The Maslach Burnout Inventory is not a measure of burnout.

For decades, the Maslach Burnout Inventory (MBI) has been regarded as the "gold standard" for the assessment of burnout. The present paper demonstrates that the MBI fails to measure the construct it is purported to measure. On a deeper level, the problems affecting the MBI question the very idea of burnout. These problems may be unsurprising in light of the genesis of the burnout construct. Burnout emerged in the mid-1970s as a largely predefined entity. Burnout's definition was not predicated on robust empirical investigations or sound theorizing, nor was it anchored in a systematic review of the literature on stress and health. Interestingly, other measures deemed to assess burnout, such as the Oldenburg Burnout Inventory, similarly fail to measure what they are claimed to measure. Despite far-reaching implications for our ability to study and promote occupational health, the flaws that undermine the conceptualization and measurement of burnout remain widely underappreciated. We hope this paper will help raise awareness of these flaws and correct current practices in research on job-related distress. Alternatives to burnout do exist and may enable us to support our workforce more effectively.

A validation study of the Occupational Depression Inventory in Poland and Ukraine.

This study examined the psychometric and structural properties of the Polish and Ukrainian versions of the Occupational Depression Inventory (ODI). We relied on two samples of Polish employees (NSample1 = 526, 47% female; NSample2 = 164, 64% female) and one sample of Ukrainian employees (NSample3 = 372, 73% female). In all samples, the ODI exhibited essential unidimensionality and high total-score reliability (e.g., McDonald's omegas > 0.90). The homogeneity of the scale was strong (e.g., 0.59 ≤ scale-level Hs ≤ 0.68). The ODI's total scores thus accurately ranked individuals on a latent occupational depression continuum. We found evidence of complete measurement invariance across our samples, a prerequisite for between-group comparisons involving observed scores. Looking into the criterion validity of the ODI, we found occupational depression to correlate, in the expected direction, with resilience and job-person fit in six areas of working life-workload, control, rewards, community, fairness, and values. The prevalence of occupational depression was estimated at 5% in Sample 1, 18% in Sample 2, and 3% in Sample 3. Our findings support the use of the ODI's Polish and Ukrainian versions. This study adds to a growing corpus of research suggesting that the ODI is a robust instrument.

Psychometric and structural properties of the Karolinska Exhaustion Disorder Scale: a 1,072-patient study.

OBJECTIVE: Exhaustion disorder is a stress-related diagnosis that was introduced in 2005 to the Swedish version of the International Statistical Classification of Diseases and Related Health Problems, 10th edition (ICD-10). The Karolinska Exhaustion Disorder Scale (KEDS) was developed to assess exhaustion disorder symptomatology. While the KEDS is intended to reflect a single construct and be used based on its total score, the instrument's characteristics have received limited attention. This study investigated the KEDS's psychometric and structural properties in a large clinical sample. METHODS: The study relied on data from 1,072 patients diagnosed with exhaustion disorder that were included in two clinical trials in Sweden. We investigated the dimensionality, homogeneity, and reliability of the KEDS using advanced statistical techniques, including exploratory structural equation modeling (ESEM) bifactor analysis. RESULTS: A one-factor confirmatory analytic model exhibited a poor fit, suggesting at least a degree of multidimensionality. The ESEM bifactor analysis found the general factor to explain about 72% of the common variance extracted, with an omega hierarchical coefficient of 0.680. Thus, the ESEM bifactor analysis did not clearly support the scale's essential unidimensionality. A homogeneity analysis revealed a scale-level H of only 0.296, suggesting that KEDS's total scores do not accurately rank individuals on the latent continuum assumed to underlie the measure. The KEDS's reliability was modest, signaling considerable measurement error. CONCLUSION: Findings reveal important limitations to the KEDS with possible implications for the status of exhaustion disorder as a nosological category. TRIAL REGISTRATION: This study was pre-registered on Open Science Framework (osf.io) on April 24, 2022 ( https://osf.io/p34sq/ ).

Validation of the Occupational Depression Inventory in Sweden.

