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van de Leur JC, Jovicic F, Åhslund A, McCracken LM, Buhrman M. Psychological Treatment of Exhaustion Due to Persistent Non-Traumatic Stress: A Scoping Review. Int J Behav Med 2024; 31:175-191. [PMID: 37308772 PMCID: PMC11001660 DOI: 10.1007/s12529-023-10185-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/14/2023] [Indexed: 06/14/2023]
Abstract
BACKGROUND Exhaustion due to persistent non-traumatic stress (ENTS) is a significant health problem with substantial personal, social, and economic impact. While there are increasing studies of ENTS, there is no international agreement on how it should be diagnosed and treated. This scoping review aimed to map definitions, diagnoses, treatments, outcome measures, and outcomes in psychological treatment studies of ENTS. A further aim was to assess the quality of the treatments and map what change processes are described within ENTS interventions. METHODS A PRISMA-guided scoping review of psychological treatment studies delivered in a clinical setting for ENTS was conducted using the databases of PubMed, PsycINFO, and CINAHL. RESULTS Of the 60 studies included, the majority (87%) stemmed from Europe. The most recurrent term for ENTS was burnout, and the diagnosis most often utilized was exhaustion disorder. Several treatments were reported, the most frequent being cognitive behavioral therapy (CBT) (68%). Statistically significant outcomes relevant to ENTS were reported in 65% (n = 39) of the studies, with effect sizes between 0.13 and 1.80. In addition, 28% of the treatments were rated as high quality. The most frequent change processes described were dysfunctional sleep, avoidance, behavioral activation, irrational thoughts and beliefs, worry, perceived competence/positive management, psychological flexibility, and recuperation. CONCLUSIONS While several treatments based on CBT show promising results for ENTS, there do not seem to be any uniformly established methods, theoretical models, or change processes. Instead of adopting a monocausal, syndromal, and potentially bio-reductionist perspective on ENTS, a process-based approach to treatment is encouraged.
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Affiliation(s)
- Jakob Clason van de Leur
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden.
- PBM Globen Rehab, Arenavägen 27, 121 77, Johanneshov, Sweden.
| | - Filip Jovicic
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Andreas Åhslund
- Capio Centrum För Smärta Och Utmattning, Krukmakargatan 37A, 118 51, Stockholm, Sweden
| | - Lance M McCracken
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
| | - Monica Buhrman
- Department of Psychology, Uppsala University, Box 1225, 751 42, Uppsala, Sweden
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Deng J, Wang H, Fu T, Xu C, Zhu Q, Guo L, Zhu Y. Physical activity improves the visual-spatial working memory of individuals with mild cognitive impairment or Alzheimer's disease: a systematic review and network meta-analysis. Front Public Health 2024; 12:1365589. [PMID: 38605880 PMCID: PMC11007231 DOI: 10.3389/fpubh.2024.1365589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2024] [Accepted: 03/08/2024] [Indexed: 04/13/2024] Open
Abstract
Objective Our network meta-analysis aimed to ascertain the effect of physical activity on the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease as well as to propose tailored exercise interventions for each group. Methods Employing a frequentist approach, we performed a network meta-analysis to compare the effectiveness of different exercise interventions in improving the visual-spatial working memory of individuals with mild cognitive impairment and Alzheimer's disease. Subsequently, we explored the moderating variables influencing the effectiveness of the exercise interventions through a subgroup analysis. Results We included 34 articles involving 3,074 participants in the meta-analysis, comprised of 1,537 participants from studies on mild cognitive impairment and 1,537 participants from studies on Alzheimer's disease. The articles included exhibited an average quality score of 6.6 (score studies) and 6.75 (reaction time [RT] studies), all passing the inconsistency test (p > 0.05). In the mild cognitive impairment literature, mind-body exercise emerged as the most effective exercise intervention (SMD = 0.61, 95% CI: 0.07-1.14). In Alzheimer's disease research, aerobic exercise was identified as the optimal exercise intervention (SMD = 0.39, 95% CI: 0.06-0.71). Conclusion The results of the subgroup analysis suggest that the most effective approach to enhancing the visual-spatial working memory of individuals with mild cognitive impairment entails exercising at a frequency of three or more times per week for over 60 min each time and at a moderate intensity for more than 3 months. Suitable exercise options include mind-body exercise, multicomponent exercise, resistance exercise, and aerobic exercise. For individuals with Alzheimer's disease, we recommend moderately intense exercise twice per week for over 90 min per session and for a duration of 3 months or longer, with exercise options encompassing aerobic exercise and resistance exercise.
