Association of Personal Distress With Burnout,Compassion Fatigue,and Compassion Satisfaction Among Clinical Social Workers

ABSTRACT

Studies of empathy and empathy-related responding show that while some people respond to observing the suffering of another with a prosocial concern and urge to help the suffering person, others have an aversive, avoidant response that is primarily self-focused and aimed toward relieving their own distress rather than helping the other person. This self-focused response, labeled personal distress, is associated with various social and psychological problems. This article discusses the concept of personal distress and describes a study of licensed clinical social workers (n = 171) that examines the relationship of personal distress and three other aspects of the empathy construct with compassion fatigue, burnout, and compassion satisfaction. Results of ordinary least squares multiple regression analyses indicate that the model of empathy components and control variables explain 20% to 23% of the variance in the dependent variables. Personal distress is the only component of the empathy construct with significant associations with the dependent variables. Higher personal distress is associated with higher compassion fatigue and burnout and lower compassion satisfaction among clinical social workers. Implications for future research and for social work education are discussed.     

Empathy-related Responding: Associations with Prosocial Behavior, Aggression, and Intergroup Relations

Empathy-related responding, including empathy, sympathy, and personal distress, has been implicated in conceptual models and theories about prosocial behavior and altruism, aggression and antisocial behavior, and intergroup relationships. Conceptual arguments and empirical findings related to each of these topics are reviewed. In general, there is evidence that empathy and/or sympathy are important correlates of, and likely contributors to, other-oriented prosocial behavior, the inhibition of aggression and antisocial behavior, and the quality of intergroup relationships. Applied implications of these findings, including preventative studies, are discussed, as are possible future directions.     

Maternal Social Coaching Quality Interrupts the Development of Relational Aggression During Early Childhood

Previous research has shown that parents of socially competent young children provide them with elaborative, explicit, appropriate, and emotion‐laden advice about peer interactions. The current study analyzed mothers' conversations with preschoolers (N = 175; 52 percent female; M age = 52 months, SD = 7 months) about peer conflicts involving relational aggression. Conversations were coded for maternal elaboration, emotion references, and discussion of norm violations. Information about relational and physical aggression was collected from teachers at two assessments approximately 12 months apart for a subsample of 136 children. Regression analyses, controlling for physical aggression, showed that average and high levels of effective coaching operated as a protective factor against stable high levels of relational aggression. Theoretical and practical implications for our understanding of the early development of relational aggression are discussed.     

Aggression in toddlerhood: The roles of parental beliefs,parenting behavior and precursors of theory of mind

Parental beliefs, parenting behavior, and precursors of theory of mind have been related uniquely to each other and to early aggression, but have not yet been studied simultaneously. The present study combined these risk factors in the prediction of aggression during toddlerhood using a sample of 152 mother–child dyads. At 20 months, mothers' parental beliefs (parental self‐efficacy and perceived parental impact) were examined with the Parental Cognitions and Conduct Toward the Infant Scale. Maternal parenting behavior (sensitivity, intrusiveness, and successful positive engagement) was observed during free play and teaching tasks, and children's precursors of theory of mind were assessed using a visual perspectives task and an imitation task. At 30 months, child aggression was examined using the Child Behavior Checklist. A regression analysis indicated that lower parental self‐efficacy and lower imitation skills predicted more aggressive behavior. When estimating the indirect effects using bootstrapping, a final model was found indicating that lower perceived parental impact was related to less successful positive engagement, which, in turn, was associated with children's poorer imitation abilities which predicted more aggressive behavior. It can be concluded that aggression during toddlerhood is predicted significantly by interrelated parental beliefs, parenting behavior, and children's early social cognitive abilities.     

