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Psycho-oncology May 2018To determine the prevalence of high levels of emotional exhaustion and depersonalization and low personal accomplishment in nursing professionals in oncology services. (Meta-Analysis)
Meta-Analysis Review
OBJECTIVE
To determine the prevalence of high levels of emotional exhaustion and depersonalization and low personal accomplishment in nursing professionals in oncology services.
METHODS
A meta-analytical study was performed. The search was carried out in March 2017 in Pubmed, CINAHL, Scopus, Scielo, Proquest, CUIDEN, and LILACS databases. Studies using Maslach Burnout Inventory for the assessment of burnout were included.
RESULTS
The total sample of oncology nurses was n = 9959. The total number of included studies was n = 17, with n = 21 samples for the meta-analysis of emotional exhaustion and n = 18 for depersonalization and low personal accomplishment. The prevalence of emotional exhaustion and of depersonalization was 30% (95% CI = 26%-33%) and 15% (95% CI = 9%-23%), respectively, and that of low personal performance was 35% (95% CI = 27%-43%).
CONCLUSIONS
The are many oncology nurses with emotional exhaustion and low levels of personal accomplishment. The presence and the risk of burnout among these staff members are considerable.
Topics: Achievement; Adult; Burnout, Professional; Burnout, Psychological; Depersonalization; Emotions; Female; Humans; Job Satisfaction; Male; Nursing Staff, Hospital; Oncology Nursing; Prevalence; Stress, Psychological
PubMed: 29314432
DOI: 10.1002/pon.4632 -
BMC Health Services Research Nov 2022Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine;...
BACKGROUND
Burnout is common among physicians and has detrimental effects on patient care and physician health. Recent editorials call attention to perfectionism in medicine; however, no studies to date have examined the effect of perfectionism on burnout in physicians practicing in the United States. This study examined associations among demographics, perfectionism and personality traits, and burnout among practicing physicians.
METHODS
This cross-sectional study included general pediatric and pediatric sub-specialist physicians. Out of the 152 physicians contacted, 69 enrolled (Mean = 44.16 ± 9.98; 61% female). Emotional exhaustion, depersonalization, and personal accomplishment burnout were assessed via the Maslach Burnout Inventory. Validated instruments were used to measure personality and perfectionism. Data were analyzed using linear regression models.
RESULTS
Across physicians assessed, 42% reported either high emotional exhaustion burnout or depersonalization burnout. High self-critical perfectionism uniquely predicted both high emotional exhaustion burnout (B = 0.55, 95%CI 0.25-0.85) and depersonalization burnout (B = 0.18, 95%CI 0.05-0.31). Low conscientiousness (B = -6.12; 95%CI, -10.95- -1.28) predicted higher emotional exhaustion burnout and low agreeableness (B = -3.20, 95%CI -5.93- -0.46) predicted higher depersonalization burnout.
CONCLUSIONS
Perfectionism is understudied among physicians and the current findings suggest that addressing system and individual-level factors that encourage perfectionism is warranted and may reduce risk for physician burnout.
Topics: Female; Humans; Child; Adult; Middle Aged; Male; Perfectionism; Cross-Sectional Studies; Burnout, Psychological; Physicians; Medicine
PubMed: 36443726
DOI: 10.1186/s12913-022-08785-7 -
Annals of Clinical and Translational... Sep 2019Depersonalization refers to the sensation of being detached from one's body, often associated with feelings of loss of control over one's own body, actions, or thoughts....
OBJECTIVE
Depersonalization refers to the sensation of being detached from one's body, often associated with feelings of loss of control over one's own body, actions, or thoughts. Derealization refers to the altered perception of one's surroundings that is experienced as unreal. Although usually reported by psychiatric patients suffering from depression or anxiety, single case reports and small case series have described depersonalization- and derealization-like symptoms in the context of epilepsy.
METHODS
We investigated the brain mechanisms of ictal depersonalization- and derealization like symptoms by analyzing clinical and neuropsychological data as well as the epileptogenic zone based on a multimodal approach in a group of patients reporting depersonalization- (n = 9) and derealization-like symptoms (n = 7), from a single presurgical epilepsy center with focal epilepsy. We compared them with a group of control patients with experiential phenomena due to temporal lobe epilepsy (n = 28).
RESULTS
We show that all patients with ictal depersonalization-like symptoms report altered self-identification with their body and mostly suffer from frontal lobe epilepsy with the epileptogenic zone in the dorsal premotor cortex, while patients with derealization-like symptoms suffer from temporal lobe epilepsy. This finding is supported by post-ictal neuropsychological deficits, showing that depersonalization-like symptoms were significantly more often associated with frontal lobe dysfunction as compared to the control patients and patients with derealization-like symptoms.