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Affiliation(s)
- Jie Deng
- College of Physical Education, Southwest University, Chongqing, China
| | - Hong Wang
- College of Physical Education and Health Sciences, Chongqing Normal University, Chongqing, China
| | - Tingting Fu
- College of Physical Education, Southwest University, Chongqing, China
| | - Chong Xu
- Ministry of Sports and National Defense Education, Chongqing College of Electronic Engineering, Chongqing, China
| | - Qiqi Zhu
- College of Physical Education, Southwest University, Chongqing, China
| | - Liya Guo
- College of Physical Education, Southwest University, Chongqing, China
| | - Yu Zhu
- College of Physical Education, Southwest University, Chongqing, China
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3
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Abstract
The COVID-19 pandemic outbreak-as a typical emergency event-significantly has impacted employees' psychological status and thus has negatively affected their performance. Hence, along with focusing on the mechanisms and solutions to alleviate the impact of work stress on employee performance, we also examine the relationship between work stress, mental health, and employee performance. Furthermore, we analyzed the moderating role of servant leadership in the relationship between work stress and mental health, but the result was not significant. The results contribute to providing practical guidance for enterprises to improve employee performance in the context of major emergencies.
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Affiliation(s)
- Biao Chen
- School of Business, Zhengzhou University, Zhengzhou, China
| | - Lu Wang
- School of Business, Zhengzhou University, Zhengzhou, China
| | - Biao Li
- School of Business, Zhengzhou University, Zhengzhou, China
| | - Weixing Liu
- Henan Research Platform Service Center, Zhengzhou, China
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Norström F, Järvholm LS, Eskilsson T. Healthcare utilisation among patients with stress-induced exhaustion disorder treated with a multimodal rehabilitation programme - a longitudinal observational study. BMC Psychiatry 2022; 22:642. [PMID: 36229810 PMCID: PMC9563845 DOI: 10.1186/s12888-022-04300-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Accepted: 10/10/2022] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Stress-induced exhaustion disorder is a major challenge in Swedish working life. Despite its increase in prevalence, there is still limited knowledge about the effectiveness of different rehabilitation methods. In this study, we aim to describe the healthcare utilisation for patients with stress-induced exhaustion disorder before, during and after a multi-modal rehabilitation (MMR) programme, as well as the health-related quality of life, work ability, sick leave level and psychological measures, and their possible relations. METHODS In this longitudinal observational study, 53 patients who were part of an MMR programme at the Stress Rehabilitation Clinic participated with survey data, and among them 43 also contributed with healthcare data. Data were collected from one year before start of MMR to one year after the end of it. The patients also answered a questionnaire at the start of, end of and at a one-year follow-up of the MMR, which included questions about health-related quality of life, work ability, clinical burnout, sick leave level, anxiety and depression. RESULTS There was a statistically significant increase in healthcare consumption during MMR, if including visits to the Stress Rehabilitation Clinic, while it decreased if excluding such visits, when comparing with before and after MMR. During the follow-up period there was a non-statistically significant (p=0.11), but still rather large difference (15.4 compared with 12.0 visits per patient), in healthcare consumption in comparison with the period before MMR, when excluding follow-up visits at the Stress Rehabilitation Clinic. Health-related quality of life was rated as poor before MMR (mean 0.59). There was a statistically significant improvement, but values were still below normal at the end of follow-up (mean 0.70). In addition, the level of sick leave, the work ability and signs of clinical burnout improved statistically significantly after MMR, but were not fully normalised at the end of follow-up. Individual healthcare consumption was related to residual health problems. CONCLUSIONS Patients with stress-induced exhaustion disorder have not reduced their healthcare consumption notably after MMR, and residual health problems remain for some patients. More studies are needed for a deeper understanding of the individual effectiveness of MMR, and also of its cost-effectiveness.
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Affiliation(s)
- Fredrik Norström
- Department of Epidemiology and Global Health, Umeå University, SE-901 87, Umeå, Sweden.
