Emotional exhaustion and cognitive performance in apparently healthy teachers: a longitudinal multi-source study

Attention Deficits in Healthcare Workers with Non-Clinical Burnout: An Exploratory Investigation

Burnout syndrome is characterized by exhaustion, cynicism, and reduced effectiveness. Workers with high burnout scores who continue their professional activities are identified as experiencing non-clinical burnout (NCB), which includes early stages where burnout symptoms (BNS) are present but not yet severe enough to necessitate work leave. This study aimed to investigate the impact of BNS on attention performance among healthcare workers (HCWs) at a COVID-19 reference hospital during the pandemic. The Maslach Burnout Inventory (MBI) was applied to assess the three burnout dimensions. The Continuous Visual Attention Test (CVAT) evaluated four different attention subdomains. Participants were divided into two groups based on their scores on the MBI: controls and NCB. Thirteen controls were matched with 13 NCB subjects based on age, sex, and HCW category. This sample (n = 26, 65% male) consisted of 11 physicians and 15 nursing professionals with a mean age of 35.3 years (standard deviation = 5.47). NCB subjects had higher impulsivity than controls. There were not any significant group differences in the other attention subdomains. We found significant correlations between impulsivity and all burnout dimensions: higher absolute scores in BNS are associated with higher impulsivity. We concluded that NCB leads to executive attention deficits.

Mental health adverse events with cannabis use diagnosed in the Emergency Department: what are we finding now and are our findings accurate?

We have previously reviewed the types and numbers of cannabis-associated adverse events that have mental health presentations that are encountered in the Emergency Department. A particular challenge in examining these events is disentangling cannabis use adverse events from adverse events associated with use of multiple recreational substances. Since that review was published, cannabis legalization for recreational use has greatly expanded world-wide and with these changes in the legal climate has come clearer information around the frequency of adverse events seen in the Emergency Department. However, as we examined the current state of the literature, we also examined some of research designs and the biases that may be impacting the validity of the data in this field. The biases both of clinicians and researchers as well as research approaches to studying these events may be impacting our ability to assess the interaction between cannabis and mental health. For example, many of the studies performed examining cannabis-related admissions to the Emergency Department were administrative studies that relied on front line clinicians to identify and attribute that cannabis use was associated with any particular admission. This narrative review provides an overview on what we currently know about mental health adverse events in the Emergency Department with a focus on the mental health impacts both for those with and without a history of mental illness. The evidence that cannabis use can adversely impact genders and sexes differently is also discussed. This review outlines what the most common adverse events related to mental health with cannabis use are; as well as noting the most concerning but much rarer events that have been reported. Additionally, this review suggests a framework for critical evaluation of this field of study going forward.

Study related factors associated with study engagement and student burnout among German university students

Introduction

Student burnout has become a health concern in higher education systems. Its prevalence rates are high due to specific demands in this life situation. It leads not only to increased academic dropout rates but is also associated with negative health outcomes both physically and mentally. Its counterpart is study engagement, which is a positive, fulfilling, study-related attitude characterized by energy, dedication, and absorption. There has not been a systematical approach covering the demands directly posed by the academic environment itself. Additionally, academic subject fields apart from medicine and nursing sciences have been mostly neglected in regards to this research field. The aim of the study is therefore to identify contributing factors for both burnout and engagement within the academic environment in a sample of different subject fields at a German university.

Methods

In a cross-sectional study, a sample of 3,451 students of all academic subjects at a technical university in Germany has been analyzed using an online survey. Sociodemographic data, study engagement, student burnout, study satisfaction, academic workload, number of semesters and occupational liabilities have been analyzed. Binary logistic regression was used to determine the associations of burnout symptoms and study engagement.

Results

Almost a third of the students showed frequent burnout symptoms, while 42.5% showed a high degree of study engagement with no differences in gender. Age was identified as a risk factor for frequent signs of cynicism (OR = 1.073). Study satisfaction (OR between 0.459 and 0.702), semester progression (OR = 0.959) and working moderately (OR between 0.605 and 0.637) was associated with fewer symptoms in different burnout-dimensions. Study satisfaction is positively associated with study engagement (OR = 2.676). Academic workload is positively related to both burnout (OR between 1.014 and 1.021) and study engagement (OR = 1.014).

