Coping self-efficacy mediates effects of posttraumatic distress on communal coping in parent-adolescence dyads after floods.

Social cognitive theory provides a framework of human agency during environmental challenges, with coping self-efficacy (CSE) as an important construct underlying adaptation. We examined two alternative models involving CSE as a mediator of the association between posttraumatic stress symptoms (PTSS) and communal coping among parent-youth dyads after severe floods using Bayesian dyadic multilevel modeling. The first model included PTSS as the independent variable and communal coping as the dependent variable (disaster distress model). The independent and dependent variables were replaced for each other in the second model (communal coping model). We used data from 485 parent-youth dyads who experienced floods between 2015 and 2016 in Texas, USA. Parents of children (69% women) aged 10-19 years old, and their oldest child (53% male; Mean age = 13.75) in that age range were recruited. We assessed PTSS, CSE, and communal coping for parents and youths. Results favored the disaster distress model over the communal coping model. In the disaster distress model, results demonstrated that CSE declines as PTSS increases, predicting decreased communal coping. This mediation effect of CSE is stronger for youths compared to parents, indicating that children's CSE is affected more by PTSS.

Japanese public health nurses classified based on empathy and secondary traumatic stress: variable-centered and person-centered approaches.

BACKGROUND: Healthcare providers frequently help traumatized people and are regularly exposed to indirect trauma from their work, resulting in negative psychological responses, such as secondary traumatic stress. Empathy has been associated with patient's quality of care and secondary traumatic stress among healthcare providers. However, the relationship between dispositional empathy and secondary traumatic stress has not been fully elucidated. This study used person- and variable-centered approaches to explore the nature of this relationship. METHODS: A total of 1,006 Japanese public health nurses working in the Tohoku region and Saitama prefecture completed questionnaires that included scales assessing dispositional empathy, secondary traumatic stress, and burnout. First, we examined predictors of secondary traumatic stress using multiple linear regression analysis. Then, we conducted a latent profile analysis to classify participants into unique groups based on four subscales of dispositional empathy (i.e., empathic concern, perspective taking, personal distress, fantasy) and secondary traumatic stress. Finally, we compared the mean values of the study variables across these groups. RESULTS: The multiple regression indicated that in those working in Saitama prefecture, lifetime traumatic experiences, work-related distress, and personal distress were positively related to secondary traumatic stress, but perceived support was negatively related to secondary traumatic stress. Latent profile analysis extracted four unique subgroups. Group 1 displayed the highest secondary traumatic stress levels. Group 2 was characterized by the highest level of empathic concern, personal distress, and fantasy and the lowest perspective taking. Group 3 had a moderate secondary traumatic stress level. Group 4 had the lowest secondary traumatic stress and personal distress scores. In these four groups, the burnout scale (exhaustion, cynicism, and professional efficacy) showed a pattern similar to the secondary traumatic stress scale. CONCLUSIONS: Our person-centered approach showed that this sample of public health nurses could be classified into four unique groups based on their empathy and secondary traumatic stress scores. Although this group of public health nurses was not large, one group displayed high personal distress levels and high secondary traumatic stress levels. Further research is needed to determine effective interventions for this group.

Social cognitive mechanisms in healthcare worker resilience across time during the pandemic.

PURPOSE: Healthcare workers are at increased risk for mental health problems during disasters such as the COVID-19 pandemic. Identifying resilience mechanisms can inform development of interventions for this population. The current study examined pathways that may support healthcare worker resilience, specifically testing enabling (social support enabled self-efficacy) and cultivation (self-efficacy cultivating support) models. METHODS: Healthcare workers (N = 828) in the Rocky Mountain West completed self-report measures at four time points (once per month from April to July of 2020). We estimated structural equation models to explore the potential mediating effects that received social support and coping self-efficacy had (at time 2 and time 3) between traumatic stress symptom severity (at time 1 and time 4). Models included covariates gender, age, minority status, and time lagged co-variations between the proposed mediators (social support and coping self-efficacy). RESULTS: The full model fit the data well, CFI = .993, SRMR = .027, RMSEA = .036 [90% CIs (0.013, 0.057)]. Tests of sequential mediation supported enabling model dynamics. Specifically, the effects of time 1 traumatic stress severity were mediated through received social support at time 2 and time 3 coping self-efficacy, in sequential order to reduce time 4 traumatic stress severity. CONCLUSIONS: Findings show the importance of received social support and coping self-efficacy in mitigating psychopathology risk. Interventions can support mental health by focusing on social resource engagement that facilitates coping empowerment, which may decrease risk for mental health job-related problems among frontline healthcare workers exposed to highly stressful events.

