دانلود رایگان مقاله استرس زندگی به عنوان عامل خطر بالقوه برای افسردگی و فرسودگی

ABSTRACT

Objective: Depression and burnout are two psychopathological labels that have been subject to an extensive discussion over the last decades. The crucial question is whether they can be seen as conceptually equal or as two distinct syndromes. One argument for the distinction is that depression impacts on the whole life of a suffering person whereas burnout is restricted to the job context. Depression has been shown to be affected by life stress. The more stressful life events a person experiences, the more he or she is susceptible for developing a depression. As there is the widespread but controversial opinion that burnout is a prodromal syndrome of depression, the present study examined whether the number of stressful life events is also associated with an increased risk for burnout. Methods: N = 755 healthy participants and N = 397 depressed patients completed the Maslach Burnout Inventory (MBI), the Beck Depression Inventory (BDI II) and reported the extent of experienced life stress. Results: A significantly closer relation between depression and life stress than between burnout and life stress was found in the healthy (z = 3.01, p = .003) as well as in the depressed sample (z = 3.41, p = .001). This finding was supported in both samples by means of a path analytic approach where the associations between life stress, burnout, and depression were controlled for possible mediator and moderator effects, also considering the influence of age. Conclusion: By considering the influence of life stress it could be demonstrated that depression and burnout are not identical although they share substantial phenotypic variance (r = .46–.61). Most important, the trivariate associations are the same in a representative employee sample and in an inpatient clinical sample suggesting the same underlying mechanisms covering the whole range from normal behavior to psychopathology. However, only longitudinal data can show if burnout necessarily turns into depression with the consequence that the burnout – life stress association approaches the depression – life stress association over time.

4. Discussion

Because of the sustained debate regarding the distinctiveness of burnout and depression and due to the lack of a conclusive definition of this construct, the aim of the present study was to test whether life stress accounts for the relationship between depression and burnout. As there is the widespread assumption that depression arises from and affects many areas of life, whereas burnout is – not only but mainly – restricted to job stressors (Hakanen & Schaufeli, 2012), we assessed experienced life stress in a large sample of employed adults and in a sample of depressed inpatients who were not employed during participation. We hypothesized that both constructs are related, but that the number of stressful life events is closer related to depression than to burnout. In our data, we found a moderate correlation between burnout and depression, which is quite similar to that reported by Toker et al. (2005) who found correlation coefficients of about r = .50 between burnout and depression for men and for women. With an amount of about 36% of shared variance in the healthy control sample, we found a closer relation than other authors suggested in the past (e.g., Iacovides et al., 2003). However, the association was still moderate which means that important shares of variance were not equal for both constructs. Furthermore, correlations of the three MBI subscales drew the typical picture of closest relation between depression and emotional exhaustion and lowest association between depression and reduced efficacy. These findings are in line with shared variance estimates by Schaufeli and Enzmann (1998), who found an overlap with depression of 12–38% (emotional exhaustion), 2–29% (depersonalization), and 3–20% (reduced efficacy) respectively. In the clinical sample, there was an amount of shared variance of about 20%, which meets the shared variance estimates of the literature very well. Worthy of note, Bianchi et al. (2014) also reported similar correlations between depression and burnout for their whole sample but report a much closer relation when only taking highly burned-out participants into account. They argue that the fact that most studies only include healthy participants might lead to an underestimation of the correlation between burnout and depression as these results cannot be generalized to a clinical setting. However, our data suggest the same underlying mechanisms in the healthy as well as in the inpatient depressed sample questioning this assumption. Moreover, the correlation between both constructs was smaller in the depressed sample than in the healthy sample (r = .456 vs. r = .613).