Discussion

A substantial number of students show frequent symptoms of burnout and the majority is not highly engaged. The included factors contribute to the model to various degrees and show that university-bound factors play a major role. Fostering a supportive environment is key for study engagement, health and well-being. The inclusion of further, individual factors should be a future concern in order to find and promote strategies for a healthy education system.

Occupational Burnout Is Linked with Inefficient Executive Functioning, Elevated Average Heart Rate, and Decreased Physical Activity in Daily Life - Initial Evidence from Teaching Professionals

Burnout is becoming a global pandemic jeopardizing brain health, with a huge impact on quality of life, available workforce, and the economy. Knowledge of the impact of burnout on cognition, physiology, and physical activity (PA) in daily life allows for an improved understanding of the health consequences and everyday ramifications of burnout. Twenty-eight volunteers participated in a three-day recording of daily physiology and PA, including heart rate (HR) and daily steps, with a wearable device. They filled in questionnaires screening for burnout (BBI-15), depression (BDI), and executive functions (EFs) in daily life (BRIEF-A). The subjects with burnout had more challenges in EFs, higher average HRs and lower numbers of steps in daily life than those without it. The BBI-15 scores correlated positively with the BDI scores and BRIEF-A indices and negatively with the awake HR variability (HRV) and daily steps. The metacognition index correlated negatively with the HRV. In conclusion, burnout is linked with compromised EFs along with alterations in cardiac physiology and PA in daily life. Such alterations may be easily detected with wearable devices, opening possibilities for novel biomarkers of burnout and other neuropsychiatric disorders. We suggest that physical activity and heart and brain health are intimately intertwined and that burnout interacts with each of them bidirectionally.

Determinants of Burnout among Teachers: A Systematic Review of Longitudinal Studies

We aimed to review the determinants of burnout onset in teachers. The study was conducted according to the PROSPERO protocol CRD42018105901, with a focus on teachers. We performed a literature search from 1990 to 2021 in three databases: MEDLINE, PsycINFO, and Embase. We included longitudinal studies assessing burnout as a dependent variable, with a sample of at least 50 teachers. We summarized studies by the types of determinant and used the MEVORECH tool for a risk of bias assessment (RBA). The quantitative synthesis focused on emotional exhaustion. We standardized the reported regression coefficients and their standard errors and plotted them using R software to distinguish between detrimental and protective determinants. A qualitative analysis of the included studies (n = 33) identified 61 burnout determinants. The RBA showed that most studies had external and internal validity issues. Most studies implemented two waves (W) of data collection with 6–12 months between W1 and W2. Four types of determinants were summarized quantitatively, namely support, conflict, organizational context, and individual characteristics, based on six studies. This systematic review identified detrimental determinants of teacher exhaustion, including job satisfaction, work climate or pressure, teacher self-efficacy, neuroticism, perceived collective exhaustion, and classroom disruption. We recommend that authors consider using harmonized methods and protocols such as those developed in OMEGA-NET and other research consortia.

Cognitive functioning in non-clinical burnout: Using cognitive tasks to disentangle the relationship in a three-wave longitudinal study

Burnout is often characterized by cognitive deficits and it has been associated with depression and anxiety. However, it is not clear whether cognitive impairment is a burnout consequence or employees with poor cognitive skills are more prone in developing burnout. Moreover, the exact nature of the association between burnout and depression, and burnout and anxiety is still unknown. Depression and anxiety are also related to cognitive impairments but their prospective associations are not fully understood. The aim of the present three-wave longitudinal study was to investigate the causality between cognitive functioning, burnout, depression, and anxiety among non-clinical burnout employees. The cause-effect associations of burnout with depression and anxiety were also explored. Perceived family support as a protective factor against cognitive decline, burnout, depression and anxiety was examined as well. A wide range of cognitive tasks tapping different cognitive domains were administered to employees of the general working population. Burnout, depression, anxiety, and perceived family support were assessed with self-reported questionnaires. Present results suggest that visuospatial functioning deficits are a burnout consequence and they indicate the role of automatic processing skills and executive functions in burnout onset. Additionally, current findings support that burnout is differentiated from depression and anxiety but it is reciprocally associated with the two psychological phenomena. Lastly, current results support the inclusion of perceived family support as an intervention to help individuals who suffer from mental health and cognitive difficulties.

