Explicit and implicit sense of agency in depersonalisation experiences.

The sense of agency, the feeling of controlling one's bodily actions and the world is altered in Depersonalisation (DP), a condition that makes people feel detached from one's self and body. To investigate the link between depersonalisation and both implicit and explicit sense of agency, an online study was conducted using the influential Intentional Binding paradigm in a sample of non-clinical DP participants. The results did not reveal significant differences between individuals with low and high occurrences of DP experiences on the implicit and explicit sense of agency. However, participants with high occurrences of DP experiences showed a more time-sensitive explicit sense of agency and greater temporal distortions for short intervals in the absence of self-initiated motion. These results suggest that there is a discrepancy between implicit and explicit sense of agency in people with high levels of depersonalisation. Altogether, these findings call for further investigations of the key role of time perception on altered sense of self and agency in both non-clinical and clinical populations, to disentangle the mechanisms associated with the explicit and implicit sense of agency.

Confrontation with others' emotions changes bodily resonance differently in those with low and high levels of depersonalization.

We present novel research on the cortical dynamics of atypical perceptual and emotional processing in people with symptoms of depersonalization-derealization disorder (DP-DR). We used electroencephalography (EEG)/event-related potentials (ERPs) to delineate the early perceptual mechanisms underlying emotional face recognition and mirror touch in adults with low and high levels of DP-DR symptoms (low-DP and high-DP groups). Face-sensitive visual N170 showed markedly less differentiation for emotional versus neutral face-voice stimuli in the high- than in the low-DP group. This effect was related to self-reported bodily symptoms like disembodiment. Emotional face-voice primes altered mirror touch at somatosensory cortical components P45 and P100 differently in the two groups. In the high-DP group, mirror touch occurred only when seeing touch after being confronted with angry face-voice primes. Mirror touch in the low-DP group, however, was unaffected by preceding emotions. Modulation of mirror touch following angry others was related to symptoms of self-other confusion. Results suggest that others' negative emotions affect somatosensory processes in those with an altered sense of bodily self. Our findings are in line with the idea that disconnecting from one's body and self (core symptom of DP-DR) may be a defence mechanism to protect from the threat of negative feelings, which may be exacerbated through self-other confusion. This article is part of the theme issue 'Sensing and feeling: an integrative approach to sensory processing and emotional experience'.

Prevalence and risk of burnout among HIV service providers in South Africa and Zambia: findings from the HPTN 071 (PopART) trial.

BACKGROUND: In the high disease burden and resource-constrained contexts of sub-Saharan Africa (SSA), health workers experience a range of psychosocial stressors that leave them vulnerable to developing burnout, which can reduce service quality and negatively impact their own health and wellbeing. As universal testing and treatment (UTT) for HIV scales up across SSA, we sought to understand the implications of this human resource-intensive approach to HIV prevention to inform decision-making about health workforce staffing and support needs. METHODS: Using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS), we assessed the prevalence of three domains of burnout-emotional exhaustion, depersonalization, and personal accomplishment-among three cadres of health workers delivering health services in areas receiving a UTT intervention in Zambia and South Africa. These cadres included health facility workers (n = 478), community health workers (n = 159), and a study-specific cadre of community HIV care providers (n = 529). We used linear regression to assess risk factors associated with emotional exhaustion, the only domain with sufficient variation in our sample. RESULTS: The MBI-HSS was completed by 1499/2153 eligible participants (69.6% response rate). Less than 1% of health workers met Maslach's definition for burnout. All groups of health workers reported lower levels of emotional exhaustion than found in previous studies of this type (mean score scores ranged from 10.7 to 15.4 out of 54 across health cadres). Higher emotional exhaustion was associated with higher educational attainment (ßadj = 2.24, 95% CI 0.76 to 3.72), greater years providing HIV services (ßadj = 0.20, 95% CI 0.03 to 0.36), and testing negative for HIV at last HIV test (ßadj = - 3.88 - 95% CI 5.69 to - 2.07). Working as a CHW was significantly associated with lower emotional exhaustion (ßadj = - 2.52, 95% CI - 4.69 to - 0.35). Among all health workers, irrespective of HIV status, witnessing stigmatizing behaviors towards people living with HIV among their co-workers was associated with significantly increased emotional exhaustion (ßadj = 3.38, 95% CI 1.99 to 4.76). CONCLUSIONS: The low level of burnout detected among health workers is reassuring. However, it remains important to assess how UTT may affect levels of emotional exhaustion among health workers over time, particularly in the context of emerging global pandemics, as burnout may impact the quality of HIV services they provide and their own mental health and wellbeing. Interventions to reduce HIV stigma in health facilities may protect against emotional exhaustion among health workers, as well as interventions to increase mindfulness and resilience among health workers at risk of burnout. Trial registration ClinicalTrials.gov number: NCT01900977.

