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Liu W, Zhang R, Wang H, Rule A, Wang M, Abbey C, Singh MK, Rozelle S, She X, Tong L. Association between anxiety, depression symptoms, and academic burnout among Chinese students: the mediating role of resilience and self-efficacy. BMC Psychol 2024; 12:335. [PMID: 38849921 PMCID: PMC11162059 DOI: 10.1186/s40359-024-01823-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 05/27/2024] [Indexed: 06/09/2024] Open
Abstract
BACKGROUND To explore the associations between anxiety and depression symptoms and academic burnout among children and adolescents in China, and to examine the role of resilience and self-efficacy in addressing academic burnout. METHODS A total of 2,070 students in grades 4-8 were recruited from two primary and three middle schools in Shanghai, completed the Elementary School Student Burnout Scale (ESSBS), the Multidimensional Anxiety Scale for Children-Chinese (MASC-C), the Center for Epidemiological Studies Depression Scale (CES-D), the Connor-Davidson Resilience Scale (CD-RISC), and the General Self-Efficacy Scale (GSES), with 95.04% effective response rate. Multivariable regression analyses examining the associations between anxiety / depression symptoms and academic burnout (as well as the associations between resilience / self-efficacy and academic burnout) were performed using STATA 16.0 and SmartPLS 3.0. RESULTS Anxiety symptoms (β = 0.124, p < 0.01) and depression symptoms (β = 0.477, p < 0.01) were positively correlated with academic burnout. Resilience partially mediated the association between depression symptoms and academic burnout (β = 0.059, p < 0.01), with a mediation rate of 12.37%. Self-efficacy partially mediated the associations between anxiety symptoms and academic burnout (β = 0.022, p < 0.01) and between depression symptoms and academic burnout (β = 0.017, p < 0.01), with mediation rates of 17.74% and 3.56%, respectively. Resilience and self-efficacy together (β = 0.041, p < 0.01) formed a mediating chain between depression symptoms and academic burnout, with a mediation rate of 8.6%. CONCLUSIONS Anxiety and depression symptoms were positively associated with academic burnout. Resilience and self-efficacy were found to mediate the associations partially.
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Affiliation(s)
- Wanqing Liu
- Department of Maternal, Child and Adolescent Health, School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education of China, 138 Yixueyuan Road, P.O. Box 244, Shanghai, 200032, China
| | - Ruiyun Zhang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education of China, 138 Yixueyuan Road, P.O. Box 244, Shanghai, 200032, China
| | - Huan Wang
- Stanford Center of China's Economy and Institutions, Freeman Spogli Institute of International Studies, Stanford University, Stanford, Palo Alto, CA, 94305, USA
| | - Andrew Rule
- Stanford Center of China's Economy and Institutions, Freeman Spogli Institute of International Studies, Stanford University, Stanford, Palo Alto, CA, 94305, USA
| | - Min Wang
- Stanford Center of China's Economy and Institutions, Freeman Spogli Institute of International Studies, Stanford University, Stanford, Palo Alto, CA, 94305, USA
| | - Cody Abbey
- Stanford Center of China's Economy and Institutions, Freeman Spogli Institute of International Studies, Stanford University, Stanford, Palo Alto, CA, 94305, USA
| | | | - Scott Rozelle
- Stanford Center of China's Economy and Institutions, Freeman Spogli Institute of International Studies, Stanford University, Stanford, Palo Alto, CA, 94305, USA
| | - Xinshu She
- Stanford University School of Medicine, Stanford, Palo Alto, CA, 94305, USA.
- Department of Pediatrics, Stanford University School of Medicine, 453 Quarry Road, Mail Code 5660, Stanford, Palo Alto, CA, 94305, USA.
| | - Lian Tong
- Department of Maternal, Child and Adolescent Health, School of Public Health, Key Laboratory of Public Health Safety, Fudan University, Ministry of Education of China, 138 Yixueyuan Road, P.O. Box 244, Shanghai, 200032, China.