BACKGROUND: The Occupational Depression Inventory (ODI) was recently devised to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to overcome limitations in current assessments of job-related distress. This study aimed to validate the Swedish version of the ODI. METHODS: The study involved 365 individuals employed in Sweden. In addition to the ODI, the study included the Satisfaction with Life Scale, the Effort-Reward Imbalance Questionnaire, the Demand-Control-Support Questionnaire, the GAD-2, and the PHQ-9. We inquired into the factorial validity, dimensionality, scalability, test-score reliability, criterion validity, convergent validity, discriminant validity, and measurement invariance of the ODI. RESULTS: Exploratory structural equation modeling bifactor analysis indicated that the ODI's Swedish version meets the requirements for essential unidimensionality (e.g., explained common variance = 0.872). Measurement invariance held across sexes, age groups, and occupational categories. The instrument exhibited strong scalability (e.g., H = 0.662). The observed total scores thus accurately ranked respondents on the latent continuum underlying the scale. The ODI's total-score reliability was high (e.g., McDonald's ω = 0.929). Speaking to the instrument's criterion validity, we found occupational depression to correlate, in the expected direction, with various work (e.g., job support) and nonwork (e.g., general anxiety) variables. Occupational depression showed large correlations with effort-reward imbalance (r = 0.613) and demand-control imbalance (r = 0.566) at work. Multiple regression analyses supported these associations further. As expected, we observed both a degree of convergent validity and a degree of discriminant validity when examining the ODI against the PHQ-9, an attribution-free measure of depression. DISCUSSION: This study indicates that the ODI performs well within the Swedish context, consistent with the findings obtained in other linguistic and geographic contexts. The ODI promises to help researchers, practitioners, and public health decision-makers address job-related distress more effectively.

Validation of the Occupational Depression Inventory in Brazil: A study of 1612 civil servants.

OBJECTIVE: The Occupational Depression Inventory (ODI) assesses work-attributed depressive symptoms. The ODI has demonstrated robust psychometric and structural properties. To date, the instrument has been validated in English, French, and Spanish. This study examined the psychometric and structural properties of the ODI's Brazilian-Portuguese version. METHODS: The study involved 1612 civil servants employed in Brazil (MAGE = 44, SDAGE = 9; 60% female). The study was conducted online across all Brazilian states. RESULTS: Exploratory structural equation modeling (ESEM) bifactor analysis indicated that the ODI meets the requirements for essential unidimensionality. The general factor accounted for 91% of the common variance extracted. We found measurement invariance to hold across sexes and age groups. Consistent with these findings, the ODI showed strong scalability (H = 0.67). The instrument's total score accurately ranked respondents on the latent dimension underlying the measure. Furthermore, the ODI exhibited excellent total-score reliability (e.g., McDonald's ω = 0.93). Occupational depression correlated negatively with work engagement and each of its components (vigor, dedication, and absorption), speaking to the ODI's criterion validity. Finally, the ODI helped clarify the issue of burnout-depression overlap. Relying on ESEM confirmatory factor analysis (CFA), we found burnout's components to correlate more strongly with occupational depression than with each other. Using a higher-order ESEM-within-CFA framework, we found a correlation of 0.95 between burnout and occupational depression. CONCLUSION: The ODI displays robust psychometric and structural properties within the Brazilian context. The ODI constitutes a valuable resource for occupational health specialists and may help advance research on job-related distress.

The Pandemic Anxiety Inventory: A validation study.

The Pandemic Anxiety Inventory (PAI) assesses anxiety symptoms individuals attribute to the presence of a pandemic. We conducted this study of 379 British adults during the COVID-19 pandemic and found that the PAI exhibited excellent reliability and solid criterion validity. Pandemic anxiety was associated with reduced social support, anticipated life changes, financial strain, job loss, economic insecurity, and the hospitalization or death of a close friend or relative. Using correlational and bifactor analyses, we found that the PAI demonstrated solid convergent and discriminant validity. The findings suggest that the PAI can be used in research and clinical practice.

Towards a new approach to job-related distress: A three-sample study of the Occupational Depression Inventory.

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. One purpose of the ODI is to respond to limitations of current assessments of job-related distress, most notably, assessments relying on the burnout construct. In this study, we conducted a thorough examination of the psychometric and structural properties of the ODI using exploratory structural equation modelling bifactor analysis and Mokken scale analysis. The study involved three samples of employed individuals, recruited in France (N = 3454), Switzerland (N = 1971), and Australia (N = 1485). Results were consistent across the three samples. The ODI exhibited essential unidimensionality and excellent total-score reliability-as indexed by McDonald's omega, Cronbach's alpha, Guttman's lambda-2, and the Molenaar-Sijtsma statistic. We found evidence for measurement invariance across sexes, age groups, and samples. Mokken scale analysis revealed that the ODI's scalability was strong. No monotonicity violation was detected. Invariant item ordering showed sufficient accuracy. In all three samples, suicidal ideation was the least commonly endorsed item-thus acting as a sentinel item-and fatigue/loss of energy was the most commonly endorsed item. The ODI exhibits excellent psychometric and structural properties, suggesting that occupational health specialists can effectively employ the instrument.

