Our searches identified 284 titles of potentially relevant peer-reviewed articles (Fig. 1). After synthesizing the data from multiple reports on the same set of participants, 66 articles describing 62 studies with 14,161 participants met our inclusion criteria (Table 1).
Although our searches were for the literature starting in 1966, the included studies were all published between 1990 and 2018 (Fig. 2)—notably, half were published in the past 6 years.
Although most of the studies were conducted in the USA9, 10, 12, 13, 15,16,17, 21,22,23,24,25,26,27,28,29,30,31,32, 34,35,36,37,38, 42, 43, 45, 49,50,51,52,53,54,55,56,57, 61, 62, 64, 65, 67, 73 and Canada,19, 44, 46, 66, 68 twenty-one studies evaluated populations in other countries including five in Austria,39, 58,59,60, 63 five in Australia/New Zealand,20, 31, 70, 71, 74 four in Germany,11, 14, 47, 48, 58 three in Iran,33, 40, 41 two in the UK,20, 69 and one each in Belgium72 and Korea.73
Nearly all of the included studies were single-arm observational studies (Table 1). Most commonly, the authors identified a population of interest, screened them with a validated impostor syndrome questionnaire and other psychometric assessment tools, then described the prevalence of impostor syndrome and co-occurring psychological issues. Two studies also included semi-structured interviews.37, 38, 44 One study included an experimental design in which subjects were exposed to successes and failures and asked to report on impostor feelings after these exposures.31 The only longitudinal assessment was of college students with impostor syndrome who were followed before and after a midterm examination.25 Notably, there were no randomized trials and only one study presented qualitative information about the clinical management people with impostor syndrome.
Overall, the quality of the included studies was fair: Only 20 studies reporting having Institutional Review Board (IRB) approval.10, 12, 13, 20,21,22,23, 28, 44, 46, 48, 50,51,52, 54, 58, 59, 62, 64, 66, 73 Many studies lacking IRB approval were of student populations—often in the authors’ own institutions. Response rates for the populations surveyed ranged from 2.8 to 97.2% (and many articles did not report response rates) (Table 1).
The included studies evaluated 14,161 participants, 60% of whom were women. Among those studies reporting a mean population age, the weighted mean age was 20 years (Fig. 3)—not surprising given that 34 of the included studies were of students. However, 17 studies included populations with a mean age of > 30 years and 5 additional studies were of professional populations but did not report a mean age.]-->
Half of the included studies were of student populations: 5 evaluated elementary and high-school students,16, 19, 27, 49, 61 29 evaluated undergraduates,10, 14, 20,21,22,23,24,25, 28, 30, 31, 35, 41,42,43, 45, 50,51,52, 55,56,57,58, 63,64,65,66, 68,69,70 and 12 evaluated graduate students.17, 29, 31, 33, 34, 36, 39, 50, 55, 65, 67, 73 Students with impostor syndrome had fears that were significantly related to maintaining their social standing and not wanting to display imperfection to others31; however, social support and self-worth were highly negatively associated with impostor symptoms.16 Impostor feelings were significantly related to pessimism, perfectionistic traits, and low self-esteem, and although there were no differences in grades between impostors and non-impostors, impostors expected to perform worse and were more anxious about exams.25 Interestingly, Ferrari found that students with impostor feelings were significantly less likely to cheat on examinations and to plagiarize written assignments than students without impostor feelings.30
Students of Minority Groups
Eleven included articles evaluated impostor syndrome in minority groups.10, 12, 13, 21,22,23, 29, 51, 52, 54, 64, 73 They demonstrated that impostor syndrome is common among African American, Asian American, and Latino/a American college students and that impostor feelings are significantly negatively correlated with psychological well-being and positively correlated with depression and anxiety.21,22,23, 54 Several factors may predispose minority students to increased psychological stress during their educational experiences including lack of adequate financial aid, the need to work to support themselves in school, racial discrimination, enduring negative stereotypes, and being the first in their families to pursue advanced education.21, 29 Moreover, using MANOVA, one study found that impostor feelings were stronger predictors of mental health than minority status stress.21 Austin et al. found that impostor syndrome, depression, and survivor guilt were highly correlated among African American college students.10 Bernard et al. found that African American freshmen who reported frequent racial discrimination but low levels of distress from discrimination had higher levels of impostor syndrome than those who reported high levels of distress from racial discrimination.12, 13 Few non-White individuals have been included in the samples used to standardize the assessment for impostor syndrome—thereby potentially invalidating these tools for minority populations.29
Nineteen of the included articles described impostor syndrome among employed populations.9, 11, 14, 15, 26, 32, 37, 38, 40, 44, 46,47,48, 53, 58, 59, 62, 72, 74 Five of these were of nurses and physicians,9, 40, 44, 46, 62 the rest included managers, teachers, and accountants, among others. Given the tendency of people with impostor syndrome to aggressively pursue achievement while not being able to accept recognition when success is achieved, affected employees may experience increased levels of stress, burnout, and decreased job performance and satisfaction over time.26, 37, 72 Employees who persistently question their professional legitimacy are at higher risk for experiencing adverse psychological outcomes with implications to career retention, advancement, and job performance. Moreover, impostor feelings among employees is associated with fear of failure, fear of success, and low self-esteem.58 Employees who report more impostor feelings report less career planning and motivation to lead.58, 60
Bechtoldt found that supervisors across a variety of industries scoring high on impostorism were more inclined to delegate both routine and challenging tasks to subordinates who doubted their own professional abilities.11
Crawford et al. found a significant relationship between impostor syndrome and self-reported conflict managing work/life balance among community college employees; however, this relationship was minimized if employees perceived greater organizational support.26 This suggests a role for managers and executives in mitigating the effects of impostor syndrome on employees.