Behavioural, autonomic, and neural responsivity in depersonalisation-derealisation disorder: A systematic review of experimental evidence.

Depersonalisation-derealisation disorder (DDD) is characterised by distressing experiences of separation from oneself and/or one's surroundings, potentially resulting from alterations in affective, cognitive, and physiological functions. This systematic review aimed to synthesise current experimental evidence of relevance to proposed mechanisms underlying DDD, to appraise existing theoretical models, and to inform future research and theoretical developments. Studies were included if they tested explicit hypotheses in DDD samples, with experimental manipulations of at least one independent variable, alongside behavioural, subjective, neurological, affective and/or physiological dependent variables. Some evidence for diminished subjective responsivity to aversive images and sounds, and hyperactivation in neurocircuits associated with emotional regulation when viewing aversive images emerged, corroborating neurobiological models of DDD. Inconsistencies were present regarding behavioural and autonomic responsivity to facial expressions, emotional memory, and self-referential processing. Common confounds included small sample sizes, medication, and comorbidities. Alterations in affective reactivity and regulation appear to be present in DDD; however, further research employing more rigorous research designs is required to provide stronger evidence for these possible mechanisms.

The association between empathy and burnout in medical students: a systematic review and meta-analysis.

BACKGROUND: Burnout levels in medical students are higher than in other student groups. Empathy is an increasingly desired outcome of medical schools. Empathy is negatively associated with burnout in physicians. Our objective was to quantitatively review the available literature on associations between empathy and burnout in medical students, and to explore associations between specific empathy aspects (cognitive and affective) and burnout sub-dimensions (emotional exhaustion, depersonalization and personal accomplishment). METHODS: A comprehensive search of the literature published up until January 2024 was undertaken in the PubMed, EMBASE, CINAHL, The Cochrane Library, and PsycINFO databases. Two independent reviewers screened 498 records and quality-rated and extracted data from eligible studies. The effect size correlations (ESr) were pooled using a random-effects model and between-study variation explored with meta-regression. The review was preregistered with PROSPERO (#CRD42023467670) and reported following the PRISMA guidelines. RESULTS: Twenty-one studies including a total of 27,129 medical students published between 2010 and 2023 were included. Overall, empathy and burnout were negatively and statistically significantly associated (ESr: -0.15, 95%CI [-0.21; -0.10], p < .001). When analyzing sub-dimensions, cognitive empathy was negatively associated with emotional exhaustion (ESr: -0.10, 95%CI [-0.17; -0.03], p = .006) and depersonalization (ESr: -0.15, 95%CI [-0.24; 0.05], p = .003), and positively associated with personal accomplishment (ESr: 0.21, 95%CI [0.12; 0.30], p < .001). Affective empathy was not statistically significantly associated with emotional exhaustion, depersonalization or personal accomplishment. Supplementary Bayesian analysis indicated the strongest evidence for the positive association between cognitive empathy and personal accomplishment. Response rate and gender moderated the relationship so that higher response rates and more male respondents strengthen the negative association between empathy and burnout. CONCLUSION: Greater empathy, in particular cognitive empathy, is associated with lower burnout levels in medical students. This appears to be primarily driven by cognitive empathy's positive association with personal accomplishment. PROTOCOL REGISTRATION: #CRD42023467670.

The role of the immune system in depersonalisation disorder.

OBJECTIVES: Depersonalisation-derealization disorder (DPD) is a dissociative disorder that impairs cognitive function and occupational performance. Emerging evidence indicate the levels of tumour necrosis factor-α and interleukin associated with the dissociative symptoms. In this study, we aimed to explore the role of the immune system in the pathology of DPD. METHODS: We screened the protein expression in serum samples of 30 DPD patients and 32 healthy controls. Using a mass spectrometry-based proteomic approach, we identified differential proteins that were verified in another group of 25 DPD patients and 30 healthy controls using immune assays. Finally, we performed a correlation analysis between the expression of differential proteins and clinical symptoms of patients with DPD. RESULTS: We identified several dysregulated proteins in patients with DPD compared to HCs, including decreased levels of C-reactive protein (CRP), complement C1q subcomponent subunit B, apolipoprotein A-IV, and increased levels of alpha-1-antichymotrypsin (SERPINA3). Moreover, the expression of CRP was positively correlated with visuospatial memory and the ability to inhibit cognitive interference of DPD. The expression of SERPINA3 was positively correlated with the ability to inhibit cognitive interference and negatively correlated with the perceptual alterations of DPD. CONCLUSIONS: The dysregulation of the immune system may be the underlying biological mechanism in DPD. And the expressions of CRP and SERPINA3 can be the potential predictors for the cognitive performance of DPD.