| | - Lisbeth Slunga Järvholm
- grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
| | - Therese Eskilsson
- grid.12650.300000 0001 1034 3451Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden ,grid.12650.300000 0001 1034 3451Department of Community Medicine and Rehabilitation, Section of Physiotherapy, Umeå University, Umeå, Sweden
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Lindsäter E, Svärdman F, Wallert J, Ivanova E, Söderholm A, Fondberg R, Nilsonne G, Cervenka S, Lekander M, Rück C. Exhaustion disorder: scoping review of research on a recently introduced stress-related diagnosis. BJPsych Open 2022; 8:e159. [PMID: 36458830 PMCID: PMC9438479 DOI: 10.1192/bjo.2022.559] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Symptoms related to chronic stress are prevalent and entail high societal costs, yet there is a lack of international consensus regarding diagnostics and treatment. A new stress-related diagnosis, exhaustion disorder, was introduced into the Swedish version of ICD-10 in 2005. Since then, use of the diagnosis has increased rapidly. AIMS To create the first comprehensive synthesis of research on exhaustion disorder to report on the current state of knowledge. Preregistration: Open Science Framework (http://www.w3.org/1999/xlink">osf.io), doi 10.17605/OSF.IO/VFDKW. METHOD A PRISMA-guided scoping review of all empirical studies of exhaustion disorder was conducted. Searches were run in the MEDLINE, PsycInfo and Web of Science databases. Data were systematically charted and thematically categorised based on primary area of investigation. RESULTS Eighty-nine included studies were sorted into six themes relating to lived experience of exhaustion disorder (n = 9), symptom presentation and course (n = 13), cognitive functioning (n = 10), biological measures (n = 24), symptom measurement scales (n = 4) and treatment (n = 29). Several studies indicated that individuals with exhaustion disorder experience a range of psychiatric and somatic symptoms beyond fatigue, but robust findings within most thematic categories were scarce. The limited number of studies, lack of replication of findings and methodological limitations (e.g. small samples and scarcity of specified primary outcomes) preclude firm conclusions about the diagnostic construct. CONCLUSIONS More research is needed to build a solid knowledge base for exhaustion disorder. International collaboration regarding the conceptualisation of chronic stress and fatigue is warranted to accelerate the growth of evidence.
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Affiliation(s)
- Elin Lindsäter
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm, Sweden; and Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Frank Svärdman
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and Stockholm Health Care Services, Stockholm, Sweden
| | - John Wallert
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and Stockholm Health Care Services, Stockholm, Sweden
| | - Ekaterina Ivanova
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and Stockholm Health Care Services, Stockholm, Sweden
| | - Anna Söderholm
- Department of Psychology, Umeå Universitet, Umeå, Sweden
| | - Robin Fondberg
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and Stockholm Health Care Services, Stockholm, Sweden
| | - Gustav Nilsonne
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and Stress Research Institute, Department of Psychology, Stockholm University, Stockholm, Sweden
| | - Simon Cervenka
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stockholm Health Care Services, Stockholm, Sweden; and Department of Medical Sciences, Psychiatry, Uppsala University, Uppsala, Sweden
| | - Mats Lekander
- Division of Psychology, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; Stress Research Institute, Department of Psychology, Stockholm University, Sweden; and Osher Center for Integrative Medicine, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Christian Rück
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden; and Stockholm Health Care Services, Stockholm, Sweden
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Nelson A, Gavelin HM, Boraxbekk CJ, Eskilsson T, Josefsson M, Slunga Järvholm L, Neely AS. Subjective cognitive complaints in patients with stress-related exhaustion disorder: a cross sectional study. BMC Psychol 2021; 9:84. [PMID: 34006315 PMCID: PMC8132387 DOI: 10.1186/s40359-021-00576-9] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 04/22/2021] [Indexed: 01/23/2023] Open
Abstract
Background Stress-related exhaustion is associated with cognitive impairment as measured by both subjective cognitive complaints (SCCs) and objective cognitive test performance. This study aimed to examine how patients diagnosed with exhaustion disorder differ from healthy control participants in regard to levels and type of SCCs, and if SCCs are associated with cognitive test performance and psychological distress. Methods We compared a group of patients with stress-related exhaustion disorder (n = 103, female = 88) with matched healthy controls (n = 58, female = 47) cross-sectionally, concerning the type and magnitude of self-reported SCCs. We furthermore explored the association between SCCs and cognitive test performance as well as with self-reported depression, anxiety and burnout levels, in the patient and the control group, respectively. Results Patients reported considerably more cognitive failures and were more likely than controls to express memory failures in situations providing few external cues and reminders in the environment. In both groups, SCCs were associated with demographic and psychological factors, and not with cognitive test performance. Conclusion Our findings underline the high burden of cognitive problems experienced by patients with exhaustion disorder, particularly in executively demanding tasks without external cognitive support. From a clinical perspective, SCCs and objective cognitive test performance may measure different aspects of cognitive functioning, and external cognitive aids could be of value in stress rehabilitation. Trial registration Participants were recruited as part of the Rehabilitation for Improved Cognition (RECO) study (ClinicalTrials.gov: NCT03073772). Date of registration: 8 March 2017 Supplementary Information The online version contains supplementary material available at 10.1186/s40359-021-00576-9.
