Abstract
Objectives: Vital exhaustion has been shown to predict the progression and manifestation of cardiovascular disease. Little is known about the relationship between vital exhaustion and overcommitment, the inability to withdraw from obligations at work. The aim of this study was to explore the relationship between vital exhaustion and overcommitment at work, as measured by the intrinsic-effort scale of the effort–reward model after consideration of other potentially salutogenetic and pathogenetic working conditions. Methods: This cross-sectional study is based on a stratified random sample of 634 employees (mean age 39.9 years, standard deviation 10.7 years) from a manufacturing and assembly plant for aeroplane parts. Participants completed a questionnaire, which included the nine-item shortened Maastricht exhaustion questionnaire to score the dependent variable exhaustion, and the six-item short form of the intrinsic-effort scale (“immersion”) of the effort–reward-imbalance model as the primary independent variable. Perceived work stress was assessed by Siegrist’s effort–reward-imbalance questionnaire and the 52-item, 13 subscale salutogenetic subjective work assessment (SALSA) questionnaire, which focuses on indicators of perceived work stress in terms of pathogenetic and salutogenetic descriptors of decision latitude, psychological job demands, and social support. Additional candidate covariates included depression, anxiety and type-D personality. Results: In regression analysis, overcommitment (r=0.516; P<0.0001) was independently associated with vital exhaustion. Multivariable linear regression analysis showed that overcommitment explained 27% of the variance of vital exhaustion. Conclusions: Overcommitment, indicating an exhaustive work-related coping style, is independently associated with vital exhaustion. It appears to be an important personality trait that may contribute to feelings of exhaustion at times of increased job strain.
Similar content being viewed by others
References
Appels A (1990) Mental precursors of myocardial infarction. Br J Psychiatry 156:465–471
Appels A (1997) Why do imminent victims of a cardiac event feel so tired? Int J Clin Pract 51:447–450
Appels A, Mulder P (1988) Excess fatigue as a precursor of myocardial infarction. Eur Heart J 9:758–764
Appels A, Mulder P (1989) Fatigue and heart disease. The association between ‘vital exhaustion’ and past, present and future coronary heart disease. J Psychosom Res 33:727
Appels A, Hoppener P, Mulder P (1987) A questionnaire to assess premonitory symptoms of myocardial infarction. Int J Cardiol 17:15–24
Bosma H, de Jonge J, Marmot M (1997) Low job control and risk of coronary heart disease in Whitehall II (prospective cohort) study. BMJ 314:558–565
Cole SR, Kawachi I, Sesso HD, Paffenbarger RS, Lee IM (1999) Sense of exhaustion and coronary heart disease among college alumni. Am J Cardiol 84:1401–1405
Denollet J (2000) Type-D personality: a potential risk factor refined. J Psychosom Res 49:255–266
Denollet J, Brutsaert DL (1998) Personality, disease severity, and the risk of long-term cardiac events in patients with a decreased ejection fraction after myocardial infarction. Circulation 92:167–173
Denollet J, Van Heck GL (2001) Psychological risk factors in heart disease: what type-D personality is (not) about. J Psychosom Res 51:465–468
van Diest R, Appels A (1991) Vital exhaustion and depression: a conceptual study. J Psychosom Res 35:535–544
Friedman M, Rosenman R (1959) Association of specific overt behavior pattern with blood and cardiovascular findings. JAMA 169:1286–1296
Hemingway H, Marmot M (1999) Psychosocial factors in the aetiology and prognosis of coronary heart disease: systematic review of prospective cohort studies. BMJ 318:1460–1467
Herrmann-Lingen C, Grande G, Jordan J, Denollet J (2002) Die deutsche DS14: Ein kurzes Selbstbeurteilungsverfahren zur Erfassung des prognoserelevanten “distressed personality type” (Typ D). Psychother Psychosom Med Psychol 52:92
