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[Body language group: depersonalization and repersonalization using make-up].

Make up was used as a support by a corporal expression group which met two hours a week during three months. This method call particularly for tact and sight, the importance of these factors being well known to attain the elaboration and the integration of body scheme. In a recreative, therefore reassuring context, reinforced by the group phenomenon, the dynamism of gesture and relationship extends far beyond the features. The trends of make-up during the sessions and themes based on mimesis allowed to measure progress.

Adult↗

Burnout in occupational therapists.

Burnout is a job-related condition involving feelings of emotional exhaustion, depersonalization, and reduced personal accomplishment. The Maslach Burnout Inventory (Maslach & Jackson, 1981a) is the instrument most widely used to measure job-related stress in human service professions, such as occupational therapy. This study explored the application of the Maslach Burnout Inventory for use with occupational therapists. The subjects were 99 registered occupational therapists residing in the southeastern United States. Mean scores lower than the aggregate occupational norms provided by the test's authors on the Emotional Exhaustion and Depersonalization subscales supported the need to develop specific norms for occupational therapists. Results of this study indicate that use of the aggregate norms would underestimate the level of experienced burnout. Correlational analyses delineated significant relationships between age and Emotional Exhaustion and Depersonalization, education and Emotional Exhaustion and Depersonalization, years of work as an occupational therapist and Depersonalization and Personal Accomplishment, years in the present position and Personal Accomplishment (intensity only), hours of direct patient contact and Emotional Exhaustion (intensity only), and hours of direct patient contact and Depersonalization (frequency only). These correlates of burnout furnish clues for understanding the development of work-related stress in occupational therapists.

Adult↗

Empathy and burnout in male and female helping professionals.

Relationships between empathy and burnout and possible confounding influences of sex and profession were explored in a sample of 492 male and female nurses, social workers, and teachers. Respondents completed Mehrabian's Emotional Empathy Scale, Stotland's Fantasy-Empathy Scale, and the Maslach Burnout Inventory (MBI). There were no main effects of profession on empathy or burnout variables. There was, however, an interaction effect of sex and profession on depersonalization, which was accounted for by subjects in social work and teaching. Women had significantly higher empathy scores than men; however, men had higher scores than male normative groups. Age related negatively to depersonalization and emotional exhaustion for women, whereas percentage of work time spent in direct practice correlated with depersonalization for men. The possibility that empathy and burnout might represent opposite poles of the same underlying construct was examined but not found. Instead, emotional empathy was significantly positively correlated with both emotional exhaustion and personal accomplishment, whereas emotional exhaustion was also positively related to depersonalization. It is hypothesized that high emotional empathy may predispose helping professionals to emotional exhaustion and that emotional exhaustion, if not mediated by personal accomplishment, may lead to the development of depersonalization. This more complex, interactive model of the empathy-burnout relationship needs longitudinal study.

Burnout, Professional↗

Predictors of dropout and burnout in AIDS volunteers: a longitudinal study.

Burnout among HIV/AIDS volunteers contributes to the loss of dedicated personnel resulting in strain on the HIV/AIDS care system. Past research has suggested that there were significant stresses and burnout associated with AIDS caregiving. We investigated the predictors of dropout in AIDS volunteers over time, and specifically, which of the variables of the stressors and rewards of being a volunteer (collected at baseline) predicted who would drop out two years later. The volunteers were the subjects of Nesbitt et al. (1996), who were members of an interfaith religious-based organization in Houston, Texas. The subjects were re-contacted by mail after two years, and 76 of the 174 respondents completed a brief questionnaire which gave details of current volunteering activity, reasons for dropout (if they had dropped out) and completed the Texas Revised Inventory of Grief (TRIG). Forty dropped-out from volunteering while 36 continued. Data show the independent variables of total stressor score, the Maslach Burnout Inventory score of Depersonalization intensity and the three subscale scores involving stress: client problems and role ambiguity, emotional overload and organizational factors as being significant in predicting dropout in HIV/AIDS volunteers over time. The best predictors of the dropping-out of HIV/AIDS volunteers can be divided into the stresses (client problems and role ambiguity, emotional overload and organizational factors) and depersonalization intensity. The results showed that volunteers who experienced more client problems and role ambiguity, more emotional overload and more problems with organizational factors are more likely to drop out from the volunteer programme. They also show that the dropout volunteers have a significantly higher level of depersonalization intensity than the continuing volunteers, with the risk of dropout increasing by almost a third in the highest tertile of depersonalization intensity scores compared with those with lower scores. These data indicate that it is the stressors of AIDS volunteering, including the intensity of depersonalization, which lead to dropout, and that rewards do not appear to have a protective effect.