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Affiliation(s)
- Andreas Nelson
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden. .,Department of Anaesthesiology, Central Hospital of Karlstad, Karlstad, Region Värmland, Sweden.
| | - Hanna Malmberg Gavelin
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia.,Department of Psychology, Umeå University, Umeå, Sweden
| | - Carl-Johan Boraxbekk
- Department of Radiation Sciences, Diagnostic Radiology, Umeå University, Umeå, Sweden.,Institute of Sports Medicine Copenhagen (ISMC), Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark.,Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital, Amager and Hvidovre, Denmark
| | - Therese Eskilsson
- Department of Public Health and Clinical Medicine, Section for Sustainable Health, Umeå University, Umeå, Sweden.,Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Maria Josefsson
- Centre for Demographic and Ageing Research (CEDAR), Umeå University, Umeå, Sweden.,Department of Statistics Umeå, University, Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Department of Public Health and Clinical Medicine, Section for Sustainable Health, Umeå University, Umeå, Sweden
| | - Anna Stigsdotter Neely
- Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden.,Department of Social Sciences, Technology and Arts, Luleå University of Technology, Luleå, Sweden.,Department of Health, Education and Technology, Luleå University of Technology, Luleå, Sweden
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Ornek OK, Esin MN. Effects of a work-related stress model based mental health promotion program on job stress, stress reactions and coping profiles of women workers: a control groups study. BMC Public Health 2020; 20:1658. [PMID: 33148247 PMCID: PMC7641806 DOI: 10.1186/s12889-020-09769-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2019] [Accepted: 10/26/2020] [Indexed: 02/02/2023] Open
Abstract
Background Work-related stress and its detrimental effects on human health have rapidly increased during the past several years. It causes many different stress reactions, related diseases and unhealthy behavior among workers, but especially women workers. Thus, the aim of this study was to examine the effects of the work-related stress model based Workplace Mental Health Promotion Programme on the job stress, social support, reactions, salivary immunoglobulin A and Cortisol levels, work absenteeism, job performance and coping profiles of women workers. Methods This study had a “pre-test post-test non-equivalent control groups” design and included 70 women workers (35 in each study group) selected by randomized sampling from two factories. The programme was delivered as an intervention including 12 weeks of follow-up. Reminder messages, videos, and WhatsApp texts were used at the follow-up stage. The research measurements were; the assessment form, the Brief Job Stress Questionnaire, the Brief Coping Profile Scale, salivary ELISA kits, and a self-reported check-list. Results There were no differences in sociodemographic characteristics, general health or working conditions between the Intervention and control groups(p > .05). Three months after the intervention, there was a significant decrease in job stress(p ≤ .001), physical and mental reactions’ scores(p ≤ .001) and work absenteeism(p < .05), and there was an increase in job performance(p < .05), social support(p ≤ .001) among the intervention group. The programme showed positive effects on coping profiles(p < .05). After the intervention salivary-cortisol and IgA levels showed a statistically significant decrease(p < .05). A majority of effect sizes were very large (ηp2 > .14). Conclusions Work-ProMentH was found to be effective and useful in job stress management and promotion of effective coping profiles. It enables its users to holistically assess worker stress and to plan and examine intervention programmes via a systematic approach. There is a need for more empirical studies that may support the data of the present study, but it is thought that the intervention can be maintained for the long-term. We recommend that occupational health professionals at workplaces should consider using this model-based cost-effective intervention, which seems easy and practical to apply in real-life situations. Trial registration ISRCTN registration ID: ISRCTN14333710 (2020/10/03, retrospective registration).
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Affiliation(s)
- Ozlem Koseoglu Ornek
- Occupational and Environmental Epidemiology & NetTeaching Unit, Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU, Ziemssenstr. 1, 80336, Munich, Germany. .,Department of Nursing, Faculty of Health Sciences, Istanbul Bilgi University, Dolapdere Kampus, Hacıahmet Mahallesi, Pir Hüsamettin Sokak No: 20, 34440, Beyoğlu/ Istanbul, Turkey.
| | - Melek Nihal Esin
- Department of Public Health Nursing, İstanbul University-Cerrahpasa Florence Nightingale Faculty of Nursing, İstanbul Üniversitesi Florence Nightingale Hemşirelik Fakültesi, Abide-i Hürriyet Caddesi, Şişli/İstanbul, Turkey
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Strömbäck M, Fjellman-Wiklund A, Keisu S, Sturesson M, Eskilsson T. Restoring confidence in return to work: A qualitative study of the experiences of persons with exhaustion disorder after a dialogue-based workplace intervention. PLoS One 2020; 15:e0234897. [PMID: 32735586 PMCID: PMC7394387 DOI: 10.1371/journal.pone.0234897] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 06/04/2020] [Indexed: 12/02/2022] Open
Abstract
Background Stress-induced exhaustion disorder (SED) is a primary cause for sickness absence among persons with mental health disorders in Sweden. Interventions involving the workplace, and supporting communication between the employee and the supervisor, are proposed to facilitate return to work (RTW). The aim of this study was to explore experiences of persons with SED who participated in a dialogue-based workplace intervention with a convergence dialogue meeting performed by a rehabilitation coordinator. Methods A qualitative design based on group interviews with 15 persons with SED who participated in a 24-week multimodal rehabilitation program was used. The interviews were analyzed with the methodology of grounded theory. Results The analysis resulted in a theoretical model where the core category, restoring confidence on common ground, represented a health promoting process that included three phases: emotional entrance, supportive guidance, and empowering change. The health promoting process was represented in participant experiences of personal progress and safety in RTW. Conclusions The intervention built on a health-promoting pedagogy, supported by continuous guidance from a rehabilitation coordinator and structured convergence dialogue meetings that enhanced common communication and collaboration with the supervisor and others involved in the RTW process. The intervention balanced relationships, transferred knowledge, and changed attitudes about SED among supervisors and colleagues in the workplace. The inclusion of a rehabilitation coordinator in the intervention was beneficial by enhancing RTW and bridging the gaps between healthcare, the workplace, and other organizational structures. In addition, the intervention contributed to a positive re-orientation towards successful RTW instead of an endpoint of employment. In a prolonged process, a dialogue-based workplace intervention with convergence dialogue meetings and a rehabilitation coordinator may support sustainable RTW for persons with SED.