Examining links between affective empathy,cognitive empathy,and peer relationships at the transition to school

The current study aimed to (i) examine associations across features of affective and cognitive empathy, and (ii) explore their independent role for children's peer relationships at the transition to school. Affective empathy was measured using both observations of children's facial affect during an empathy-eliciting event and dispositional affective empathy to peer distress via teacher report. Cognitive empathy was measured using an index of children's proclivity to engage in perspective taking when witnessing the distress of another. Children's theory of mind was also assessed given close links with cognitive empathy. Participants were 114 Australian children (M_age = 67 months, SD = 5 months) assessed across two sessions during their first year of formal schooling. Findings showed that features of children's affective and cognitive empathy were unrelated, but both showed independent associations with children's positive peer relationships (assessed via peer-reported social preference and teacher-rated peer social maturity). The current study provides support for the delineation between features of affective and cognitive empathy in early school-age children, and the importance of understanding both affective and cognitive empathy for children's peer relationships at the transition to school. These findings have implications how we understand both the nature of empathy in childhood and the role it plays in supporting children's positive peer relationships.     

Aggressive Behaviors in Social Interaction and Developmental Adaptation: A Narrative Analysis of Interpersonal Conflicts During Early Adolescence

Using conflict narratives reported by adolescents in grade 7 (mean age = 13.4 years), this study investigated the interactional properties and developmental functions of four types of aggressive behaviors: social aggression, direct relational aggression, physical aggression, and verbal aggression. A total of 475 participants from the Carolina Longitudinal Study ( Cairns & Cairns, 1994 ) were included. Results showed that the majority of conflict interactions involved more than a dyad. The use of social aggression (e.g., concealed social attack) was associated with more individuals involved in the conflict. Social aggression was primarily reported as an initiating behavior for interpersonal conflicts, while direct relational aggression was a responding behavior. Medium to high levels of reciprocity were found for physical, verbal, and direct relational aggression, whereas a low level of reciprocity was reported for social aggression. School authorities were most likely to intervene in physical aggression. The use of social aggression was associated with higher network centrality among adolescents. Developmental maladjustment in late adolescence and early adulthood was primarily predicted by physical aggression.     

Testing the qualitative differences between empathy and personal distress: Measuring core affect and self-orientation

In two studies the emotional valence, the level of arousal and self-orientation of empathic concern and personal distress are tested. The empathic concern prevalence versus personal distress prevalence is induced through pictures in Study 1 (N = 62) and perspective-taking instructions in Study 2 (N = 60). Results of Study 1 show that participants in the personal distress-prevalence condition report significantly more negative emotional valence (d = .65), higher arousal (d = .48), and higher self-orientation (d = .57) than participants in the empathic concern-prevalence condition. Results of Study 2 show that participants in the self-oriented condition report the highest arousal, followed by participants in the other-oriented condition, and the objective condition (η_p² = .58). Concerning the increase of self-orientation, results show that it is mediated by the personal distress induced by self-perspective instructions. Similar results in emotional valence were found between self- and other-oriented conditions.     

From Classroom to Dyad: Actor and Partner Effects of Aggression and Victim Reputation

This study examined whether early adolescents’ classroom aggression predicted their aggression in a one‐on‐one dyadic setting, and whether early adolescents’ classroom victimization predicted their victimization in the dyadic setting. After completing peer nominations for aggression and victimization, 218 early adolescents (M age = 11.0 years) participated in a dyadic paradigm in which they were led to believe that they played against a same‐sex classmate for whom they could set the intensity of noise blasts. Analyses with the actor–partner interdependence model by Olsen and Kenny showed that peer‐nominated physical aggression for boys and relational aggression for girls predicted noise blast aggression in the dyadic setting. For girls but not boys, peer‐nominated victimization predicted victimization in the dyadic setting.     

Rejection Reactivity,Executive Function Skills,and Social Adjustment Problems of Inattentive and Hyperactive Kindergarteners

This study examined emotional reactivity to rejection and executive function (EF) skills as potential mediators of the social behavior problems of inattentive and hyperactive kindergarteners. Participants included 171 children, including 107 with clinical levels of ADHD symptoms, 23 with sub‐clinical levels of ADHD symptoms, and 41 typically developing children (63 percent male; 73 percent Caucasian, 11 percent African‐American, 4 percent Latino/Hispanic, 1 percent Asian, and 11 percent multiracial; M_age = 5.2 years). Inattention (but not hyperactivity) was uniquely associated with poor EF, social withdrawal, and aggression. In structural equation models, EF skills mediated the associations between inattention and both aggression and social withdrawal. Hyperactivity (but not inattention) was uniquely associated with rejection reactivity and each contributed uniquely to aggression. Findings suggest that difficulties with emotion regulation may warrant more attention in early interventions planned for children with high levels of ADHD symptoms.     