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Rudaz M, Ledermann T, Fincham FD. The interplay between mindfulness and caring for bliss on later student burnout. JOURNAL OF AMERICAN COLLEGE HEALTH : J OF ACH 2024; 72:188-194. [PMID: 35021036 DOI: 10.1080/07448481.2021.2024549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 11/10/2021] [Accepted: 12/26/2021] [Indexed: 06/14/2023]
Abstract
Objectives: While there are good reasons to assume that mindfulness protects against burnout in students, nothing is known about the role of caring for bliss. This study examined whether caring for bliss moderated the relationship between mindfulness at baseline and aspects of burnout approximately 12 weeks later. Participants: Students (n = 92) from a university in the United States. Methods: Online surveys were administered in 2018. Results: Moderated regression analyses, controlling for depressive symptoms and burnout at baseline, revealed that caring for bliss moderated the relationship between earlier mindfulness and two aspects of later student burnout, namely emotional exhaustion and cynicism. Specifically, exhaustion and cynicism were low when students reported either low or high scores on both mindfulness and caring for bliss. No moderating effect was found for academic efficacy. Conclusions: Mindfulness and caring for bliss appear to work synergistically to reduce aspects of student burnout over time.
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Affiliation(s)
- Myriam Rudaz
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
| | - Thomas Ledermann
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
| | - Frank D Fincham
- Department of Human Development and Family Science, Florida State University, Tallahassee, FL, USA
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Wallace MM. Strategies for Improving Mental Health in Physician Assistant Students. J Physician Assist Educ 2023; 34:157-159. [PMID: 37133898 DOI: 10.1097/jpa.0000000000000507] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/04/2023]
Affiliation(s)
- Michelle M Wallace
- Michelle M. Wallace, DMSc, PA-C, is a clinical professor and Director of Didactic Education in the Physician Associate Program, Wichita State University, Wichita, Kansas
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Koutsimani P, Montgomery A. A Two-Wave Study On The Associations Of Burnout With Depression And Anxiety: The Mediating And Moderating Role Of Perceived Family Support. Psychol Rep 2023; 126:220-245. [PMID: 34841980 DOI: 10.1177/00332941211051263] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Studies have shown strong associations between burnout and depression and burnout and anxiety but their exact interrelationships still remain unclear. Few studies have examined the psychosocial mechanisms that might underlie these two relationships. Non-work social factors such as perceived family support can affect mental health. The present study investigated the distinctiveness and the reciprocal associations between burnout and depression, and burnout and anxiety by collecting data twice over an 8 month interval. Perceived family support was examined as a mediating and a moderating factor underlying the two relationships. The Maslach Burnout Inventory-General Survey, the Hospital Depression and Anxiety Scale, and the Julkunen Family Support Scale were administered to employees of the general working population (N = 52). First, our results revealed moderate associations between burnout and depression, and burnout and anxiety, supporting the distinctiveness of burnout from the two psychological phenomena. Second, the exhaustion and cynicism burnout dimensions showed reciprocal associations with depression. Moreover, anxiety was found to be a consequence of cynicism while it presented reciprocal associations with the exhaustion dimension of burnout. Perceived family support did not mediate the burnout-depression and burnout-anxiety relationships. However, it moderated the depression-exhaustion relationship in a direction opposite from our hypothesis.
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Affiliation(s)
- Panagiota Koutsimani
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, 414877University of Macedonia, Egnatia, Greece
| | - Anthony Montgomery
- Department of Educational & Social Policy, School of Social Sciences, Humanities and Arts, 414877University of Macedonia, Egnatia, Greece
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Gázquez Linares JJ, Molero Jurado MDM, Pérez-Fuentes MDC, Martos Martínez Á, Simón Márquez MDM. Mediating Role of Emotional Intelligence in the Relationship between Anxiety Sensitivity and Academic Burnout in Adolescents. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 20:572. [PMID: 36612892 PMCID: PMC9819131 DOI: 10.3390/ijerph20010572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 12/17/2022] [Accepted: 12/26/2022] [Indexed: 06/17/2023]
Abstract
(1) Background: Increased stress and study overload during adolescence could be related to academic burnout. Anxiety sensitivity of students seems to affect burnout levels, while emotional intelligence enables emotion management under stressful conditions. The objective of this study is to analyze the roles of anxiety sensitivity and emotional intelligence in academic burnout. (2) Methods: In this quantitative cross-sectional study conducted in Spain, the sample comprised 1287 high school students aged 14 to 18 who filled out the Maslach Burnout Inventory-General Survey, the Spanish version adapted for high school students of the Anxiety Sensitivity Index-3, and Brief Emotional Intelligence Inventory. (3) Results: Anxiety sensitivity was significantly higher in cynicism and emotional exhaustion. Furthermore, the mediation analysis showed that high anxiety sensitivity directly affected student exhaustion, cynicism, and efficacy levels. These effects were mediated mainly through stress management but also through the effect of stress management on mood, both emotional intelligence factors. (4) Conclusions: The academic changes that occur during high school hinder engagement and performance. Promoting the development of emotional skills would enable young people to manage their emotions when they become overwhelming and diminish their lack of interest and exhaustion in the classroom.
