenaventura, Nathan W. Stapley, Felicia Ruocco, Umme Begum, Sara R. Guariglia, W. Ted Brown, Mohamad Junaid

Publications and Research

Background: Studies have indicated that altered maternal micronutrients and vitamins influence the development of newborns and altered nutrient exposure throughout the lifetime may have potential health effects and increased susceptibility to chronic diseases. In recent years, folic acid (FA) exposure has significantly increased as a result of mandatory FA fortification and supplementation during pregnancy. Since FA modulates DNA methylation and affects gene expression, we investigated whether the amount of FA ingested during gestation alters gene expression in the newborn cerebral hemisphere, and if the increased exposure to FA during gestation and throughout the lifetime alters behavior in C57BL/6J mice.

Methods …

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 …

Risk Factors For Posttraumatic Stress Disorder In Haitian Students, Gretel Silvestre, Pascale Anacréon, Michèle Théodore, Emmanuel Silvestre, Eugenia Garcia-Dubus

Publications and Research

The aim of this study was to assess the prevalence of posttraumatic stress disorder (PTSD) in undergraduate students after the Haiti earthquake on January 12, 2010, as well as to identify the risk factors involved in the development of PTSD symptoms in this sample. Evaluations concerning depression, anxiety, risk and protective factors, and PTSD symptoms were conducted in 246 Haitian undergraduate students enrolled in a Dominican private university. Results indicate a prevalence of 36% for PTSD 2 years after the earthquake, with a high prevalence also of depression (31.7%) and anxiety (21.1%). Some of the risk factors identified are being …

The Benefits Of Neighborhood Racial Diversity: Neighborhood Factors And Its Association With Increased Physical Activity In Acs Patients, Ellen-Ge Denton, Philip Green, Jonathan Newman, Ye Siqin, Karina W. Davidson, Joseph Schwartz

Publications and Research

Regular physical activity reduces the risk of adverse events after an acute coronary syndrome (ACS) [1]. Physical activity level is influenced by neighborhood factors such as racial diversity in the general population [2,3], but the impact of neighborhood factors on physical activity after an ACS is unknown. We therefore prospectively evaluated the relationship of post-ACS physical activity assessed by continuous activity monitors with neighborhood characteristics, including ethnic density, income, female headed households, and racial diversity, in patients enrolled in the Prescription Use, Lifestyle, and Stress Evaluation (PULSE) Study.

Utilizing Fast Spin Echo Mri To Reduce Image Artifacts And Improve Implant/Tissue Interface Detection In Refractory Parkinson’S Patients With Deep Brain Stimulators, Subhendra N. Sarkar, Pooja R. Sarkar, Efstathios Papavassiliou, Rafael Rojas

Publications and Research

Introduction. In medically refractory Parkinson’s disease (PD) deep-brain stimulation (DBS) is an effective therapeutic tool. Postimplantation MRI is important in assessing tissue damage and DBS lead placement accuracy. We wanted to identify which MRI sequence can detectDBS leads with smallest artifactual signal void, allowing better tissue/electrode edge conspicuity.

Methods. Using an IRB approved protocol 8 advanced PDpatientswere imagedwithinMRconditional safety guidelines at lowRF power (SAR ≤ 0.1 W/kg) in coronal plane at 1.5T by various sequences.The image slices were subjectively evaluated for diagnostic quality and the lead contact diameters were compared to identify a sequence least affected by metallic leads.

Results …

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 …

Idiots Savants, Retarded Savants, Talented Aments, Mono-Savants, Autistic Savants, Just Plain Savants, People With Savant Syndrome, And Autistic People Who Are Good At Things: A View From Disability Studies, Joseph N. Straus

Publications and Research

People identified as idiot savants have long comprised an identifiable group (a high level of skill in the context of perceived mental deficiency) whose story has mostly been told by psychiatrists and psychologists within a medicalized model of disability that assumes deficiency and seeks remediation and normalization. More recently, people identified as savants have become common figures of literary and cinematic representation. Both of these narrative frames have enfreaked them as alien Others, whose gifts and disabilities place them outside the normal run of human intelligence and creativity. With a focus on music, this article tries to see through these …

The Association Between A Medical History Of Depression And Gestational Diabetes In A Large Multi-Ethnic Cohort In The United States, Katherine Bowers, S. Katherine Laughon, Sungduk Kim, Sunni L. Mumford, Jennifer Brite, Michele Kiely, Cuilin Zhang

Publications and Research

Background: Both major depression and gestational diabetes mellitus (GDM) are prevalent among women of reproductive age. Our objective was to determine whether a medical history of depression is related to subsequent development of GDM.

