Slower information processing speed is associated with persistent burnout symptoms but not depression symptoms in nursing workers.

Introduction: Burnout and depression both occur with chronic work-related stress, and cognitive deficits have been found when symptom severity results in work disability. Less is known about cognitive deficits associated with milder symptoms among active workers, and few studies have examined whether cognitive deficits predict persistent burnout and depression symptoms. The goal of this study was to examine the association of information processing speed and executive function performance to burnout and depression symptoms at baseline and 12-month follow-up in a sample of actively working individuals (N = 372).Method: The design was prospective with laboratory cognitive data at baseline, and burnout and depressive symptoms assessed at baseline and monthly follow-ups. Information processing speed and executive functions were assessed in a task-switching paradigm, including single-task reaction time (RT), switching costs, and mixing costs. Burnout was assessed with the Exhaustion subscale of the Oldenburg Burnout Inventory and depression with the Patient Health Questionnaire-9.Results: Slower RT was modestly associated with higher levels of burnout symptoms both cross-sectionally and prospectively, but switching costs and mixing costs were not associated with burnout symptoms. None of the cognitive measures were associated with depression symptoms cross-sectionally or prospectively.Conclusions: Despite statistically significant findings of slowed RT in acute exhaustion-related burnout, the proportion of variance accounted for in the models was small and did not predict clinically significant levels of distress. The absence of statistically significant findings for depression symptoms suggests the cognitive profile associated with the exhaustion dimension of burnout may be distinct from that of depression, which reflects a more heterogeneous symptomatology. Our data suggest the clinical impact of burnout symptoms on actively working individuals is marginal; nonetheless, it is important to screen and intervene on burnout and depression symptoms in the workplace because they can lead to other forms of work impairment.

[Neuroenhancement in four occupations in Germany]. / Neuroenhancement in Deutschland am Beispiel von vier Berufsgruppen.

OBJECTIVE: The aim of this study was to assess the prevalence of pharmacological neuroenhancement in 4 occupations and to investigate its association with psychosocial working conditions and mental health. METHODS: In the study on "Neuroenhancement Behaviour in the Context of Stressful Workload - empirical Studies on Employees", 4166 employed physicians, advertising experts, publishers and software developers were surveyed with computer-assisted personal interviews. Lifetime, 12 months and 4 weeks prevalence rates with corresponding confidence intervals were calculated. The association of neuroenhancement with psychosocial working conditions and mental health were estimated in Poisson regression models. RESULTS: The lifetime prevalence of pharmacological neuroenhancement was 8.4%, the 12 months prevalence 2.9% and the 4 weeks prevalence 1.3%. Advertising experts and female software developers showed elevated prevalence rates for neuroenhancement. Psychosocial working conditions, such as support from colleagues, role clarity, emotional demands and job insecurity were associated with neuroenhancement in men. Burnout and depressive symptoms were related to an increase in neuroenhancement. CONCLUSIONS: Compared to samples from the general population or the overall working population, the estimated prevalence rates among the investigated occupations were slightly elevated. Burnout and depressive symptoms might operate as potential risk factors or consequences of pharmacological neuroenhancement.

Lagged versus concurrent changes between burnout and depression symptoms and unique contributions from job demands and job resources.

Burnout and depression pose significant threats to emotional and occupational functioning; however, questions exist over how these 2 conditions are associated with each other over time, and how these are related to underlying job stressors. The job demands-resources model provides a useful framework for understanding how job demands and job resources may lead to burnout, but questions remain about their distinct association with depression symptoms. The current study examined these questions in a sample of 402 nursing workers. The Exhaustion subscale of the Oldenburg Burnout Inventory, the Patient Health Questionnaire-9 depression assessment, and items reflecting job demands and job resources from the Copenhagen Psychosocial Questionnaire were assessed at baseline; additionally, Oldenburg Burnout Inventory Exhaustion and Patient Health Questionnaire-9 depression were assessed over 12 monthly follow-ups. Linear mixed models assessed longitudinal bidirectional associations between burnout and depression in both concurrent and lagged models. Longitudinal models found bidirectional relationships between burnout and depression symptoms over time, with relatively stronger associations for concurrent models relative to lagged models. Job demands and job resources each predicted unique variance in burnout and depression symptoms over time. Results provide evidence that burnout and depression symptoms change in the same direction, in tandem, rather than one condition having a distinctly stronger temporal association over the other. Results also indicate that both job demands and job resources are associated with depression symptoms independent from their association with burnout symptoms. Our results highlight the importance of considering burnout symptoms, depression symptoms, and job stressors concurrently in evaluating worker mental health. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

