Can we predict burnout severity from empathy-related brain activity?

Abstract

Empathy cultivates deeper interpersonal relationships and is important for socialization. However, frequent exposure to emotionally-demanding situations may put people at risk for burnout. Burnout has become a pervasive problem among medical professionals because occupational burnout may be highly sensitive to empathy levels. To better understand empathy-induced burnout among medical professionals, exploring the relationship between burnout severity and strength of empathy-related brain activity may be key. However, to our knowledge, this relationship has not yet been explored. We studied the relationship between self-reported burnout severity scores and psychological measures of empathic disposition, emotional dissonance and alexithymia in medical professionals to test two contradictory hypotheses: Burnout is explained by (1) ‘compassion fatigue' that is, individuals become emotionally over involved; and (2) ‘emotional dissonance' that is, a gap between felt and expressed emotion, together with reduced emotional regulation. Then, we tested whether increased or decreased empathy-related brain activity measured by fMRI was associated with burnout severity scores and psychological measures. The results showed that burnout severity of medical professionals is explained by ‘reduced' empathy-related brain activity. Moreover, this reduced brain activity is correlated with stronger emotional dissonance and alexithymia scores and also greater empathic disposition. We speculate that reduced emotion recognition (that is, alexithymia) might potentially link with stronger emotional dissonance and greater burnout severity alongside empathy-related brain activity. In this view, greater empathic disposition in individuals with higher burnout levels might be due to greater difficulty identifying their own emotional reactions. Our study sheds new light on the ability to predict empathy-induced burnout.

Circles of engagement: Childhood pain and parent brain

“…Chronic ‘sharing of an emotional state’ with an offspring can lead to maladaptive changes in brain processing and emotional burnout, as high levels of empathy not only provides an advantage for recognizing others emotions, but is also associated with a bias toward negative emotions with a higher risk for empathic distress (Chikovani et al, 2015). Emotional burnout has been linked to decreased activation in the temporoparietal junction and the anterior insula coupled with a decreased ability to identify an internal emotional state (alexithymia) (Tei et al, 2014). These and other influences may alter the empathetic response in parents (Preston, 2013; Shirtcliff et al, 2009; Soria Bauser et al, 2012; Thakkar et al, 2009) including stress reactivity (Obradovic et al, 2010; Rodrigues et al, 2009; Shirtcliff et al, 2009).…”

Empathy in paediatric intensive care nurses part 2: Neural correlates

“…This last point, together with the findings of Tei et al. () who showed more burnout in nurses, raises an important issue that needs to be taken into consideration in the training of nurses working in ICUs. Sharing pain vicariously and repetitively does come with some cost and while experience may attenuate part of the affective response, such change might occur at the expense of nurses’ mental health.…”

“…This adds to the evidence that paediatric nurses’ chronic exposure to infant pain leads to a habituation effect in the IFG/AI response to this pain. Of relevance, a previous study (Tei et al., ) has shown that activation in this region in response to vicarious pain was lower in nurses with higher symptoms of burnout.…”

A latent profile analysis of trait emotional intelligence to identify beneficial and risk profiles in well-being and job performance: a study among Japanese eldercare nurses

“…In support of this finding, several studies have indicated that higher empathy may not always be associated with positive outcomes. For instance, although empathy is considered a central factor in establishing a superior professional-client partnership in nursing (Augusto-Landa and López-Zafra, 2010), excessive empathy was a risk factor for compassion fatigue (Wentzel and Brysiewicz, 2014), burnout (Tei et al, 2014) and depression (Schieman and Turner, 2001). Moreover, a similar finding has also been reported for altruism (Altun, 2002).…”