Personality and Individual Differences 58 (2014) 112–115

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Personality and Individual Differences

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Type D personality and job burnout: The moderating role of physicalactivity

0191-8869/$ - see front matter � 2013 Published by Elsevier Ltd.http://dx.doi.org/10.1016/j.paid.2013.10.020

⇑ Tel.: +972 45661782.E-mail address: galitarmon@psy.haifa.ac.il

Galit Armon ⇑Department of Psychology, University of Haifa, Haifa 31905, Israel

a r t i c l e i n f o

Article history:Received 1 March 2013Received in revised form 23 August 2013Accepted 21 October 2013Available online 13 November 2013

Keywords:PersonalityType DDistressed personalityBurnoutPhysical activity

a b s t r a c t

Type D or ‘‘distressed’’ personality (TDP) is the tendency to experience a high amount of negativeaffectivity (NA) and social inhibition (SI) together. This study was designed to test whether TDP isassociated with job burnout and the degree to which physical activity attenuates the TDP-burnoutassociation. Participants (n = 455, 63% men) completed questionnaires during periodic health examina-tions. Burnout was assessed by the Shirom-Melamed burnout measure. TPD was assessed by the DS14.Regression analyses treated TDP as a dimensional construct, using the subscales NA and SI as continuousvariables and defining TDP by their interactive term. Age, gender, education, and chronic medical diseasewere controlled. NA, SI and their interactive term were positively associated with burnout. Additionally, asignificant interactive effect was found for NA/SI and physical activity. Respondents who scored high onNA or SI and who were highly engaged in physical activity had less burnout compared to those with lowengagement in physical activity. The results suggest TDP is positively associated with job burnout, andthat physical activity might be a protective mechanism in this association.

� 2013 Published by Elsevier Ltd.

1. Introduction

Current theory and accumulated evidence support the associa-tion of personality with physical health (Chapman, Roberts, &Duberstein, 2011). In the current study, we focused on Type D or‘‘distressed’’ personality (TDP), defined as the tendency to experi-ence high amounts of negative affectivity (NA) and social inhibition(SI) together (Denollet, 2005). Individuals that score high on NAtend to experience negative emotions, while those who score highon SI tend not to express these emotions, because of fear ofrejection or disapproval by others. In general, strong evidence asso-ciates TDP with poor health outcomes, especially risk of cardiovas-cular disease (CVD) (Chapman et al., 2011; Denollet, 2012).However, the mechanisms responsible for these effects remain tobe uncovered. Recent research suggests that a possible pathwaylinking negative affective states with risk to poor physical healthincludes job burnout (Melamed, Shirom, Toker, Berliner, & Shapira,2006). Job burnout, conceptualised as individuals’ affective re-sponses to the depletion of their energetic resources followingexposure to chronic job stress (Shirom, 2003), is implicated inworkers’ physical health impairment, including increased risk ofCVD (see Melamed et al., 2006, for a review). The current studywas designed to examine the possibility of a positive associationbetween TDP and job burnout.

During the last two decades, accumulated evidence hasindicated that personality might play an important role in thedevelopment of job burnout (Alarcon, Eschleman, & Bowling,2009). However, to date only two studies focused on the associa-tion between TDP and burnout (Oginska-Bulik, 2006; Polman,Borkoles, & Nicholls, 2010). The first study found that TDP wasassociated with higher levels of burnout (Oginska-Bulik, 2006).The second study, found that TDP moderated the relationship be-tween perceived stress and levels of burnout, such that those withTDP experienced higher levels of burnout at low and average stresslevels (Polman et al., 2010). The two studies suffer from significantshortcomings. Polman et al. (2010) conducted their study on a stu-dent sample focusing on academic burnout. Oginska-Bulik (2006)evaluated a limited occupational category (healthcare profession-als) within the same employer, using a small sample. Thus, thegeneralisability of the findings from both studies is questionable.Finally, both studies used a categorical measure to define TDP byscores in the high NA/high SI quadrant, whereas some authors haverecently demonstrated that a categorical classification of TDP maynot be adequate and suggested that TDP is better represented as adimensional construct (i.e., using the subscales NA and SI as con-tinuous variables, and defining TDP as an interaction) (Coyne &de Voogd, 2012; Ferguson et al., 2009).

