The Longitudinal Association of Reduced Vagal Tone with Burnout.
The Longitudinal Association of Reduced Vagal Tone with Burnout.
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DOI：
10.1097/psy.0000000000000750
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发表时间：
2019-11
影响因子：
3.3
通讯作者：
M. Wekenborg;LaBarron K Hill;J. Thayer;M. Penz;R. A. Wittling;C. Kirschbaum
中科院分区：
文献类型：
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作者：
M. Wekenborg;LaBarron K Hill;J. Thayer;M. Penz;R. A. Wittling;C. Kirschbaum
目的先前的研究表明，倦怠症状与迷走神经介导的心率变异性(HRV)减少之间存在联系；然而，这种联系的方向性在很大程度上仍不清楚。本研究的目的是检验一年来心率变异性与职业倦怠症状的纵向关系，特别关注情绪衰竭[EE]职业倦怠的子维度，它与抑郁症状的重叠仍然没有得到充分的区分。方法我们提供了167名个体(平均年龄43.43岁，SD 11.78岁；30.5%男性)的HRV和行为数据，他们参加了德累斯顿职业倦怠研究的两次生物标记物采样(T1和T2)，时间间隔约12个月。结果在分层线性回归分析中，在调整了年龄、性别、BMI、不良健康行为和抑郁症状后，T1 HRV显著负向预测T2总体职业倦怠症状(？)和EE(？)重要的是，只有T1时的高EE(？=-0.22；p=0.04)，而不是T1的MBI总分，才能预测从T1到T2的HRV降低。结论我们首次报道了纵向证据，即HRV与职业倦怠症状的改变有关，与抑郁症状无关。结果表明，迷走神经功能障碍对倦怠症状具有预测性和特异性，使HRV成为解释倦怠症状和心血管疾病(CVD)的生物生理机制的一个有希望的起点。仅在T1的EE可以预测HRV的变化，这一发现强调了力竭对自主神经调节中调制的重要性。
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 over one year, with a special focus on the emotional exhaustion [EE] burnout sub-dimension which remains inadequately distinguished from overlapping with depressive symptoms. METHODS Here we present HRV and behavioural data from 167 individuals (mean age 43.43, SD 11.78 years; 30.5% male) who attended two biomarker samplings (T1 and T2) of the Dresden Burnout Study approximately twelve months apart. RESULTS In hierarchical linear regression analyses, T1 HRV significantly inversely predicted T2 overall burnout symptoms (ß = -0.16; p = 0.03), and EE (ß = -0.23; p = 0.02), adjusting for age, sex, BMI, adverse health behaviors, and depressive symptoms. Importantly, only high EE at T1 (ß = -0.22; p = 0.04), and not the T1 MBI total score, predicted reductions in HRV from T1 to T2. CONCLUSION 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 bio-physiological mechanisms underlying burnout symptoms and cardiovascular diseases (CVD). The finding of only EE at T1 being predictive for changes in HRV underscores the importance of exhaustion for modulations in autonomic regulation.