Measurement invariance of the Pandemic Anxiety Inventory in different demographic groups.

BACKGROUND: The Pandemic Anxiety Inventory (PAI) was developed in the context of the COVID-19 pandemic. Its content allows it to assess anxiety in connection to any pandemic. Previous research has demonstrated the instrument's reliability and validity. An important question for clinicians and researchers, however, remains open: Does the PAI have similar meaning for members of different demographic groups? The finding of measurement invariance would allow clinicians and researchers to comparatively assess pandemic-related anxiety across demographic groups, including favored and disfavored groups. METHODS: We conducted a multi-group confirmatory factor analysis to assess the measurement invariance of the PAI using data obtained from a sample of 379 residents of the United Kingdom. RESULTS: The PAI demonstrated invariance across genders, age groups, individuals who are married or in a relationship and those who are not, as well as individuals with higher and lower incomes. In an ancillary analysis, we found invariance across subsamples of Whites and Nonwhites, although we note that the Nonwhite group was small (n = 60) and heterogeneous. The findings of a supplemental MIMIC analysis were consistent with the above. CONCLUSIONS: The PAI shows measurement invariance across a variety of demographic groups. Our findings suggest that the instrument can be meaningfully employed to compare pandemic-related anxiety across these groups.

How client death impacts home care aides' workforce outcomes: an exploratory analysis of return to work and job retention.

Home health aides face a range of stressors that may result in departing the workforce. One stressor that has emerged in multiple qualitative studies as potentially influencing retention is client death. Using 2019 data from a single agency in New York City employing approximately 1700 aides, we used logistic and linear regression to explore case and aide factors associated with workforce outcomes after client death. We found that longer case length (Beta = 0.01, p < .001) was associated with longer return to work for aides experiencing client death and longer job tenure (Beta = -0.002, p = .002) was associated with shorter return to work (n = 67). We found no difference in retention between aides who experienced client death and those who did not (n 216). This analysis suggests the importance of research on the period of time following client death and of offering support to aides after clients die, particularly after longer cases.

Validation of the Occupational Depression Inventory in Brazil: A study of 1612 civil servants.

OBJECTIVE: The Occupational Depression Inventory (ODI) assesses work-attributed depressive symptoms. The ODI has demonstrated robust psychometric and structural properties. To date, the instrument has been validated in English, French, and Spanish. This study examined the psychometric and structural properties of the ODI's Brazilian-Portuguese version. METHODS: The study involved 1612 civil servants employed in Brazil (MAGE = 44, SDAGE = 9; 60% female). The study was conducted online across all Brazilian states. RESULTS: Exploratory structural equation modeling (ESEM) bifactor analysis indicated that the ODI meets the requirements for essential unidimensionality. The general factor accounted for 91% of the common variance extracted. We found measurement invariance to hold across sexes and age groups. Consistent with these findings, the ODI showed strong scalability (H = 0.67). The instrument's total score accurately ranked respondents on the latent dimension underlying the measure. Furthermore, the ODI exhibited excellent total-score reliability (e.g., McDonald's ω = 0.93). Occupational depression correlated negatively with work engagement and each of its components (vigor, dedication, and absorption), speaking to the ODI's criterion validity. Finally, the ODI helped clarify the issue of burnout-depression overlap. Relying on ESEM confirmatory factor analysis (CFA), we found burnout's components to correlate more strongly with occupational depression than with each other. Using a higher-order ESEM-within-CFA framework, we found a correlation of 0.95 between burnout and occupational depression. CONCLUSION: The ODI displays robust psychometric and structural properties within the Brazilian context. The ODI constitutes a valuable resource for occupational health specialists and may help advance research on job-related distress.

Towards a new approach to job-related distress: A three-sample study of the Occupational Depression Inventory.

