Feelings of professional inadequacy among psychiatrists may be closely linked to burnout, compassion fatigue, and maladaptive perfectionism, according to a cross-sectional study published in BMC Psychiatry.
The study surveyed 160 psychiatrists in Turkey using validated self-report measures of burnout, compassion fatigue, compassion satisfaction, maladaptive perfectionism, and imposter phenomenon. Across analyses controlling for age and professional experience, higher levels of burnout and compassion fatigue were consistently associated with stronger imposter feelings in both men and women. Maladaptive perfectionism – defined by a perceived gap between high personal standards and actual performance – was also strongly linked to imposter phenomenon.
Path analyses suggested that maladaptive perfectionism influenced imposter phenomenon both directly and indirectly through burnout and compassion fatigue. Burnout partially mediated the relationship between perfectionism and imposter feelings, while compassion fatigue provided an additional indirect pathway, pointing to a reinforcing cycle in which self-critical perfectionism and work-related emotional strain amplify feelings of professional fraudulence.
Gender differences were also observed. Female psychiatrists reported higher levels of imposter phenomenon, maladaptive perfectionism, burnout, and compassion fatigue than their male counterparts, while men reported higher compassion satisfaction. Imposter feelings and maladaptive perfectionism were inversely related to age and professional experience, suggesting confidence may increase over time.
Rather than framing imposter phenomenon as an individual vulnerability alone, the authors position it within broader professional and cultural contexts. Psychiatry’s reliance on subjective clinical judgment and emotionally demanding therapeutic relationships may heighten uncertainty and self-doubt, pressures that may be compounded by training environments that normalize perfectionism and discourage acknowledgment of error.
The researchers caution that the study’s cross-sectional design limits causal inference and that reliance on self-report measures may introduce bias. However, they argue that the findings underscore the need to address systemic contributors to burnout and maladaptive perfectionism, rather than focusing solely on individual resilience.
Discussing implications, the authors caution against viewing imposter phenomenon as an individual problem alone, arguing it should be considered within the context of occupational stressors such as burnout, compassion fatigue, and maladaptive perfectionism.
The authors declared no competing interests.
Source: BMC Psychiatry
