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Burnout

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Full-Text Articles in Health Psychology

The Relation Between Disordered Eating And Perceived Stress, Tori E. Byars Jan 2024

The Relation Between Disordered Eating And Perceived Stress, Tori E. Byars

Electronic Theses and Dissertations

Disordered eating behavior encompasses a spectrum of maladaptive eating patterns, including emotional eating, binging, restricting, and other similar behaviors. Perceived stress is the extent that an individual perceives their demands exceed their ability to cope. Existing research has demonstrated a positive relation between high ratings of perceived stress and disordered eating behaviors (King et al., 2009; Skead et al., 2018). The current study aimed to expand this research by examining the relation between disordered eating and stress in students, workers, and those who partake in both commitments. Utilizing a single survey, participants completed assessments including the Perceived Stress Scale, the …


Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Schonfeld Nov 2023

Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Schonfeld

Publications and Research

Burnout has elicited growing interest among occupational health specialists in recent decades. Since 2019, the World Health Organization has characterized burnout as a syndrome resulting from chronic, unmanageable workplace stress. Accordingly, three symptoms define the entity: (i) feelings of energy depletion or exhaustion; (ii) increased mental distance from one’s job or feelings of negativism or cynicism towards one’s job; and (iii) a sense of ineffectiveness and lack of accomplishment. We call into question the definition of burnout embodied in the Maslach Burnout Inventory and incorporated into the ICD-11. We draw stakeholders’ attention to the fact that burnout’s symptoms and etiology …


Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Sam Schonfeld Nov 2023

Examining The Evidence Base For Burnout, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout has elicited growing interest among occupational health specialists in recent decades. Since 2019, the World Health Organization has characterized burnout as a syndrome resulting from chronic, unmanageable workplace stress. According to the ICD-11, three symptoms define the entity: feelings of exhaustion, increased mental distance from one’s job, and a sense of ineffectiveness at work, all of which correspond to the structure of the Maslach Burnout Inventory. The ICD-11 includes burnout among the factors that influence health status. This paper calls into question that conceptualization based on a number of lines of evidence. The evidence includes the following: burnout was …


The Effects Of Stepped Care On Burnout For University Counseling Center Clinicians, Madison Estrada Jul 2023

The Effects Of Stepped Care On Burnout For University Counseling Center Clinicians, Madison Estrada

Dissertations

The ability of university counseling centers (UCCs) to meet the increased demand for service by students is becoming an increasing concern. While UCCs are seeing more students than ever, this increased demand has not been met with an increase in resources. As such, UCC clinicians are at a greater risk for developing burnout. However, according to the Demand – Control – Support Model, this risk could be reduced if UCC staff were afforded higher degrees of control over the resources they do have and received adequate support and acknowledgement for the work they accomplish. Through surveying 339 UCC clinicians in …


Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard Apr 2023

Peer-Supervision Of Nursing Professionals: A Shield Against Burnout, Kyle Gamache, Sarah Gamache, Joseph Robillard

Journal of Wellness

Introduction: Burnout is a major risk in healthcare professions and is a significant contributor to the current nursing shortage. Strategies to combat burnout of healthcare professionals are in desperate need. The purpose of this project is to introduce the clinical peer supervision model as a method to alleviate burnout in nursing professionals.

Approach: Eight nurses from in-patient settings participated in a peer-supervision support group, modeled after existing European nursing and mental health provider-support protocols. To assess the effect of this intervention, qualitative data analysis was conducted on the transcripts of session and the results described. All participants reported statistically high …


Sources Of Stress, Burnout, And Career Decisions Of Male Health And Nursing Professionals: A Qualitative Inquiry Of The Challenges During The Covid-19 Pandemic, Luis Miguel Dos Santos Mar 2023

Sources Of Stress, Burnout, And Career Decisions Of Male Health And Nursing Professionals: A Qualitative Inquiry Of The Challenges During The Covid-19 Pandemic, Luis Miguel Dos Santos