Validity and reliability of the Secondary Traumatic Stress Scale-Japanese version.

AIM: This study assessed the validity and reliability of the Secondary Traumatic Stress Scale-Japanese Version. METHODS: The original Secondary Traumatic Stress Scale was translated into Japanese, and Japanese items were back-translated to English to confirm the accuracy of the translation. A total of 870 public health nurses from the Tohoku region in Japan completed the Secondary Traumatic Stress Scale-Japanese Version. An exploratory factor analysis was conducted to identify the number of components. Moreover, 351 public health nurses from the Saitama prefecture in Japan also completed the scale. A confirmatory factor analysis was performed with the factor structure identified in the exploratory factor analysis. RESULTS: The exploratory factor analysis identified two components: one associated with client-related distress and the other with trauma-related distress. The confirmatory factor analysis confirmed the two-factor structure. The two-factor structure model was better than the three-factor model presented in the original validation study for the English version of the scale. The two-factor model had good internal consistency for the overall product and the subscales. Pearson correlations showed that this model had good convergent validity against the Maslach Burnout Inventory, a psychological measure similar to the Secondary Traumatic Stress Scale. Finally, the two-factor model had good discriminant validity against the Maslach Burnout Inventory. CONCLUSION: This study identified two components of the Secondary Traumatic Stress Scale-Japanese Version that differ from the three components found in the original English version. The differences in the factor structure might indicate that the factor structure was culturally influenced.

Mental health risks differentially associated with immunocompromised status among healthcare workers and family members at the pandemic outset.

The mental health of healthcare workers (HCWs) is critical to their long-term well-being and future disaster preparedness. Goal 1 of this study was to identify rates of mental health problems experienced by HCWs. Goal 2 was to test a model of risk stemming from pandemic-related stressors and vulnerability factors. This cross-sectional study included HCWs (N â€‹= â€‹2,246 [1,573 clinical providers; 673 non-clinical staff]) in the Rocky Mountain West who voluntarily completed an online survey in April/May 2020. Respondents completed measures for traumatic stress symptoms, depression, anxiety, alcohol use, and sleep. Logistic regressions stratified by professional role (clinical versus non-clinical) were specified to predict clinical screening cutoff (positive/negative) as a function of five pandemic-related stressors (immunocompromised self; immunocompromised household member; care provision to infected patients; clinical management role; positive cases). Results showed that more than half of HCWs surveyed (52.5%) screened positive (above cutoff) for traumatic stress, depression, or anxiety, with ~20% reporting problematic alcohol use, and variable insufficient sleep from ~10% off shift to ~50% on shift. Clinical employees with an immunocompromised household member had increased odds of screening positive for a mental health problem. Non-clinical HCWs who were immunocompromised were at elevated risk for screening positive a mental health problem. Being female, minority status, and younger increased odds for mental health problems. Implications include alleviating a portion of the mental health burden of HCWs involved in response to the SARS-CoV-2 pandemic by considering policies to protect immunocompromised HCWs and their families (e.g., vaccine priorities, telework options).

Pandemic-related mental health risk among front line personnel.

The mental health of frontline workers is critical to a community's ability to manage crises and disasters. This study assessed risks for mental health problems (traumatic stress, depression, anxiety, alcohol use, insomnia) in association with pandemic-related stressors in a sample of emergency and hospital personnel (N = 571). Respondents completed self-report surveys online from April 1st to May 7th, 2020 in the Rocky Mountain region of the United States. Results showed that roughly fifteen to thirty percent of respondents screened positive for each disorder. Odds of screening positive were similar between groups for probable acute traumatic stress, depressive disorder, anxiety disorder, and alcohol use disorder; emergency personnel reported significantly higher rates of insufficient sleep than healthcare workers. Logistic regressions showed that respondents who reported having an immunocompromised condition had higher odds of acute traumatic stress, anxiety, and depression. Having an immunocompromised household member was associated with higher odds of insufficient sleep and anxiety. Being in a direct care provision role was associated with higher odds of screening positive for risky alcohol use. Being in a management role over direct care providers was associated with higher odds of screening positive for anxiety, risky alcohol use, and insufficient sleep. There was an inverse relationship between number of positive COVID-19 cases and anxiety, such that as positive cases went up, anxiety decreased. Overall, the mental health risks that we observed early in the COVID-19 pandemic are elevated above previous viral outbreaks (SARS) and comparable to rates shown in disasters (9/11 attacks; Hurricane Katrina).

