The Relationship Between Depression, Anxiety, and Burnout Among Physician Assistant Students: A Multi-Institutional Study

Association between anxiety, depression symptoms, and academic burnout among Chinese students: the mediating role of resilience and self-efficacy

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.

The interplay between mindfulness and caring for bliss on later student burnout

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.

A Two-Wave Study On The Associations Of Burnout With Depression And Anxiety: The Mediating And Moderating Role Of Perceived Family Support

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.

Mediating Role of Emotional Intelligence in the Relationship between Anxiety Sensitivity and Academic Burnout in Adolescents

(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.

Assessing the Utility of Mental Health First Aid Training for Physician Assistant Students

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.

Association Between Stress and Program Length in Underrepresented Minority Physician Assistant Students

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 .

Development and validation of a nomogram for predicting the risk of mental health problems of factory workers and miners

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.

Association of occupational burnout and occupational exposure factors on psychological health among factory workers and miners: a propensity score analysis

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.