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to respond to limitations of current assessments of job-related distress, most notably, assessments relying on the burnout construct. In this study, we conducted a thorough examination of the psychometric and structural properties of the ODI using exploratory structural equation modelling bifactor analysis and Mokken scale analysis. The study involved three samples of employed individuals, recruited in France (N = 3454), Switzerland (N = 1971), and Australia (N = 1485). Results were consistent across the three samples. The ODI exhibited essential unidimensionality and excellent total-score reliability-as indexed by McDonald's omega, Cronbach's alpha, Guttman's lambda-2, and the Molenaar-Sijtsma statistic. We found evidence for measurement invariance across sexes, age groups, and samples. Mokken scale analysis revealed that the ODI's scalability was strong. No monotonicity violation was detected. Invariant item ordering showed sufficient accuracy. In all three samples, suicidal ideation was the least commonly endorsed item-thus acting as a sentinel item-and fatigue/loss of energy was the most commonly endorsed item. The ODI exhibits excellent psychometric and structural properties, suggesting that occupational health specialists can effectively employ the instrument.

Measuring individual true change with PROMIS using IRT-based plausible values.

AIMS: A primary advantage of IRT-based patient-reported outcome measures such as PROMIS short forms and computer-adaptive tests is that each estimate of the latent trait comes with a standard error. Such measurement error needs to be acknowledged, in particular when monitoring individual patients over time. In this study, we use plausible values to account for measurement error and analyze the probability of true within-individual change. METHODS: We use a longitudinal, observational study of stable and exacerbated COPD patients (N = 185), providing PROMIS Physical Function and Fatigue T-scores over 3 months. At each measurement, we imputed 1000 plausible values from the scores' posterior distribution. These were then used to calculate probability of true change using a pre-specified threshold such as minimally important difference supported by the literature, or [Formula: see text] > 0. We demonstrate assessment of change in individuals and in groups, across different measures (Short Forms and CATs), and at various levels of confidence. RESULTS: Using plausible value imputation and with 95% certainty, 47.5% of participants in the exacerbated group reported less fatigue, compared with 26.5% of participants in the stable group. Comparison of Short Forms and CATs suggests that CATs have better ability to detect change compared to short forms. We also illustrate this method using an individual's probability of change at different time points. CONCLUSION: Plausible values offer a flexible way to include measurement error in analysis of individuals and on sample level. Assessment of probability of true change can complement existing distribution-based approaches and facilitates interpretation of improvement or decline.

Is the PHQ-9 a unidimensional measure of depression? A 58,272-participant study.

The PHQ-9 has become a measure of reference in depression research and clinical practice. However, the issue of the PHQ-9's unidimensionality has not been fully elucidated, and the usability of the PHQ-9's total score requires clarification. In this study, we examined the dimensionality, scalability, and monotonicity properties of the PHQ-9 as well as the scale's total-score reliability. We did so based on exploratory structural equation modeling (ESEM) bifactor analysis and Mokken scale analysis (MSA). We relied on a total of 58,272 participants (63% female; Mage = 43, SDage = 13) from 29 samples involving seven different countries (e.g., Germany, the U.S.) and five different languages (e.g., German, English). We found no concerning deviations from measurement invariance for our ESEM bifactor model, neither across samples nor across sexes, age groups, and languages. The PHQ-9 met the requirements for essential unidimensionality in the pooled sample and across sex-, age-, and language-based subsamples. In each case, the general factor was strong (e.g., factor loadings ranged from 0.725 to 0.893 in the pooled sample) and Omega Hierarchical values exceeded 0.900. The correlations between the general factor and the observed total scores were large (≥ 0.952). Our MSA, including multilevel MSA, revealed that the PHQ-9's scalability is satisfactory. No monotonicity violation was detected, suggesting that the scale's total score accurately orders respondents on the latent Depression variable. Total-score reliability was good. This study provides robust evidence that the PHQ-9 can be used as a unidimensional measure of depressive symptoms by researchers and practitioners. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The Fisher information function and scoring in binary ideal point item response models: a cautionary tale.

This article examines the Fisher information functions, I(θ) , and explores implications for scoring of binary ideal point item response models. These models typically appear to have I(θ) that are bimodal and identically equal to 0 at the ideal point. The article shows that this is an inherent property of ideal point IRT models, which either have this property or are indeterminate and thus violate the likelihood regularity conditions. For some models, the indeterminacy can be resolved, generating an effectively unimodal I(θ) , albeit with violated regularity conditions. In other cases, I(θ) diverges. All reasonable ideal point IRT models exhibit this behaviour. Users should exercise caution when relying on asymptotics, particularly for shorter assessments. Use of simulated plausible values or prediction from a fully Bayesian estimation is recommended for scoring.

Individual factors and cisgender college students' attitudes and behaviors toward transgender individuals.

