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Handbook of Stress in the Occupations

Edited by Janice Langan-Fox and Cary Cooper

The Handbook of Stress in the Occupations sets a new agenda for stress research and gives fresh impetus to scholars who wish to focus on issues and problems associated with specific jobs, some of which have received little attention in the past.
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Chapter 4: Occupational Stress, Professional Burnout and Job Satisfaction Among Psychiatrists

Antonio Lasalvia


Antonio Lasalvia INTRODUCTION Professionals caring for long-term and seriously ill patients frequently experience distressing emotional situations and profound suffering. These emotions may include the need to ‘rescue’ patients, a sense of failure and frustration when illness progresses, feelings of powerlessness against illness and its associated losses, grief, fear of becoming ill oneself, and a desire to remain emotionally distant from and/or avoid patients to escape these feelings. Although common in everyday clinical practice, these emotions often affect both the quality of care physicians provide and their own well-being (Meier et al., 2001). Individuals working in the mental health field have been identified as a high-risk group for mental illness (Leary and Brown, 1995; Nolan et al., 1995) and burnout (Pines and Maslach, 1978; Leiter and Harvie, 1996) themselves. Psychiatrists in particular are at a high risk of depression, anxiety, psychiatric caseness and burnout (Looney et al., 1980; Naisberg-Fennig et al., 1991; Deary et al., 1996a; Prosser et al., 1996). Fagin et al. (1996) proposed a three-stage model of the stress process in mental health care: external stressors (i.e. specific occupational stressors, minor ‘hassles’ and major life events); mediating or buffering factors (such as self-esteem, social support and individual coping skills); and stress outcomes (generally measured in terms of psychological ill health, burnout and job satisfaction). This chapter examines external sources of stress that impact psychiatrists’ professional lives (with a specific emphasis on occupational stressors) and discusses the negative outcomes of chronic exposure to external job-related stressors, i.e. professional burnout and...

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