Emotional Labor and Burnout among Teachers: A Systematic Review

A significant amount of emotional labor takes place during teaching. Teaching is a multitasking profession that consists of both cognitive and emotional components, with teachers engaging in emotional labor on a daily basis as an instrumental part of achieving teaching goals and positive learning outcomes. The purpose of the present review was to explore the relationship between emotional labor and burnout in school settings. The review focused specifically on teachers from elementary and high schools, between January 2006 and August 2021, and 21 studies fit the inclusion criteria. Overall, the review of the literature supports the significant associations between burnout and emotional labor with the majority of results pointing to the consistent relationship between surface acting and burnout. However, the results regarding the association of deep acting and naturally felt emotions with burnout were mixed. There is considerable scope for improvement in our study of emotional labor in terms of the study designs we employ, the variables we study and our appreciation of the historical and cultural factors that moderate and mediate the relationship between emotional labor and burnout.

Proactive Personality as a Predictor of Career Adaptability and Career Growth Potential: A View From Conservation of Resources Theory

In the present study, we offered a new account for the development of career adaptability and the realization of career growth potential based on conservation of resources (COR) theory. Using data collected from 903 university students in China, we examined how and when proactive personality influences students' career adaptability and career growth potential by introducing emotional exhaustion as a mediator as well as friend support and teacher individualized consideration as boundary conditions. Specifically, the results confirmed a positive effect of proactive personality on career adaptability, with this relationship mediated by emotional exhaustion. In addition, results suggested a positive effect of proactive personality on career growth potential, with this relationship mediated by emotional exhaustion and career adaptability. Moreover, results showed that in-school social support (i.e., friend support and teacher individualized consideration) served as moderators in the relationship between proactive personality and emotional exhaustion, such that the negative effect of proactive personality on emotional exhaustion was strengthened when students received high levels of social support. Theoretical implications of career adaptability research and COR theory and practical implications for promoting adaptability resources and career growth in university are provided.

Burnout and Cognitive Performance

The aim of this study was to investigate the relationship between burnout and cognitive functioning. The associations of depression, anxiety and family support with burnout and cognitive functioning were also examined both independently and as potential moderators of the burnout–cognitive functioning relationship. Seven different cognitive tasks were administered to employees of the general working population and five cognitive domains were assessed; i.e., executive functions, working memory, memory (episodic, visuospatial, prospective), attention/speed of processing and visuospatial abilities. Burnout, depression, anxiety and family support were assessed with the Maslach Burnout Inventory-General Survey, the Hospital Anxiety and Depression Scale and the Family Support Scale respectively. In congruence with the first and fourth (partially) Hypotheses, burnout and perceived family support are significantly associated with some aspects of cognitive functioning. Moreover, in line with the third Hypothesis, perceived family support is inversely related to burnout. However, in contrast to the second and fourth Hypotheses, depression, anxiety and perceived family support do not moderate the burnout–cognitive functioning relationship. Additional results reveal positive associations between burnout depression and anxiety. Overall findings suggest that cognitive deficits, depression and anxiety appear to be common in burnout while they underpin the role of perceived family support in both mental health and cognitive functioning. Implications for practice are discussed.

Self-reported cognitive difficulties and cognitive functioning in relation to emotional exhaustion: Evidence from two studies

Individuals with burnout often report having difficulties with concentration and memory in everyday life. However, empirical evidence on cognitive decline using performance-based measures is limited and often obtained on small clinical samples. The aim of the present two studies was to investigate cognitive correlates of emotional exhaustion on otherwise healthy populations at different life stages with varying degrees of burnout. A total of 201 graduate and undergraduate students participated in Study 1, and a heterogeneous sample (N = 203) of working individuals took part in Study 2. Cognitive performance was assessed by self-reported cognitive difficulties and three performance-based cognitive tests of sustained attention, inhibition of irrelevant information, and inhibition of prepotent responses. Controlling for gender, age, and depression symptoms, multiple regression analyses in Study 1 indicated a positive relationship between emotional exhaustion and self-reported cognitive difficulties but no correlation with the performance-based cognitive measures. A similar pattern of results emerged in Study 2. However, we found tentative evidence for cognitive impairment on the sustained attention measure. The results of these two studies partially support previous findings and extend the literature on cognitive aspects of burnout.

