A five-sample confirmatory factor analytic study of burnout-depression overlap

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 factor than with each other, even with fatigue‐related items removed from the PHQ‐9. Second‐order factor analyses indicated that the latent Depression factor and the latent factors pertaining to burnout’s components were reflective of the same overarching factor. Conclusions: This study suggests that the burnout-depression distinction is artificial

The toll of stalking: the relationship between features of stalking and psychopathology of victims.

Information on the psychological consequences of stalking on victims is scarce. The present study aimed to investigate whether stalking victims have a heightened prevalence of psychopathology and the extent to which symptom levels are associated with stalking features. Stalking victims (N = 241) completed the General Health Questionnaire and provided information on specific features of their stalking experiences. High levels of psychopathology were found among stalking victims. Symptom levels were comparable with those of psychiatric outpatients. The frequency, pervasiveness, duration, and cessation of stalking were associated with symptom levels but explained only 9% of the variance of the level of distress. It is concluded that stalking victims generally have many symptoms of psychopathology. The symptoms are largely independent of features of their stalking experience. These findings indicate that better therapy outcomes can be expected from therapies focusing on boosting general coping skills and on decreasing general vulnerability than from therapies focusing on specifically dealing with the stalking situation

The Impact of Major Events on the Lives of Family Caregivers of Children with Disabilities

Copyright 1996 Families International, Inc.The authors examine the family caregiving experience among families with children with severe emotional disabilities from a perspective that recognizes the importance of the family's views and feelings. This viewpoint anticipates the occurrence of both positive and negative experiences and seeks to illuminate the caregiving process from the perspective of outcomes achieved. Family caregivers of 164 children with serious emotional disorders were asked to identify major pleasant and stressful events that had occurred in the past 12 months. The most frequently described pleasant events related to children's behavior, school activities, and interactions with professionals and friends. Frequently described problem areas included children's behavior, professionals/services, and difficulty with school. The impact of these pleasant and stressful events was examined with respect to caregivers' perceived well-being: (I) overall stress, (2) the ability to fulfill responsibilities, and (3) pleasure experienced in various life domains. Implications of the study findings for supporting family caregivers in their roles are discussed

Associations between socioeconomic status and psychological therapy outcomes: A systematic review and meta-analysis

Background: Socioeconomic deprivation is associated with higher prevalence of mental health problems; however, the influence of socioeconomic status (SES) on psychological therapy outcomes is as yet unclear. Aim: To review published evidence on the association between indicators of SES (income, education, employment, neighbourhood deprivation, social position) and the outcomes of psychological interventions for depression and anxiety. Methods: Systematic review and meta-analysis of outcomes research studies published in the last 10 years. Results: Seventeen studies including 165,574 patients measured at least one indicator of SES and its relationship with psychological therapy outcomes. Twelve of these studies found significant relationships between SES measures and mental health outcomes. Six studies focusing on employment status offered sufficient quantitative information to conduct meta-analysis. The overall effect of employment was not significant (-0.66, C.I. -1.33, 0.02). A sensitivity analysis (k=5) showed a small effect (-0.22, C.I. -0.36, -0.09) of employment on treatment outcomes. Conclusions: There is some evidence to indicate that socioeconomic deprivation is associated with poorer treatment outcomes, although limitations of the available data warrant treating this as a preliminary conclusion

Psychosocial correlates with depressive symptoms six years after a first episode of psychosis as compared with findings from a general population sample

BACKGROUND: Depression is frequently occurring during and after psychosis. The aim of this study was to analyze if the psychosocial characteristics associated with depression/depressive symptoms in the late phase of a first episode psychosis (FEP) population were different compared to persons from the general population. METHODS: A questionnaire was sent out to all individuals six years after their FEP and to a general population sample. Depressive symptoms were recorded using a self-rating scale, the Major Depression Inventory. RESULTS: Formerly FEP persons had a higher representation of depressive symptoms/depression, unemployment, financial problems and insufficient social network. Depressive symptoms/depression were found to be associated with psychosocial problems. An age and gender effect was found in the general population, but not in the FEP sample. When the psychosocial characteristics were taken into account there were no association between having had FEP and depressive symptoms. CONCLUSIONS: The association between having been a FEP patient and depressive symptoms/depression disappeared when negative social aspects were taken into account

The Four-Dimensional Symptom Questionnaire (4DSQ): a validation study of a multidimensional self-report questionnaire to assess distress, depression, anxiety and somatization

BACKGROUND: The Four-Dimensional Symptom Questionnaire (4DSQ) is a self-report questionnaire that has been developed in primary care to distinguish non-specific general distress from depression, anxiety and somatization. The purpose of this paper is to evaluate its criterion and construct validity. METHODS: Data from 10 different primary care studies have been used. Criterion validity was assessed by comparing the 4DSQ scores with clinical diagnoses, the GPs' diagnosis of any psychosocial problem for Distress, standardised psychiatric diagnoses for Depression and Anxiety, and GPs' suspicion of somatization for Somatization. ROC analyses and logistic regression analyses were used to examine the associations. Construct validity was evaluated by investigating the inter-correlations between the scales, the factorial structure, the associations with other symptom questionnaires, and the associations with stress, personality and social functioning. The factorial structure of the 4DSQ was assessed through confirmatory factor analysis (CFA). The associations with other questionnaires were assessed with Pearson correlations and regression analyses. RESULTS: Regarding criterion validity, the Distress scale was associated with any psychosocial diagnosis (area under the ROC curve [AUC] 0.79), the Depression scale was associated with major depression (AUC = 0.83), the Anxiety scale was associated with anxiety disorder (AUC = 0.66), and the Somatization scale was associated with the GPs' suspicion of somatization (AUC = 0.65). Regarding the construct validity, the 4DSQ scales appeared to have considerable inter-correlations (r = 0.35-0.71). However, 30–40% of the variance of each scale was unique for that scale. CFA confirmed the 4-factor structure with a comparative fit index (CFI) of 0.92. The 4DSQ scales correlated with most other questionnaires measuring corresponding constructs. However, the 4DSQ Distress scale appeared to correlate with some other depression scales more than the 4DSQ Depression scale. Measures of stress (i.e. life events, psychosocial problems, and work stress) were mainly associated with Distress, while Distress, in turn, was mainly associated with psychosocial dysfunctioning, including sick leave. CONCLUSION: The 4DSQ seems to be a valid self-report questionnaire to measure distress, depression, anxiety and somatization in primary care patients. The 4DSQ Distress scale appears to measure the most general, most common, expression of psychological problems

Will the Public's Health Fall Victim to the Home Foreclosure Epidemic?

Gary Bennett and colleagues discuss the ways in which the dramatic rise in home foreclosures, particularly in the US, may have health consequences