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Affiliation(s)
- Maria Strömbäck
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Clinical Science, Psychiatry, Umeå University, Umeå, Sweden
- * E-mail:
| | | | - Sara Keisu
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Marine Sturesson
- Department of Community Medicine and Rehabilitation, Occupational therapy, Umeå University, Umeå, Sweden
| | - Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
- Department of Public Health and Clinical Medicine, Section of Sustainable Health, Umeå University, Umeå, Sweden
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Verhavert Y, De Martelaer K, Van Hoof E, Van Der Linden E, Zinzen E, Deliens T. The Association between Energy Balance-Related Behavior and Burn-Out in Adults: A Systematic Review. Nutrients 2020; 12:nu12020397. [PMID: 32024269 PMCID: PMC7071204 DOI: 10.3390/nu12020397] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Revised: 01/29/2020] [Accepted: 01/31/2020] [Indexed: 11/16/2022] Open
Abstract
Although it is believed that physical activity, sedentary, and dietary behavior (i.e., energy balance-related behavior) may decrease the risk of burn-out, the association between both is currently not well understood. Therefore, the aim of this systematic review was to synthesize studies investigating the relationship between energy balance-related behavior and burn-out risk. A systematic literature search was conducted in four databases, resulting in 25 included studies (ten experimental and 15 observational studies). Nine out of ten experimental studies showed that exercise programs were effective in reducing burn-out risk. Fourteen out of fifteen observational studies found a negative association between physical activity and burn-out risk, whereas one study did not find a relation. Two of the 15 observational studies also showed that being more sedentary was associated with a higher burn-out risk, and two other studies found that a healthier diet was related to a lower burn-out risk. No experimental studies were found for the latter two behaviors. It can be concluded that physical activity may be effective in reducing burn-out risk. The few observational studies linking sedentary and dietary behavior with burn-out risk suggest that being more sedentary and eating less healthy are each associated with higher burn-out risk. More high-quality research is needed to unravel the causal relationship between these two behaviors and burn-out risk.
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Affiliation(s)
- Yanni Verhavert
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (K.D.M.); (E.V.D.L.); (T.D.)
- Correspondence:
| | - Kristine De Martelaer
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (K.D.M.); (E.V.D.L.); (T.D.)
- Faculty of Social and Behavioral Sciences, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands
| | - Elke Van Hoof
- Department of Psychology, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium;
| | - Eline Van Der Linden
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (K.D.M.); (E.V.D.L.); (T.D.)
| | - Evert Zinzen
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (K.D.M.); (E.V.D.L.); (T.D.)
| | - Tom Deliens
- Department of Movement and Sport Sciences, Vrije Universiteit Brussel, Pleinlaan 2, 1050 Brussels, Belgium; (K.D.M.); (E.V.D.L.); (T.D.)
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Eskilsson T, Fjellman-Wiklund A, Ek Malmer E, Stigsdotter Neely A, Malmberg Gavelin H, Slunga Järvholm L, Boraxbekk CJ, Nordin M. Hopeful struggling for health: Experiences of participating in computerized cognitive training and aerobic training for persons with stress-related exhaustion disorder. Scand J Psychol 2020; 61:361-368. [PMID: 31995652 DOI: 10.1111/sjop.12623] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 12/16/2019] [Indexed: 11/28/2022]
Abstract
It is important to understand how people with exhaustion disorder (ED) perceive interventions aiming to facilitate cognitive functioning. Therefore, the overall aim of this study was to explore experiences from persons with ED after participating in a 12-week intervention of either computerized cognitive training or aerobic training. Both interventions were performed in addition to a multimodal rehabilitation programme. Thirteen participants, 11 women and 2 men, were interviewed about pros and cons with participating in the training. The interviews were analysed with Qualitative Content Analysis. The analyses resulted in the theme hopeful struggling for health and the categories support, motivation and sensations. It was hard work recovering from ED. Support from others who are in the same situation, family members, and technology and routines for the training were strongly emphasized as beneficial for recovery. Timing, i.e., matching activities to the rehabilitation programme, getting feedback and perceiving joy in the training were important for motivation. Participants in both interventions experienced positive sensations with improved memory performance, everyday life functioning and increased faith in the prospect of recovery. However, it is important to consider various aspects of support and motivation in both computerized cognitive training and aerobic training to enable participants to pursue their participation.