Methods: The Consortium on Safe Labor was a US retrospective cohort study of 228 562 births between 2002 and 2008. Exclusion criteria for the present analysis included multiple gestation pregnancies (n = 5059), pre-existing diabetes (n = 12 771), deliveries(n = 395), site GDM prevalence (

Results: The final analytic population included 121 260 women contributing 128 295 pregnancies, of which 5606 were affected by GDM. …

Exploring Epigenetic Regulation Of Fear Memory And Biomarkers Associated With Post-Traumatic Stress Disorder, Stephanie A. Maddox, Glenn E. Schafe, Kerry J. Ressler

Publications and Research

This review examines recent work on epigenetic mechanisms underlying animal models of fear learning as well as its translational implications in disorders of fear regulation, such as Post-traumatic Stress Disorder (PTSD). Specifically, we will examine work outlining roles of differential histone acetylation and DNA-methylation associated with consolidation, reconsolidation, and extinction in Pavlovian fear paradigms. We then focus on the numerous studies examining the epigenetic modifications of the Brain-derived neurotrophin factor (BDNF) pathway and the extension of these findings from animal models to recent work in human clinical populations. We will also review recently published data on FKBP5 regulation of …

A Naturally-Occurring Histone Acetyltransferase Inhibitor Derived From Garcinia Indica Impairs Newly Acquired And Reactivated Fear Memories, Stephanie A. Maddox, Casey S. Watts, Valerie Doyere, Glenn E. Schafe

Publications and Research

The study of the cellular and molecular mechanisms underlying the consolidation and reconsolidation of traumatic fear memories has progressed rapidly in recent years, yet few compounds have emerged that are readily useful in a clinical setting for the treatment of anxiety disorders such as post-traumatic stress disorder (PTSD). Here, we use a combination of biochemical, behavioral, and neurophysiological methods to systematically investigate the ability of garcinol, a naturallyoccurring histone acetyltransferase (HAT) inhibitor derived from the rind of the fruit of the Kokum tree (Garcina indica), to disrupt the consolidation and reconsolidation of Pavlovian fear conditioning, a widely studied rodent model …

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 …

Psychosocial Vulnerabilities To Depression After Acute Coronary Syndrome: The Pivotal Role Of Rumination In Predicting And Maintaining Depression, Ellen-Ge Denton, Nina Rieckmann, Karina W. Davidson, William F. Chaplin

Publications and Research

Psychosocial vulnerabilities may predispose individuals to develop depression after a significant life stressor, such as an acute coronary syndrome (ACS).The aims are (1) to examine the interrelations among vulnerabilities, and their relation with changes in depressive symptoms 3 months after ACS, (2) to prospectively assess whether rumination interacts with other vulnerabilities as a predictor of later depressive symptoms, and (3) to examine how these relations differ between post-ACS patients who meet diagnostic criteria for depression at baseline versus patients who do not. Within 1week after hospitalization for ACS, and again after 3 months, 387 patients (41% female, 79.6% white, mean …

Posttraumatic Stress And Myocardial Infarction Risk Perceptions In Hospitalized Acute Coronary Syndrome Patients, Donald Edmondson, Jonathan A. Shaffer, Ellen-Ge Denton, Daichi Shimbo, Lynn Clemow

Publications and Research

Posttraumatic stress disorder (PTSD) is related to acute coronary syndrome (ACS; i.e., myocardial infarction or unstable angina) recurrence and poor post-ACS adherence to medical advice. Since risk perceptions are a primary motivator of adherence behaviors, we assessed the relationship of probable PTSD to ACS risk perceptions in hospitalized ACS patients (n = 420). Participants completed a brief PTSD screen 3-7 days post-ACS, and rated their 1-year ACS recurrence risk relative to other men or women their age. Most participants exhibited optimistic bias (mean recurrence risk estimate between "average" and "below average"). Further, participants who screened positive for current PTSD (n …

Culture Ontogeny: Lifespan Development Of Religion And The Ethics Of Spiritual Counselling, Glen Milstein, Amy Manierre

Publications and Research

The counsellor has an ethical obligation to treat the whole person. Humans are cultural beings and the foundation of most cultures is religion. Religion and culture are received from our early relation~ ships and modified through later relationships across the lifespan. The paper introduces the term "culture ontogeny" to emphasize that this is a biological process wherein abstract ideas of culture and religion become material in the developing neurophysiology of each brain. A framework and methods are offered to examine the changing roles of religion in clients' emotional self~ structure, inclusive of those who describe themselves as spiritual, not religious. …

Pulsed Out Of Awareness: Eeg Alpha Oscillations Represent A Pulsed-Inhibition Of Ongoing Cortical Processing, Kyle E. Mathewson, Alejandro Lleras, Diane M. Beck, Monica Fabiani, Tony Ro, Gabriele Gratton

Publications and Research

Alpha oscillations are ubiquitous in the brain, but their role in cortical processing remains a matter of debate. Recently, evidence has begun to accumulate in support of a role for alpha oscillations in attention selection and control. Here we first review evidence that 8–12 Hz oscillations in the brain have a general inhibitory role in cognitive processing, with an emphasis on their role in visual processing. Then, we summarize the evidence in support of our recent proposal that alpha represents a pulsed-inhibition of ongoing neural activity. The phase of the ongoing electroencephalography can influence evoked activity and subsequent processing, and …