Examining the association between depersonalisation traits and the bodily self in waking and dreaming.

Depersonalisation (DP) is characterized by fundamental alterations to the sense of self that include feelings of detachment and estrangement from one's body. We conducted an online study in healthy participants (n = 514) with DP traits to investigate and quantify the subjective experience of body and self during waking and dreaming, as the vast majority of previous studies focussed on waking experience only. Investigating dreams in people experiencing DP symptoms may help us understand whether the dream state is a 'spared space' where people can temporarily 'retrieve' their sense of self and sense of bodily presence. We found that higher DP traits-i.e. higher scores on the Cambridge Depersonalisation Scale (CDS)-were associated with more frequent dream experiences from an outside observer perspective (r = 0.28) and more frequent dream experiences of distinct bodily sensations (r = 0.23). We also found that people with higher CDS scores had more frequent dream experiences of altered bodily perception (r = 0.24), more frequent nightmares (r = 0.33) and higher dream recall (r = 0.17). CDS scores were negatively correlated with body boundary scores (r = - 0.31) in waking states and there was a negative association between CDS scores and the degree of trust in interoceptive signals (r = - 0.52). Our study elucidates the complex phenomenology of DP in relation to bodily selfhood during waking and dreaming and suggests avenues for potential therapeutic interventions in people with chronic depersonalisation (depersonalisation -derealisation disorder).

[The current situation and influencing factors of depersonalization in clinical nurses].

Objective: To investigate the depersonalization status and to analyze the effect of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization in clinical nurses. Methods: In May 2019, 10 cities were selected as sampling cities by the method of grabbing random ball in Henan Province and Fujian Province. Using the stratified sampling, clinical nurses were selected as the research objects for a questionnaire survey in 22 tertiary hospitals and 23 secondary hospitals, included 1200 nurses. A total of 1200 questionnaires were issued and collected, and 1159 valid questionnaires were collected with effective recovery of 96.6%. Clinical nurses were investigated by Workplace Incivility Scale, Event Related Rumination Inventory, Fear of Negative Evaluation Scale, Maslach Burnout Inventory-General Survey. The demographic characteristics of nurses' depersonalization were compared and analyzed with t test and single factor analysis of variance. The influence mechanism of workplace incivility perception, intrusive rumination and fear of negative evaluation on depersonalization was analyzed with Bootstrap. Results: Depersonalization scores were (9.3±2.6) points, 467 of those had depersonalization symptoms in clinical nurses (40.3%). The scores of depersonalization of those with <3 years of service [ (10.5±2.9) points] was higher than those with 3-10 years [ (9.1±2.8) points] and 11-31 years [ (9.0±2.9) points]. The scores of depersonalization of those with monthly earning of <3000 yuan [ (10.1±2.8) points] was higher than those with 3000-7999 yuan [ (8.4±2.7) points] and 8000-12000 yuan [ (8.0±2.9) points]. The scores of depersonalization of clinical nurses in surgical departments [ (10.0±2.9) points] was higher than those in non-surgical departments [ (8.7±2.6) points]. The scores of depersonalization of clinical nurses in tertiary hospitals [ (10.0±2.7) points] was higher than those in secondary hospitals [ (8.6±2.8) points]. The differences were statistically significant (P<0.05). Workplace incivility perception affected depersonalization through the single mediating role of intrusive rumination, fear of negative evaluation and the chain mediating role of intrusive rumination and fear of negative evaluation (ß=0.16, 0.17, 0.07, 95%CI: 0.15-0.20, 0.15-0.21, 0.03-0.09, P<0.05) . Conclusion: Workplace incivility perception directly or through the independent mediating effects of intrusive rumination or fear of negative evaluation, and the chain mediating effects of intrusive rumination and fear of negative evaluation influences the depersonalization of clinical nurses.

Depersonalization and derealization as sequelae of a temporal lobe lesion: a case report.

