Tei S, Becker C, Kawada R, Fujino J, Jankowski K F, Sugihara G, Murai T, Takahashi H
1] Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan [2] Institute of Applied Brain Sciences, Waseda University, Tokyo, Japan [3] School of Human and Social Sciences, Department of Human Development and Sport sciences, Tokyo International University, Saitama, Japan.
Kokoro Research Center, Kyoto University, Kyoto, Japan.
Transl Psychiatry. 2014 Jun 3;4(6):e393. doi: 10.1038/tp.2014.34.
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.
同理心有助于培养更深厚的人际关系,对社交至关重要。然而,频繁置身于情感要求高的情境中可能会使人面临职业倦怠的风险。职业倦怠已成为医疗专业人员中普遍存在的问题,因为职业倦怠可能对同理心水平高度敏感。为了更好地理解医疗专业人员中由同理心引发的职业倦怠,探索职业倦怠严重程度与同理心相关大脑活动强度之间的关系可能是关键。然而,据我们所知,这种关系尚未得到探讨。我们研究了医疗专业人员自我报告的职业倦怠严重程度得分与同理心倾向、情绪失调和述情障碍的心理测量指标之间的关系,以检验两个相互矛盾的假设:职业倦怠可由(1)“同情疲劳”来解释,即个体在情感上过度投入;以及(2)“情绪失调”来解释,即感受与表达的情绪之间存在差距,同时情绪调节能力下降。然后,我们测试了通过功能磁共振成像(fMRI)测量的与同理心相关的大脑活动增加或减少是否与职业倦怠严重程度得分及心理测量指标相关。结果表明,医疗专业人员的职业倦怠严重程度可由与同理心相关的大脑活动“减少”来解释。此外,这种大脑活动的减少与更强的情绪失调和述情障碍得分以及更高的同理心倾向相关。我们推测,情绪识别能力下降(即述情障碍)可能与更强的情绪失调和更高的职业倦怠严重程度以及与同理心相关的大脑活动存在潜在联系。从这个角度来看,职业倦怠水平较高的个体具有更强的同理心倾向可能是由于他们更难识别自己的情绪反应。我们的研究为预测由同理心引发的职业倦怠的能力提供了新的见解。