Social engagement, self-efficacy, and posttraumatic stress symptoms across 6 months of psychotherapy.

OBJECTIVE: The current study was conducted in a naturalistic treatment setting to examine whether and how perceptions about social engagement, trauma coping self-efficacy, and posttraumatic stress symptoms (PTS) influence one another across 6 months of psychotherapy for trauma survivors. METHOD: The sample included 183 clients who reported exposure to traumatic events and significant PTS (PCL-5 ≥ 33). Participants (Mage = 37.8, 53.6% female) completed surveys at intake, 3 months, and 6 months into treatment. A cross-lagged panel analysis was used to test the relationships among perceived social engagement, coping self-efficacy, and PTS across three assessment points. RESULTS: PTS at 3-months was a mediator in the relationship between intake perceived social engagement and 6-month coping self-efficacy and between intake perceived social engagement and 6-month perceived social engagement. CONCLUSIONS: PTS several months into treatment may serve as a mechanism between intake perceived social engagement and functional outcomes such as coping self-efficacy.

Non-linear Dynamic Shifts in Distress After Wildfires: Further Tests of the Self-Regulation Shift Theory.

Worldwide exposure to explosive wildfires has become increasingly common. The psychological impact of these fires is substantial, demanding a deeper understanding of post-wildfire adaptation. This paper consists of two studies aiming to test self-regulation shift theory and its predicted non-linear shifts in distress using cusp catastrophe analyses. Study 1 tested a cusp catastrophe model on distress after the Waldo Canyon wildfire, Colorado (June, 2012). Results of study 1 showed that coping self-efficacy early after the wildfire was a significant bifurcation factor affecting when a shift in distress levels occurred from a lower state to an upper state. Perceived loss was a significant asymmetry controlling factor affecting the relative strength of each state. These findings indicate that a non-linear shift is more likely to occur at lower levels of coping self-efficacy and higher perceived loss. Study 2 tested the same model among survivors of several wildfires in California during 2017 and 2018. Results of study 2 confirmed the importance of coping self-efficacy again as a significant bifurcation factor. In this case, peritraumatic dissociation was found to be a significant asymmetry controlling factor instead of loss. These results indicate that an upward shift in distress occurs when coping self-efficacy is lower and peritraumatic dissociation is higher. Collectively, the combined findings suggest that coping self-efficacy is a pivotal variable consistent with self-regulation shift theory predictions. Intervention implications are discussed.

The Capability for Suicide in Firefighters.

OBJECTIVE: Suicide among firefighters is a critical mental health concern that remains under studied. The interpersonal-psychological theory of suicidal behavior (IPTS) states that, to engage in lethal suicidal behaviors, an individual must possess thwarted belongingness, perceived burdensomeness, and fearlessness about death (IPTS factors). Social cognitive theory may assist IPTS in explaining suicidal behavior. METHOD: Participants for the study were 216 volunteers and career firefighters. The sample was almost exclusively male, non-Hispanic or Latino, and Caucasian with a mean age of 40.6. We examined the mediating effect of firefighter coping self-efficacy (FFCSE) and coping self-efficacy for trauma (CSE-T) in the relationship between critical incidents and the IPTS factors. Moderated mediation analyses were performed with separate conditional effects of each social support subscale on the indirect effect of each self-efficacy perception in the relationship between critical incidents and the IPTS factors. RESULTS: Mediation analysis indicated that FFCSE did not mediate the relationships; however, CSE-T did mediate the relationships between critical incidents and the IPTS factors. These significant indirect effects of CSE-T were moderated by social support from significant other. CONCLUSIONS: CSE-T within the context of significant other support is important to consider in understanding firefighter mental health.

Negative Consequences of Providing Nursing Care in the Neonatal Intensive Care Unit.