BACKGROUND: Depersonalization and derealization can occur not just from psychiatric causes but also from various organic etiologies, such as seizures and intracerebral structural abnormalities. However, there have been no previous reported cases to the authors' knowledge detailing isolated depersonalization and derealization in the absence of clinical seizure activity or other psychiatric pathology, as sequelae of structural intracerebral lesions. CASE PRESENTATION: In this case report, we detail the unique presentation of a 68-year-old woman under the care of palliative medicine who experienced depersonalization and derealization secondary to a metastatic lesion in her temporal lobe, in the parahippocampal gyrus to medial occipitotemporal gyrus region. These symptoms were present in the absence of any clinical seizure activity or other psychiatric symptomatology and largely resolved with the use of steroidal therapy, before returning secondary to disease progression. CONCLUSIONS: We discuss the relationship among isolated depersonalization and derealization with pathology of the left posterior temporal lobe in the context of this interesting case. This case expands our knowledge of the neurobiology of these phenomena, given the specific localization of the intracerebral pathology and temporal specificity of symptoms relative to tumor growth and treatment course.

Impact of depersonalization on the course of depression: longitudinal observations from the gutenberg health study.

BACKGROUND: Symptoms of depersonalization (DP) and derealization (DR) are a risk factor for more severe impairment, non-response to various treatments, and a chronic course. In this study, we investigated the effects of DP/DR symptoms in patients with clinically significant depressive symptoms on clinical characteristics and various outcomes in a representative population-based sample with a 5-year follow-up. METHODS: The middle-aged sample comprised n = 10,422 persons at baseline, of whom n = 9,301 were free from depressive and DP/DR symptoms. N = 522 persons had clinically significant depression (PHQ-9 ≥ 10) and co-occurring DP/DR symptoms, and n = 599 persons had clinically significant depression (PHQ-9 ≥ 10) without DP/DR symptoms. RESULTS: There were substantial health disparities between persons with and without depression. These disparities concerned a wide range of life domains, including lower quality of the recalled early life experiences with the parents, current socioeconomic status, social integration (partnership, loneliness), current social and interpersonal stressors (family, work), functional bodily complaints (e.g., tinnitus, migraine, chest pain), unhealthy lifestyle, and the prevalence of already developed physical diseases. These disparities persisted to the 5-year follow-up and were exceptionally severe for depressed persons with co-occurring DP/DR symptoms. Among the depressed persons, the co-occurrence of DP/DR symptoms more than doubled the risk for recurrence or persistence of depression. Only 6.9% of depressed persons with DP/DR symptoms achieved remission at the 5-year follow-up (PHQ-9 < 5). Depression with and without co-occurring DP/DR worsened self-rated physical health significantly. The impact of depression with co-occurring DP/DR on the worsening of the self-rated physical health status was stronger than those of age and major medical diseases (e.g., heart failure). However, only depression without DP/DR was associated with mortality in a hazard regression analysis adjusted for age, sex, and lifestyle. CONCLUSIONS: The results demonstrated that DP/DR symptoms represent an important and easily assessable prognostic factor for the course of depression and health outcomes. Given the low remission rates for depression in general and depression with DP/DR in particular, efforts should be made to identify and better support this group, which is disadvantaged in many aspects of life.

Finding neural correlates of depersonalisation/derealisation disorder via explainable CNN-based analysis guided by clinical assessment scores.

Mental health disorders are typically diagnosed based on subjective reports (e.g., through questionnaires) followed by clinical interviews to evaluate the self-reported symptoms. Therefore, considering the interconnected nature of psychiatric disorders, their accurate diagnosis is a real challenge without indicators of underlying physiological dysfunction. Depersonalisation/derealisation disorder (DPD) is an example of dissociative disorder affecting 1-2 % of the population. DPD is characterised mainly by persistent disembodiment, detachment from surroundings, and feelings of emotional numbness, which can significantly impact patients' quality of life. The underlying neural correlates of DPD have been investigated for years to understand and help with a more accurate and in-time diagnosis of the disorder. However, in terms of EEG studies, which hold great importance due to their convenient and inexpensive nature, the literature has often been based on hypotheses proposed by experts in the field, which require prior knowledge of the disorder. In addition, participants' labelling in research experiments is often derived from the outcome of the Cambridge Depersonalisation Scale (CDS), a subjective assessment to quantify the level of depersonalisation/derealisation, the threshold and reliability of which might be challenged. As a result, we aimed to propose a novel end-to-end EEG processing pipeline based on deep neural networks for DPD biomarker discovery, which requires no prior handcrafted labelled data. Alternatively, it can assimilate knowledge from clinical outcomes like CDS as well as data-driven patterns that differentiate individual brain responses. In addition, the structure of the proposed model targets the uncertainty in CDS scores by using them as prior information only to guide the unsupervised learning task in a multi-task learning scenario. A comprehensive evaluation has been done to confirm the significance of the proposed deep structure, including new ways of network visualisation to investigate spectral, spatial, and temporal information derived in the learning process. We argued that the proposed EEG analytics could also be applied to investigate other psychological and mental disorders currently indicated on the basis of clinical assessment scores. The code to reproduce the results presented in this paper is openly accessible at https://github.com/AbbasSalami/DPD_Analysis.