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Affiliation(s)
- Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden.,Department of Public Health and Clinical Medicine, Sustainable Health and Medicine, Umeå University, Umeå, Sweden
| | | | - Elin Ek Malmer
- Department of Rehabilitation Medicine, Danderyd Hospital, Stockholm, Sweden
| | - Anna Stigsdotter Neely
- Department of Psychology, Umeå University, Umeå, Sweden.,Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Hanna Malmberg Gavelin
- Department of Psychology, Umeå University, Umeå, Sweden.,Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Australia
| | - Lisbeth Slunga Järvholm
- Department of Public Health and Clinical Medicine, Sustainable Health and Medicine, Umeå University, Umeå, Sweden
| | - Carl-Johan Boraxbekk
- Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark.,Department of Radiation Sciences, Umeå University, Umeå, Sweden
| | - Maria Nordin
- Department of Psychology, Umeå University, Umeå, Sweden
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11
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Giorgi G, Lecca LI, Leon-Perez JM, Pignata S, Topa G, Mucci N. Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment-A Narrative Review. Biomed Res Int 2020; 2020:1742123. [PMID: 32083124 DOI: 10.1155/2020/1742123] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 01/07/2020] [Indexed: 12/29/2022]
Abstract
Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014-2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted.
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12
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Phillips NS, Howell CR, Lanctot JQ, Partin RE, Pui CH, Hudson MM, Robison LL, Krull KR, Ness KK. Physical fitness and neurocognitive outcomes in adult survivors of childhood acute lymphoblastic leukemia: A report from the St. Jude Lifetime cohort. Cancer 2019; 126:640-648. [PMID: 31631333 DOI: 10.1002/cncr.32510] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2019] [Revised: 06/26/2019] [Accepted: 08/02/2019] [Indexed: 11/12/2022]
Abstract
BACKGROUND Survivors of childhood acute lymphoblastic leukemia (ALL) are at increased risk for both treatment-related exercise intolerance and neurocognitive deficits. This analysis aimed to identify the association between exercise intolerance and neurocognitive impairments in ALL survivors. METHODS Cardiopulmonary exercise testing, results from a 2-hour standardized neuropsychological assessment, and self-report questionnaires were obtained for 341 adult survivors of childhood ALL and 288 controls. Multivariable modeling was used to test associations between oxygen uptake at 85% estimated heart rate (rpkVO2 ) and neuropsychological test and self-reported questionnaire domains, adjusted for sex, age at diagnosis, cranial radiation, anthracycline, and methotrexate exposure and tobacco smoking status. RESULTS Compared with controls, survivors had worse rpkVO2 and performance on verbal intelligence, focused attention, verbal fluency, working memory, dominant/nondominant motor speed, visual-motor speed, memory span, and reading and math measures (all P < .001). In adjusted models, exercise intolerance was associated with decreases in performance of verbal ability, focused attention, verbal fluency, working memory, dominant motor speed, nondominant motor speed, visual-motor speed, memory span, reading academics, and math academics in survivors. CONCLUSION This study demonstrates an association between exercise intolerance and neurocognitive outcomes. Research is needed to determine whether interventions that improve exercise tolerance impact neurocognitive function in ALL survivors.