Executive function and theory of mind as predictors of aggressive and prosocial behavior and peer acceptance in early childhood

Executive function (EF) and theory of mind (ToM) are related to children's social interactions, such as aggression and prosocial behavior, as well as their peer acceptance. However, limited research has examined different forms of aggression and the moderating role of gender. This study investigated links between EF, ToM, physical and relational aggression, prosocial behavior and peer acceptance and explored whether these relations are gender specific. Children (N = 106) between 46‐ and 80‐months‐old completed tasks assessing cool and hot EF and ToM. Teaching staff rated children's aggression, prosocial behavior, and peer acceptance. EF and ToM predicted physical, but not relational, aggression. Poor inhibition and delay of gratification were uniquely associated with greater physical aggression. EF and ToM did not predict prosocial behavior or peer acceptance. Added to this, gender did not moderate the relation between either EF or ToM and social outcomes. The correlates of aggression may therefore differ across forms of aggression but not between genders in early childhood.     

Developmental deviations in happy victimization across early childhood predict behavioral adjustment in middle childhood

This study examined whether the development of happy victimizing (HV) from early to middle childhood predicted prosocial and aggressive behaviors 3 years later. Participants included 150 children (50% female, M_age at study onset = 4.53 years) and their parents at four annual time points. At each time point, semi-structured interviews were conducted to assess children's emotional expectations after committing hypothetical transgressions. Child and parent reports of children's prosocial behaviors and aggression were provided at the beginning and end of the study. Children who experienced faster declines in HV reported higher prosocial behaviors 3 years later, controlling for initial levels of prosocial behaviors. Children who exhibited increases or lesser declines in HV reported higher aggression at the study end. The development of HV was not related significantly to parent reports of prosocial behaviors and aggression in middle childhood. Findings confirm theorizing on the normative developmental trajectory of HV and suggest that deviations in HV across early childhood may partially explain later behavioral adjustment.     

The roles of moral sensitivity and father presence on the relationship between violent video game exposure and aggression among left-behind adolescents

This cross-sectional study explored the relationship between violent video game exposure (VVGE) and aggression in left-behind adolescents (LBAs) in China, taking into account the effects of moral sensitivity and father presence. A cluster sampling design was applied in this study; we recruited 615 adolescents (45.85% male, age range 12–18 years, M_age = 14.70 years, SD = 1.66) from China. The results by using SPSS 25.0 and the PROCESS macro showed that VVGE was positively associated with LBAs' trait aggression and its items, and moral sensitivity played a partial mediating role in these relationships. Moreover, father presence moderated VVGE and LBAs' trait aggression, verbal aggression and hostility. Specifically, at a high level of father presence, the direct effect of VVGE on trait aggression was significantly moderated by increasing the level of father presence, whereas this moderating effect was not significant at a low level of father presence. The results were similar for verbal aggression and hostility. Thus, moral sensitivity and father presence should be considered in prevention and intervention strategies aimed at reducing LBAs' aggression.     