The present study is one of few to investigate both anti-trans discrimination and anti-trans prejudice. It examined four individual factors (religiosity; political beliefs; affiliation with LGBTQ [lesbian, gay, bisexual, transgender, and queer] people; gender role beliefs) through a lens of hetero-cis-normativity to understand their association with anti-trans attitudes and reported behaviors. Using a sample of 302 cisgender college students from across the United States, hierarchical multiple regressions on bootstrap samples were used to analyze how these factors are associated with anti-trans attitudes and behaviors. More liberal political beliefs, affiliation with more LGBTQ friends and family members, and less traditional gender role beliefs were related to more positive attitudes toward transgender people. Less traditional gender role beliefs and more positive attitudes were associated with more positive reported behaviors toward transgender individuals. Interventions designed to challenge traditional gender role beliefs and approximate affiliation with LGBTQ persons may be most effective to reduce pervasive hetero-cis-normative prejudice and discrimination within schools.

Burnout-Depression Overlap: Exploratory Structural Equation Modeling Bifactor Analysis and Network Analysis.

Burnout has been viewed as a work-induced condition combining exhaustion, cynicism, and professional inefficacy. Using correlational analyses, an exploratory structural equation modeling bifactor analysis, structural regression analyses, and a network analysis, we examined the claim that burnout should not be mistaken for a depressive syndrome. The study involved 1,258 educational staff members. Burnout was assessed with the Maslach Burnout Inventory-General Survey and depression with the Patient Health Questionnaire-9 and the Hospital Anxiety and Depression Scale. Illegitimate work tasks and work-nonwork interferences were additionally measured. We notably found that (a) on average, exhaustion, cynicism, and professional inefficacy correlated less strongly with each other than with depression; (b) exhaustion-burnout's core-was more strongly associated with depression than with either cynicism or professional inefficacy; (c) the Patient Health Questionnaire-9 did not correlate more strongly with the Hospital Anxiety and Depression Scale than with exhaustion; (d) exhaustion and depression loaded primarily on a general distress/dysphoria factor in the exploratory structural equation modeling bifactor analysis; (e) on average, burnout and depression were related to job stressors in a similar manner; (f) work-nonwork interferences were strongly linked to distress/dysphoria. Overall, burnout showed no syndromal unity and lacked discriminant validity. Clinicians should systematically assess depressive symptoms in individuals presenting with a complaint of "burnout."

Measuring Trauma Exposure: Count Versus Variety of Potentially Traumatic Events in a Binational Sample.

Traumatic event checklists typically ask respondents to indicate whether they have experienced particular types of potentially traumatic events (PTEs) and then sum these endorsements to gauge cumulative trauma exposure. However, the sum of these endorsements indicates the variety of PTEs respondents have experienced rather than the count of exposure events. The main objective of the present study was to explore the association between PTE count and variety to examine assumptions regarding the use of traumatic event checklists to measure cumulative trauma exposure. The limited empirical research suggests that count and variety are strongly associated; however, there may be variation in magnitude concerning whether participants' environments confer an increased or decreased risk of exposure. We present Life Event Checklist data from a large sample of Mexican and U.S. participants (n = 1,820), which allowed us to compare reports of count and variety. Count and variety were strongly correlated, Kendall's tau-b = .74, such that count accounted for 54.6% of the variance in variety. A negative binomial regression analysis revealed that this association was moderated by county and municipio homicide rate, used as a proxy for violent crime, but not by natural disaster history. Variety was more strongly associated with scores on the Posttraumatic Stress Checklist for DSM-5, Kendall's tau-b = .26, than was PTE count, Kendall's tau-b = .22, Fisher's z = -8.04, p < .001. Although there are challenges in estimating PTE counts, the present findings suggest that PTE variety is not a good proxy for cumulative trauma exposure.

A five-sample confirmatory factor analytic study of burnout-depression overlap.