The Qualitative Report

The human resources and workforce shortage of registered health and nursing professionals has been a long-term problem in health systems internationally, particularly during the COVID-19 pandemic. Many health and nursing professionals face stress and burnout, which may influence their career decisions and long-term human resources development. The purpose of this study is to investigate and understand the relationship(s) between sources of stress and the reasons why male health and nursing professionals decide to leave the profession within the next six months. With the employment of the social cognitive career and motivation theory and general inductive approach with 40 male health …


A Case Study On Factors Influencing Retention Of Mental Health Clinicians In A New Hampshire Community Mental Health Center, William E. Keating Jan 2023

A Case Study On Factors Influencing Retention Of Mental Health Clinicians In A New Hampshire Community Mental Health Center, William E. Keating

Antioch University Full-Text Dissertations & Theses

This study examined the perspectives of master-level clinical mental health providers and members of leadership at a Community Mental Health Center (CMHC) in New Hampshire, to understand clinician and leadership perspectives as to why master-level providers choose to continue working at CMHCs. Most prior research on turnover in such organizations has focused on why so many leave their positions, however this study instead focuses on factors related to the decision to stay at a specific CMHC in an urban area of New Hampshire. A single case study method was utilized to focus on masters-level mental health care providers with additional …


“Living In Trauma 24/7”: A Qualitative Exploration Of Factors Contributing To Secondary Traumatic Stress And Burnout Among Student Services Professionals Working With Marginalized Student Populations, Delia Sanchez, Portia A. Jackson Preston, Christine Vu, Lucia Alcala Oct 2022

“Living In Trauma 24/7”: A Qualitative Exploration Of Factors Contributing To Secondary Traumatic Stress And Burnout Among Student Services Professionals Working With Marginalized Student Populations, Delia Sanchez, Portia A. Jackson Preston, Christine Vu, Lucia Alcala

Journal of Human Services: Training, Research, and Practice

Higher education professionals are at risk of secondary traumatic stress (STS) as a result of supporting students experiencing trauma, while overwhelming workload, inadequate resources, and unclear role responsibilities may lead to burnout. This study explored contributing factors to STS and burnout and coping efforts among faculty, students, and staff working in a capacity in which they provide non-instructional support to programs or centers focusing on marginalized student populations. Participants (N=56) represented twenty-two U.S. regional universities, and were a subset of respondents to a larger mixed-methods study (n=559). Qualitative responses to three open-ended questions on challenges and coping efforts were analyzed …


Burned-Out With Burnout? Insights From Historical Analysis, Renzo Bianchi, Katarzyna Wac, James Francis Sowden, Irvin Sam Schonfeld Sep 2022

Burned-Out With Burnout? Insights From Historical Analysis, Renzo Bianchi, Katarzyna Wac, James Francis Sowden, Irvin Sam Schonfeld

Publications and Research

Fierce debates surround the conceptualization and measurement of job-related distress in occupational health science. The use of burnout as an index of job-related distress, though commonplace, has increasingly been called into question. In this paper, we first highlight foundational problems that undermine the burnout construct and its legacy measure, the Maslach Burnout Inventory (MBI). Next, we report on advances in research on job-related distress that depart from the use of the burnout construct. Tracing the genesis of the burnout construct, we observe that (a) burnout’s definition was preestablished rather than derived from a rigorous research process and (b) the MBI …


Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport Apr 2022

Communicating Comfort In Crisis: A Literature Review On Overcoming The Emergency Room Environment To Foster The Nurse-Patient Relationship, Faith G. Davenport

Senior Honors Theses

The average emergency room patient is not receiving the compassionate nurse-patient communication that patients experience on other hospital floors. Fewer positive nurse-patient interactions prompt patients to state that they feel uncomforted and dissatisfied on hospital exit surveys, inciting hospital management to investigate how to reverse this trend to retain their federal funding. Emergency room nurses cite multiple barriers inherent in their work environment that prevent them from building rapport with their patients, including a layout not conducive to private conversations, strict time constraints, and a fluctuating workload. Working for a prolonged period under these conditions is driving many nurses to …