The present study improves upon the earlier reports by using alarge, representative sample of participants and by controlling forage, gender, education and chronic medical disease as potentialcovariates. Additionally, the prediction of job burnout was

G. Armon / Personality and Individual Differences 58 (2014) 112–115 113

analysed from the dimensional construct of TDP. This study alsoextends prior research by investigating whether or not physicalactivity (PA) moderates the personality-burnout relationship.While a few studies have recently provided empirical support fora main effect of PA on job burnout (e.g., Bernaards et al., 2006),nothing is known about the potentially positive contribution ofPA as a protective mechanism in the relationship between TDPand job burnout.

1.1. The putative association between TDP and job burnout

TDP could be associated with burnout for several reasons. First,TDP is inextricably linked with the experience of negative emo-tions, such as symptoms of depression and anxiety (e.g., Pedersen,Van Domburg, Theuns, Jordaens, & Erdman, 2004), and similarly ismore likely to experience burnout. Second, individuals with TDPhave the disposition to interpret events negatively (Williams,O’Carroll, & O’Connor, 2009), thereby perceiving their workplaceas more stressful (Oginska-Bulik, 2006; Polman et al., 2010).Plausibly, this predisposition could increase levels of burnout.Third, in addition to its influence on the experience and appraisalof stress, TPD might negatively influence the ability to cope withstressors (Connor-Smith & Flechsbart, 2007; Mols & Denollet,2010), thereby contributing to the etiology of burnout.

1.2. The moderating role of PA

PA is any body movement that works the muscles that increaseheart rate and causes sweating (U.S. Department of Health &Human Services, 2008). Although the positive influence of PA onmental health has been extensively explored (Brown, Ford, Burton,Marshall, & Dobson, 2005; Sanchez-Villegas et al., 2008), studies onthe role of PA in reducing job burnout are scarce (Bernaards et al.,2006; Toker & Biron, 2012). In the current study, PA is expected toact as a buffer against job burnout in individuals with TDP for thefollowing reasons: first, engaging in PA has received empiricalsupport for enhancing coping self-efficacy (Craft, 2005). Thus, foremployees with TDP, engaging in an exercise program may providethe mastery experiences needed to promote their perceived abilityto cope with negative thoughts, and thereby, decrease their likeli-hood of feeling burned out. Second, exercise might also serve tomodify emotional action tendencies — one of the ‘‘fundamental’’therapeutic strategies according to Barlow, Allen, and Choate(2004). More specifically, exercise involves an action (i.e., activa-tion approach) that is inconsistent with the natural action tenden-cies associated with the personality characteristics of NA and SI(passivity and avoidance) (Connor-Smith & Flechsbart, 2007) thatisolate individuals from opportunities for positive affect and thus,propagate burnout. Third, PA may act as a means of recovery byallowing employees with TDP to be temporarily relieved of stress.The relief may enable them to replenish the personal resourcesneeded to once again face job demands and might reduce addi-tional resource loss (van Hooff, Geurts, Beckers, & Kompier,2011). From a physiological perspective, PA may reduce an individ-ual’s physical vulnerability to stress, as manifested by increasedheart rate or blood pressure (see Salmon, 2011, for a review), andmay increase the availability of central neurotransmitters (e.g.,serotonin, endogenous opioids) that are responsible for antidepres-sant effects (Salmon, 2011). This antidepressant effect will bestronger in employees with TDP who tend to be more vulnerableto stress, allowing individuals to confidently and effectively handlejob stress without feeling overwhelmed or letting it evolve intoburnout. Additionally, PA is associated with improvements in thesleep cycle. Sleep disturbance has been found to increase the like-lihood of burn-out (Melamed et al., 2006) and commonly observed

in those who are high on NA and SI (see Van de Laar, Verbeek,Pevernagie, Aldenkamp, & Overeem, 2010, for a review).

2. Method

2.1. Participants

Study participants (N = 495) were employees attending theCenter for Periodic Health Examinations of the Tel Aviv-Souraskymedical center inflammation survey (TAMCIS) for routine healthexaminations and gave written informed consent for participationin the study, according to the instructions of the local ethics com-mittee. These examinations were provided by employers as a sub-sidised fringe benefit.

A total of 455 (92%) agreed to participate (63% men). Their meanage was 42.47 years (S.D. = 10.82). They had completed a mean of15 years of education and worked an average of 9.6 h/day. The 40(8%) examinees who refused to participate in the study did not dif-fer from participants on any of the socio-demographic variablesevaluated.

2.2. Measures

Job burnout was assessed by the Shirom-Melamed burnoutmeasure (SMBM), whose reliability and validity have been demon-strated in several studies (Melamed et al., 2006; Shirom &Melamed, 2006). The SMBM consists of 14 items scored on a 7-point frequency scale, ranging from 1 (almost never) to 7 (almostalways). The alpha coefficient in the present study was 0.92. Exam-ple of the item is ‘‘I feel fed up’’. The SMBM was translated into sev-eral languages and is currently used in several countries, yieldingfindings that cross-validate the results obtained in Israel (Soares,Grossi, & Sundin, 2007). Burnout was used as a continuousmeasure.