Acquired Immunodeficiency Syndrome↗

A Canadian-Dutch comparison of teachers' burnout.

Scores on burnout among 631 Canadian and 1,180 Dutch teachers were compared with various demographic variables (sex and age) and factors related to work (experience in teaching, type of school, and number of hours employed). Burnout was assessed with the Maslach Burnout Inventory of three dimensions, Emotional Exhaustion, Depersonalization, and Personal Accomplishment. Analysis indicated that, over-all, Canadian teachers reported higher scores on Emotional Exhaustion and Depersonalization than their Dutch peers. Differences in the number of hours employed were also significant: full-time Canadian teachers scored higher on Depersonalization than their Dutch colleagues. Across countries, sex and type of school appeared significantly related to burnout. Male teachers rated higher on Emotional Exhaustion and Depersonalization than the women. Especially with regard to the attitudinal components of burnout, i.e., Depersonalization and Personal Accomplishment, secondary school teachers reported higher scores than elementary school teachers. Age was not significantly related to measures.

Adult↗

Burnout among primary care physicians and mental health professionals in a managed health care setting.

This study assessed burnout within a large Health Maintenance Organization. Primary care physicians and one psychiatric clinic staff were studied. The Maslach Burnout Inventory was used to develop frequency data in the areas of emotional exhaustion, depersonalization, and personal achievement. Among the primary care physicians, moderate emotional exhaustion, and depersonalization were found. Personal achievement was high. Among the psychiatric staff, high emotional exhaustion and depersonalization were found. Again, personal achievement was high. The entire professional group, with the one exception, was significantly higher in emotional exhaustion, depersonalization, and personal achievement than Maslach's normative sample. Psychiatrists and social workers had significantly higher scores on depersonalization than the primary care physicians or psychologists. High burnout in a Health Maintenance Organization setting suggests that managed health care providers may be more prone to burnout than fee-for-service practitioners. Several suggestions were made for such organizations to help alleviate burnout in their staffs.

Adult↗

[Concept of the person in psychiatry].

At first sight, the concept of "person" appears in psychiatric terminology only in the negative sense, i.e., as in depersonalization. However, self-alienation may be regarded as the hallmark of mental illness in general and is based on the ambiguous structure of human personality itself. Thorough analysis of the concept of the person is therefore indispensable to understanding psychopathology. This paper focuses on the contrast of "persona" ("mask" or "role") on the one hand to "person" as an individual self on the other. Their dialectical relation derives from basic anthropological structures such as sociality, self-reference, self-transcendence, and fictionality. As can be shown, the historical and cultural ontogeny of the personality includes experiences of self-alienation which may become relevant for psychiatry as depersonalization syndromes. The example of depression is used to illustrate vital and emotional depersonalization, whereas schizophrenia may be described as "intentional depersonalization." Following this line of reasoning, the classic schizophrenic experiences of alien control or thought insertion are interpreted as a disturbance in the fundamental personality structures.

Defense Mechanisms↗

An early Dutch study of déjà vu experiences.

In 1904 and 1906, Heymans reported the results of two prospective questionnaire surveys on déjà vu experiences and depersonalization in a sample of mainly students. Déjà vu experiences appeared to be more frequent than episodes of depersonalization. Emotional sensitivity, unstable mood fluctuations, apathetic episodes and irregular working rhythm emerged as predisposing personality traits. With the exception of the working rhythm, these traits were more prominent among the respondents with episodes of depersonalization than among those with déjà vu experiences. Heymans inferred that these findings supported his hypothesis that déjà vu experiences and depersonalization both resulted from the diminishing or disappearance of a sense of familiarity due to a momentary reduction of psychological energy. A re-analysis of Heymans' data partly confirmed his findings and conclusions as to the predisposing factors. The authors conclude that his studies and his hypothesis have been hitherto undervalued and would deserve more attention.