Brain condition may mediate the association between training and work engagement

Over the past two decades, the number of studies on work engagement has increased rapidly. Work engagement refers to a positive, affective-motivational state of high energy combined with high levels of dedication and a strong focus on work, leading to various work-related outcomes, including higher work performance. Several studies have indicated that training or coaching may increase work engagement, but other studies have shown contradicting results. These inconsistencies may be due to the indirectness between training/coaching and work engagement. Therefore, we investigated the relationship between training and brain structure as well as between brain structure and work engagement in cognitively normal participants. Brain structure was assessed using neuroimaging-derived measures, including the gray-matter brain healthcare quotient (GM-BHQ) and the fractional-anisotropy brain healthcare quotient (FA-BHQ), which are approved as the international standard (H.861.1) by ITU-T. Work engagement was assessed using the Utrecht Work Engagement Scale. To validate and enrich the analysis, we employed another two representative questionnaires, which are known to be close to but different from work engagement: The Social interaction Anxiety Scale and the Maslach Burnout Inventory-General Survey to gauge the levels of human relation ineffectiveness and burnout. The latter scale is subdivided into three variables including "Exhaustion," "Cynicism," and "Professional Efficacy." The results of the present study indicate that training is associated with an increase of FA-BHQ scores, and that an increase of the FA-BHQ scores is associated with an increase in Work Engagement and a decrease in Cynicism. On the other hand, the training with coaching was associated with a decrease in Interaction Anxiety. However, no correlation was observed for training with Work Engagement or the subscales of Burnout. Likewise, no correlation was observed for FA-BHQ with Exhaustion, Professional Efficacy, and Interaction Anxiety. The results of the current research provide the possibility to use brain information to evaluate training effectiveness from the viewpoint of neuroscience.

Influence of Emotional Intelligence and Burnout Syndrome on Teachers Well-Being: A Systematic Review

Background: Emotional Intelligence (EI) has become a key factor in educational environments, which facilitates and contributes to the mental well-being of teachers, and therefore, favours the teaching and learning process. However, education professionals are under constant stress. This stress is caused by a large number of social interactions, the new skills to be acquired, and the workload, developing in many situations the Burnout Syndrome (BS). Methods and Results: The study presents a systematic review, paying special attention to the scientific literature that combines IE and BS in the work performance of teachers as fundamental factors in the work carried out by educators at different educational stages, as well as the influence they have on the quality of the teaching-learning process. The Web of Science (WOS) has been used as a database, obtaining a total of 36 scientific articles intimately related to the topic of the work, published between 2005 and 2017. Many studies show that teachers are increasingly experiencing high feelings of stress, which affect the quality of education, as well as the relevance of developing emotional intelligence, which helps prevent these negative feelings from appearing. Conclusions: EI is a capacity that should be developed in teachers, since it gives the individual the ability to regulate his emotions, making him stronger in terms of decision-making in daily situations in the teaching environments, as well as being a key factor for the success of education. Through the positive reinforcement of EI, levels of stress and anxiety that worry society so much are reduced, since this avoids the feeling of frustration before their professional realisation, which leads to improved teaching practice, health and mental well-being of teachers.