Burned-out with burnout? Insights from historical analysis.

Fierce debates surround the conceptualization and measurement of job-related distress in occupational health science. The use of burnout as an index of job-related distress, though commonplace, has increasingly been called into question. In this paper, we first highlight foundational problems that undermine the burnout construct and its legacy measure, the Maslach Burnout Inventory (MBI). Next, we report on advances in research on job-related distress that depart from the use of the burnout construct. Tracing the genesis of the burnout construct, we observe that (a) burnout's definition was preestablished rather than derived from a rigorous research process and (b) the MBI has little in the way of a theoretical or empirical foundation. Historical analysis suggests that the burnout construct was cobbled together from unchallenged personal impressions and anecdotal evidence before getting reified by the MBI. This state of affairs may account for many of the disconcerting problems encountered in burnout research. We close our paper by presenting the Occupational Depression Inventory (ODI), a recently developed instrument reflective of a renewed approach to job-related distress. The ODI has demonstrated robust psychometric and structural properties across countries, sexes, age groups, occupations, and languages. The instrument addresses job-related distress both dimensionally and categorically. A dimensional approach can be useful, for instance, in examining the dynamics of etiological processes and symptom development. A categorical approach can serve screening and diagnostic purposes and help clinicians and public health professionals in their decision-making. It is concluded that the ODI offers occupational health specialists a promising way forward.

Holistic Assessment of Factors Associated with Exhaustion, the Main Symptom of Burnout: A Meta-Analysis of Longitudinal Studies.

BACKGROUND: This meta-analysis summarized longitudinal findings pertaining to exhaustion's predictors. In so doing, our aim was ultimately to identify target factors for the prevention of burnout. METHODS: We searched for studies that (a) examined predictors of exhaustion longitudinally and (b) reported correlation coefficients as an effect estimate. We conducted our literature search in three databases: MEDLINE, PsycINFO, and Embase. We focused on studies published between January 1990 and November 2020. Predictors were grouped into families, subfamilies, and subgroups. A meta-analysis of z-transformed correlation coefficients (rho) was performed. The results were scrutinized in relation to studies' follow-up length. RESULTS: We included 65 studies assessing 242 predictors of different types captured across different occupations. Our findings highlighted mostly weak associations (rho < 0.30). For six predictors-Job control, Job resources, Interactions at work, Communication and leadership, Job attitudes, and Work-family interface-longer length of follow-up involved weaker associations with exhaustion. The quality of the evidence available was generally low. CONCLUSIONS: The evidence available does not point to clear target factors for preventing burnout. The decrease in associations as the follow-up length increases may suggest a relatively short latency period, followed by recovery. Higher-quality cohorts should be conducted to better understand the etiology and course of burnout.

Occupational depression in a Spanish-speaking sample: associations with cognitive performance and work-life characteristics / Depresión ocupacional en una muestra hispanohablante: asociaciones con el rendimiento cognitivo y características de la vida laboral

This 386-participant study investigated the structural and psychometric properties of the Spanish version of the Occupational Depression Inventory (ODI). Exploratory structural equation modeling bifactor analysis revealed that the ODI meets the requirements for essential unidimensionality. Measurement invariance held across our sample and the English- and French-speaking samples used in the ODI's initial validation study. Mokken scale analysis indicated that (a) the scalability of the instrument was strong, (b) no violations of monotonicity or local independence were present, and (c) invariant item ordering was sufficiently accurate. The ODI's reliability was optimal. The ODI exhibited both convergent validity and discriminant validity vis-à-vis a job-unrelated measure of depression. Furthermore, occupational depression correlated substantially, and in the expected direction, with objective cognitive performance and 10 widely studied work-life characteristics. This study suggests that the ODI's Spanish version has excellent structural and psychometric properties and can be confidently employed by occupational health specialists.(AU)

El presente estudio, realizado con 386 participantes, ha indagado en las propiedades estructurales y psicométricas de la versión española del Inventario de Depresión Ocupacional (ODI, según sus siglas en inglés). Un análisis bifactorial de un modelo exploratorio de ecuaciones estructurales mostró que el ODI reúne los requisitos de unidimensionalidad esencial. La invarianza de la medida se mantuvo en nuestra muestra y en las muestras anglo y francoparlantes utilizadas en el estudio de validación inicial. Un análisis Mokken de la escala indica que: a) el instrumento tenía un fuerte carácter escalar, b) no hubo violación de la monotonicidad o independencia local y c) el orden invariante de los ítems fue lo suficientemente preciso. La fiabilidad ha sido óptima. El ODI presentó tanto validez convergente como discriminante en relación con una medida de depresión no relacionada con el trabajo. Además, la depresión laboral correlacionó en gran medida, en la dirección esperada, con el desempeño cognitivo objetivo y 10 características muy estudiadas de la vida laboral. El estudio destaca que la versión española del ODI tiene unas propiedades estructurales y psicométricas excelentes, por lo que puede utilizarse con toda confianza por los especialistas en salud ocupacional.(AU)

Is the PHQ-9 a unidimensional measure of depression? A 58,272-participant study.