Deja Vu↗

The social validity of an argument supporting a ban on aversive procedures.

There is currently a controversy regarding the use of non-aversive and aversive procedures in the treatment of severe behaviour problems in individuals with mental retardation. One specific criticism directed at professionals who support the non-aversive position is that they have taken quotations from scientific articles out of context in order to give the impression of empirical support for their position. The present authors addressed this issue by assessing the social validity of references made to selected scientific articles in support of a specific argument in a monograph by Guess et al. (1987). Three groups of individuals were surveyed in this study: (1) psychologists working with individuals with mental retardation at six state schools in Texas (Group I); (2) selected professionals with expertise in the area of self-injurious behaviour and in the use of behaviour modification techniques with individuals who are mentally retarded (Group II); and (3) the authors of the six journal articles that were selected for the present study (Group III). The study focused on references made to journal articles in support of the 'depersonalization hypothesis' that aversive therapies serve to depersonalize the recipients of these treatments. Results indicate that the authors of the monograph were not completely accurate in their references to the six articles. Sixty per cent of the respondents from Group I, 71% of respondents from Group II, and two out of the three respondents from Group III rated the citations made in the monograph as inaccurate. In addition, the respondents rated the articles as not supportive of the depersonalization hypothesis for which they were cited. Over half of Group I respondents, and all respondents from Groups II and III rated the articles as non-supportive of the depersonalization hypothesis. These findings suggest that the authors of the monograph have used references selectively and incorrectly in support of their views in at least some instances. This emphasizes the importance of critical reading and hypotheses based on bodies of knowledge rather than selected sources. Furthermore, this study indicates the need for operationally defined hypotheses which may be examined empirically.

Attitude of Health Personnel↗

Stress, burnout and health in the clinical period of dental education.

The study examined the extent of stress, burnout and health problems experienced by fourth and fifth year dental students from the three universities of Dresden, Freiburg and Bern. The objectives of the study were to: (i) identify frequent sources of stress and to report the prevalence rates of burnout and health problems in dental students, (ii) determine the rate of students suffering from severe burnout symptoms and (iii) identify stress factors related to the burnout symptoms of emotional exhaustion and depersonalization. A total of 161 dental students from Dresden, Freiburg and Bern participated in the study. They completed the Psychosocial Stress Inventory, the Maslach Burnout Inventory and the Health Survey Questionnaire. Frequent sources of stress were limitation of leisure time, examination anxiety and the transition stress that was related to the adaptation to the demands of the clinical phase of dental education. Few differences existed between the students of the fourth and the fifth study year. Study-related stress was lowest in Bern and considerably higher in Dresden. Differences of mean levels of burnout symptoms were found only for the burnout dimension of emotional exhaustion. Students from Dresden and Freiburg were more emotionally exhausted than students from Bern, students from Dresden also reported more health problems than students from Bern or Freiburg. Ten per cent of the dental students suffered from severe emotional exhaustion, 17% complained about a severe lack of accomplishment and 28% reported severe depersonalization symptoms. Forty-four per cent of the variance of emotional exhaustion was explained by study-related factors such as lack of leisure time, examination anxiety and transition stress. The only predictor of depersonalization was a lack of social integration, accounting for 3% of the variance. A lack of social integration may be an indicator of low social competence which may cause difficulties in dealing with patients adequately and therefore result in depersonalization. The results indicate a need to identify the group of students who may have insufficient social skills for dealing adequately with the patients, and to train them accordingly.

Adult↗

Burnout among female indoor sex workers.

