Original articleAlexithymia and occupational burnout are strongly associated in working population
Introduction
In the early 1970s Sifneos [1] coined the term alexithymia. Alexithymia means literally “no words for feelings” and refers to a personality construct characterized by impoverishment of fantasy, a poor capacity for symbolic thought, and difficulties in experiencing and verbalizing emotions. Alexithymia is thought to reflect a deficit in the cognitive processing of emotion, and alexithymics are thought to lack the capacity for mental representation of emotions [2], [3], [4]. These deficiencies are believed to cause an inability to regulate emotions and affects and, therefore, to predispose the alexithymic individuals to both psychological and somatic symptoms. Alexithymia is, by definition, considered a stable personality trait [1], [5].
Alexithymia has been shown to be associated with several medical conditions and mental health problems such as depression, some anxiety disorders, and substance abuse [5], [6]. The association between alexithymia and depression has been a subject of some debate. According to some previous studies, alexithymia is more prevalent among the depressed, and alexithymia scores decrease as depression is alleviated. Therefore, it has been claimed that alexithymia is associated with the level of depression and may be a state-dependent phenomenon [7], [8], [9]. On the other hand, several studies have yielded evidence on both the absolute and the relative stability of alexithymia, in accordance with the original theoretical definition that alexithymia is a personality trait [6], [10], [11], [12], [13], [14], [15], [16]. The prevalence figures of alexithymia in working-age populations have been 9–17% for men and 5–10% for women in four studies, three of which were conducted in Finland [17], [18], [19], [20]. On population level, alexithymia is associated with older age, male sex, lower socioeconomic status, fewer years of education, single marital status, and poorer perceived health [17], [18], [19], [20].
Occupational burnout is an important health and organizational issue in modern work life [21], [22]. It is defined as a prolonged response to chronic stressors on the job [23]. It is a state of exhaustion in which one is cynical about the value of one's work (cynicism) and doubtful of one's capacity to perform (lack of professional efficacy) [24]. It is mainly predicted by job demands but also by lack of job resources [25]. Discrepancy between the expectations and values of a motivated employee and the reality in unfavourable working conditions is thought to lead to burnout via dysfunctional ways of coping [26]. Difficulties in working conditions, such as diminished support from superior, cooperation and autonomy, as well as deteriorated organisational climate have been found to predispose to occupational burnout. Sense of coherence, strong self-esteem and sense of competence are individual characteristics that seem to prevent workers from burning out [27]. Occupational burnout has been shown to be related to age, gender, marital status, and education [26], [28]. There is also a strong association between burnout and depression [29] and physical illnesses [30]. Furthermore, burnout has predicted medically certified sick-leave absences due to mental disorders and physical diseases [31], [32].
As far as we know, there are no previous studies on the associations between alexithymia and occupational burnout in working populations. In this study, we analysed the associations between alexithymia and occupational burnout in a representative population sample. We hypothesised that alexithymia and burnout were positively related.
Section snippets
Study design and data collection
This study was a part of a multidisciplinary epidemiological health survey, the Health 2000 Study [33], [34]. The nationally representative sample comprised 8028 persons aged ≥30. A large national network coordinated by the National Public Health Institute was responsible for the planning and execution of the field study. The study was designed according to the concept of a two-stage stratified cluster sampling [33]. The strata were all the five Finnish university hospital districts, each
Results
The prevalence of alexithymia was n=187 (5.6%) for the whole sample. The gender difference was significant: 66 women (3.8%) and 121 men (7.6%) were alexithymic (χ2=21.56, d.f.=1, P<.001). Mild occupational burnout was found in 840 (25.3%) of the subjects and severe occupational burnout in 84 (2.5%). Of the subjects with mild or severe burnout, 120 (13.0%) were alexithymic while 67 (2.8%) of those without burnout were alexithymic (χ2=130.45, d.f.=1, P<.001). Depressive symptoms were found in 636
Discussion
The main finding of the present study was the strong association of alexithymia with occupational burnout. According to the logistic regression analyses, the association between alexithymia and burnout seems to be driven primarily by DIF. Because of the cross-sectional design of our study, we cannot draw any conclusions as to whether alexithymia predisposes working population to occupational burnout or whether it is a secondary phenomenon occurring with burnout. However, because alexithymia,
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