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Affiliation(s)
| | | | - María del Carmen Pérez-Fuentes
- Department of Psychology, University of Almería, 04120 Almería, Spain
- Department of Psychology, Universidad Politécnica y Artística del Paraguay, Asunción 1628, Paraguay
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Forbes J, Noller DT, Henriquez M, Scantamburlo S, Ward I, Lee H. Assessing the Utility of Mental Health First Aid Training for Physician Assistant Students. J Physician Assist Educ 2022; 33:325-330. [PMID: 36409243 DOI: 10.1097/jpa.0000000000000467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION Physician assistant (PA) students are at increased risk for anxiety and depression compared with the general population. The demands of studying medicine can contribute to a decline in mental health, which may impede a student's ability to progress in his or her PA program. Mental Health First Aid (MHFA) is one strategy that can be used to increase mental health literacy, promote help-seeking behavior, reduce stigma, and improve confidence in providing help to individuals showing signs of a mental health disorder. The aim of this outcomes assessment was to assess PA students' satisfaction with the MHFA course and their posttraining confidence in using the skills learned. METHODS Participants were PA students (N = 435) across 9 PA programs in their didactic year of training who had completed an MHFA course through the PA Foundation's Mental Health Outreach Fellowship. MHFA postcourse evaluations, completed by the PA students, were analyzed to determine PA students' satisfaction with the course and their posttraining confidence in using the skills learned to help both themselves as well as the general population. RESULTS The mean of the MHFA course evaluation items corresponding to satisfaction with the course was 4.82 (maximum score of 5), and the mean of the items corresponding to posttraining confidence in using the skills learned was 4.74 (maximum score of 5). When asked, "Would you recommend this course to others?" 99.3% of the PA students trained in MHFA answered "yes," indicating a high level of satisfaction with the training they had received. DISCUSSION PA students who received MHFA training from the PA Foundation's Mental Health Outreach fellows showed high levels of satisfaction with the MHFA course and posttraining confidence in using the skills learned.
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Affiliation(s)
- Jennifer Forbes
- Jennifer Forbes, MHS, PA-C, is a clinical assistant professor for the Idaho State University physician assistant program in Meridian, Idaho
- Diana T. Noller, DHSc, MMS, MSPT, PA-C, is an associate professor of medical science and director of the physician assistant program at Austin College in Sherman, Texas
- Madeleine Henriquez, MPAS, PA-C, is a physician assistant at the MD Anderson Cancer Center in Houston, Texas
- Sarah Scantamburlo, MSW, MS, PA-C, is a psychiatric physician assistant at CNS Healthcare in Novi, Michigan
- Ian Ward, DHSc, PA-C, is the academic coordinator and assistant professor of clinical medicine at the Methodist University physician assistant program in Fayetteville, North Carolina
- Hwal Lee, MSPA, PA, is a community health physician assistant at the Whitney M. Young, Jr. Health Center in Albany, New York
| | - Diana T Noller
- Jennifer Forbes, MHS, PA-C, is a clinical assistant professor for the Idaho State University physician assistant program in Meridian, Idaho
- Diana T. Noller, DHSc, MMS, MSPT, PA-C, is an associate professor of medical science and director of the physician assistant program at Austin College in Sherman, Texas
- Madeleine Henriquez, MPAS, PA-C, is a physician assistant at the MD Anderson Cancer Center in Houston, Texas
- Sarah Scantamburlo, MSW, MS, PA-C, is a psychiatric physician assistant at CNS Healthcare in Novi, Michigan
- Ian Ward, DHSc, PA-C, is the academic coordinator and assistant professor of clinical medicine at the Methodist University physician assistant program in Fayetteville, North Carolina
- Hwal Lee, MSPA, PA, is a community health physician assistant at the Whitney M. Young, Jr. Health Center in Albany, New York
| | - Madeleine Henriquez
- Jennifer Forbes, MHS, PA-C, is a clinical assistant professor for the Idaho State University physician assistant program in Meridian, Idaho
- Diana T. Noller, DHSc, MMS, MSPT, PA-C, is an associate professor of medical science and director of the physician assistant program at Austin College in Sherman, Texas