This study examined levels of "burnout" and associated factors among a sample of female indoor sex workers in the Netherlands (N=96). Levels of burnout on 3 dimensions (emotional exhaustion, depersonalization, and personal competence) were assessed. Only sex workers' mean score on depersonalization was significantly higher than that of a comparison group of female nurses and comparable to those of another comparison group of patients with work-related psychological problems. Evidence was provided for the importance of experiential and context-related factors in burnout among indoor sex workers. For instance, 42% of the variance in depersonalization was explained by not working by choice, negative social reactions, experiences of violence, and lack of control in interaction with clients. Depersonalization may be a strategy to cope with negative conditions and experiences in sex work, but was significantly related to indicators of stress and emotional exhaustion. More than half (53%) of the variance in emotional exhaustion was explained by lack of management support, negative social reactions, not working by choice, and negative working motivation. Personal competence was highest among sex workers with a professional attitude, who started sex work at a relatively older age, and who were well supported by colleagues and management. It is concluded that burnout is not as much associated with sex work per se, but with sex work under certain conditions, among which stigma (notably negative social reactions) and stigma-related experiences (such as role conflict, experiences with violence, and lack of a worker-supportive organizational context) are important.

Adult↗

Burnout in psychiatric nursing.

INTRODUCTION: Burnout in nursing is of both individual and organizational concern with ramifications for well-being, job performance, absenteeism and turnover. Burnout is rarely assessed as part of a comprehensive model of occupational stress, a short-coming which this paper attempts to redress. METHOD: A randomly selected sample of 510 psychiatric nurses from one Scottish Trust completed a questionnaire based on a psychological model of occupational stress which included the Maslach Burnout Inventory (MBI) as the dependent variable. FINDINGS: The respondents reported average, low and average levels of emotional exhaustion, depersonalization and personal accomplishment, respectively. The study sample had significantly lower scores on emotional exhaustion and depersonalization than normative data but also significantly lower levels of personal accomplishment than a normative group of physicians and nurses. Only 2.0% of the study sample could be categorized as having high burnout overall (i.e. high emotional exhaustion, high depersonalization, low personal accomplishment) and they differed significantly from the rest only in terms of males being over-represented. Hierarchical regression analysis revealed that selected explanatory variables accounted for 41.9% of emotional exhaustion, 16.4% of depersonalization and 25.6% of personal accomplishment in the study sample. IMPLICATIONS: The paper discusses the implications of the findings in terms of a comprehensive approach to intervention aimed at minimizing the risk of burnout in psychiatric nurses. Such an approach will involve interventions at the organizational and individual level.

Adult↗

Emotional implications of working in a burn unit.

Burnout is a syndrome that has been characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment associated with chronic occupational stressors. The purpose of this study was to determine the prevalence of burnout in healthcare professionals involved in primary burn care and to gain an understanding of the stressors and pleasures they experience. A cross-sectional survey was administered between February and March 2004 to healthcare professionals working in the burn unit (BU, study group) and critical care unit (CrCU, control group) of a teaching hospital. Three questionnaires were administered: a demographic data sheet, the Maslach Burnout Inventory (MBI), and a questionnaire evaluating sources of stress, pleasures of work, and coping mechanisms used by staff. All 75 surveys distributed were completed (BU=36, CrCU=39). Respondents from the BU were nurses (66.7%), occupational or physical therapists (11.1%), physicians (8.3%), respiratory therapists (5.6%), social workers (2.8%), and others (5.6%). There were no significant differences between BU and CrCU professionals in years of experience on the unit (6.7 vs 8.0 years), years in the field (16.5 vs 14.7 years), weekly hours of patient care (35.1 vs 39.6 hours), and number of ventilated patients cared for per month (8.4 vs 19.3 patients). On the MBI, there were no significant differences between units with respect to the emotional exhaustion and personal accomplishment subscales. However, staff in the BU reported lower rates of depersonalization (P=.049) compared with the CrCU counterparts. There was no significant difference in the perceived sources of workplaces stressors, but differences existed in the coping mechanisms. BU professionals exercised less (P=.007), talked less with their families (P=.006), ate less (P=.002), and watched less television (P=.002) compared with CrCU professionals as a means of coping with their workplace stress. In conclusion, although BU and CrCU have similar work environments, BU staff was significantly less depersonalized compared with CrCU staff. However, the two units had comparable rates of emotional exhaustion and depersonalization. The mechanisms for coping with workplace stress differed significantly between the two units.

Adaptation, Psychological↗