BACKGROUND: Compassion fatigue, secondary traumatic stress, and burnout are negative consequences of providing nursing care among nurses. PURPOSE: This cross-sectional study examined a model of negative consequences of providing nursing care (i.e., compassion fatigue, secondary traumatic stress, and burnout) in the Neonatal Intensive Care Unit. METHODS: Data were collected from 174 registered nurses in the level III and IV NICUs in a Midwestern state. Moderated mediation analysis was conducted. FINDINGS: Self-compassion mediated the relationship between strength of the nurse-infant/family relationship and the negative consequences only when the nurse-physician-collegiality was high. There was no such relationship when the level was low. DISCUSSION: The study findings support the model of a mechanism for the development of negative consequences, involving self-compassion and nurse-physician collegiality. CONCLUSIONS: The findings may be applied to development of interventions to address negative consequences in nurses and help nursing administrators reduce staff nurses' negative consequences.

Predicting Change in Posttraumatic Distress Through Change in Coping Self-Efficacy After Using the My Trauma Recovery eHealth Intervention: Laboratory Investigation.

BACKGROUND: Technology offers a unique platform for delivering trauma interventions (ie, eHealth) to support trauma-exposed populations. It is important to evaluate mechanisms of therapeutic change in reducing posttraumatic distress in eHealth for trauma survivors. OBJECTIVE: This study evaluated a proactive, scalable, and individually responsive eHealth intervention for trauma survivors called My Trauma Recovery. My Trauma Recovery is an eHealth intervention aiming to support trauma survivors and consisting of 6 modules: relaxation, triggers, self-talk, professional help, unhelpful coping, and social support. It was designed to enhance trauma coping self-efficacy (CSE). We tested 3 hypotheses. First, My Trauma Recovery would decrease posttraumatic stress symptoms (PTSS). Second, My Trauma Recovery would increase CSE. And last, changes in CSE would be negatively correlated with changes in PTSS. METHODS: A total of 92 individuals exposed to trauma (78/92, 85% females, mean age 34.80 years) participated. Our study was part of a larger investigation and consisted of 3 sessions 1 week apart. Participants completed the baseline online survey assessing PTSS and CSE. Each session included completing assigned modules followed by the online survey assessing CSE. PTSS was remeasured at the end of the last module. RESULTS: PTSS significantly declined from T1 to T9 (F1,90=23.63, P<.001, η2p=.21) supporting the clinical utility of My Trauma Recovery. Significant increases in CSE for sessions 1 and 2 (F8,83=7.51, P<.001) were found. No significant change in CSE was found during session 3 (N=92). The residualized scores between PTSS T1 and T9 and between CSE T1 and T9 were calculated. The PTSS residualized score and the CSE residualized score were significantly correlated, r=-.26, P=.01. Results for each analysis with a probable PTSD subsample were consistent. CONCLUSIONS: The findings of our study show that participants working through My Trauma Recovery report clinically lower PTSS after 3 weeks. The results also demonstrate that CSE is an important self-appraisal factor that increased during sessions 1 and 2. These improvements are correlated with reductions in PTSS. Thus, changes in CSE may be an important mechanism for reductions in PTSS when working on a self-help trauma recovery website and may be an important target for eHealth interventions for trauma. These findings have important implications for trauma eHealth interventions.

Self-Regulation Shift Theory: A Dynamic Personal Agency Approach to Recovery Capital and Methodological Suggestions.

Recovery capital highlights person and environmental resources associated with overcoming significant life challenges. This paper utilizes social cognitive theory as a framework for understanding how recovery capital functions in trauma adaptation. This theory outlines the bidirectional, dynamic interactions among person (e.g., cognitive and affective), behavioral (e.g., problem focused coping), and environmental variables (i.e., triadic reciprocal determinism). The value of this approach to understanding human adaptation to trauma is that it targets the self-regulatory processes that unfold for trauma survivors as they attempt to put their lives back together. Self-regulation shift theory (SRST), as an extension to social cognitive theory, is offered to explain how self-regulation is involved in both positive and negative adjustment. The theory uses a dynamical systems approach and highlights the mechanisms related to non-linear shifts in both positive and negative trauma recovery. According to SRST, trauma recovery may not be linear with threshold shifts (i.e., bifurcations) from one organized state (broken self) to another (empowered self). Coping self-efficacy perceptions are a critical factor influencing these threshold shifts. This paper concludes with a brief review of study designs and analytic procedures that can facilitate the application of non-linear dynamic research in this area.

Burnout Among US Military Behavioral Health Providers.