Together, these findings suggest that individuals who struggle with impostor syndrome may be limited in their ability to fully develop their professional potential and may be a significant contributor to burnout both among healthcare professionals and others.
Several tools have been developed to assess impostor syndrome. The preponderance of included articles used the Clance Imposter Phenomenon Scale (or its German translation),75 a 20-item scale on a 5-point Likert scale related to self-assessed competency, praise, and success. Six studies16, 27, 29, 45, 49, 61 used the Harvey Impostor Phenomenon Scale (HIPS),76 a 14-item questionnaire on a 7-point Likert scale regarding personality traits (where a higher score indicates greater identification with impostor syndrome). Two used the Leary Imposter Scale,55, 56 two used self-developed questionnaires,15, 19 one45 used the Perceived Fraudulence Scale,1 and one used the Young Imposter scale.73
There is considerable variation in how researchers interpret specific scores on the impostor syndrome diagnostic scales. For some, a score of < 40 on the CIPS denotes no impostorism, 40–59 mild, 60–79 moderate, and > 80 as severe impostor feelings.75 Others recommend using a score of 62 on the CIPs77 or use the median CIP score in their population25 to distinguish impostors from non-impostors. We note the cutoffs used, when reported.
Few of the included studies were designed to assess the prevalence of impostor syndrome, which varied widely from 9 to 82% largely depending on the screening tool and cutoff used to assess symptoms. For example, Chae et al.18 found that the prevalence of impostor syndrome among 654 Korean Catholics varied from 24% using a CIPS cutoff of 62 to 39% using a cutoff of 58. We suspect that the included literature on the prevalence of impostor syndrome may be subject to publication bias (i.e., the tendency of journals to publish studies with positive findings rather than negative findings) since all of the included studies reported some participants endorsing impostor feelings.
Predictors of Impostor Syndrome
Thirty-three articles compared the rates of impostor syndrome by gender.10, 14, 18, 21, 23, 25, 27, 28, 32, 35,36,37,38,39, 42, 43, 45,46,47,48,49,50, 54, 57, 62, 63, 68, 70, 72, 73 Sixteen of these found that women reported statistically significantly higher rates of impostor feelings than men.23, 28, 33, 35,36,37,38,39, 42, 43, 46, 50, 57, 62, 63, 73 Hutchins and colleagues found that men and women cope differently with their impostor feelings.37, 38 In contrast, 17 studies found no difference in rates of impostor syndrome between men and women.10, 18, 21, 24, 25, 27, 32, 40, 45, 47,48,49, 53, 54, 68, 70, 72 Brauer and Proyer studied two populations—psychology students and professionals—and found gender effects for impostor syndrome only among the students, not the professionals.14 Thus, the body of evidence suggests that while impostor syndrome is common in women, it also affects men.
Six studies compared the rates of impostor syndrome by age.14, 18, 49, 62, 70, 74 Two studies reported that increased age was associated with decreased impostor feelings.18, 70 Three studies found no age effect.49, 62, 74 Brauer and Proyer evaluated impostor syndrome in two cohorts (244 psychology students and 222 working professionals in Germany)—they found that age was significantly negatively correlated with impostor feelings among working professionals but not undergraduates.14 Notably, in their study, the age range of the working professionals was much larger than that of the students, perhaps contributing to the likelihood of finding an age effect.
Many included articles explored the psychological issues that are often found to co-exist with impostor syndrome including depression,41, 47,48,49, 57, 62, 69, 78 anxiety,34, 41, 79, 80 low self-esteem,58, 62 somatic symptoms, and social dysfunctions.41 Impostor feelings among high school students correlated significantly with a history of prior suicidal ideation and attempts and depression.49 Clearly, the care of patients with impostor syndrome requires a careful assessment for comorbid conditions and treatment of them in addition to addressing the impostor feelings.
None of the included articles presented an evaluation of a specific treatment (e.g., cognitive behavioral therapy) for managing impostor symptoms. A 1985 paper by Matthews and Clance qualitatively described their experiences in private practice caring for 41 people with impostor feelings.53 They recommended validating patients’ doubts and fears, directly addressing fears of failure, and providing group therapy since these patients often feel isolated and that they alone experience impostor feelings; however, no data were presented on treatment intensity, duration, or improvements on any diagnostic tool.
Lay Literature Results
We found considerable lay interest in impostor syndrome. During the year (March 28, 2018–March 18, 2019), 2317 Internet articles were published on impostor syndrome (150–200 articles/month). These resulted in 133,425 engagements (e.g., “likes,” re-postings, comments) on social media platforms such as Facebook and Twitter. While numerous Internet users interacted with content originating from sites like Psychology Today (968 engagements), the majority of readers engaged with articles posted on blogging platforms like Medium.com (3111 engagements) or sites targeted toward professionals, like Inc.com (1568 engagements), LinkedIn.com (795 engagements), and Forbes.com (688 engagements).81
A detailed review of the content of these articles is outside the scope of this study. However, the vast majority were tagged as “What is…” articles, which define impostor syndrome followed by “How-To” articles, which offer treatment tips. Many of the articles classified as “What is…” articles also include tips about how to manage impostor syndrome. These tips run the gamut from “embracing authenticity” to “comparing notes with peers and mentors about shared impostor feelings”; however, much of this advice involves changing the thought processes that affirm feeling like a fraud. In 2018, Time Magazine published an article with an accompanying short video entitled, “Yes, Imposter syndrome is real. Here’s how to deal with it.”82 Among other suggestions, they recommend that people suffering with impostor syndrome learn to reframe their thoughts and visit a psychologist.
Notably, whereas the academic literature on the topic is nearly all indexed with the term Impostor Phenomenon, the entirety of the lay literature is indexed with the term Imposter Syndrome.