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Affiliation(s)
- Nicholas S Phillips
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Carrie R Howell
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Jennifer Q Lanctot
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Robyn E Partin
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Ching-Hon Pui
- Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Melissa M Hudson
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Oncology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Leslie L Robison
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee.,Department of Pyschology, St. Jude Children's Research Hospital, Memphis, Tennessee
| | - Kirsten K Ness
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee
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13
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Feter N, Spanevello RM, Soares MSP, Spohr L, Pedra NS, Bona NP, Freitas MP, Gonzales NG, Ito LGMS, Stefanello FM, Rombaldi AJ. How does physical activity and different models of exercise training affect oxidative parameters and memory? Physiol Behav 2018; 201:42-52. [PMID: 30552921 DOI: 10.1016/j.physbeh.2018.12.002] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2018] [Revised: 11/20/2018] [Accepted: 12/01/2018] [Indexed: 10/27/2022]
Abstract
The present study investigated the chronic effects of different physical exercise and physical activity models on cognitive function, cholinergic activity, and oxidative stress markers in the cerebral cortex and hippocampus. Eighty 60-day old C57BL/6 mice were divided into the following five groups: Sedentary (SED), moderate-intensity continuous training (MICT), high-intensity interval training (HIIT), resistance training (RT), and physical activity (RW, for "running wheel"). Cognitive function (recognition and spatial memory), oxidative stress parameters, and acetylcholinesterase (AChE) activity in the cerebral cortex and hippocampus were evaluated. MICT mice exhibited enhanced recognition memory compared to SED mice (p = .046) and other exercised groups (HIIT: p < .001; RW: p = .003; RT: p < .001). The RT group showed better spatial memory compared to the SED (p = .004), MICT (p = .019), and RW (p = .003) groups. RW, MICT, HIIT, and RT training models reduced nitrites in the hippocampus compared to the SED group. RT led to a significant increase in both lipid peroxidation (p = .01) and reactive oxygen species (ROS) (p < .001) levels compared to the SED group in the hippocampus. MICT promoted an increase in catalase (CAT) activity (p = .002), while superoxide dismutase (SOD) activity was diminished by RT compared to MICT and HIIT (p = .008). In the cerebral cortex, RT increased ROS levels, but exhibited the lowest lipid peroxidation level among the groups (p < .001). The RW group showed an activity-induced increase in lipid peroxidation level compared to the SED group, and the highest level of CAT activity among all groups (p < .001). AChE activity was higher in the RT group compared to the SED, MICT, and RW groups (p = .039) in the cerebral cortex. In summary, nitrite levels in the hippocampus were decreased in all intervention groups regardless of activity or exercise model. Likewise, MICT improved recognition memory besides increasing CAT activity. We conclude that the MICT and RT protocols seem to act as oxidative stress regulators and non-pharmacological strategies to improve cognitive function.
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Affiliation(s)
- Natan Feter
- Post-graduate Program in Physical Education, Federal University of Pelotas, Pelotas 96055-630, Brazil.
| | | | | | - Luiza Spohr
- Post-graduate Program in Biochemistry, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | - Nathalia Stark Pedra
- Post-graduate Program in Biochemistry, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | - Natália Pontes Bona
- Post-graduate Program in Biochemistry, Federal University of Pelotas, Pelotas 96055-630, Brazil
| | | | | | | | | | - Airton José Rombaldi
- Post-graduate Program in Physical Education, Federal University of Pelotas, Pelotas 96055-630, Brazil
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14
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Ochentel O, Humphrey C, Pfeifer K. Efficacy of Exercise Therapy in Persons with Burnout. A Systematic Review and Meta-Analysis. J Sports Sci Med 2018; 17:475-484. [PMID: 30116121 PMCID: PMC6090391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2018] [Accepted: 07/23/2018] [Indexed: 06/08/2023]
Abstract
An increasing amount of scientific work suggests positive effects of exercise-related interventions in patients with burnout. Exercise therapy could therefore be a useful intervention procedure in the treatment of burnout. The aim of this meta-analysis is to examine empirical findings for exercise therapy used to treat burnout in the occupational setting, including the variety of the application and variety of the exercise modality itself. Electronic databases (PubMed, Cochrane Library, Scopus, PubPsych, PsycInfo) were searched (January 2018) for randomized controlled trials reporting on exercise therapy intervention studies in persons with burnout. The burnout scores from the various measurement instruments as well as standardized mean differences (SMDs) with 95% confidence intervals (CI) were calculated and seen as the main outcomes and measures. Four out of six studies with a total sample of 248 participants could be used for meta-analysis. A statement on the combined effect size can only be made with caution due to the length of the confidence interval of [-0.41; 0.09]. With an I² value of 0%, no heterogeneity is present in this meta-analysis. Ultimately there was no clear difference found between intervention and control conditions. This paper does not support the widespread assumption that exercise therapy seems to be a successful means to alleviate burnout symptoms. However, the different types of physical activity and treatment modalities used in the included studies impede clear conclusions. Future studies should deal with the specific efficacy of different exercise modalities and their combination with further cognitive behavioural or mindfulness-based interventions.
