Abstract

Research on burnout has garnered considerable attention since its inception. However, the ongoing debate persists regarding the conceptual model of burnout and its relationship with depression. Thus, we conducted a network analysis to determine the dimensional structure of burnout and the burnout-depression overlap. The Maslach Burnout Inventory-Student Survey and Patient Health Questionnaire-9 were used to measure burnout and depression among 1096 college students. We constructed networks for burnout, depression, and a burnout-depression co-occurrence network. The results showed that cynicism symptom was the most central to the burnout network. In the co-occurrence network, depressive symptoms (“anhedonia”, “fatigue”) and burnout symptom (“doubting the significance of studies”) were the most significant in causing burnout-depression comorbidity. Community detection revealed three communities within burnout symptoms, aligning closely with their three dimensions identified through factor analysis. Additionally, there was no overlap between burnout and depression. In conclusion, our findings support a multidimensional structure of burnout, affirming it as a distinct concept separate from depression. Cynicism, rather than exhaustion, plays the most important role in burnout and the burnout-depression comorbidity.

Introduction

Burnout has long been recognized as an occupational hazard in various human service occupations (Lacy and Chan, 2018; Maslach and Leiter, 2016; Sullivan et al., 2022; Weigl, 2022). Since its emergence, the concept of burnout has attracted increasing attention worldwide and has gradually expanded to include a more general range of occupations (Aronsson et al., 2017; Embriaco et al., 2007; Shanafelt et al., 2019). Burnout is now defined as a psychological syndrome, caused by prolonged occupational stressors. Additionally, personality traits, particularly neuroticism, play an important role in the development of burnout (Angelini, 2023). People with high levels of neuroticism may adopt maladaptive coping strategies that magnify the impact of adverse events in the workplace, leading to greater anxiety and exhaustion from work. In summary, both external and internal factors influence the development of burnout.

The widely accepted conceptual model of burnout is a multidimensional model that stratifies burnout into three dimensions: exhaustion, cynicism or depersonalization, and a lack of professional efficacy (Maslach and Leiter, 2016). However, in contrast to the increasing research on burnout, minimal advances have been achieved in the establishment of clinical diagnoses. An undetermined definition of burnout is reportedly the primary issue for a diagnostic consensus (Rotenstein et al., 2018). The evolving definitions of burnout contribute to variability in estimating its prevalence, posing challenges in policy development. Initially, exhaustion was identified as the most central and obvious manifestation of burnout (Maslach et al., 2001). Accordingly, in a few northern European countries, the diagnosis of burnout has been simplified to exhaustion; consequently, the focus of the public and policy has been limited to exhaustion alone. Meanwhile, some argued that despite the importance of exhaustion, it was not the most central component of burnout (Maslach and Leiter, 2008) and that focusing on exhaustion devalued the significance of burnout as a distinct construct. A recent study on the relationship between the three dimensions of burnout suggested that exhaustion is not the most closely associated dimension (Wu et al., 2021). Measurements using an alternative burnout structure exhibit better validity (Shoman et al., 2021). To date, there has been minimal consensus on the definition or dimensional structure of burnout, as well as the most important symptoms of burnout (Tavella et al., 2021).

Conclusion

The current study was designed to determine the structure of burnout and the burnout-depression overlap among college students at the network level. It specifically identified cynicism symptoms as crucial factors for burnout and burnout-depression comorbidity. Additionally, community detection analysis suggested a multidimensional structure for burnout, emphasizing that burnout should be considered distinct from the concept of depression. This study provides insights into the structure of burnout from the perspective of network analysis, and delineates the overlap between burnout and depression.