Prospective Associations between Peer Aggression and Victimization: The Moderating Roles of Physiological Stress Reactivity and Gender

The present investigation examined whether heightened skin conductance reactivity (SCLR) to peer stress strengthened the prospective associations between physical and relational aggression and victimization, and whether associations were stronger for physical forms of aggression and victimization among boys and relational forms of aggression and victimization among girls. A total of 91 children [M age = 10.18 years, standard deviation (SD) = .68] were assessed twice over 1 year. At the first assessment, SCLR in response to recounting a relational stressor (e.g., exclusion; SCLR‐R) and an instrumental stressor (e.g., property theft; SCLR‐I), and teacher‐reported aggression were measured. Parents reported on child victimization at both time points. Among youth with heightened SCLR‐I, physical aggression was associated with increases in physical victimization for boys and decreases in physical victimization for girls. Among youth with heightened SCLR‐R, relational aggression was associated with increases in physical victimization for girls only. Results were largely consistent with the hypothesis that aggressors with a propensity to exhibit negative displays of emotion, as indexed by heightened sympathetic nervous system (SNS) reactivity to peer stress, may be especially likely to suffer peer victimization. Gender‐specific effects highlight the importance of including both physical and relational forms of aggression and victimization to capture victimization risk among aggressive boys and girls.     

Physiological Regulation and Fearfulness as Predictors of Young Children's Empathy‐related Reactions

Indices of physiological regulation (i.e., resting respiratory sinus arrhythmia [RSA] and RSA suppression) and observed fearfulness were tested as predictors of empathy‐related reactions to an unfamiliar person's simulated distress within and across 18 (T1, N = 247) and 30 (T2, N = 216) months of age. Controlling for T1 helping, high RSA suppression and low fearfulness at T1 predicted T2 helping. In a structural model, empathic concern was marginally positively related to resting RSA at both assessments whereas personal distress was related to RSA suppression within time (marginally positively at T1 and significantly negatively at T2). Fearfulness was associated with self‐oriented, distress‐related reactions within time. Comfort seeking (an index of personal distress) declined in mean level with age whereas helping increased, and both behaviors exhibited differential continuity (as did resting RSA). Individual, as well as developmental, differences in the types of reactions that young children exhibit when witnessing others' suffering and distress were discussed.     

Hostile interpretation as a transdiagnostic factor for cooccurring anxiety in boys with aggressive behavior problems

Many children with aggressive behavior problems also suffer from anxiety. This cooccurrence may perhaps be explained by transdiagnostic factors. Identifying these factors seems crucial, as they may be important targets to treat these cooccurring problems effectively. This two-study paper investigates whether hostile interpretation of others’ intentions is a transdiagnostic factor for cooccurring aggression and anxiety problems, examining two samples of boys in middle childhood. We assessed boys’ aggression and anxiety using teacher-report in Study 1 (N = 84, M_age = 10.10), and parent-report in Study 2 (N = 115, M_age = 10.55). In both studies, we assessed hostile interpretation using vignettes describing ambiguous provocations by peers. Both studies revealed a strong association between aggression and anxiety problems, underscoring the necessity to examine factors that can explain this cooccurrence. However, in neither study was this association reduced when we added hostile interpretation to the model, suggesting that hostile interpretation did not function as a transdiagnostic factor in our samples. One possible explanation for these findings is that hostile interpretation predicts both aggression and anxiety problems, but in different children. We, therefore, encourage scholars to conduct more research to explain the high comorbidity of aggression and anxiety problems in children. Future research should also examine hostile interpretation as predictor or transdiagnostic factor for aggression and anxiety problems in more diverse population, including girls and other age groups.     

Empathy and Observed Anger and Aggression in Five-Year-Olds

In Roberts and Strayer (1996 ), we reported that emotional expressiveness and anger were important predictors of empathy for school‐age children, and that empathy strongly predicted prosocial behaviors aggregated across methods and sources. In this paper, we report how empathy was associated with direct observations of anger and aggression in peer play groups. Twenty‐four initially unacquainted five‐year‐old children (50% girls) were randomly assigned to six same‐sex groups; each group met for three one‐hour play sessions. Physical and verbal aggression, object struggles and anger were coded from videotapes, as were prosocial and social behaviors. As expected, empathy (aggregated across methods and sources) was negatively associated with aggression and anger, and positively associated with prosocial behaviors. Although children who were more angry were also more aggressive, anger and aggression did not covary across play sessions as a simple causal model requires. These results suggest further directions for research in emotions and aggression.     

