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The Longitudinal Association of Reduced Vagal Tone With Burnout

Wekenborg, Magdalena K. MSc; Hill, LaBarron K. PhD; Thayer, Julian F. PhD; Penz, Marlene PhD; Wittling, Ralf Arne PhD; Kirschbaum, Clemens PhD

doi: 10.1097/PSY.0000000000000750

Objective Previous research indicates a link between burnout symptoms and reduced vagally mediated heart rate variability (HRV); however, the directionality of this relationship is still largely unknown. The objective of the present study was to examine the longitudinal relationship between HRV and burnout symptoms for 1 year, with a special focus on the emotional exhaustion (EE) burnout subdimension, which remains inadequately distinguished from overlapping with depressive symptoms.

Methods Here we present HRV and behavioral data from 167 individuals (mean [SD] age = 43.43 [11.78] years; 30.5% male) who attended two biomarker samplings (T1 and T2) of the Dresden Burnout Study approximately 12 months apart.

Results In hierarchical linear regression analyses, T1 HRV significantly inversely predicted T2 overall burnout symptoms (β = −.16; p = .03) and EE (β = −.23; p = .02), adjusting for age, sex, body mass index, adverse health behaviors, and depressive symptoms. Importantly, only high EE at T1 (β = −.22; p = .04), and not the T1 Maslach Burnout Inventor total score, predicted reductions in HRV from T1 to T2.

Conclusions We report for the first time longitudinal evidence that HRV is associated with changes in burnout symptoms, independently of depressive symptoms. Results suggest vagal dysfunction being predictive and specific for burnout symptoms, making HRV a promising starting point for the explanation of biophysiological mechanisms underlying burnout symptoms and cardiovascular diseases. The finding of only EE at T1 being predictive for changes in HRV underscores the importance of exhaustion for modulations in autonomic regulation.

From the Department of Psychology (Wekenborg, Penz, Kirschbaum), TU Dresden, Dreseden, Germany; Department of Psychiatry and Behavioral Sciences (Hill) and Center for the Study of Aging and Human Development (Hill), Duke University Medical Center, Durham, North Carolina; Department of Psychology (Thayer), The Ohio State University, Columbus, Ohio; and ZNF – Center for Neuroscience Research NPO (Wittling), Trier, Germany.

Address correspondence to Magdalena K. Wekenborg, MSc, Department of Psychology, TU Dresden, Zellescher Weg 19, D-01069 Dresden, Germany. E-mail:

Received for publication November 12, 2018; revision received August 9, 2019.

Online date: October 8, 2019

Copyright © 2019 by American Psychosomatic Society
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