Who Needs To Be “Burned-Out”? Time For A New Approach To Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld Oct 2021

Who Needs To Be “Burned-Out”? Time For A New Approach To Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Burnout is a popular indicator of job-related distress, notably in research on the ill-being of medical professionals. The burnout construct is, however, plagued by definitional and measurement problems. Often unnoticed, these problems undermine findings and conclusions emanating from burnout research. The definitional and measurement problems affecting the burnout construct hamper knowledge growth, waste resources, and impede our ability to make informed decisions and take effective action to support personnel. It is time for occupational health specialists to abandon the idea of burnout and focus on occupational depression.


The Occupational Depression Inventory—A Solution For Estimating The Prevalence Of Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld Jan 2021

The Occupational Depression Inventory—A Solution For Estimating The Prevalence Of Job-Related Distress, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

We are concerned about researchers’ reliance on the burnout construct and the MBI-GS to estimate the prevalence of job-related distress. In this paper, we first describe some of the problems plaguing the burnout construct and its measures. Then, we present the Occupational Depression Inventory, a new instrument designed to help occupational health specialists get a clearer view of the mental health status of the workforce (Bianchi and Schonfeld, 2020).


A Solution For Breaking The Impasse Of Burnout Measurement, Renzo Bianchi, Irvin Sam Schonfeld Jan 2021

A Solution For Breaking The Impasse Of Burnout Measurement, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

In view of the profound problems affecting burnout’s conceptualization and measurement and because there is now robust evidence that burnout is a depressive condition, we recommend that occupational health specialists shift their focus from burnout to depression. A measure of job-related depressive symptoms, the Occupational Depression Inventory (ODI), has recently been developed. Advantageously, the ODI resolves many of the persistent problems linked to burnout while being consistent with burnout researchers’ original aim of assessing a work-attributed form of distress. The ODI includes a diagnostic algorithm that allows investigators to estimate the prevalence of depressive disorders that individuals specifically ascribe to …


Occupational Depression, Cognitive Performance, And Task Appreciation: A Study Based On Raven’S Advanced Progressive Matrices, Renzo Bianchi, Irvin Sam Schonfeld Jan 2021

Occupational Depression, Cognitive Performance, And Task Appreciation: A Study Based On Raven’S Advanced Progressive Matrices, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. Research on the criterion validity of the instrument is still in its infancy. In this study, we examined whether the ODI predicted performance on, and appreciation of, a cognitively challenging test. In light of the link established between clinical depression and neuropsychological impairment, and considering that individuals with depressive symptoms are more likely to feel helpless under challenging circumstances, we hypothesized that occupational depression would be associated with poorer cognitive performance and a darkened appreciation of the task undertaken. We relied …


Is Burnout A Depressive Condition? A 14-Sample Meta-Analytic And Bifactor Analytic Study, Renzo Bianchi, Jay Verkuilen, Irvin S. Schonfeld, Jari J. Hakanen, Markus Jansson-Fröjmark, Guadalupe Manzano-García, Eric Laurent, Laurenz L. Meier Jan 2021

Is Burnout A Depressive Condition? A 14-Sample Meta-Analytic And Bifactor Analytic Study, Renzo Bianchi, Jay Verkuilen, Irvin S. Schonfeld, Jari J. Hakanen, Markus Jansson-Fröjmark, Guadalupe Manzano-García, Eric Laurent, Laurenz L. Meier

Publications and Research

There is no consensus on whether burnout constitutes a depressive condition or an original entity requiring specific medical and legal recognition. In this study, we examined burnout–depression overlap using 14 samples of individuals from various countries and occupational domains (N = 12,417). Meta-analytically pooled disattenuated correlations indicated (a) that exhaustion—burnout’s core—is more closely associated with depressive symptoms than with the other putative dimensions of burnout (detachment and efficacy) and (b) that the exhaustion–depression association is problematically strong from a discriminant validity standpoint (r = .80). The overlap of burnout’s core dimension with depression was further illuminated in 14 exploratory structural …


