Maladaptive schemata and effort-reward imbalance in physicians and psychotherapists Systematic literature review

Background According to studies, physicians frequently suffer from work stress and burnout. This is caused in particular by the working conditions. In addition, intrinsic factors also play a role. Early maladaptive schemata (MS) can serve as markers for intrinsic stress. A schema includes permanent, unfavorable patterns of feelings, thoughts and memories that control behavior in a specific situation. This article provides a systematic overview of the international study situation on effort-reward imbalance and MS among physicians/psychotherapists (PT). Material and methods Systematic literature search of studies between 2000 and 2020 in PubMed, Psyndex and Google Scholar. Registration was carried out in OSF registries (osf.io/jxhga/). Search terms were schema, maladaptive schema combined with physician, psychiatrist, psychotherapist, psychologist, as an additional search linked with effort reward (imbalance) or effort-reward (imbalance). Results A first search revealed 906 publications and a second 1088 publications. By filtering duplicates, screening abstracts and the texts, the number was reduced to two publications. By means of a forward and backward search, five further articles and therefore seven relevant publications were identified. Conclusion There are so far only a few studies dealing with intrinsic factors related to effort-reward imbalance and mental health among physicians/PT. In particular, the more complex concept of schemata appears to be more meaningful than one-dimensional personality traits. Intrinsic factors are of great importance to develop preventive and support measures for stressed physicians/PT.

Automated summary

There is limited research on the intrinsic factors related to effort-reward imbalance and mental health among physicians/psychotherapists. The more complex concept of schemata appears to be more meaningful than one-dimensional personality traits. Intrinsic factors are crucial in developing support measures for stressed physicians/PT.