OBJECTIVE: It has been asserted that burnout-a condition ascribed to unresolvable job stress-should not be mistaken for a depressive syndrome. In this confirmatory factor analytic study, the validity of this assertion was examined. METHODS: Five samples of employed individuals, recruited in Switzerland and France, were mobilized for this study (N = 3,113). Burnout symptoms were assessed with the Shirom-Melamed Burnout Measure, the Maslach Burnout Inventory (MBI)-General Survey, and the MBI for Educators. Depressive symptoms were measured with the PHQ-9. RESULTS: In all five samples, the latent factors pertaining to burnout's components correlated on average more highly with the latent Depression factor than with each other, even with fatigue-related items removed from the PHQ-9. Second-order factor analyses indicated that the latent Depression factor and the latent factors pertaining to burnout's components were reflective of the same overarching factor. CONCLUSIONS: This study suggests that the burnout-depression distinction is artificial.

Retrieval practice and spacing effects in multi-session treatment of naming impairment in aphasia.

Retrieval practice and spacing are two factors shown to enhance learning in basic psychological research. The present study investigated the clinical applicability of these factors to naming treatment in aphasia. Prior studies have shown that naming treatment that provides retrieval practice (i.e., practice retrieving names for objects from semantic memory) improves later naming performance in people with aphasia (PWA) more so than repetition training. Repetition training is a common form of naming treatment that can support errorless production of names for objects, but it does not provide retrieval practice. Prior work has also demonstrated enhanced naming treatment benefit in PWA when an item's training trials are separated by multiple intervening trials (i.e., spacing) compared to only one intervening trial (i.e., massing). However, in those studies, items were only trained in one session. Also, the effects of the learning factors were probed after one day and one week. The goal of the present study was to examine the effects of retrieval practice and spacing in a more clinically-inspired schedule of delivery and to assess the effects of the learning factors at retention intervals of greater functional significance. Matched sets of errorful items for each of four PWA were presented for multiple trials of retrieval practice or repetition in a spaced or massed schedule in each of multiple training sessions. Mixed regression analyses revealed that retrieval practice outperformed repetition, and spacing outperformed massing, at an initial post-treatment test administered after one week. Furthermore, the advantage for retrieval practice over repetition persisted at a follow-up test administered after one month. The potential clinical relevance of retrieval practice and spacing for multi-session interventions in speech-language treatment is discussed.

An exploratory structural equation modeling bi-factor analytic approach to uncovering what burnout, depression, and anxiety scales measure.

In this study, we addressed the ongoing debate about what burnout and depression scales measure by conducting an exploratory structural equation modeling (ESEM) bifactor analysis. A sample of 734 U.S. teachers completed a survey that included the Center for Epidemiologic Studies Depression scale (CES-D-10), the depression module of the Patient Health Questionnaire (PHQ-9), the Generalized Anxiety Disorder scale (GAD-7), and the Maslach Burnout Inventory (MBI), which contains emotional exhaustion (EE), depersonalization (DP), and (diminished) personal accomplishment (PA) subscales. Job adversity and workplace support were additionally measured for the purpose of a nomological network analysis. EE, burnout's core, was more highly correlated with the depression and anxiety scales than it was with DP and PA, even with controls for item content overlap. The CES-D-10, PHQ-9, GAD-7, and EE subscale of the MBI were similarly related to job adversity and workplace support. ESEM bifactor analysis revealed that the CES-D-10, PHQ-9, GAD-7, and EE items loaded highly on a general factor, which we labeled nonspecific psychological distress (NSPD). We conclude that depression, anxiety, and EE scales reflect NSPD. DP items largely reflect two factors, NSPD and depersonalization, about equally. PA items were found to be less related to NSPD. With respect to the debate surrounding burnout-depression overlap, our findings do not support the view that the burnout construct represents a syndrome that consists of EE, DP, and diminished PA and excludes (or does not primarily include) depressive symptoms. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Network models can help focus research on the role of culture and context in psychopathology, but don't discount latent variable models.

Borsboom et al. correctly note that the use of latent variable models in cross-cultural research has resulted in a futile search for universal, biological causes of psychopathology; however, this is not an inevitable outcome of such models. While network analytic approaches require further development, network models have the potential to better elucidate the role of cultural and contextual variables related to psychopathology.

Inquiry into the correlation between burnout and depression.