[Working Conditions and Mental Health Among Salaried Physicians: A Nationwide Comparison With a Representative Sample of Employees]. / Arbeitsbedingungen und psychische Gesundheit bei sozialversicherungspflichtig beschäftigten Ärzten: Ein bundesweiter Vergleich mit einer repräsentativen Beschäftigtenstichprobe.

AIM: Do the amount of workload, strain and the association between both differ between employed physician and other employees subject to social security contributions? This is investigated in this present study by comparing two representative samples. METHODS: Psycho-social working conditions were by assessed computer-assisted personal interviews and supplemented by questions about burnout and depressive symptoms. The associations were investigated by linear regression analysis including moderating effects due to differences between occupations. RESULTS: The score for depressive symptoms was lower among male and female physicians than in the comparison groups. Moreover, male physician had higher scores for burnout. Quantitative demands and job insecurity were associated with an increase of scores for burnout and depressive symptoms. Higher quality of leadership, role clarity, and decision latitude contributed to a decrease of both scores. Additional effects were found for hours worked per week (females) and number of night shifts (males). The moderating effect of occupational group was detected for quantitative demands and decision latitude. CONCLUSION: The associations of working conditions with mental health indicators are similar in the compared groups. There is a higher workload and higher level of burnout among physicians but there is no indication for more depressive symptoms.

Work-Related Determinants of Burnout in a Nationally Representative Sample of German Employees: Results From the Study on Mental Health at Work.

OBJECTIVE: The aim of the study was to present first representative data on burnout measured as exhaustion in German employees. METHODS: Data were taken from the Study on Mental Health at Work (n = 4058). Computer-assisted personal interviews were conducted in 2011 to 2012. Multiple linear regression models were estimated to investigate the association between work-related and personal variables and burnout. RESULTS: Severe burnout was detected in nearly 3% of employees. Job demands were associated with higher burnout scores, more resources with lower scores. Independent of personal factors, higher quantitative demands (men: regression coefficient [ß] = 0.19; 95% confidence interval [CI], 0.16 to 0.23; women: ß = 0.24; 95% CI, 0.20 to 0.27) was identified as the strongest predictor of burnout measured as exhaustion. The model explained 28% to 33% of the total variance. CONCLUSIONS: Quantitative demands seem to be important risk factors for burnout independent of critical life events and general self-efficacy.

12-month trajectories of depressive symptoms among nurses-Contribution of personality, job characteristics, coping, and burnout.

BACKGROUND: Job related factors have been associated with higher risk for developing depression, but past studies lacked full consideration of individual factors such as personality and coping. We sought to evaluate associations of personality, coping, job characteristics, and burnout with 12-month trajectories of depressive symptoms among nursing workers. METHODS: Cohort of nursing workers (N = 281) in a private hospital system, with baseline assessments of personality, job characteristics, and coping. Burnout and depression were measured at baseline and during monthly follow-ups. Linear mixed modeling was used to examine contributions to between- and within-individual variation in monthly depressive symptoms. RESULTS: Personality trait of negative affectivity accounted for 36% of between-individual variation in depressive symptoms over 12 months, while job characteristics and coping explained an additional 5% and 8% of this variation, respectively. Exhaustion dimension of burnout was associated with between-individual variation in depressive symptoms (fixed effect ß coefficient 2.44, p < 0.001), but not with within-individual variation in symptoms. Disengagement dimension of burnout was not associated with between-individual variation in depressive symptoms, but contributed to within-individual variation in depressive symptoms over time (fixed effect ß coefficient 0.52, p = 0.01). LIMITATIONS: Participants were nursing workers within a single hospital system. Participants who were excluded due to missing baseline data were more likely of non-white race, which may also limit the generalizability of our results. We used latent variables to represent certain job and coping characteristics, which may make our results less comparable with other studies examining the role of these factors in work-associated depression. CONCLUSIONS: Future interventions to prevent depression in healthcare workers should consider multiple job and individual factors. Potential components include strategies to manage negative affectivity and reduce avoidant coping, such as cognitive reframing and mindfulness-based techniques, and organizational approaches to address burnout through augmentation of job resources.