Intention to leave, depersonalisation and job satisfaction in physicians and nurses: a cross-sectional study in Europe.

The European healthcare sector faces a significant shortage of healthcare workers. Assessing the prevalence of this issue and understanding its direct and indirect determinants are essential for formulating effective recruitment programs and enhancing job retention strategies for physicians and nurses. A multicentric cross-sectional study was conducted, involving 381 physicians and 1351 nurses recruited from eight European hospitals in Belgium, the Netherlands, Italy, and Poland. The study focused on assessing turnover intentions among healthcare workers based on the Job Demands-Resources model, using an online questionnaire. Structural equation models were employed to test the data collection questionnaires' construct validity and internal consistency. The turnover intention was assessed by agreement with the intention to leave either the hospital or the profession. Among physicians, 17% expressed an intention to leave the hospital, while 9% intended to leave the profession. For nurses, the figures were 8.9% and 13.6%, respectively. The internal consistency of the questionnaires exceeded 0.90 for both categories of health workers. Depersonalization and job dissatisfaction were identified as direct determinants of turnover intention, with work engagement being particularly relevant for nurses. We found a higher intention to leave the hospital among physicians, while nurses were more prone to leave their profession. To mitigate turnover intentions, it is recommended to focus on improving job satisfaction, work engagement and fostering a positive working climate, thereby addressing depersonalisation and promoting job retention.

Association between occupational burnout and psychological symptoms among Chinese medical staff: moderating role of social support.

This study aimed to examine the association between occupational burnout and psychological symptoms among Chinese medical staff, assuming social support to play a moderating role in the aforementioned relationship. The survey was conducted online from May 1 to June 28, 2022, and the questionnaires were distributed and retrieved through a web-based platform. The final sample was comprised of 1461 Chinese medical staff in this cross-sectional study. Several multiple linear regressions were performed to analyze the data. After controlling for potential confounding factors, all three dimensions of occupational burnout were associated with poorer psychological symptoms. Emotional exhaustion (ß = 0.33; 95% confidence interval [CI], 1.018, 1.479) had the strongest association with psychological symptoms, followed by depersonalization and diminished personal accomplishment. Moreover, medical staff with higher levels of friend support (ß = -0.11; 95% CI, -4.063, -0.573) and significant other support (ß = -0.10; 95% CI, -3.965, -0.168) were less likely to suffer from psychological symptoms when faced with occupational burnout. The results suggested that interventions aimed at lessening occupational burnout and boosting social support can be an effective way to promote the psychological health of medical staff.

The Treatment of Depersonalization-Derealization Disorder: A Systematic Review.

Depersonalization-derealization disorder (DPD) is characterized by persistent or recurrent experiences of detachment from oneself and surroundings, as well as a sense of unreality. Considering the inadequacy of current research on treatment, we performed a systematic review of the available pharmacotherapies, neuromodulations, and psychotherapies for DPD. The systematic review protocol was based on PRISMA 2020 guidelines and pre-registered. The PubMed, Web of Science, PsycINFO, Embase, the Cochrane Library, Scopus, and ScienceDirect databases were searched from inception to June 2021. All treatments for DPD and all study types, including controlled and observational studies as well as case reports, were assessed. Of the identified 17,540 studies, 41 studies (four randomized controlled trials, one non-randomized controlled trial, 10 case series, and 26 case reports) involving 300 participants met the eligibility criteria. We identified 30 methods that have been applied independently or in combination to treat DPD since 1955. The quality of these studies was considered. The relationship between individual differences, such as symptoms, comorbidities, history, and duration since onset, and treatment effects was explored. The results suggest that a series of treatments, such as pharmacotherapies, neuromodulation, and psychotherapies, could be considered in combination. However, the quality and quantity of studies were generally low considering the high prevalence of DPD. The review concludes with suggestions for future research and an urgent call for more high-quality research.

