Peter Jönsson

The Lund University Checklist for Incipient Exhaustion-a cross-sectional comparison of a new instrument with similar contemporary tools

BackgroundStress-related health problems (e.g., work-related exhaustion) are a societal concern in many postindustrial countries. Experience suggests that early detection and intervention are crucial in preventing long-term negative consequences. In the present study, we benchmark a new tool for early identification of work-related exhaustion–the Lund University Checklist for Incipient Exhaustion (LUCIE)–against other contextually relevant inventories and two contemporary Swedish screening scales.MethodsA cross-sectional population sample (nu2009=u20091355) completed: LUCIE, Karolinska Exhaustion Disorder Scale (KEDS), Self-reported Exhaustion Disorder Scale (s-ED), Shirom-Melamed Burnout Questionnaire (SMBQ), Utrecht Work Engagement Scale (UWES-9), Job Content Questionnaire (JCQ), Big Five Inventory (BFI), and items concerning work-family interference and stress in private life.ResultsIncreasing signs of exhaustion on LUCIE were positively associated with signs of exhaustion on KEDS and s-ED. The prevalence rates were 13.4, 13.8 and 7.8xa0%, respectively (3.8xa0% were identified by all three instruments). Increasing signs of exhaustion on LUCIE were also positively associated with reports of burnout, job demands, stress in private life, family-to-work interference and neuroticism as well as negatively associated with reports of job control, job support and work engagement.ConclusionsLUCIE, which is intended to detect pre-stages of ED, exhibits logical and coherent positive relations with KEDS and s-ED as well as other conceptually similar inventories. The results suggest that LUCIE has the potential to detect mild states of exhaustion (possibly representing pre-stages to ED) that if not brought to the attention of the healthcare system and treated, may develop in to ED. The prospective validity remains to be evaluated.

Sleep and the generalization of fear learning

Fear conditioning is an important survival mechanism, as is the ability to generalize learned fear responses to stimuli that are similar to the original conditioned stimulus. Overgeneralization of fear learning, prominent in many anxiety disorders, is however highly maladaptive. Because sleep is involved in the consolidation of fear learning, and in active processing of information, the present study explored the effect of sleep on generalization of fear learning. Participants watched a random sequence of pictures of a small and a big circle, one of them coupled with an aversive sound. Then, after a delay period containing either a nap or wake, generalization was examined as participants watched the two circles again, together with eight novel circles that gradually varied in size between the former two. Results showed that the fear response increased as a function of similarity to the conditioned response. However, there was no difference in the degree of generalization between the sleep and the wake group.

Two Swedish screening instruments for exhaustion disorder : cross-sectional associations with burnout, work stress, private life stress, and personality traits

Aims: To examine the relationships of two screening instruments recently developed for assessment of exhaustion disorder (ED) with some other well-known inventories intended to assess ED-related concepts and self-reports of job demands, job control, job support, private life stressors, and personality factors. Methods: A cross-sectional population sample (n = 1355) completed: the Karolinska Exhaustion Disorder Scale (KEDS), Self-reported Exhaustion Disorder Scale (s-ED), Shirom–Melamed Burnout Questionnaire (SMBQ), Utrecht Work Engagement Scale (UWES-9), Job Content Questionnaire (JCQ), Big Five Inventory (BFI), and items concerning family-to-work interference and stress in private life. Results: Compared to participants without any indication of ED, participants classified as having ED on KEDS or s-ED had higher scores on all four SMBQ subscales, lower scores on the UWES-9 subscales vigor and dedication, higher JCQ job demands scores, lower JCQ job support scores, higher degrees of family-to-work interference and stress in private life, and higher BFI neuroticism and openness scores. In addition, participants classified as having ED on KEDS had lower scores on the UWES-9 absorption subscale, the JCQ job control scale, and lower BFI extraversion, agreeableness and conscientiousness scores, compared to the subgroup not classified as having ED. Conclusions: As expected, we observed an overall pattern of associations between the ED screening inventories KEDS and s-ED and measures of burnout, work engagement, job demands-control-support, stress in private life, family-to-work interference, and personality factors. The results suggest that instruments designed to assess burnout, work engagement, and ED share common ground, despite their conceptual differences.

The Lund University Checklist for Incipient Exhaustion: a prospective validation of the onset of sustained stress and exhaustion warnings

BackgroundThe need for instruments that can assist in detecting the prodromal stages of stress-related exhaustion has been acknowledged. The aim of the present study was to evaluate whether the Lund University Checklist for Incipient Exhaustion (LUCIE) could accurately and prospectively detect the onset of incipient exhaustion and to what extent work stressor exposure and private burdens were associated with increasing LUCIE scores.MethodsUsing surveys, 1355 employees were followed for 11 quarters. Participants with prospectively elevated LUCIE scores were targeted by three algorithms entailing 4 quarters: (1) abrupt onset to a sustained Stress Warning (nu2009=u200918), (2) gradual onset to a sustained Stress Warning (nu2009=u200942), and (3) sustained Exhaustion Warning (nu2009=u200936). The targeted participants’ survey reports on changes in work situation and private life during the fulfillment of any algorithm criteria were analyzed, together with the interview data. Participants untargeted by the algorithms constituted a control group (nu2009=u2009745).ResultsEighty-seven percent of participants fulfilling any LUCIE algorithm criteria (LUCIE indication cases) rated a negative change in their work situation during the 4 quarters, compared to 48xa0% of controls. Ratings of negative changes in private life were also more common in the LUCIE indication groups than among controls (58xa0% vs. 29xa0%), but free-text commentaries revealed that almost half of the ratings in the LUCIE indication groups were due to work-to-family conflicts and health problems caused by excessive workload, assigned more properly to work-related negative changes. When excluding the themes related to work-stress-related private life compromises, negative private life changes in the LUCIE indication groups dropped from 58 to 32xa0%, while only a negligible drop from 29 to 26xa0% was observed among controls. In retrospective interviews, 79xa0% of the LUCIE indication participants confirmed exclusively/predominantly work stressors, while 6xa0% described a predominance of private life stressors.ConclusionsNegative changes in the work situation were the most prominent change related to a sustained increase in LUCIE scores. The findings seem to confirm that LUCIE is a potentially useful tool for clinical screening of incipient work-related exhaustion.

Effects of age, BMI, anxiety and stress on the parameters of a stochastic model for heart rate variability including respiratory information

Recent studies have focused on investigating different factors that may affect heart rate variability (HRV),pointing especially to the effects of age, gender and stress level. Other findings raise ...

Effects of acute stress provocation on cortisol levels, zonulin and inflammatory markers in low- and high-stressed men

The virtual version of the Trier Social Stress Test (V-TSST) is an effective and standardized tool for social stress induction. This study aimed to examine gut permeability and physiological and inflammatory markers of reactivity to acute psychosocial stress. Forty young men were classified as high-stressed (HIGHS) or low-stressed (LOWS) according to the Shirom-Melamed Burnout Questionnaire. Cardiovascular reactivity and gut dysfunction were studied along with cortisol, zonulin and cytokines. Gut permeability was shown to be affected within one hour after the psychosocial stress induction, and shown to be dependent on age. Interleukin-6 increased with time, most pronounced at the end of the one-hour recovery after V-TSST, and was positively correlated to age. HIGHS experienced more abdominal dysfunction compared to LOWS. In conclusion, this study is the first to show fluctuations in gut permeability after psychosocial stress induction. This was partly associated with changes in inflammatory markers.