The Occupational Depression Inventory: A New Tool For Clinicians And Epidemiologists, Renzo Bianchi, Irvin Sam Schonfeld Oct 2020

The Occupational Depression Inventory: A New Tool For Clinicians And Epidemiologists, Renzo Bianchi, Irvin Sam Schonfeld

Publications and Research

Background: Depressive symptoms induced by insurmountable job stress and sick leave for mental health reasons have become a focal concern among occupational health specialists. The present study introduces the Occupational Depression Inventory (ODI), a measure designed to quantify the severity of work-attributed depressive symptoms and establish provisional diagnoses of job-ascribed depression. The ODI comprises nine symptom items and a subsidiary question assessing turnover intention. Methods: A total of 2254 employed individuals were recruited in the U.S., New Zealand, and France. We examined the psychometric and structural properties of the ODI as well as the nomological network of work-attributed depressive symptoms. …


Memory Bias Toward Emotional Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Lucas M. Bietti, Eric Mayor Sep 2020

Memory Bias Toward Emotional Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Lucas M. Bietti, Eric Mayor

Publications and Research

A sample of 1015 educational staff members, exhibiting various levels of burnout and depressive symptoms, underwent a memory test involving incident encoding of positive and negative words and a free recall task. Burnout and depression were each found to be associated with increased recall of negative items and decreased recall of positive items. Results remained statistically significant when controlling for history of depressive disorders. Burnout and depression were not related to mistakes in the reported words, or to the overall number of recalled words. This study suggests that burnout and depression overlap in terms of memory biases toward emotional information.


Treading Water: Coping With Uncertainty During A Novel Pandemic, Sachin Patel Aug 2020

Treading Water: Coping With Uncertainty During A Novel Pandemic, Sachin Patel

Patient Experience Journal

The abruptness with which the COVID-19 pandemic has changed the delivery of healthcare will have a lasting effect on patients and families of intensive care unit survivors. Using the best science and epidemiology healthcare systems developed protocols and policies to implement the highest level of care but mitigate disease spread. Out of these initiatives the “no visitor” policy was born. The impact of COVID-19 causing florid respiratory failure immediately derailed the lives of a happily retired couple. While on mechanical ventilation for sixteen days, Betty was unable to connect with her husband of over 40 years. In that time, the …


Using Art To Mitigate Burnout For Those Working In Direct Care, Jessica E. Goodchild May 2020

Using Art To Mitigate Burnout For Those Working In Direct Care, Jessica E. Goodchild

Expressive Therapies Capstone Theses

Through a critical review of the existing literature, this capstone thesis seeks to investigate the potential benefits and drawbacks to the integration of guided artistic practices within the workplace. The literature reviewed focused on both qualitative and quantitative studies of burnout and explored the professional benefits that art making can provide in mitigating burnout for those within a western culture working in the field of mental health and social services, particularly in the capacity of a direct care worker (DCW). Through the review of the literature a case can be made for the benefits of using visual art to engage …


The Watson Room: Mitigating Compassion Fatigue In Oncology Nurses, Patricia A. Viscardi May 2020

The Watson Room: Mitigating Compassion Fatigue In Oncology Nurses, Patricia A. Viscardi

Doctors of Nursing Practice (DNP) Final Projects, 2020-current

Aim: The aim of this project was to plan, develop, and implement “The Watson Room” or “Quiet Room” in an inpatient oncology nursing population and evaluate changes in Professional Quality of Life (ProQOL).