Executive control, ERP and pro-inflammatory activity in emotionally exhausted middle-aged employees. Comparison between subclinical burnout and mild to moderate depression.

Burnout is a syndrome occurring mainly in individuals with long-term stressful work. The main complaints are emotional exhaustion and reduced performance. Burnout also largely overlaps with depression. Both are characterized by increased incidence of infections due to dysregulation of the immune system, overexpression of pro-inflammatory cytokines and cognitive deficits, particularly related to executive functions. To distinguish between burnout and depression already at the pre-clinical stage, the present double-blinded study compared immunological and cognitive parameters in seventy-six employees from emotionally demanding occupations who were post-hoc subdivided into two groups scoring low (EE-) and high (EE+) in emotional exhaustion and low (DE-) and high (DE+) in depression. Immunological parameters were measured from blood samples. Executive functions were studied by analyzing event-related brain potentials (ERPs) and performance during a task switching paradigm. Psychosocial job parameters were measured with standardized questionnaires. Burnout and mild to moderate depression largely overlapped. However, several subjects showed burnout without depressive symptoms. Higher levels of the pro-inflammatory cytokines IL-6 and IL-12 were correlated with burnout severity and depressive symptoms in male individuals. In the switch task a trend for lower performance in the EE+ vs. EE- group and no difference between DE+ and DE- groups were found. In the ERPs, however, differences were observed which distinguished between subclinical burnout and depression: the terminal contingent negative variation (CNV), indicating preparatory activity and the P3b, related to allocation of cognitive resources were generally reduced in EE+ vs. EE-, whereas no differences were found in the DE+ vs. DE- groups. The frontal P3a was selectively reduced in switch trials in the EE+ vs. EE- group and showed only a trend in DE+ vs. DE-, indicating impairment of executive control in subclinical burnout. Taken together, the results unveil specific immunological changes and declines in brain functions in employees with subclinical burnout that are not apparent in persons with moderate depression. Hence, the combination of immunological, behavioral and ERP methods renders a promising method for distinguishing both syndromes and for improving an early diagnosis of burnout before a clinical stage is reached.

Burnout is associated with changes in error and feedback processing.

Burnout is a pattern of complaints in individuals with emotionally demanding jobs that is often seen as a precursor of depression. One often reported symptom of burnout is cognitive decline. To analyze cognitive control and to differentiate between subclinical burnout and mild to moderate depression a double-blinded study was conducted that investigates changes in the processing of performance errors and feedback in a task switching paradigm. Fifty-one of 76 employees from emotionally demanding jobs showed a sufficient number of errors to be included in the analysis. The sample was subdivided into groups with low (EE-) and high (EE+) emotional exhaustion and no (DE-) and mild to moderate depression (DE+). The behavioral data did not significantly differ between the groups. In contrast, in the EE+ group, the error negativity (Ne/ERN) was enhanced while the error positivity (Pe) did not differ between the EE+ and EE- groups. After negative feedback the feedback-related negativity (FRN) was enhanced, while the subsequent positivity (FRP) was reduced in EE+ relative to EE-. None of these effects were observed in the DE+ vs. DE-. These results suggest an upregulation of error and negative feedback processing, while the later processing of negative feedback was attenuated in employees with subclinical burnout but not in mild to moderate depression.

The Study on Mental Health at Work: Design and sampling.

