Health Psychology Commons^™

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 …

‘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 …

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 …

Predictors Of Substance Use, Relationship Arrangements And Intimacy Expectancies Among Gay Couples And Associations To Erikson Intimacy Development, Jonathan Lopez Matos

Theses and Dissertations

This study explored relationship arrangements, intimacy expectancies of substance use and the potential role of Eriksonian intimacy development on drug use among gay and bisexual men. Data were collected from 339 partnered gay/bisexual men across the United States. Measures addressed arrangement type, intimacy expectancies, Eriksonian intimacy and drug use.

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.

Negotiating And Navigating Invisible Food Deserts: An Exploratory Study On Foodways Of Adults On The Autism Spectrum, Jungja Park Cardoso

Dissertations, Theses, and Capstone Projects

I explored foodways of adults on the autism spectrum in order to understand how they negotiate and navigate their food environments. Foodways are beliefs and practices involved in food production, preparation, distribution and consumption (Counihan 2008). In an effort to hear marginalized voices in autism discourse, I conducted an online survey and interviews in modes chosen by participants to accommodate the communication needs of a wide range of autistic adults. The primary participants were highly educated adults with a formal autism diagnosis (n = 23) and self-diagnosed adults (n = 6). Out of the 29 autistic participants who …

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 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 …

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 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 …

"Sociocultural Predictors Of Risky Sexual Behaviors: 1 The Role Of Nativity Status, Race, Ethnic Identity And Self-Construal", Elvine B. Andjembe

Dissertations and Theses

Recent national health reports have shown that despite a considerable increase in sexual health knowledge, risky sexual behaviors’ rates among the youth are on the rise. Minorities are disproportionately affected, which translates into strong racial disparities in health outcomes such as STI/STDs, and HIV prevalence. The literature examining ethnic differences in health behaviors has studied ethnic identity (self-identification with and commitment to the values of one’s ethnic group) as a protective factor against an array of maladaptive behaviors. In addition, self-construal, which refers to the extent to which one is individualistic or collectivistic has also been established as a positive …

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 …

Social Media Use And Hiv Transmission Risk Behavior Among Ethnically Diverse Hiv-Positive Gay Men: Results Of An Online Study In Three U.S. States, Sabina Hirshfield, Christian Grov, Jeffrey T. Parsons, Ian Anderson, Mary Ann Chiasson

Publications and Research

Though Black and Hispanic men who have sex with men (MSM) are at an increased risk for HIV, few HIV risk reduction interventions that target HIV-positive MSM, and even fewer that use technology, have been designed to target these groups. Despite similar rates of social media and technology use across racial/ethnic groups, online engagement of minority MSM for HIV prevention efforts is low. Since minority MSM tend to have less representation in online HIV prevention studies, the goals of this online anonymous study of HIV-positive gay-identified men were to test the feasibility of conducting targeted recruitment by race/ethnicity and sexual …

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 …

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 …

Health, Wellbeing, And Academic Achievement Among Urban College Students, Elise Tanzini

Dissertations and Theses

The post-secondary educational environment is full of demands—both academically and outside of the direct college setting—and as a result, stress is a prevailing concern for college students. Chronic, high levels of stress have been linked to a number of negative health outcomes, such as anxiety and depression, and academic outcomes, such as lower academic achievement. Using a diverse sample of undergraduate and masters students [n=84; mean (SD) age = 22.89 (5.99) years] from an urban, public college, the current study measured students’ experiences of stress (Perceived Stress Scale) and the adaptive and maladaptive strategies they utilized to cope with stress, …

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 …

Utilizing Emotionally Responsive Virtual Human Role-Play Simulations To Train Users To Identify, Talk To And Refer Students In Psychological Distress Including Those At-Risk For Suicide: A Meta-Analysis, Glenn Albright, Jesse Davidson, Ron Goldman, Kristen Shockley, Sue Eastgard, Joy Himmel

Publications and Research

Background: The American College Health Association found that over 30% of students reported difficulty in functioning due to feeling depressed, overwhelming anxiety (50%) and anger (36%). Suicide is the second leading cause of death among US adolescents and over half of mental illnesses emerge prior to adulthood. A similar study found that nearly half of student veterans met criteria for Post Traumatic Stress Disorder and 46% had suicidal ideation. Left untreated, mental illness can lead to increased absenteeism, lower academic performance, disrupted classroom behaviors and compromises school safety. Educators and students are well positioned to identify and refer students in …

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 Solely Job-Related? A Critical Comment, Bianchi Renzo, Didier Truchot, Eric Laurent, Romain Brisson, Irvin Sam Schonfeld

Publications and Research

Within the field‐dominating, multidimensional theory of burnout, burnout is viewed as a work‐specific condition. As a consequence, the burnout syndrome cannot be investigated outside of the occupational domain. In the present paper, this restrictive view of burnout's scope is criticized and a rationale to decide between a work‐specific and a generic approach to burnout is presented. First, the idea that a multidimensional conception of burnout implies a work‐restricted scope is deconstructed. Second, it is shown that the burnout phenomenon cannot be confined to work because chronic, unresolvable stress – the putative cause of burnout – is not limited to …

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 …

Difficulties Of Alternatively Certified Teachers, Irvin Sam Schonfeld, Samantha J. Feinman

Publications and Research

This daily diary study followed, over a 2-week period, 252 beginning New York City public school teachers. Seventy percent were alternatively certified (New York City Teaching Fellows) and the rest, traditionally certified teachers. Alternatively certified teachers were more likely to experience stressors such as violent incidents and classroom management problems. No differences were found in exposure to stressors/difficulties such as problematic adults, student learning problems, and students experiencing emotional upset. Although differences in the rates of exposure to violent stressors could be explained by other factors (e.g., working in a low-performing school and years of experience), differences …