Joksimovic L, Starke D, von dem Knesenbeck O, Siegrist J (2002) Perceived work stress, overcommitment and self-reported musculoskeletal pain: a cross-sectional investigation. Int J Behav Med 9:122–138
de Jonge J, Bosma H, Peter R, Siegrist J (2000) Job strain, effort–reward imbalance and employee well-being: a large-scale cross-sectional study. Soc Sci Med 50:1317–1327
Kop WJ, Appels AP, Mendes de Leon CF, de Swart HB, Bar FW (1994) Vital exhaustion predicts new cardiac events after successful coronary angioplasty. Psychosom Med 56:281–287
Kop WJ, Hamulyak K, Pernot C, Appels A (1998) Relationship of blood coagulation and fibrinolysis to vital exhaustion. Psychosom Med 60:352–358
Kopp MS, Falger PR, Appels A, Szedmak S (1998) Depressive symptomatology and vital exhaustion are differentially related to behavioral risk factors for coronary artery disease. Psychosom Med 60:752–758
Pedersen S, Middel B (2001) Increased vital exhaustion among type-D patients with ischemic heart disease. J Psychosom Res 51:443–449
Raikkonen K, Lassila R, Keltikangas-Jarvinen L, Hautanen A (1996) Association of chronic stress with plasminogen activator inhibitor-1 in healthy middle-aged men. Arterioscler Thromb Vasc Biol 16:363–367
Rimann M, Udris I, (1997) Subjektive Arbeitsanalyse: Der Fragebogen SALSA. In: Strohm O (eds) Unternehmen arbeitspsychologisch bewerten. vdf Hochschulverlag, Zürich
Rozanski A, Blumenthal JA, Kaplan JR (1999) Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. Circulation 99:2192–2217
Schmidt Pedersen S, Middel B (2001) Increased vital exhaustion among type-D patients with ischemic heart disease. J Psychosom Res 51:443–449
Schnorpfeil P, Noll A, Wirtz P, Schulze R, Ehlert U, Frey K, Fischer JE (2002) Assessment of exhaustion and related risk factors in employees in the manufacturing industry—a cross-sectional study. Int Arch Occup Environ Health 75:535–540
Siegrist J (2001) A theory of occupational stress. In: Dunham J (ed) Stress in the workplace: past, present and future. Whurr, London, pp 52–66
Siegrist J (2002) Effort-reward imbalance at work and health. In: Perrewé PL, Ganster DC (eds) Historical and current perspectives on stress and health. JAI Elsevier, New York, pp 261–292
Siegrist J, Klein D, Voigt KH (1997) Linking sociological with physiological data: the model of effort–reward imbalance at work. Acta Physiol Scand Suppl 640:112–116
The Review Panel on Coronary-Prone Behavior and Coronary Heart Disease (1981) Coronary-prone behavior and coronary heart disease: a critical review. Circulation 63:1199–1215
Tsutsumi A, Kayaba K, Theorell T, Siegrist J (2001) Association between job stress and depression among Japanese employees threatened by job loss in a comparison between two complementary job-stress models. Scand J Work Environ Health 27:146–153
Vrijkotte TG, van Doornen LJ, Geus EJ (1999) Work stress and metabolic and hemostatic risk factors. Psychosom Med 61:796–805
Williams RB (1987) Refining the type A hypothesis: emergence of the hostility complex. Am J Cardiol 60:27J–32J
Wojciechowski F, Strik J, Falger P, Lousberg R, Honig A (2000) The relationship between depressive and vital exhaustion symptomatology post-myocardial infarction. Acta Psychiatr Scand 102:359–365
Zigmond AS, Snaith RP (1983) The hospital anxiety and depression scale. Acta Psychiatr Scand 67:361–370
Acknowledgements
This work was supported by grants from the Swiss Federal Institute of Technology and the EADS GmbH, Werk Augsburg, Germany.
Author information
Authors and Affiliations
Corresponding author
Appendix
Appendix
Rights and permissions
About this article
Cite this article
Preckel, D., Känel, R.v., Kudielka, B.M. et al. Overcommitment to work is associated with vital exhaustion. Int Arch Occup Environ Health 78, 117–122 (2005). https://doi.org/10.1007/s00420-004-0572-8
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00420-004-0572-8