AIMS: The Study on Mental Health at Work (S-MGA) generates the first nationwide representative survey enabling the exploration of the relationship between working conditions, mental health and functioning. This paper describes the study design, sampling procedures and data collection, and presents a summary of the sample characteristics. METHODS: S-MGA is a representative study of German employees aged 31-60 years subject to social security contributions. The sample was drawn from the employment register based on a two-stage cluster sampling procedure. Firstly, 206 municipalities were randomly selected from a pool of 12,227 municipalities in Germany. Secondly, 13,590 addresses were drawn from the selected municipalities for the purpose of conducting 4500 face-to-face interviews. The questionnaire covers psychosocial working and employment conditions, measures of mental health, work ability and functioning. Data from personal interviews were combined with employment histories from register data. Descriptive statistics of socio-demographic characteristics and logistic regressions analyses were used for comparing population, gross sample and respondents. RESULTS: In total, 4511 face-to-face interviews were conducted. A test for sampling bias revealed that individuals in older cohorts participated more often, while individuals with an unknown educational level, residing in major cities or with a non-German ethnic background were slightly underrepresented. CONCLUSIONS: There is no indication of major deviations in characteristics between the basic population and the sample of respondents. Hence, S-MGA provides representative data for research on work and health, designed as a cohort study with plans to rerun the survey 5 years after the first assessment.

Cognitive Training Sustainably Improves Executive Functioning in Middle-Aged Industry Workers Assessed by Task Switching: A Randomized Controlled ERP Study.

Recently, we reported results of a cross-sectional study investigating executive functions in dependence of aging and type of work. That study showed deficits in performance and electrophysiological activity in middle-aged workers with long-term repetitive and unchallenging work. Based on these findings, we conducted a longitudinal study that aimed at ameliorating these cognitive deficits by means of a trainer-guided cognitive training (CT) in 57 further middle-aged workers with repetitive type of work from the same factory. This study was designed as a randomized controlled trail with pre- (t1), post- (t2), and a 3-month follow-up (t3) measure. The waiting control group was trained between t2 and t3. The training lasted 3 months (20 sessions) and was evaluated with the same task switching paradigm used in the previous cross-sectional study. The CT improved performance in accuracy at the behavioral level and affected the electrophysiological correlates of retrieval of stimulus-response sets (P2), response selection (N2), and error detection (Ne), thus unveiling the neuronal background of the behavioral effects. The same training effects were observed in the waiting control group after CT at t3. Moreover, at t3, most of the behavioral and electrophysiological training-induced changes were found stable. Hence, CT appears to be an important intervention for compensating cognitive deficits in executive functions in middle-aged employees with cognitively unchallenging work.

Cardiovascular costs of working memory performance: effects of age and performance feedback.

Ageing is associated with impaired working memory (WM) performance that may increase cardiovascular costs in older workers. Performance feedback (FB) was assumed to compensate for performance decline and reduce cardiovascular costs. Forty-eight younger (29 ± 3 yr) and 45 older (55 ± 4 yr) healthy workers had to perform a 0-back task (low WM load), 2-back task (high WM load) and 2-back task with FB (high WM load & FB). Age-related performance decline and enhanced blood pressure (BP) reactivity to WM load were found. The baroreflex sensitivity (BRS) decreased under high WM load in older workers compared to younger workers. The FB abolished age differences in omission rate and increased low frequency heart rate variability (HRV) in both age groups. Moreover, FB reduced heart rate in older workers and increased BRS as well as high frequency HRV in younger workers. The results suggest that older workers compensate for WM performance decline at cost of heightened BP due to age-related reductions of vagal tone and impairments of the baroreflex mechanism. The performance FB helps older workers to partly compensate for performance deficits and reduce cardiovascular costs by moderate decreases in sympathetic tone.

Effects of working memory load on performance and cardiovascular activity in younger and older workers.