The PHQ-9 has become a measure of reference in depression research and clinical practice. However, the issue of the PHQ-9's unidimensionality has not been fully elucidated, and the usability of the PHQ-9's total score requires clarification. In this study, we examined the dimensionality, scalability, and monotonicity properties of the PHQ-9 as well as the scale's total-score reliability. We did so based on exploratory structural equation modeling (ESEM) bifactor analysis and Mokken scale analysis (MSA). We relied on a total of 58,272 participants (63% female; Mage = 43, SDage = 13) from 29 samples involving seven different countries (e.g., Germany, the U.S.) and five different languages (e.g., German, English). We found no concerning deviations from measurement invariance for our ESEM bifactor model, neither across samples nor across sexes, age groups, and languages. The PHQ-9 met the requirements for essential unidimensionality in the pooled sample and across sex-, age-, and language-based subsamples. In each case, the general factor was strong (e.g., factor loadings ranged from 0.725 to 0.893 in the pooled sample) and Omega Hierarchical values exceeded 0.900. The correlations between the general factor and the observed total scores were large (≥ 0.952). Our MSA, including multilevel MSA, revealed that the PHQ-9's scalability is satisfactory. No monotonicity violation was detected, suggesting that the scale's total score accurately orders respondents on the latent Depression variable. Total-score reliability was good. This study provides robust evidence that the PHQ-9 can be used as a unidimensional measure of depressive symptoms by researchers and practitioners. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Are Australian teachers burned-out or depressed? A confirmatory factor analytic study involving the Occupational Depression Inventory.

OBJECTIVE: There is mounting evidence that burnout problematically overlaps with depression. However, the generalizability of this finding remains debated. This study examined the burnout-depression distinction based on a recently developed measure of work-attributed depressive symptoms-the Occupational Depression Inventory (ODI). METHODS: We relied on a sample of 891 Australian teachers. The ODI was employed to assess work-attributed depressive symptoms. The Shirom-Melamed Burnout Measure (SMBM) and the Oldenburg Burnout Inventory (OLBI) were employed to assess burnout symptoms. The SMBM assesses burnout as a syndrome combining physical fatigue, cognitive weariness, and emotional exhaustion. The OLBI assesses burnout as a syndrome of exhaustion and disengagement. RESULTS: Confirmatory factor analysis indicated that the factors underlying burnout's components correlated more highly with the Occupational Depression factor than with each other, calling into question the syndromal unity of burnout. Moreover, the factors underlying burnout's components and the Occupational Depression factor were reflective of a common higher-order factor. CONCLUSIONS: Our findings are consistent with the view that burnout symptoms are part of a depressive syndrome and do not reflect a unique or distinct entity. Conducted in the Australian context, this study strengthens the generalizability of the finding that burnout problematically overlaps with depression. Given the profound problems affecting the burnout construct, we recommend a paradigm shift from burnout to occupational depression. Such a shift raises the prospects of more reliably and validly assessing severity and prevalence of job-related distress and, consequently, of reaching more psychologically meaningful and productive conclusions regarding treatment, prevention, and public health decision-making.

Italian version of the Occupational Depression Inventory: Validity, reliability, and associations with health, economic, and work-life characteristics.

Background: The Occupational Depression Inventory (ODI) reflects a new approach to job-related distress centered on work-attributed depressive symptoms. The instrument was developed with reference to the characterization of major depression found in the Diagnostic and statistical manual of mental disorders, fifth edition. The ODI has been validated in English, French, and Spanish. This study (a) investigated the psychometric and structural properties of the ODI's Italian version and (b) inquired into the nomological network of occupational depression. Methods: A convenience sample of 963 employed individuals was recruited in Italy (69.9% female; mean age = 40.433). We notably relied on exploratory structural equation modeling bifactor analysis, common-practice confirmatory factor analysis, and Mokken scale analysis to examine our dataset. Results: Our analyses indicated that the Italian version of the ODI meets the requirements for essential unidimensionality, thus justifying the use of the instrument's total score. The ODI's reliability was excellent. Measurement invariance held across sexes, age groups, and occupations. Occupational depression was negatively associated with general wellbeing and positively associated with a 12-month history of depressive disorder, current antidepressant intake, 12-month sick leave, 6-month physical assault at work, 6-month verbal abuse at work, lack of money for leisure activities, and financial strain in the household. Conclusions: The ODI's Italian version exhibits robust psychometric and structural properties, suggesting that the instrument can be fruitfully used for addressing job-related distress in Italian-speaking populations. Furthermore, the present study relates occupational depression to important health, economic, and work-life characteristics, including past depressive episodes, antidepressant medication, sickness-related absenteeism, workplace violence, and economic stress.

