Burnout, perceived stress, & cortisol responses to awakening

OBJECTIVE: The effects of burnout and perceived stress on

early morning free cortisol levels after awakening were

investigated in a group of teachers. Previous studies revealed

that cortisol levels show a significant increase after

awakening, with high intraindividual stability.


Sixty-six teachers from local public schools (42 women and 24

men, mean age 42+/-5 years) were asked to sample saliva for

cortisol analysis on 3 consecutive days. On each day, cortisol

levels were measured at the time of awakening and 15, 30, and

60 minutes thereafter. On the night before the third day,

subjects took 0.5 mg dexamethasone orally for testing

glucocorticoid feedback inhibition. Burnout and perceived

stress were measured by three different questionnaires.

RESULTS: Perceived stress correlated with increases of

cortisol levels during the first hour after awakening after

dexamethasone pretreatment. In addition, teachers scoring high

on burnout showed lower overall cortisol secretion on all

sampling days, and a higher suppression of cortisol secretion

after dexamethasone administration. In the subgroup of

teachers with both high levels of perceived stress and high

levels of burnout, a lower overall cortisol secretion was

observed on the first 2 days, with stronger increases during

the first hour after awakening after dexamethasone

suppression. This subgroup also showed the lowest self-esteem,

the highest external locus of control, and the highest number

of somatic complaints.

CONCLUSIONS: These results demonstrate

differential effects of burnout and perceived stress on

hypothalamic-pituitary-adrenal axis regulation.

Pruessner JC, Hellhammer DH, Kirschbaum C

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