[Correction Notice: An Erratum for this article was reported online in Journal of Occupational Health Psychology on Sep 9 2019 (see record 2019-54511-001). In the article, there were wording errors in the Results section. Specifically, we referred to imposing "constraints" when we meant the opposite, namely, relaxing constraints, such as allowing residuals to correlate. We corrected the wording errors, added chi-square statistics, and corrected four small typographic errors bearing on fit statistics (three changes of .001 and one change of .003). The results remain fundamentally the same. All versions of this article have been corrected.] The extent to which burnout refers to anything other than a depressive condition remains an object of controversy among occupational health specialists. In three studies conducted in two different countries and two different languages, we investigated the discriminant validity of burnout scales by evaluating the magnitude of the correlation between (latent) burnout and (latent) depression. In Study 1 (N = 911), burnout was assessed with the Maslach Burnout Inventory-General Survey's Exhaustion subscale and depression with the depression module of the Patient Health Questionnaire (PHQ). In Study 2 (N = 1,386), the Shirom-Melamed Burnout Measure was used to assess burnout and the PHQ, depression. In Study 3 (N = 734), burnout was assessed with the Maslach Burnout Inventory-Educators Survey and depression, with the PHQ and the Center for Epidemiological Studies Depression scale; additionally, anxiety was measured with the Generalized Anxiety Disorder scale. In each study, we examined the burnout-depression association based on confirmatory factor analysis (CFA), controlling for item-level content overlap. In the three studies, latent exhaustion, the core of burnout, and latent depression were highly correlated (correlations ranging from .83 to .88). In Studies 2 and 3, second-order CFAs indicated that depressive (and anxiety) symptoms and the exhaustion and depersonalization components of burnout are reflective of the same second-order distress/dysphoria factor. Our findings, with their replication across samples, languages, and measures, together with meta-analytic findings, cast serious doubt on the discriminant validity of the burnout construct. The implications of burnout's problematic discriminant validity are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Meta-analyses of the relation of goal consensus and collaboration to psychotherapy outcome.

This article provides meta-analyses of the relation between goal consensus and collaboration and individual psychotherapy outcome using studies published in English between 1978 and June 2017. Inclusion criteria involved (a) a measure of psychotherapy outcome, (b) a measure of goal consensus and/or collaboration, (c) a group design, (d) adult patients (aged 18 years or older), and (e) a reported effect or statistic that could be converted to an effect size. For the 54 studies (N = 7,278) of goal consensus and outcome, the result was r = .24 (95% confidence interval [CI] [.19, .28]) or d = .49, representing a medium effect. For the 53 studies (N = 5,286) of patient-therapist collaboration and outcome, the result was r = .29 (95% CI [.24, .34]) or d = .61, another medium effect. In all, 21 studies (N = 2,081) of therapist collaboration and outcome yielded an omnibus effect of .26 (95% CI [.18, .35]) or d = .54. Results suggest patient-therapist goal consensus and collaboration enhance psychotherapy outcome. The article concludes with research limitations, diversity considerations, and therapeutic practices. Limitations of the studies included a dearth of diverse samples, assessment of goal consensus and/or collaboration at a single time during treatment, failure to relate measures to outcome, and analyses that do not permit causal conclusions. Research suggests that therapists seek input from patients to form and effect treatment goals and plans, provide patients with regular feedback, and seek their involvement throughout therapy. (PsycINFO Database Record (c) 2018 APA, all rights reserved).

Crystallized and fluid intelligence of university students with intellectual disability who are fully integrated versus those who studied in adapted enrichment courses.

BACKGROUND: Inclusion of people with intellectual disability (ID) in higher postsecondary academic education is on the rise. However, there are no scientific criteria for determining the eligibility for full inclusion of students with ID in university courses. This study focuses on two models of academic inclusion for students with ID: (a) separate adapted enrichment model: students with ID study in separate enrichment courses adapted to their level; (b) full inclusion model: students with ID are included in undergraduate courses, receive academic credits and are expected to accumulate the amount of credits for a B.A. AIM: (a) To examine whether crystallized and fluid intelligence and cognitive tests can serve as screening tests for determining the appropriate placement of students with ID for the adapted enrichment model versus the full inclusion model. (b) To examine the attitudes towards the program of students with ID in the inclusion model. METHOD/PROCEDURE: The sample included 31 adults with ID: students with ID who were fully included (N = 10) and students with ID who participated in the adapted enrichment model (N = 21). Crystallized and fluid intelligence were examined (WAIS-III, Wechsler, 1997) and Hebrew abstract verbal tests (Glanz, 1989). Semi-structured interviews were conducted in order to examine the attitudes of students in the inclusion model towards the program. OUTCOMES AND RESULTS: The ANOVAs indicate that the most prominent difference between the groups was in vocabulary, knowledge and working memory. ROC analysis, a fundamental tool for diagnostic test evaluation, was used to determine the students' eligibility for appropriate placement in the two models. Seven tests distinguished between the groups in terms of sensitivity and specificity. The interviews were analyzed according to three phases. CONCLUSIONS/IMPLICATIONS: The results indicate that students with ID are able to participate in undergraduate courses and achieve academic goals. The general IQ and idioms test seem to be best determiners for appropriate placement of students with ID to one of the two models. The included students with ID are motivated and self-determined in continuing in the program.