From Burnout to Occupational Depression: Recent Developments in Research on Job-Related Distress and Occupational Health.

Job-related distress has been a focal concern in occupational health science. Job-related distress has a well-documented health-damaging and life-threatening character, not to mention its economic cost. In this article, we review recent developments in research on job-related distress and examine ongoing changes in how job-related distress is conceptualized and assessed. By adopting an approach that is theoretically, empirically, and clinically informed, we demonstrate how the construct of burnout and its measures, long favored in research on job-related distress, have proved to be problematic. We underline a new recommendation for addressing job-related distress within the long-established framework of depression research. In so doing, we present the Occupational Depression Inventory, a recently developed instrument devised to assess depressive symptoms that individuals specifically attribute to their work. We close our paper by laying out the advantages of a paradigm shift from burnout to occupational depression.

Validation and measurement invariance of the Occupational Depression Inventory in South Africa.

This study aimed to validate the recently developed Occupational Depression Inventory (ODI) in South Africa. A total of 327 employees (60% female) participated in the study. Bifactor exploratory structural equation modeling analysis indicated that the ODI can be considered essentially unidimensional. The ODI displayed strong scalability (e.g., scale-level H = 0.657). No monotonicity violation was detected. The reliability of the instrument, as indexed by Cronbach's alpha, McDonald's omega-total, Guttman's λ2, and the Molenaar-Sijtsma statistic, was highly satisfactory. Measurement invariance was observed across age groups, sexes, and ethnicities, as well as between our sample and the ODI's original validation sample. As expected, the ODI showed both a degree of convergent validity and a degree of discriminant validity vis-à-vis a measure of "cause-neutral" depressive symptoms. Moreover, the ODI manifested substantial associations, in the anticipated directions, with measures of work engagement, job satisfaction, and life satisfaction. Overall, the ODI exhibited excellent structural and psychometric properties within the South African context. Consistent with previous research, this study suggests that occupational health specialists can confidently rely on the ODI to investigate job-related distress.

Occupational Depression, Cognitive Performance, and Task Appreciation: A Study Based on Raven's Advanced Progressive Matrices.

The Occupational Depression Inventory (ODI) was recently developed to assess depressive symptoms that individuals specifically attribute to their work. Research on the criterion validity of the instrument is still in its infancy. In this study, we examined whether the ODI predicted performance on, and appreciation of, a cognitively challenging test. In light of the link established between clinical depression and neuropsychological impairment, and considering that individuals with depressive symptoms are more likely to feel helpless under challenging circumstances, we hypothesized that occupational depression would be associated with poorer cognitive performance and a darkened appreciation of the task undertaken. We relied on a sample of 1,359 educational staff members. We used an abridged version of Raven's Advanced Progressive Matrices (RAPMs) as a cognitively challenging task and measure of cognitive performance. RAPMs assess so-called eductive ability (meaning-making and problem-solving abilities) through items of various degrees of difficulty. Transient mood was assessed with a three-item measure before RAPMs were administered. Task appreciation was assessed with a single-item measure after the completion of RAPMs. We found occupational depression to be negatively linked to cognitive performance. A two-step cluster analysis, in which ODI and RAPMs scores were used as classifiers, revealed two profiles of respondents. The first profile was characterized by relatively low levels of depressive symptoms and high levels of cognitive performance; the second profile, by relatively high levels of depressive symptoms and low levels of cognitive performance. The two profiles differed strongly from one another, as indexed by Cohen's ds of 2.492 regarding depressive symptoms and 1.263 regarding cognitive performance. As anticipated, occupational depression predicted a darkened appreciation of the test. The association remained statistically significant, and largely unchanged, controlling for pretest mood and test performance. The highest levels of depressive symptoms were observed among individuals evaluating the task as "frustrating" and "discouraging." Our study suggests that occupational depression predicts poorer cognitive performance and a negativized experience of cognitive challenge. Such features may be part of a self-sustaining loop fostering the maintenance of depressive symptoms. The extent to which the ODI predicts performance in the work context needs to be investigated.