Aggression in toddlers: Associations with temper loss and parent-child conflict

Using a normative US sample of 477 mothers of 6- to 24- month-old children, we explored the relations among toddlers’ physical aggression, child temper loss, and parent-child conflict to gain a better understanding of how aggression develops from infancy to toddlerhood. An inventory of specific aggressive acts was subject to factor analysis to test whether the acts clustered as hypothesized. Consistent with our hypothesis, confirmatory factor analyses supported the distinction between the two types of aggression, directed and exploratory physical aggression. Although the two types were correlated, they showed differential associations with temper loss and parent-child conflict consistent with theory. Directed aggression had a relatively stronger relation with child defiance and temper loss than did exploratory aggression. Moreover, the association between directed aggression and defiance was stronger for older children. The findings from this cross-sectional study provide preliminary support for two forms of early aggression that may differ in trajectory and context.     

Relations between close friendships and adolescent aggression: Structural and behavioral friendship features

Friendships have the potential to perpetuate or mitigate youth's aggressive behavior. We investigated concurrent and longitudinal effects of friendships on aggression by examining both structural (size and interconnectedness of the local friendship network) and behavioral (friends' aggression) friendship features. Participants were 868 sixth to eighth grade middle‐school students (M = 12.10 years; 49.9% girls; 44% Latina/o) who completed questionnaires at two time points. Participants nominated their friends; reciprocal friendship nominations were used to calculate structural friendship group features (size and interconnectedness). Peer nominations were also used to measure youth's and their friends' aggression. Having more reciprocal friends was associated with more aggression concurrently (particularly for youth whose friends were highly aggressive), and having an interconnected friendship group was associated with decreased aggression over time. Given that findings were different for group size and interconnectedness, we discuss the unique importance of each of these structural friendship features. Practical implications regarding the potential to decrease aggressive behavior based on specific friendship features are also discussed.     

Patterns of Reactive and Proactive Aggression in Young Adolescents in Singapore

The authors investigated the patterns of reactive and proactive aggression exhibited by young male (N = 604) and female (N = 544) adolescents in Singapore. Self‐report measures of reactive and proactive aggression, behavioral and emotional adjustment, parenting styles, and delinquency were administered to students aged 13–14. Using cluster analysis, three distinct patterns of aggression emerged: a low aggressive group, a combined aggressive group with high reactive and proactive aggression, and a reactively aggressive group with low proactive and high reactive aggression. The two aggressive groups showed similar disturbances in adjustment and delinquency, but the combined group showed the greatest disruptions. Findings indicate cross‐cultural stability of patterns of aggression as well as the usefulness of the reactive/proactive distinction in early identification of individuals with adjustment problems.     

Reactive and proactive aggression in children with and without ADHD and negative emotional lability

Children with attention‐deficit/hyperactivity disorder (ADHD) exhibit marked difficulty with frequent and intense shifts in negative or positive emotions, referred to as emotional lability. This study examines the relationships between negative emotional lability (NEL), ADHD, and reactive and proactive aggression. A community sample of 96 children (53 with ADHD, 43 control) ages 8–12 and their parents completed a baseline session include a diagnostic structured interview and the Reactive–Proactive Aggression Questionnaire (RPAQ). Parents then rated their child's NEL using the Positive and Negative Affect Scale as part of an Ecological Momentary Assessment protocol 3 times a day for 28 days. Seventy‐three participants (37 with ADHD, 36 control) completed the RPAQ at follow‐up. Hierarchical regression analyses indicated that NEL significantly and independently estimates reactive aggression at baseline and follow‐up, regardless of ADHD status. NEL and ADHD status significantly estimates concurrent proactive aggression, but not at follow‐up. Results of this study suggest that NEL accounts for a significant amount of the variability in reactive aggression, a common difficulty in children with ADHD. Further, individuals that are reportedly emotionally labile become more reactively aggressive over time. Both ADHD diagnostic and NEL are predictors of proactive aggression at baseline, although no interaction occurred.