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Affiliation(s)
- Oliver Ochentel
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Crystal Humphrey
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
| | - Klaus Pfeifer
- Department of Sport Science and Sport, Friedrich-Alexander-University Erlangen-Nürnberg, Germany
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15
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Malmberg Gavelin H, Eskilsson T, Boraxbekk CJ, Josefsson M, Stigsdotter Neely A, Slunga Järvholm L. Rehabilitation for improved cognition in patients with stress-related exhaustion disorder: RECO - a randomized clinical trial. Stress 2018; 21:279-291. [PMID: 29693483 DOI: 10.1080/10253890.2018.1461833] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Stress-related exhaustion has been associated with selective and enduring cognitive impairments. However, little is known about how to address cognitive deficits in stress rehabilitation and how this influences stress recovery over time. The aim of this open-label, parallel randomized controlled trial (ClinicalTrials.gov: NCT03073772) was to investigate the long-term effects of 12 weeks cognitive or aerobic training on cognitive function, psychological health, and work ability for patients diagnosed with exhaustion disorder (ED). One-hundred-and-thirty-two patients (111 women) participating in multimodal stress rehabilitation were randomized to receive additional cognitive training (n = 44), additional aerobic training (n = 47), or no additional training (n = 41). Treatment effects were assessed before, immediately after and one-year post intervention. The primary outcome was global cognitive function. Secondary outcomes included domain-specific cognition, self-reported burnout, depression, anxiety, fatigue and work ability, aerobic capacity, and sick-leave levels. Intention-to-treat analysis revealed a small but lasting improvement in global cognitive functioning for the cognitive training group, paralleled by a large improvement on a trained updating task. The aerobic training group showed improvements in aerobic capacity and episodic memory immediately after training, but no long-term benefits. General improvements in psychological health and work ability were observed, with no difference between interventional groups. Our findings suggest that cognitive training may be a viable method to address cognitive impairments for patients with ED, whereas the effects of aerobic exercise on cognition may be more limited when performed during a restricted time period. The implications for clinical practice in supporting patients with ED to adhere to treatment are discussed.
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Affiliation(s)
| | - Therese Eskilsson
- b Department of Community Medicine and Rehabilitation, Physiotherapy , Umeå University , Umeå , Sweden
| | - Carl-Johan Boraxbekk
- c Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research , Copenhagen University Hospital Hvidovre , Hvidovre , Denmark
- d Centre for Demographic and Aging Research (CEDAR) , Umeå University , Umeå , Sweden
| | - Maria Josefsson
- d Centre for Demographic and Aging Research (CEDAR) , Umeå University , Umeå , Sweden
| | - Anna Stigsdotter Neely
- a Department of Psychology , Umeå University , Umeå , Sweden
- e Department of Social and Psychological Studies , Karlstad University , Karlstad , Sweden
| | - Lisbeth Slunga Järvholm
- f Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine , Umeå University , Umeå , Sweden
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16
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Gavelin HM, Neely AS, Andersson M, Eskilsson T, Järvholm LS, Boraxbekk CJ. Neural activation in stress-related exhaustion: Cross-sectional observations and interventional effects. Psychiatry Res Neuroimaging 2017; 269:17-25. [PMID: 28917154 DOI: 10.1016/j.pscychresns.2017.08.008] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Revised: 08/18/2017] [Accepted: 08/25/2017] [Indexed: 12/16/2022]
Abstract
The primary purpose of this study was to investigate the association between burnout and neural activation during working memory processing in patients with stress-related exhaustion. Additionally, we investigated the neural effects of cognitive training as part of stress rehabilitation. Fifty-five patients with clinical diagnosis of exhaustion disorder were administered the n-back task during fMRI scanning at baseline. Ten patients completed a 12-week cognitive training intervention, as an addition to stress rehabilitation. Eleven patients served as a treatment-as-usual control group. At baseline, burnout level was positively associated with neural activation in the rostral prefrontal cortex, the posterior parietal cortex and the striatum, primarily in the 2-back condition. Following stress rehabilitation, the striatal activity decreased as a function of improved levels of burnout. No significant association between burnout level and working memory performance was found, however, our findings indicate that frontostriatal neural responses related to working memory were modulated by burnout severity. We suggest that patients with high levels of burnout need to recruit additional cognitive resources to uphold task performance. Following cognitive training, increased neural activation was observed during 3-back in working memory-related regions, including the striatum, however, low sample size limits any firm conclusions.
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Affiliation(s)
- Hanna Malmberg Gavelin
- Department of Psychology, Umeå University, Umeå, Sweden; Umeå Centre for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden.
| | - Anna Stigsdotter Neely
- Department of Psychology, Umeå University, Umeå, Sweden; Department of Social and Psychological Studies, Karlstad University, Karlstad, Sweden
| | - Micael Andersson
- Umeå Centre for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden; Department of Integrative Medical Biology, Physiology Section, Umeå University, Umeå, Sweden
| | - Therese Eskilsson
- Department of Community Medicine and Rehabilitation, Physiotherapy, Umeå University, Umeå, Sweden
| | - Lisbeth Slunga Järvholm
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, Umeå, Sweden
| | - Carl-Johan Boraxbekk
- Umeå Centre for Functional Brain Imaging (UFBI), Umeå University, Umeå, Sweden; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Denmark; Centre for Demographic and Aging Research (CEDAR), Umeå University, Umeå, Sweden
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