Background: Oncology Nurses are at high risk for compassion fatigue (CF), burn-out (BO), and secondary traumatic stress (STS) related to the effects of living the traumas of oncology patients and their families through their cancer journey and the innate stress in a complex and intense workplace. High levels of compassion fatigue, burn-out, and secondary traumatic stress that are poorly managed reduces the nurse’s ability to self-regulate their …


A Five-Sample Confirmatory Factor Analytic Study Of Burnout-Depression Overlap, Renzo Bianchi, Irvin Sam Schonfeld, Jay Verkuilen Jan 2020

A Five-Sample Confirmatory Factor Analytic Study Of Burnout-Depression Overlap, Renzo Bianchi, Irvin Sam Schonfeld, Jay Verkuilen

Publications and Research

Objective: It has been asserted that burnout—a condition ascribed to unresolvable job stress—should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined.

Methods: Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom–Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)—General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ‐9.

Results: In all five samples, the latent factors pertaining to burnout’s components correlated on average more highly with the latent Depression …


Secondary Trauma Of Lay Mental Health Workers In Low Resource Locations: Bukavu, Janny Jinor Jan 2020

Secondary Trauma Of Lay Mental Health Workers In Low Resource Locations: Bukavu, Janny Jinor

Journal of Social, Behavioral, and Health Sciences

A general consensus exists in the literature that working with a trauma population will produce negative personal, psychological, and professional consequences including secondary trauma. However, a significant research gap occurs with regard to how secondary trauma affects psychosocial assistants (PAs) who work in low-resource and conflict-stricken Bukavu in the Democratic Republic of Congo (DRC). The DRC is plagued by psychological problems resulting from numerous past and ongoing conflicts, but sufficient trained mental health personnel and resources are lacking. As a result, the dire responsibility of providing mental health services to survivors of rape has shifted to minimally trained PAs. This …


Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi Apr 2019

Redefining Burnout: Exploring Common Conceptualizations And The Neurophysiology Of Chronic Stress To Establish An Integrated Allostatic Model, Danny A. Guzzi

Dissertations

Burnout is a widely researched stress-related phenomenon associated with numerous adverse outcomes for employees and organizations. Unfortunately, burnout is not well understood and research to this point has been flawed due to a lack of consensus on the definition, dimensionality, and context of the construct. Prevalent conceptualizations of burnout have been criticized for being arbitrarily developed without solid theoretical foundation and for failing to clearly distinguish burnout from depression or other work-related conditions such as compassion fatigue, secondary traumatization, and vicarious traumatization. The current project first examines relevant literature to identify commonalities among prevalent burnout conceptualizations. Then relevant stress research …


A Program Of Research On Burnout-Depression Overlap, Irvin Sam Schonfeld Jan 2019

A Program Of Research On Burnout-Depression Overlap, Irvin Sam Schonfeld

Publications and Research

The article describes a program of research aimed at unraveling the nature of the relationship of job-related burnout to depression. The research tends to show that burnout symptoms are depressive symptoms and what is termed a state of burnout often reflects an episode of depression.


Burnout: Moving Beyond The Status Quo, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent Jan 2019

Burnout: Moving Beyond The Status Quo, Renzo Bianchi, Irvin Sam Schonfeld, Éric Laurent

Publications and Research

Burnout has been defined as a job-induced syndrome combining emotional exhaustion, depersonalization/cynicism, and a sense of reduced personal accomplishment. In this article, we expand on past analyses of burnout by reviewing key, yet overlooked, problems affecting the construct. We concomitantly examine the implications of these problems for the overall validity of burnout research. Our work shows that burnout research is undermined by 4 main problems. First, what constitutes a case of burnout is unclear. Second, the basic conceptualization and operationalization of burnout are ill aligned. Third, burnout is unlikely to be the specifically job-induced syndrome it has been posited to …


Inquiry Into The Correlation Between Burnout And Depression, Irvin Sam Schonfeld, Jay Verkuilen, Renzo Bianchi Jan 2019

Inquiry Into The Correlation Between Burnout And Depression, Irvin Sam Schonfeld, Jay Verkuilen, Renzo Bianchi