Demandas e recursos para predição da síndrome de burnout em psicólogos clínicos / Demands and resources for burnout syndrome on clinical psychologists / Demandas y recursos para la predicción del síndrome de burnout en psicólogos clínicos

O modelo de demandas e recursos foi utilizado para identificar o poder preditivo do estilo pessoal do terapeuta e do trabalho emocional (demandas), e da inteligência emocional e autoeficácia profissional (recursos) sobre as dimensões da síndrome de Burnout (SB), em uma amostra de 240 psicólogos clínicos brasileiros. Os dados foram coletados por meio de plataforma online, tendo como instrumentos de pesquisa um Questionário de dados sociodemográficos e laborais, o Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, o Cuestionario del Estilo Personal del Terapeut, o Questionário de Avaliação Relacionado a Demandas Emocionais e Dissonância da Regra da Emoção, Medida de Inteligência Emocional, e Escala de Autoeficácia Geral Percebida. Os resultados obtidos revelaram um modelo preditor das dimensões da SB, constituído pelas variáveis dissonância emocional, automotivação, demandas emocionais, instrução, envolvimento e autoeficácia. Ressalta-se a relevância de estratégias voltadas para a prevenção da SB nessa categoria profissional, bem como a necessidade de ações que visem a promoção e o desenvolvimento da inteligência emocional e da autoeficácia como fortalecimento dos recursos emocionais para atuação na prática clínica.(AU)

The Model of Demands - Resources was used to identify the predictive power of therapist's personal style, emotional work (Demands), Emotional intelligence, and professional self-efficacy (Resources) over the Burnout syndrome dimensions in a sample of 240 Brazilian clinical psychologists. The data was collected by an on-line platform using a Labor and social demographic data questionnaire, a work Burnout Syndrome Evaluation questionnaire (CESQT - Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo), the short version of the Therapist Personal Style Questionnaire (EPT-C Cuestionario del Estilo Personal del Terapeuta), an Evaluation questionnaire related to emotional demands and emotion rule dissonance, and the Emotional Intelligence Measure (EIM) and Perceived General Self-Efficacy Scale (GPSS) as research instruments. Results showed a predictor model of Burnout syndrome constituted by the variables Emotional dissonance, Self-motivation, Emotional demands, Instruction, Involvement, and Self-efficacy. We emphasize the relevance of strategies to prevent Burnout Syndrome in this professional category and the need for actions to promote and develop emotional intelligence and self-efficacy as a strengthening factor of the emotional resources to work as a clinical psychologist.(AU)

Se utilizó el modelo demandas y recursos para identificar el poder predictivo del estilo personal del terapeuta y del trabajo emocional (demandas), y de la inteligencia emocional y autoeficacia profesional (recursos) sobre las dimensiones del síndrome de Burnout (SB), en una muestra de 240 psicólogos clínicos brasileños. Los datos se recolectaron de una plataforma en línea, utilizando como instrumentos de investigación un cuestionario de datos sociodemográficos y laborales, el Cuestionario para la Evaluación del Síndrome de Quemarse por el Trabajo, el Cuestionario del Estilo Personal del Terapeuta, el Cuestionario de Evaluación Relacionado con Demandas Emocionales y Disonancia de la Regla de la Emoción, la Medida de Inteligencia Emocional y Escala de Autoeficacia General Percibida. Los resultados obtenidos revelaron un modelo predictor de las dimensiones de SB, constituido por las variables disonancia emocional, automotivación, exigencias emocionales, instrucción, implicación y autoeficacia. Se destaca la relevancia de las estrategias dirigidas a la prevención del SB en esta categoría profesional, así como la necesidad de acciones dirigidas a promover y desarrollar la inteligencia emocional y la autoeficacia como fortalecimiento de los recursos emocionales para trabajar en la práctica clínica.(AU)

Estresse ocupacional entre psicólogos atuantes na atenção primária à saúde no contexto pandêmico / Occupational stress in psychologists working in primary health care in the context of the pandemic / Estrés laboral entre los psicólogos que trabajan en atención primaria de salud en el contexto de la pandemia