BACKGROUND: Working memory (WM) declines with ageing, and this may cause problems in older workers who have to do complex work requiring WM. PURPOSE: We tested the assumption that an increase in WM load negatively affects performance and results in impaired cardiovascular adaptation to changing task demands in older workers relative to younger ones. METHOD: Thirty-three younger (29 ± 3 years) and 32 older (55 ± 3 years) workers had to perform a visual 0-back (low WM load) and 2-back (high WM load) task. Heart rate (HR), heart rate variability (HRV), beat-to-beat blood pressure (BP) and baroreflex were registered. RESULTS: In the high WM load condition, older adults responded more slowly and less accurately than younger adults, while no age effects in the low WM load condition were found. Older workers showed a higher systolic blood pressure (SBP) reactivity to high WM load as well as a diminished post-task recovery of SBP and HRV than younger workers. Factor analysis demonstrated a close relationship between HR, baroreflex and HRV and their modulation by a common factor ("vagal tone") in the younger group. By contrast, HR was more related to the "sympathetic" factor in the older group. CONCLUSION: The data suggest that older workers as compared with younger ones are impaired in tasks requiring WM, which is accompanied by enhanced cardiovascular "costs" in terms of increased SBP and reduced vagal control over HR.

Effects of aging and job demands on cognitive flexibility assessed by task switching.

In a cross-sectional, electrophysiological study 91 workers of a big car factory performed a series of switch tasks to assess their cognitive control functions. Four groups of workers participated in the study: 23 young and 23 middle aged assembly line employees and 22 young and 23 middle aged employees with flexible job demands like service and maintenance. Participants performed three digit categorisation tasks. In addition to single task blocks, a cue-based (externally guided) and a memory-based (internally guided) task switch block was administered. Compared to young participants, older ones showed the typical RT-decline. No differences between younger and older participants regarding the local switch costs could be detected despite the source of the current task information. In contrast, whereas the groups did not differ in mixing costs in the cued condition, clear performance decrements in the memory-based mixing block were observed in the group of older employees with repetitive work demands. These findings were corroborated by a number of electrophysiological results showing a reduced CNV suggesting an impairment of task specific preparation, an attenuated P3b suggesting reduced working memory capacity and a decreased Ne suggesting deficits in error monitoring in older participants with repetitive job demands. The results are compatible with the assumption that long lasting, unchallenging job demands may induce several neurocognitive impairments which are already evident in the early fifties. Longitudinal studies are needed to confirm this assumption.

Predictors of the discrepancy between calendar and biological age.

BACKGROUND: The rate of ageing can differ considerably between individuals. This might result in major differences between calendar age (CA) and biological age (BA). AIMS: To identify work- and health-related predictors of the discrepancy between CA and BA. METHODS: The sample analysed in this study consisted of 371 subjects of different occupational groups (teachers, office workers, nursery school teachers and managers). BA was measured with the vitality measuring station, which recorded 45 vitality indicators of physical, mental and social functions. Work ability index, effort-reward imbalance and relaxation inability were measured to determine work- and health-related predictors. RESULTS: The greatest discrepancy between CA and BA (9 years) was found for the subgroup of managers, followed by female teachers (5 years). Managers showed also the best results in work ability, the effort-reward balance and relaxation ability. By means of multiple regression analysis, particularly mental attitudes and resources towards work, occupational reward and the body fat percentage were identified as relevant predictors for the discrepancy between CA and BA. CONCLUSIONS: Our study indicates that not only health- but also work-related factors are associated with vitality and BA of employees. We assume that measures focused on promoting of health (healthy diet and physical activities) and improving working conditions (e.g. job satisfaction and social support and stress prevention) may also affect the ageing process positively.

When sound and picture do not fit: Mismatch negativity and sensory interaction.

The Mismatch Negativity (MMN), an index of auditory stimulus representation, was studied in a design of simultaneous auditory and visual stimulus presentation. A counting task drew the attention of participants to picture presentation and was unrelated to the occurring sounds. With the picture of a hammer hitting a nail a standard sound "bang" came along. Rarely, a deviant picture showed the hammer hitting the finger combined with a corresponding deviant sound "ouch." Sometimes this deviant picture was combined with the standard sound. In spite of the absence of a sound deviancy to the standard sounds, also in the latter case a significant MMN was detected, indicating that the actual visual context affected the incoming auditory information leading to a mismatch with the prevailing auditory memory trace. Herewith, MMN gains importance as an index of auditory stimulus representation also in studies of sensory interaction.