- Madeleine Henriquez, MPAS, PA-C, is a physician assistant at the MD Anderson Cancer Center in Houston, Texas
- Sarah Scantamburlo, MSW, MS, PA-C, is a psychiatric physician assistant at CNS Healthcare in Novi, Michigan
- Ian Ward, DHSc, PA-C, is the academic coordinator and assistant professor of clinical medicine at the Methodist University physician assistant program in Fayetteville, North Carolina
- Hwal Lee, MSPA, PA, is a community health physician assistant at the Whitney M. Young, Jr. Health Center in Albany, New York
| | - Sarah Scantamburlo
- Jennifer Forbes, MHS, PA-C, is a clinical assistant professor for the Idaho State University physician assistant program in Meridian, Idaho
- Diana T. Noller, DHSc, MMS, MSPT, PA-C, is an associate professor of medical science and director of the physician assistant program at Austin College in Sherman, Texas
- Madeleine Henriquez, MPAS, PA-C, is a physician assistant at the MD Anderson Cancer Center in Houston, Texas
- Sarah Scantamburlo, MSW, MS, PA-C, is a psychiatric physician assistant at CNS Healthcare in Novi, Michigan
- Ian Ward, DHSc, PA-C, is the academic coordinator and assistant professor of clinical medicine at the Methodist University physician assistant program in Fayetteville, North Carolina
- Hwal Lee, MSPA, PA, is a community health physician assistant at the Whitney M. Young, Jr. Health Center in Albany, New York
| | - Ian Ward
- Jennifer Forbes, MHS, PA-C, is a clinical assistant professor for the Idaho State University physician assistant program in Meridian, Idaho
- Diana T. Noller, DHSc, MMS, MSPT, PA-C, is an associate professor of medical science and director of the physician assistant program at Austin College in Sherman, Texas
- Madeleine Henriquez, MPAS, PA-C, is a physician assistant at the MD Anderson Cancer Center in Houston, Texas
- Sarah Scantamburlo, MSW, MS, PA-C, is a psychiatric physician assistant at CNS Healthcare in Novi, Michigan
- Ian Ward, DHSc, PA-C, is the academic coordinator and assistant professor of clinical medicine at the Methodist University physician assistant program in Fayetteville, North Carolina
- Hwal Lee, MSPA, PA, is a community health physician assistant at the Whitney M. Young, Jr. Health Center in Albany, New York
| | - Hwal Lee
- Jennifer Forbes, MHS, PA-C, is a clinical assistant professor for the Idaho State University physician assistant program in Meridian, Idaho
- Diana T. Noller, DHSc, MMS, MSPT, PA-C, is an associate professor of medical science and director of the physician assistant program at Austin College in Sherman, Texas
- Madeleine Henriquez, MPAS, PA-C, is a physician assistant at the MD Anderson Cancer Center in Houston, Texas
- Sarah Scantamburlo, MSW, MS, PA-C, is a psychiatric physician assistant at CNS Healthcare in Novi, Michigan
- Ian Ward, DHSc, PA-C, is the academic coordinator and assistant professor of clinical medicine at the Methodist University physician assistant program in Fayetteville, North Carolina
- Hwal Lee, MSPA, PA, is a community health physician assistant at the Whitney M. Young, Jr. Health Center in Albany, New York
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McWeeney M. Association Between Stress and Program Length in Underrepresented Minority Physician Assistant Students. J Physician Assist Educ 2022; 33:336-340. [PMID: 36409245 DOI: 10.1097/jpa.0000000000000460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
INTRODUCTION The purpose of this study was to determine if there was a relationship between physician assistant (PA) program length and stress measures in PA students, particularly PA students classified as underrepresented minorities in medicine. The stress measures included emotional and physical well-being. METHODS The 2019 End of Program survey data were analyzed using multiple regression to determine if emotional and physical well-being could be predicted by PA program length, age, gender, PA school debt, and UR minority in medicine status. RESULTS Shorter PA programs were associated with higher physical well-being scores, although there was no difference between UR minority in medicine and non-UR minority in medicine students. Older students, males, and students with higher levels of PA school debt had lower scores for emotional and physical well-being. DISCUSSION Shorter program lengths should be considered for optimal physical well-being in all students. Further research is needed to understand optimal program length and experiences of these students .