CONCLUSION
We argue that depersonalization of epileptic origin constitutes a distinct disorder due to frontal lobe epilepsy. We discuss these findings with respect to earlier accounts of depersonalization and the recent concept of bodily self-consciousness.
Topics: Adult; Brain; Brain Mapping; Depersonalization; Electroencephalography; Epilepsy; Female; Humans; Magnetic Resonance Imaging; Male; Neuropsychological Tests; Retrospective Studies
PubMed: 31437864
DOI: 10.1002/acn3.50870 -
Frontiers in Human Neuroscience 2022Depersonalization (DP) and derealization (DR) refer to states of dissociation in which one feels a sense of alienation in relation to one's self and environment,...
Depersonalization (DP) and derealization (DR) refer to states of dissociation in which one feels a sense of alienation in relation to one's self and environment, respectively. Whilst transient episodes often diminish without treatment, chronic experiences of DP and DR may last for years, with common treatments lacking a strong evidence base for their efficacy. We propose a theoretical explanation of DP and DR based on interoceptive predictive coding, and discuss how transient experiences of DP and DR may be induced in the non-clinical population using virtual reality. Further, we review the use of heartbeat evoked potentials in detecting the neural correlates of DP and DR allowing for an objective measure of these experiences in the non-clinical population. Finally, we discuss how the induction and detection of transient experiences of DP and DR in the non-clinical population could shed light on how the brain constructs one's sense of self and reality.
PubMed: 35321264
DOI: 10.3389/fnhum.2022.744487 -
Frontiers in Neurology 2019The aim of this study was to investigate the relation between visual and vestibular hypersensitivity, and Depersonalization/Derealization symptoms in patients with...
The aim of this study was to investigate the relation between visual and vestibular hypersensitivity, and Depersonalization/Derealization symptoms in patients with chronic dizziness. 319 adult patients with chronic dizziness for more than 3 months (214 females and 105 males, mean age: 58 years, range: 13-90) were included in this prospective cross-sectional study. Patients underwent a complete audio-vestibular workup and 3 auto questionnaires: Hospital Anxiety and Depression (HAD), Depersonalization/Derealization Inventory (DDI), and an in-house questionnaire (Dizziness in Daily Activity, DDA) assessing 9 activities with a score ranging from 0 (no difficulty) to 10 (maximal discomfort) and 11 (avoidance) to detect patients with visual and vestibular hypersensitivity (VVH, a score > 41 corresponding to mean + 1 standard deviation). DDI scores were higher in case of VVH (6.9 ± 6.79, = 55 vs. 4.2 ± 4.81, = 256 without VVH, < 0.001, unpaired test), migraine (6.1 ± 6.40, = 110 vs. 4.0 ± 4.42, = 208no migraine, < 0.001, unpaired test), and motion sickness (6.8 ± 5.93, = 41 vs. 4.4 ± 5.11, = 277 no motion sickness, < 0.01, unpaired test). Women scored DDI higher than men (5.1 ± 5.42, = 213 vs. 3.9 ± 4.91, = 105, respectively, < 0.05, unpaired test). DDI scores were also related to depression and anxiety. DDI score was also higher during spells than during the basal state. During chronic dizziness, Depersonalization/Derealization symptoms seem to be related to anxiety and depression. Moreover, they were prominent in women, in those with visual and vestibular hypersensitivity, migraine, and motion sickness.
PubMed: 30814972
DOI: 10.3389/fneur.2019.00069 -
Anxiety, Stress, and Coping Jul 2022Depersonalization is common in anxiety disorders, but little is known about factors that influence co-occurring anxiety and depersonalization.
BACKGROUND OBJECTIVES
Depersonalization is common in anxiety disorders, but little is known about factors that influence co-occurring anxiety and depersonalization.
DESIGN
We investigated trait moderators of the relationships between state and trait anxiety and depersonalization to better understand their co-occurrence and to identify potential points of intervention.
METHODS
Adults recruited on Amazon Mechanical Turk ( = 303) completed two computer tasks designed to increase variability in state anxiety and depersonalization as well as several self-report questionnaires.
RESULTS
As hypothesized, anxiety positively predicted depersonalization at both a state level and trait level. Moreover, as hypothesized, the trait anxiety-trait depersonalization relationship was strengthened by greater anxiety sensitivity; distress intolerance; and negative interpretation bias for anxiety sensations, and for depersonalization sensations. None of these hypothesized trait moderators significantly strengthened the state anxiety-state depersonalization relationship.
CONCLUSIONS
These findings suggest that, on a trait level, anxiety and depersonalization more frequently co-occur when people catastrophically misinterpret their symptoms or have lower emotional distress tolerance.
Topics: Adult; Anxiety; Anxiety Disorders; Depersonalization; Emotions; Humans; Self Report
PubMed: 34524043
DOI: 10.1080/10615806.2021.1977797 -
Journal of Behavior Therapy and... Dec 2021Anecdotal and research evidence suggests that individuals with dissociative symptoms exhibit hyperassociativity, which might explain several key features of their...