Reduced self-regulation mirrors the distorting effects of burnout symptomatology on task difficulty perception during an inhibition task

Burnout, a pathological consequence of chronic work stress, shows an increasing incidence rate in industrialized countries. Previous findings indicate that burnout may be linked to a detachment of the negative association between subjectively appraised task demand and cognitive performance, which is typically seen in healthy individuals. The present study sought to confirm this relationship and to investigate whether this dissociation is mirrored in a biological marker of self-regulation, i.e., resting vagally mediated heart rate variability (HRV). A heterogeneous sample (N = 65) of working adults (M age = 43.3, SD = 10; 23.1 % male) with varying degrees of burnout symptomatology completed three cognitive tasks (2-back, number-letter, and go/nogo) to assess different domains of executive functioning (updating, set-shifting, and inhibition), and respective demand ratings. Additionally, vagally mediated HRV at rest, operationalized as the root-mean square differences of successive R-R intervals (RMSSD), was recorded. Burnout symptomatology moderated the association between subjective task difficulty and performance parameters of the go/nogo task, such that higher burnout scores were associated with reductions in the naturally occurring negative association between self-rated task demand and response inhibition. Intriguingly, this pattern was mirrored when replacing burnout with HRV. These findings suggest that burnout symptomatology, and individual differences in self-regulatory capacities (indexed by resting HRV), may alter one's capacity for accurate task evaluation, a mechanism which could potentially underlie the dissociation between self-rated cognitive function and actual performance among individuals experiencing burnout.

Cognitive Impairments in Occupational Burnout - Error Processing and Its Indices of Reactive and Proactive Control

The presented study refers to cognitive aspects of burnout as the effects of long-term work-related stress. The purpose of the study was to investigate electrophysiological correlates of burnout to explain the mechanisms of the core burnout symptoms: exhaustion and depersonalization/cynicism. The analyzed error-related electrophysiological markers shed light on impaired cognitive mechanisms and the specific changes in information-processing in burnout. In the EEG study design (N = 80), two components of error-related potential (ERP), error-related negativity (ERN), and error positivity (Pe), were analyzed. In the non-clinical burnout group (N = 40), a significant increase in ERN amplitude and a decrease in Pe amplitude were observed compared to controls (N = 40). Enhanced error detection, indexed by increased ERN amplitude, and diminished response monitoring, indexed by decreased Pe amplitude, reveal emerging cognitive problems in the non-clinical burnout group. Cognitive impairments in burnout subjects relate to both reactive and unconscious (ERN) and proactive and conscious (Pe) aspects of error processing. The results indicate a stronger ‘reactive control mode’ that can deplete resources for proactive control and the ability to actively maintain goals. The analysis refers to error processing and specific task demands, thus should not be extended to cognitive processes in general. The characteristics of ERP patterns in burnout resemble psychophysiological indexes of anxiety (increased ERN) and depressive symptoms (decreased Pe), showing to some extent an overlapping effect of burnout and related symptoms and disorders. The results support the scarce existing data on the psychobiological nature of burnout, while extending and specifying its cognitive characteristics.

Primary school teachers in China: associations of organizational justice and effort-reward imbalance with burnout and intentions to leave the profession in a cross-sectional sample

OBJECTIVE

We examined associations of organizational justice (OJ) and effort-reward imbalance (ERI) with burnout and intentions to leave the teaching profession (ILTP) among primary school teachers in China.

METHODS

Six primary schools located in Wuhan, China, were randomly selected from three different socioeconomic areas in 2010. In total, these schools employed 533 teachers, and 436 of these (82 %) participated in a cross-sectional survey. OJ and ERI were assessed by 13-item and 10-item questionnaires, respectively. Burnout was measured using the emotional exhaustion subscale of the Chinese Maslach Burnout Inventory. ILTP were operationalized based on the frequency of thoughts about turnover during the past year. Logistic regression-based odds ratios (ORs) with 95 % confidence intervals (CIs) were estimated separately for OJ and ERI. In a second step, these work stress scales were entered into the same regression model.

RESULTS

Separate regression models suggested moderate to strong associations of OJ and ERI with burnout and ILTP. After simultaneous adjustment, the overall OJ score remained associated with burnout and ILTP, but ERI appeared to be the stronger and more consistent determinant of both outcomes. For instance, an increase of 1 standard deviation of the ERI score was associated with an OR of 2.60 (95 % CI 1.97-3.43) for burnout and with an OR of 2.26 (95 % CI 1.66-3.08) for ILTP.

CONCLUSIONS

Organizational justice and in particular ERI appeared to be determinants of burnout and ILTP among primary school teachers in China.