Publications and Research

The extent to which burnout refers to anything other than a depressive condition remains an object of controversy among occupational health specialists. In three studies conducted in two different countries and two different languages, we investigated the discriminant validity of burnout scales by evaluating the magnitude of the correlation between (latent) burnout and (latent) depression. In Study 1 (N = 911), burnout was assessed with the Maslach Burnout Inventory–General Survey’s Exhaustion subscale and depression with the depression module of the Patient Health Questionnaire (PHQ). In Study 2 (N = 1,386), the Shirom–Melamed Burnout Measure was used to assess burnout and …


An Exploratory Structural Equation Modeling Bi-Factor Analytic Approach To Uncovering What Burnout, Depression, And Anxiety Scales Measure, Irvin Sam Schonfeld, Jay Verkuilen, Renzo Bianchi Jan 2019

An Exploratory Structural Equation Modeling Bi-Factor Analytic Approach To Uncovering What Burnout, Depression, And Anxiety Scales Measure, Irvin Sam Schonfeld, Jay Verkuilen, Renzo Bianchi

Publications and Research

In this study, we addressed the ongoing debate about what burnout and depression scales measure by conducting an exploratory structural equation modeling (ESEM) bifactor analysis. A sample of 734 U.S. teachers completed a survey that included the Center for Epidemiologic Studies Depression scale (CES-D-10), the depression module of the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), and the Maslach Burnout Inventory (MBI), which contains emotional exhaustion (EE), depersonalization (DP), and (diminished) personal accomplishment (PA) subscales. Job adversity and workplace support were additionally measured for the purpose of a nomological network analysis. EE, burnout’s core, was more highly …


Understanding Burnout In Undergraduate Students: The Role Of Social Media, Paige Walker Apr 2018

Understanding Burnout In Undergraduate Students: The Role Of Social Media, Paige Walker

Brescia Psychology Undergraduate Honours Theses

This study investigated different factors relating to undergraduate burnout and whether social media could act as a protective factor. The study group was comprised of 66 female undergraduate psychology students at Brescia University College. Participants completed one questionnaire with seven subscales which measured the following variables: subjective well-being, student subjective well-being, personality traits, social support, stress, online support, and burnout. The participants were divided into three groups based on their burnout scores. The results of the ANOVA indicated that there were significant differences between the three burnout groups on: subjective well-being, student subjective well-being, conscientiousness, extraversion, openness, social support, and …


Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent Jan 2018

Burnout Syndrome And Depression, Renzo Bianchi, Irvin Sam Schonfeld, Eric Laurent

Publications and Research

In this chapter, we proposed an overview of burnout, from the introduction of the construct in the mid-1970s to the growing realization that the syndrome was better conceived of as a depressive condition. Recent studies have shown that the distinction between burnout and depression is problematic, both theoretically and empirically. The history of burnout research suggests that transdisciplinary communication and methodological standards should be strengthened to avoid the proliferation of constructs that, in fact, refer to the same phenomena. Construct proliferation, a transgression of the scientific canon of parsimony, is considered a major problem today because it undermines theory building …


Interpretation Bias Toward Ambiguous Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Jay Verkuilen, Chantal Berna Jan 2018

Interpretation Bias Toward Ambiguous Information In Burnout And Depression, Renzo Bianchi, Eric Laurent, Irvin Sam Schonfeld, Jay Verkuilen, Chantal Berna

Publications and Research

Burnout has been defined as a job-related syndrome combining pervasive fatigue and loss of motivation. In recent years, evidence has mounted that burnout may reflect a depressive condition. In this study, we expanded on past investigations of burnout-depression overlap by focusing on interpretation biases toward ambiguous information among the two entities. We conducted a web-based study involving 1056 participants (83% female; mean age: 42.87). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure and depressive symptoms with the PHQ-9. The Ambiguous Scenarios Test (AST), a measure of interpretation bias validated among dysphoric individuals, was the outcome of interest. The AST …