The present study investigated the prevalence of burnout among US military behavioral health providers (BHPs) and tested a mechanism of developing burnout in a job demands-resources model. Surveys were sent to BHPs working with US military populations globally (T1). Six months after, surveys were collected again at T2. In total, 271 providers completed T1, and 116 completed T2. The job demands-resources model showed that T1 burnout self-efficacy and support predicted T2 burnout and work engagement. T1 job demands predicted T2 burnout. To provide a deeper comparison of our findings, we included a meta-analysis, which indicated burnout among BHPs working on a military installation was equivalent with other professions. Providers working with military clients within the community reported lower burnout than other professionals. Findings suggest BHPs working on a military installation might be at greater risk of developing burnout. Burnout might be preventable by increasing job resources and decreasing job demands.

Engagement With a Trauma Recovery Internet Intervention Explained With the Health Action Process Approach (HAPA): Longitudinal Study.

BACKGROUND: There has been a growing trend in the delivery of mental health treatment via technology (ie, electronic health, eHealth). However, engagement with eHealth interventions is a concern, and theoretically based research in this area is sparse. Factors that influence engagement are poorly understood, especially in trauma survivors with symptoms of posttraumatic stress. OBJECTIVE: The aim of this study was to examine engagement with a trauma recovery eHealth intervention using the Health Action Process Approach theoretical model. Outcome expectancy, perceived need, pretreatment self-efficacy, and trauma symptoms influence the formation of intentions (motivational phase), followed by planning, which mediates the translation of intentions into engagement (volitional phase). We hypothesized the mediational effect of planning would be moderated by level of treatment self-efficacy. METHODS: Trauma survivors from around the United States used the eHealth intervention for 2 weeks. We collected baseline demographic, social cognitive predictors, and distress symptoms and measured engagement subjectively and objectively throughout the intervention. RESULTS: The motivational phase model explained 48% of the variance, and outcome expectations (beta=.36), perceived need (beta=.32), pretreatment self-efficacy (beta=.13), and trauma symptoms (beta=.21) were significant predictors of intention (N=440). In the volitional phase, results of the moderated mediation model indicated for low levels of treatment self-efficacy, planning mediated the effects of intention on levels of engagement (B=0.89, 95% CI 0.143-2.605; N=115). CONCLUSIONS: Though many factors can affect engagement, these results offer a theoretical framework for understanding engagement with an eHealth intervention. This study highlighted the importance of perceived need, outcome expectations, self-efficacy, and baseline distress symptoms in the formation of intentions to use the intervention. For those low in treatment self-efficacy, planning may play an important role in the translation of intentions into engagement. Results of this study may help bring some clarification to the question of what makes eHealth interventions work.

Self-Regulation Shift Theory: A Dynamic Systems Approach to Traumatic Stress.

Self-regulation shift theory (SRST) is a threshold theory explaining self-regulation following trauma that utilizes nonlinear dynamics to capture systemic shifts in trauma adaptation. Cusp catastrophe modeling tests nonlinear changes in an outcome (e.g., posttraumatic distress) based on an identified bifurcation factor under specific conditions (i.e., asymmetry variables). We evaluated two cusp models in a motor vehicle accident (MVA) database and then confirmed findings within a similar dataset. Based on SRST, we tested coping self-efficacy (CSE) as the bifurcation factor and a set of asymmetry controlling variables. Results demonstrated significant cusp models with CSE as a consistent bifurcation factor in all models. When participants reported lower peritraumatic dissociation, early lower CSE was a significant bifurcation factor for 3-month trauma symptoms in Sample 1, R2 = .18. The cusp model for changes in symptoms from 30 days to 3 months showed CSE as a significant bifurcation variable with higher levels of avoidant coping (R2 = .27). In a separate sample, early lower CSE was again a significant bifurcation variable with lower injury severity (R2 = .52). Results support the importance of self-regulatory appraisals in nonlinear shifts in posttraumatic stress symptoms 3 months post-MVA. Theoretical and practical implications are discussed.

Associations between job burnout and self-efficacy: a meta-analysis.