TDP The DS14 (Denollet, 2005) assesses the two global traits NA(7 items; e.g., I am often irritated) and SI (7 items; e.g., I find it hardto start a conversation). It uses a five-point Likert-type scale an-chored at 0 = false and 4 = true. The questionnaire allows the scor-ing of NA and SI as continuous variables (range 0–28). The DS14 isgenerally construed as measuring two temporally stable personal-ity traits, as indicated by good test–retest reliability and to be inde-pendent of changes in mood (Denollet, 2005). The alpha coefficientin the present study was .87 for NA and .88 for SI.

PA was assessed based on participants’ self-reports. Consistentwith the 2008 NIH guidelines, respondents were asked how manydays per week, and how many minutes each session, they engagedover the past month in strenuous PA (activity that increases theheart rate and causes sweating) during their leisure time. Thenumber of minutes was multiplied by the number of days to createa measure of weekly PA intensity. Such single-item instruments(e.g., minutes per week of vigorous PA) allow rapid assessment ofgeneral patterns of PA and have been used extensively (Andersenet al., 2006; Toker & Biron, 2012).

In order to reduce over-reporting of PA that may occur due tosocial desirability effects (Adams et al., 2005), participants com-pleted the survey outside the physician’s office. Additionally, itwas clearly stated that responses would not be seen by the medicalstaff or the participant’s employer. Moreover, self-report measuresof PA have been validated against objectively measured PA (e.g.,Pate, Ross, Dowda, Trost, & Sirard, 2003).

2.3. Covariates

Age, which has been consistently found to be associated withburnout (Schaufeli & Enzmann, 1998), was used as a control

114 G. Armon / Personality and Individual Differences 58 (2014) 112–115

variable. Gender was also controlled, following a recent studyshowing gender differences in the personality-burnout relation-ship (Alarcon et al., 2009). Additionally, educational levels (numberof years of education) was controlled following a body of evidencelinking socioeconomic status (SES) to emotions (see review ofGallo & Mathews, 2003) and to coping ability with stress (Baum,Garofalo, & Yali, 1999).

Chronic medical illness (CMI) was controlled for based on a bodyof evidence that shows that having a chronic disease tends to de-plete energy resources, which in turn increases one’s levels of dis-tress symptoms (e.g., Dirik & Karanci, 2010). CMI was coded, as inother epidemiological studies (e.g., Gunn et al., 2012), based onself-reported physician diagnosis of at least one of eight medicalconditions: diabetes, cancer, cardiovascular disease, respiratorydisease, neurological disease, musculoskeletal complaints, rheu-matic disease, or gastro-intestinal disease.

2.4. Statistical analysis

The statistical analysis followed the recommendations ofSimmons, Nelson, and Simonsohn (2011). Ordinary least squares(OLS) regressions (with SPSS software) were used. In the first step,the main effect variables of the continuous components of NA andSI and their interactive term (NAxSI) were entered. In the secondstep, the interactive term of PAxTDP was tested by a three-wayinteraction (NAxSIxPA). In order to test the three-way interaction,the main effect of PA and all the possibilities of the two-way inter-actions (NAxPA and SIxPA) were forced into the regression first. Inthe final step, the aforementioned control variables were entered.To reduce the possibility of multicollinearity among the interactiveterms and their component predictors, all predictors were centeredprior to the regression runs (Aiken & West, 1992).

3. Results

In the first step (Table 1, Model 1), NA and SI and their interac-tion term were positively associated with burnout (b = 0.52,p < 0.01; b = 0.08, p < 0.05; b = 0.09, p < 0.05, respectively). In thesecond step (Table 1, Model 2), a significant effect was found forNA and SI interacting with PA (b = �0.08, p < 0.05; b = �0.09,p < 0.05). The interaction pattern for those who showed higher lev-els of PA was, the higher the levels of NA or SI, the lower the levelof burnout compared to those with lower levels of PA. The three-

Table 1Summary of the multiple regressions of burnout on TDP, PA, and covariates.