BACKGROUND AND OBJECTIVES
Anecdotal and research evidence suggests that individuals with dissociative symptoms exhibit hyperassociativity, which might explain several key features of their condition. The aim of our study was to investigate the link between dissociative tendencies and hyperassociativity among college students.
METHODS
The study (n = 118) entailed various measures of hyperassociativity, measures of dissociative tendencies, depressive experiences, unusual sleep experiences, cognitive failures, and alexithymia.
RESULTS
We found a positive association between dissociative experiences (i.e., depersonalization) and hyperassociativity specific for associative fluency and associative flexibility tasks (including neutral and valenced material), but not for a remote association task. We also found tentative evidence for cognitive failures and alexithymia explaining the link between hyperassociativity and daytime dissociation and nighttime unusual sleep experiences.
LIMITATIONS
Limitations include the use of hyperassociation tasks limited to verbal associations vs. imagistic associations, the lack of a measure of trauma history, and a sample limited to college students.
CONCLUSION
Our study reports a link between depersonalization and hyperassociativity on tasks that allow for free associations across different semantic domains, potentially explained by alexithymia and cognitive failures. This finding may, with replication, open the pathway to applied intervention studies.
Topics: Affective Symptoms; Dissociative Disorders; Humans; Sleep; Students
PubMed: 34091386
DOI: 10.1016/j.jbtep.2021.101665 -
Frontiers in Neurology 2020
PubMed: 32153485
DOI: 10.3389/fneur.2020.00022 -
Frontiers in Psychology 2020Disruptions in the ordinary sense of selfhood underpin both pathological and "enlightened" states of consciousness. People suffering from depersonalization can...
Disruptions in the ordinary sense of selfhood underpin both pathological and "enlightened" states of consciousness. People suffering from depersonalization can experience the loss of a sense of self as devastating, often accompanied by intense feelings of alienation, fear, and hopelessness. However, for meditative contemplatives from various traditions, "selfless" experiences are highly sought after, being associated with enduring peace and joy. Little is understood about how these contrasting dysphoric and euphoric experiences should be conceptualized. In this paper, we propose a unified account of these selfless experiences within the active inference framework. Building on our recent active inference research, we propose an account of the experiences of selfhood as emerging from a temporally deep generative model. We go on to develop a view of the self as playing a central role in structuring ordinary experience by "tuning" agents to the counterfactually rich possibilities for action. Finally, we explore how depersonalization may result from an inferred loss of allostatic control and contrast this phenomenology with selfless experiences reported by meditation practitioners. We will show how, by beginning with a conception of self-modeling within an active inference framework, we have available to us a new way of conceptualizing the striking experiential similarities and important differences between these selfless experiences within a unifying theoretical framework. We will explore the implications for understanding and treating dissociative disorders, as well as elucidate both the therapeutic potential, and possible dangers, of meditation.
PubMed: 33250804
DOI: 10.3389/fpsyg.2020.539726 -
AIMS Neuroscience 2021The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a... (Review)
Review
Targeting temporal parietal junction for assessing and treating disembodiment phenomena: a systematic review of TMS effect on depersonalization and derealization disorders (DPD) and body illusions.
The temporal-parietal junction (TPJ) is a key structure for the embodiment, term referred to as the sense of being localized within one's physical body and is a fundamental aspect of the self. On the contrary, the sense of disembodiment, an alteration of one's sense of self or the sense of being localized out of one's physical body, is a prominent feature in specific dissociative disorders, namely depersonalization/derealization disorders (DPD). The aims of the study were to provide: 1) a qualitative synthesis of the effect of Transcranial Magnetic Stimulation (TMS), taking into account its use for therapeutic and experimental purposes; 2) a better understanding on whether the use of TMS could support the treatment of DPD and other clinical conditions in which depersonalization and derealization are displayed. To identify suitable publications, an online search of the PubMed, Cochrane Library, Web of science and Scopus databases was performed using relevant search terms. In addition, an in-depth search was performed by screening review articles and the references section of each included articles. Our search yielded a total of 108 records through multiple databases searching and one additional record was identified through other sources. After duplicates removal, title and abstract reading, we retained 16 records for the assessment of eligibility. According to our inclusion criteria, we retained 8 studies. The selected studies showed that TMS targeting the TPJ is a promising technique for treating disembodiment phenomena DPD and for inducing reversible disembodiment states in healthy subjects. These data represent the first step towards a greater understanding of possible treatments to be used in disembodiment disorders. The use of TMS over the TPJ appears to be promising for treating disembodiment phenomena.
PubMed: 33709023
DOI: 10.3934/Neuroscience.2021009