Measuring Depression in a Non-Western War-Affected Displaced Population: Measurement Equivalence of the Beck Depression Inventory.

Depression is commonly seen in survivors of conflict and disaster across the world. There is a dearth of research on the validity of commonly used measures of depression in these populations. Measurements of depression that are used in multiple contexts need to meet measurement equivalence, i.e., the instrument measures the same construct in the same manner across different groups. The Beck Depression Inventory (BDI) was administered to female trauma survivors in the United States (n = 268) and female survivors of war in Sri Lanka (n = 149). Three metrics of measurement equivalence-structural, metric, and scalar-were examined. Two- and three-factor structures of the BDI that have been identified in other populations did not provide a good fit for our data. However, a bifactor model revealed a similar general distress dimension across populations, but dissimilar secondary dimensions or subfactors. The Sri Lankan subfactor comprised of predominantly somatic symptoms and the United States subfactor comprised of cognitive and somatic symptoms. While intercepts of individual BDI items differed, their differences seem to be offsetting. Total BDI scores across these two populations are roughly comparable, although caution is recommended when interpreting them. Making comparisons on subscales is not recommended.

Towards a Theory of Learning for Naming Rehabilitation: Retrieval Practice and Spacing Effects.

Purpose: The purpose of this article was to examine how different types of learning experiences affect naming impairment in aphasia. Methods: In 4 people with aphasia with naming impairment, we compared the benefits of naming treatment that emphasized retrieval practice (practice retrieving target names from long-term memory) with errorless learning (repetition training, which preempts retrieval practice) according to different schedules of learning. The design was within subjects. Items were administered for multiple training trials for retrieval practice or repetition in a spaced schedule (an item's trials were separated by multiple unrelated trials) or massed schedule (1 trial intervened between an item's trials). In the spaced condition, we studied 3 magnitudes of spacing to evaluate the impact of effortful retrieval during training on the ultimate benefits conferred by retrieval practice naming treatment. The primary outcome was performance on a retention test of naming after 1 day, with a follow-up test after 1 week. Results: Group analyses revealed that retrieval practice outperformed errorless learning, and spaced learning outperformed massed learning at retention test and at follow-up. Increases in spacing in the retrieval practice condition yielded more robust learning of retrieved information. Conclusion: This study delineates the importance of retrieval practice and spacing for treating naming impairment in aphasia.

Burnout and depression: Label-related stigma, help-seeking, and syndrome overlap.

We investigated whether burnout and depression differed in terms of public stigma and help-seeking attitudes and behaviors. Secondarily, we examined the overlap of burnout and depressive symptoms. A total of 1046 French schoolteachers responded to an Internet survey in November-December 2015. The survey included measures of public stigma, help-seeking attitudes and behaviors, burnout and depressive symptoms, self-rated health, neuroticism, extraversion, history of anxiety or depressive disorder, social desirability, and socio-demographic variables. The burnout label appeared to be less stigmatizing than the depression label. In either case, however, fewer than 1% of the participants exhibited stigma scores signaling agreement with the proposed stigmatizing statements. Help-seeking attitudes and behaviors did not differ between burnout and depression. Participants considered burnout and depression similarly worth-treating. A huge overlap was observed between the self-report, time-standardized measures of burnout and depressive symptoms (disattenuated correlation: .91). The overlap was further evidenced in a confirmatory factor analysis. Thus, while burnout and depression as syndromes are unlikely to be distinct, how burnout and depression are socially represented may differ. To our knowledge, this study is the first to compare burnout- and depression-related stigma and help-seeking in the French context. Cross-national, multi-occupational studies examining different facets of stigma are needed.