Model 1 Model 2

B SEB b B

Step 1: predictors (TDP)NA 0.08** 0.01 0.52 0.08**

SI 0.02* 0.01 0.08 0.02NA X SI 0.01* 0.01 0.09 0.01*

Step 2: moderatorsPA – – – �0.05**

PA X NA – – – �0.01*

PA X SI – – – �0.01*

PA X NA X SI – – – 0.01

Step 3: covariatesAge – – – –Gender – – – –Education – – – –CMI – – – –

Note: n = 455. The symbols B and b represent the unstandardised and standardised partformer. NA, negative affectivity; SI, social inhibition; PA, physical activity; CMI, chronic* p < 0.05.** p < 0.01.

way interactive effect of NAxSIxPA was not significant. Addition-ally, after including the SIxPA interaction in the regression, theassociation between SI and burnout attenuated, resulting in mar-ginal significance. In the final step, including the covariates inthe analyses did not change any of the regression effects, exceptthe association between SI and burnout, which was nowsignificant.

4. Discussion

The longstanding theorising that personality is associated withphysical health and the accumulating empirical evidence support-ing this claim (Chapman et al., 2011) have stimulated the searchfor the underlying mediating biological and behavioural pathways.One suggested mechanism is an affective state of job burnout(Melamed et al., 2006). The current study focused on TDP, a ‘‘dis-tressed’’ personality type, described as the tendency to concur-rently experience high amounts of both NA and SI (Denollet,2005). It improves over the two previous studies on TDP and jobburnout (Oginska-Bulik, 2006; Polman et al., 2010) in two impor-tant ways. First, this study was conducted using a large, represen-tative sample of participants, controlling for important covariates.Second, this study extends prior research also by investigating thedegree to which PA attenuates the TDP-burnout relationship.

The first finding of this study was that TDP was positively asso-ciated with job burnout. Specifically, NA, SI and their two-wayinteractive effect were each independently associated with jobburnout. This finding helps uncover one of the pathways linkingpersonality with physical health. The association between TDPand burnout can be explained by the general likelihood of individ-uals with TDP to experience negative emotions (Pedersen et al.,2004) or their likelihood of perceiving their environment as morestressful than their poor coping abilities can deal with. These expe-riences and perceptions adversely influence levels of burnout(Polman et al., 2010).

This study further contributes to the literature by documentingthe protective effect of PA on job burnout. Specifically, the resultsshowed that only the two-way interactive effects were significant(NA by PA and SI by PA). In other words, PA attenuated the adverseeffects of NA and SI on burnout independently of each other. Theinability to obtain a significant three-way interaction (NA by SIby PA), often discussed in the literature, is highly prevalent in fieldresearch, and is due to the extremely low statistical power

Model 3

SEB b B SEB b

0.01 0.50 0.09** 0.01 0.500.01 0.04 0.01* 0.01 0.080.01 0.09 0.01* 0.01 0.07

0.02 �0.12 �0.04* 0.02 �0.080.01 �0.08 �0.01* 0.01 �0.050.01 �0.09 �0.01* 0.01 �0.090.01 �0.02 0.01 0.01 �0.02

– – �0.01** 0.01 �0.12– – 0.15* 0.07 0.09– – 0.02 0.02 0.05– – �0.03 0.13 �0.01

ial regression coefficients, respectively, and SEB stands for the standard error of themedical illness.

G. Armon / Personality and Individual Differences 58 (2014) 112–115 115

associated with such an analysis (McClelland & Judd, 1993).Although we cannot specify which of the proposed underlyingmechanisms might be involved; these results suggest that PA sub-stantially alleviates burnout among individuals with TDP.

The present study is not free of limitations. First, this research iscross-sectional. Additional studies with longitudinal and experi-mental designs are needed to replicate the findings. Second, be-cause the study is based on self-reports, results may be subjectto common method bias. We believe that we partially correctedfor this by creating temporal and psychological separations in thesurvey by listing the items measuring the key concepts non-consecutively; thereby, increasing the likelihood that employeeswould respond to each set of key items without recalling theirresponses to prior sets (Podsakoff, MacKenzie, Lee, & Podsakoff,2003). Additionally, interaction terms are unlikely to be an artifactof common-method bias, as respondents are unlikely to con-sciously theorise interactive relationships when they complete asurvey Siemsen, Roth, & Oliveira, 2010).

The approach taken by the TDP construct may be directly rele-vant to the emerging need for a shift towards more personalisedmedicine (Denollet, 2012). This approach may improve our under-standing of individual differences in vulnerability to health risks.The confirmation of TPD as a potential contributor to increasedjob burnout and the information that engagement in PA attenuatesthe TDP-job burnout relationship emphasise the need for appropri-ate intervention programs to encourage and increase PA and thus,decrease burnout at work.

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