Este estudo analisa o estresse ocupacional entre psicólogos que atuavam na Atenção Primária à Saúde durante a pandemia ocasionada pela covid-19, assim como as características sociodemográficas e laborais dos participantes e sua relação com o estresse ocupacional. Participaram da pesquisa 70 psicólogos atuantes em 51 unidades básicas de saúde das regiões Oeste e Extremo Oeste catarinense. Para coleta de dados, um questionário sociodemográfico e a versão reduzida da Job Stress Scale (JSS) foram aplicados. A análise dos dados foi realizada por meio da estatística descritiva e inferencial. Identificou-se que 35,7% dos psicólogos apresentaram alto desgaste no trabalho; 28,6% baixo desgaste; 27,1% se mostraram em trabalho passivo; e 8,6% em trabalho ativo. No modelo de regressão linear, os fatores associados à dimensão Demanda da JSS foram: possuir filho (a) (coeficiente -1,49; IC 95% -2,75 a -0,23) e afastamento do trabalho nos últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Os psicólogos com hipertensão arterial sistêmica autorreferida apresentaram, em média, 3,96 pontos a menos no escore de Apoio social (IC 95% -7,06 a -0,85), quando comparados aos não hipertensos, e entre os psicólogos que trabalhavam no turno da manhã identificou-se aumento de 4,46 pontos, em média, no escore de Apoio social (IC 95% 0,90 a 8,02) em relação aos profissionais do turno manhã e tarde. Evidenciou-se que um número significativo de psicólogos apresentava-se em alto desgaste no trabalho, com potenciais implicações para sua saúde e atuação profissional.(AU)

This study analyzed occupational stress among psychologists who worked in Primary Health Care during the COVID-19 pandemic and participants' sociodemographic and work characteristics and their relationship with occupational stress. In total, 70 psychologists working in 51 basic health units in the West and Far West regions of Santa Catarina participated in this research. A sociodemographic questionnaire and the short version of the Job Stress Scale (JSS) were applied to collect data. Data were analyzed by descriptive and inferential statistics. In total, 35.7% of psychologists showed high stress at work; 28.6%, low burn out; 27.1%, passive work; and 8.6%, active work. The factors in the linear regression model that were associated with the JSS demand dimension referred to having children (coefficient −1.49; 95% CI −2.75 to −0.23) and absence from work in the last 12 months (coefficient 1.88; 95% CI 0.60 to 3.15). Psychologists with self-reported systemic arterial hypertension showed, on average, 3.96 points lower in the Social Support score (95% CI −7.06 to −0.85) than non-hypertensive ones and psychologists who worked in the morning shift, an average increase of 4.46 points in the Social Support score (95% CI 0.90 to 8.02) in relation to professionals working in the morning and afternoon shifts. A significant number of psychologists had high stress at work, with potential implications to their health and professional performance.(AU)

Este estudio evalúa el estrés laboral entre los psicólogos que trabajaron en la atención primaria de salud durante la pandemia provocada por la COVID-19, así como las características sociodemográficas y laborales de ellos y su relación con el estrés laboral. En la investigación participaron setenta psicólogos que trabajan en 51 unidades básicas de salud en las regiones oeste y lejano oeste de Santa Catarina (Brasil). Para la recolección de datos se aplicó un cuestionario sociodemográfico y la versión corta de la Job Stress Scale (JSS). El análisis de los datos se realizó mediante estadística descriptiva e inferencial. Se identificó que el 35,7% de los psicólogos presentaban alto estrés en el trabajo; el 28,6% tenían poco desgaste; el 27,1% se encontraban en trabajo pasivo; y el 8,6% en trabajo activo. En el modelo de regresión lineal, los factores asociados a la dimensión demanda de la JSS fueron: tener hijo (coeficiente -1,49; IC 95% -2,75 a -0,23) y baja laboral en los últimos 12 meses (coeficiente 1,88; IC 95% 0,60 a 3,15). Los psicólogos con hipertensión arterial sistémica autoinformada presentaron un promedio de 3,96 puntos más bajo en la puntuación de apoyo social (IC 95% -7,06 a -0,85) en comparación con los no hipertensos, y entre los psicólogos que trabajaban en el turno de la mañana, se identificó un aumento promedio de 4,46 puntos en la puntuación de apoyo social (IC 95% 0,90 a 8,02) con relación a los profesionales que laboran en el turno de mañana y tarde. Quedó evidente que un número significativo de psicólogos se encontraba en situación de alto estrés en el trabajo, con posibles implicaciones para su salud y desempeño profesional.(AU)

A brief CBT intervention for depersonalisation-derealisation disorder in psychosis: Results from a feasibility randomised controlled trial.

