Burnout: An Overview of 25 Years of Research and Theorizing

Burnout is a metaphor that is commonly used to describe a state or process of mental

exhaustion, similar to the smothering of a fire or the extinguishing of a candle.

After the introduction of the concept by Freudenberger (1974) and by Maslach and her
colleagues (Maslach, 1976, 1982a, b; Pines & Maslach, 1978), burnout soon became a very
popular topic.

Despite the fact that professional burnout was initially not viewed as a serious scientific
topic, empirical research on this phenomenon started to flourish from the beginning of the
1980s.

DEFINITIONS OF BURNOUT

Probably the most often cited definition of burnout comes from Maslach & Jackson
(1986, p. 1): “Burnout is a syndrome of emotional exhaustion, depersonalization, and
reduced personal accomplishment that can occur among individuals who do ‘people
work’ of some kind”.

Its popularity is due to the fact that the most widely used self-report questionnaire, the MBI,
includes the three dimensions that are mentioned in this definition:

• Emotional exhaustion refers to the depletion or draining of emotional resources caused

by interpersonal demands.
• Depersonalization points to the development of negative, callous and cynical attitudes
toward the recipients of one’s services
• Lack of personal accomplishment is the tendency to evaluate one’s work with recipients
negatively.

But in the third edition of the MBI test manual (Maslach et al., 1996), the concept of burnout
is broadened and defined as a crisis in one’s relationship with work in general and not
necessarily as a crisis in one’s relationship with people at work. As a consequence, the three
original burnout dimensions are redefined.

➢ Exhaustion now refers to fatigue irrespective of its cause.

➢ Cynicism reflects an indifferent or distant attitude towards work instead of other people.
➢ Lack of professional efficacy encompasses both social and non-social aspects of
occupational accomplishment.
Although state definitions of burnout differ in scope, precision and dimensionality of the
syndrome, they seem to share five common elements:

i) dysphoric symptoms, and most notably emotional exhaustion, are predominant;

ii) the accent is on mental and behavioural symptoms, although atypical physical
symptoms are sometimes mentioned as well;
iii) burnout is generally considered to be work-related;
iv) symptoms are observed in “normal” individuals; and
v) decreased effectiveness and poor work performance occur because of negative
attitudes and behaviours.

Most process definitions of burnout maintain that burnout starts out with stress that results from
the discrepancy between on the one hand the individual’s expectations and ideals, and on the
other hand the harsh reality of everyday occupational life. This stress may be consciously
observed by the individual or it may remain unnoticed for a long time. Gradually, the individual
starts to feel emotionally strained, and begins to change his or her attitudes towards the job and
the people he or she works with, finally resulting in burnout. The way in which the individual
copes with stress is in most process definitions considered crucial for the development of
burnout.

Burnout and Job Stress

Pines (1993) has argued that specifically individuals who expect to derive a sense of
significance from their work are susceptible to burnout (see Section 19.6.1). Those without
such expectations would experience job stress instead of burnout. Accordingly, burnout is a
specific type of job stress that is characterized by its chronic and multifaceted nature.

Burnout and Depression

According to Warr (1987), depression concerns context-free affective well-being, whereas

burnout concerns job-related affective well-being.

Some research suggests that burnout may under certain conditions develop into depression
rather than the other way around, and that burnout will result in depression in particular when
it becomes accompanied by feelings of inferiority.
Burnout and Chronic Fatigue

Unlike CFS, burnout is a multidimensional, work-related and primarily mental syndrome,

whereas CFS is generic and predominantly characterized by unexplained fatigue and additional
physical symptoms.

Measurement

The most popular instrument is the MBI (Maslach et al., 1996), of which three versions exist:
the Human Services Survey (HSS), the Educators Survey (ES) and the General Survey (GS).

The second most widely employed burnout questionnaire is the Burnout Measure (BM).

CORRELATES, CAUSES, SYMPTOMS AND CONSEQUENCES OF BURNOUT

Comparing the relative importance of correlates of burnout, it seems that anxiety,

neuroticism and lack of hardiness are the most prominent personality characteristics.
Workload, time pressure and role conflict seem to be the most important possible causes
While depression, psychosomatic complaints and job dissatisfaction are the most
important concomitants or consequences
Quantitative demands such as time pressure and workload are clearly more strongly
related with burnout than qualitative demands such as problems in interacting with
clients or the confrontation with death and dying.
Self-report measures correlate much more highly with burnout than data based on
records, physiological measures, observations or assessments by others such as
supervisors or co-workers.

Theoretical Approaches

All individual approaches emphasize that a strong conscious or unconscious motivation (to
help)—including concomitant highly valued goals, expectations and aspirations—is a
necessary condition for the emergence of burnout. For most individual approaches empirical
evidence is rather sparse.

Interpersonal Approaches
The first approach assumes that burnout results from emotionally charged relationships
between caregivers and recipients. However, it remains unclear why the relationship between
caregiver and recipient is so demanding. This is where the second approach links in by
emphasizing that this relationship is often characterized by a lack of reciprocity from the
perspective of the caregiver. And it is this lack of reciprocity, not only in interpersonal
relationships but also in the relationship with the organization, that lies at the core of the
burnout syndrome

Organizational Approaches
Three approaches agree that similar organizational factors (e.g. qualitative and quantitative job
demands, lack of autonomy or control, lack of rewards, incongruent institutional goals or
values, and lack of social support or community) are important correlates of burnout.
Moreover, they point to the fact that burnout not only has negative effects for the individual
but that it is also detrimental to the organization in terms of lowered productivity and efficiency,
and poor quality of service.

Interventions
The core symptom of burnout—exhaustion—can be reduced by training professionals to use
particular coping skills, most notably relaxation techniques and cognitive restructuring.
Personal accomplishment, and particularly depersonalization seem rather resistant to change.
The fact that depersonalization and reduced personal accomplishment do not change is not very
surprising because most techniques that are employed in burnout workshops focus on reducing
arousal and not on changing attitudes (depersonalization) or on enhancing specific professional
skills or resources (personal accomplishment).