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Affiliation(s)
- Michelle McWeeney
- Michelle McWeeney, PhD, PA-C, is an assistant professor for the Seton Hall University Physician Assistant Program in Nutley, New Jersey
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Lu Y, Liu Q, Yan H, Liu T. Development and validation of a nomogram for predicting the risk of mental health problems of factory workers and miners. BMJ Open 2022; 12:e057102. [PMID: 35863837 PMCID: PMC9310166 DOI: 10.1136/bmjopen-2021-057102] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE A nomogram for predicting the risk of mental health problems was established in a population of factory workers and miners, in order to quickly calculate the probability of a worker suffering from mental health problems. METHODS A cross-sectional survey of 7500 factory workers and miners in Urumqi was conducted by means of an electronic questionnaire using cluster sampling method. Participants were randomly assigned to the training group (70%) and the validation group (30%). Questionnaire-based survey was conducted to collect information. A least absolute shrinkage and selection operator (LASSO) regression model was used to screen the predictors related to the risk of mental health problems of the training group. Multivariate logistic regression analysis was applied to construct the prediction model. Calibration plots and receiver operating characteristic-derived area under the curve (AUC) were used for model validation. Decision curve analysis was applied to calculate the net benefit of the screening model. RESULTS A total of 7118 participants met the inclusion criteria and the data were randomly divided into a training group (n=4955) and a validation group (n=2163) in a ratio of 3:1. A total of 23 characteristics were included in this study and LASSO regression selected 12 characteristics such as education, professional title, age, Chinese Maslach Burnout Inventory, effort-reward imbalance, asbestos dust, hypertension, diabetes, working hours per day, working years, marital status and work schedule as predictors for the construction of the nomogram. In the validation group, the Brier score was 0.176, the calibration slope was 0.970 and the calibration curve of nomogram showed a good fit. The AUC of training group and verification group were 0.785 and 0.784, respectively. CONCLUSION The nomogram combining these 12 characteristics can be used to predict the risk of suffering mental health problems, providing a useful tool for quickly and accurately screening the risk of mental health problems.
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Affiliation(s)
- Yaoqin Lu
- School of Public Health, Xinjiang Medical University, Urumqi, China
- Urumqi Center for Disease Control and Prevention, Urumqi, China
| | - Qi Liu
- School of Public Health, Xinjiang Medical University, Urumqi, China
- Postgraduate Education Management Section, Xinjiang Medical University Affiliated First Hospital, Urumqi, Xinjiang, China
| | - Huan Yan
- Department of Nutrition and Food Hygiene, Xinjiang Medical University, Urumqi, China
- Xinjiangn Engineering Technology Research Center for Green Processing of Nature Product Center, Xinjiang Autonomous Academy of Instrumental Analysis, Urumqi, China
| | - Tao Liu
- School of Public Health, Xinjiang Medical University, Urumqi, China
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Association of occupational burnout and occupational exposure factors on psychological health among factory workers and miners: a propensity score analysis. Int Arch Occup Environ Health 2020; 94:441-450. [PMID: 33108547 DOI: 10.1007/s00420-020-01587-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2019] [Accepted: 10/05/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE This study is to explore the association of occupational burnout and occupational exposure factors on psychological health among factory workers and miners. METHODS A total of 6130 factories workers and miners in Urumqi, China were included using a cluster sampling method. The occupational burnout and psychological health were investigates using the Chinese Maslach Burnout Inventory (CMBI) and the Symptom Check List-90 (SCL-90). The propensity score analysis (PSA) was used to eliminate the influence of individual characteristics, and 2164 pairs of participants on psychological healthy and unhealthy were matched. After PSA, the relationship between occupational burnout, occupational hazard exposure, and psychological health was evaluated. RESULTS The results showed that asbestos dust (OR 1.65, CI 95% 1.35-2.02) and CMBI (OR 2.59, CI 95% 2.39-2.83) were risk factors affecting psychological health (P < 0.001). CONCLUSIONS Measures need to be taken to ease occupational burnout among factories workers and miners, and strengthen personal protection to improve their psychological health.
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