BACKGROUND AND OBJECTIVES: Depersonalisation/derealisation symptoms are prevalent in psychosis patients, are associated with increased impairment, and may maintain psychosis symptoms. We aimed to establish the feasibility and acceptability of a brief, six session therapy protocol adapted from a Cognitive-Behavioural model of Depersonalisation-Derealisation Disorder (DDD) in participants with psychotic symptoms. METHODS: A single-blind, randomised controlled trial was conducted with a treatment-as-usual control condition. Feasibility and acceptability estimates included rates of referral, acceptance, eligibility, consent, satisfaction and improved skills/knowledge to manage depersonalisation. RESULTS: Twenty-one individuals were recruited to the trial. Results suggest that the intervention was feasible and acceptable to participants and there is some signal of effect on clinical outcomes. LIMITATIONS: There were some challenges in recruitment. Recruitment feasibility estimates from the research register used may not be informative for future trials recruiting directly from teams. CONCLUSIONS: Overall, the results suggest that further investigations would be of interest and recommendations for this are made.

[Depersonalization depression in young female patients]. / Depersonalizatsionnye depressii u patsientok molodogo vozrasta.

OBJECTIVE: To study psychopathological structure characteristics of depersonalization depression in young women and nonsuicidal autoaggressive and suicidal behavior characteristics in these states. MATERIAL AND METHODS: We studied 36 adolescent female patients (16-25 years) with endogenous depression (F31.3-4; F34.0; F21.3-4+F31.3-4; F60.X+F31.3-4), whose clinical picture was dominated by depersonalization disorders represented by their auto-, allo-, and somatopsychic forms or combinations. RESULTS: Depersonalization depressions in young female patients are characterized by the following features: the dominance of the manifestations of the sensory («hysterical¼) form of depersonalization (83.3%; n=30); the proximity of the phenomenon of somatopsychic depersonalization (77.8%, n=28) to the manifestations of dysmorphic disorders; the specificity of the manifestations of derealization in the form of a feeling of «pretended, staged¼ environment; infrequent manifestations of psychic anesthesia; marked polymorphism of the clinical picture with comorbid obsessive-compulsive, hysteria-conversion, senestopathic, dysmorphic, and attenuated psychotic disorders; high risk of suicide (83.3%; n=30) with the predominance of planned suicide attempts over impulsive ones; significant frequency and variety of nonsuicidal self-harm with the predominance of «depersonalizing¼ motives for its commission. CONCLUSIONS: Depersonalization depression in young female patients is characterized by the clinical specificity manifested both in depersonalization symptomatology and spectrum of comorbid disorders and in the specificity of motives and methods of suicide attempts and nonsuicidal self-harm.

Depersonalization affects self-prioritization of bodily, but not abstract self-related information.

Depersonalization is a common and distressing experience characterized by a feeling of estrangement from one's self, body, and the world. In order to examine the relationship between depersonalization and selfhood we conducted an experimental study comparing processing of three types of self-related information between nonclinical groups of people experiencing high and low levels of depersonalization. Using a sequential matching task, we compared three types of biases for processing of self-related information: prioritization of one's name, of self-associated abstract stimuli (geometrical shapes), and of self-associated bodily stimuli (avatar faces). We found that both groups demonstrated the standard pattern of results for self-prioritization of one's name and geometrical shapes, but they differed with regard to avatar faces. While people with low depersonalization showed the standard prioritization of avatar faces, people with high depersonalization showed overall better response accuracy with avatar faces, and faster response times for stranger-associated avatar faces. These results were complemented by the additional finding that people with high depersonalization reported being more likely to use avatars of a different gender to their own outside of the experimental context. Finally, in this large sample (N = 180) we investigated the relationships between different measures of self-related processing and self-identification, finding no correlation between explicit reports of self-identification with self-associated avatar faces and geometrical shapes, self-prioritization of these stimuli, and prioritization of one's name. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Factors influencing the burnout dimensions among nurses: A cross-sectional study in South Korea.

AIM: To investigate the factors influencing three dimensions of burnout among clinical nurses in South Korea. DESIGN: Descriptive, correlational and cross-sectional study. METHODS: We recruited 300 clinical nurses to participate in an online survey conducted in June 2021. Purposive sampling was used for the survey. Multiple linear regression was used for data analysis. RESULTS: The regression models explained 55.8%, 45.8% and 34.3% variances in emotional exhaustion, depersonalization and personal accomplishment respectively. Emotional exhaustion was influenced by experience in the current department, working overtime, shift type, depression, job stress and emotional labour. Depersonalization was influenced by gender, hospital size, the associated department, overtime, coping strategies, depression and emotional labour. Personal accomplishment was influenced by clinical experience, shift type, resilience and the perceived threat of coronavirus disease 2019.