BACKGROUND AND OBJECTIVES: This study aimed at systematically reviewing and meta-analyzing the strength of associations between self-efficacy and job burnout (the global index and its components). We investigated whether these associations would be moderated by: (a) the type of measurement of burnout and self-efficacy, (b) the type of occupation, (c) the number of years of work experience and age, and (d) culture. DESIGN AND METHODS: We systematically reviewed and analyzed 57 original studies (N = 22,773) conducted among teachers (k = 29), health-care providers (k = 17), and other professionals (k = 11). RESULTS: The average effect size estimate for the association between self-efficacy and burnout was of medium size (-.33). Regarding the three burnout components, the largest estimate of the average effect (-.49) was found for the lack of accomplishment. The estimates of the average effect were similar, regardless of the type of measures of burnout and self-efficacy measurement (general vs. context-specific). Significantly larger estimates of the average effects were found among teachers (compared to health-care providers), older workers, and those with longer work experience. CONCLUSIONS: Significant self-efficacy-burnout relationships were observed across countries, although the strength of associations varied across burnout components, participants' profession, and their age.

Trauma Coping Self-Efficacy: A Context-Specific Self-Efficacy Measure for Traumatic Stress.

OBJECTIVE: The psychometric properties of a Trauma Coping Self-Efficacy (CSE-T) scale that assesses general trauma-related coping self-efficacy perceptions were assessed. METHOD: Measurement equivalence was assessed using several different samples: hospitalized trauma patients (n1 = 74, n2 = 69, n3 = 60), 3 samples of disaster survivors (n1 = 273, n2 = 227, n3 = 138), and trauma-exposed college students (N = 242). This is the first multisample evaluation of the psychometric properties for a general trauma-related CSE measure. RESULTS: Results showed that a brief and parsimonious 9-item version of the CSE performed well across the samples with a robust factor structure; factor structure and factor loadings were similar across study samples. DISCUSSION: The 9-item scale CSE-T demonstrated measurement equivalence across samples indicating that the underlying concept of general posttraumatic CSE is organized in a similar manner in the different trauma-exposed groups. These results offer strong support for cross-event construct validity of the CSE-T scale. Associations of the CSE-T with important expected covariates showed significant evidence for convergent validity. Finally, discriminant validity was also supported. Replication of the factor structure, internal reliability, and other evidence for construct validity is a critical next step for future research. (PsycINFO Database Record

What Comes First, Job Burnout or Secondary Traumatic Stress? Findings from Two Longitudinal Studies from the U.S. and Poland.

This longitudinal research examined the directions of the relationships between job burnout and secondary traumatic stress (STS) among human services workers. In particular, using cross-lagged panel design, we investigated whether job burnout predicts STS at 6-month follow up or whether the level of STS symptoms explains job burnout at 6-month follow-up. Participants in Study 1 were behavioral or mental healthcare providers (N = 135) working with U.S. military personnel suffering from trauma. Participants in Study 2 were healthcare providers, social workers, and other human services professions (N = 194) providing various types of services for civilian trauma survivors in Poland. The cross-lagged analyses showed consistent results for both longitudinal studies; job burnout measured at Time 1 led to STS at Time 2, but STS assessed at Time 1 did not lead to job burnout at Time 2. These results contribute to a discussion on the origins of STS and job burnout among human services personnel working in highly demanding context of work-related secondary exposure to traumatic events and confirm that job burnout contributes to the development of STS.

From Exhaustion to Disengagement via Self-Efficacy Change: Findings from Two Longitudinal Studies among Human Services Workers.

This longitudinal research examined the relationship direction between burnout components (exhaustion and disengagement) within the context of personal resources measured by self-efficacy and social support. In line with the conservation of resources theory we hypothesized that exhaustion may trigger a spiral loss of personal resources where self-efficacy declines and subsequently, social support also declines and in turn predict disengagement. Participants in Study 1 were mental healthcare providers (N = 135) working with U.S. military personnel suffering from trauma. Participants in Study 2 were healthcare providers, social workers, and other human services professionals (N = 193) providing various types of services for civilian trauma survivors in Poland. Baseline and 6-month follow-up measurements included burnout components, burnout self-efficacy and perceived social support. The path analysis showed consistent results for both longitudinal studies; exhaustion measured at Time 1 led to disengagement at Time 2, after controlling for baseline disengagement levels. Across Study 1 and Study 2 these associations were mediated by self-efficacy change: Higher exhaustion led to greater decline in self-efficacy which in turn explained higher disengagement at the follow-up. Social support, however, did not mediate between self-efficacy and disengagement. These mediating effects were invariant across Studies 1 and 2, although the mean levels of burnout and personal resources differed significantly. The results contribute to a discussion on the internal structure of job burnout and a broader understanding of the associations between exhaustion and disengagement that may be explained by the underlying mechanism of change in self-efficacy.