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J Affect Disord. 2018 Jan 15;226:6-11. doi: 10.1016/j.jad.2017.09.017. Epub 2017 Sep 18.

Can flow experiences be protective of work-related depressive symptoms and burnout? A genetically informative approach.

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Dept of Neuroscience, Karolinska Institutet, Stockholm, Sweden; Dept of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden. Electronic address:
Dept of Psychology, University of Zagreb, Zagreb, Croatia.
Dept of Neuroscience, Karolinska Institutet, Stockholm, Sweden.



Genetic research on depression and burnout has focused mostly on adverse factors, although various aspects in daily life related to positive coping and well-being have been shown to potentially be protective. Using a large genetically informative sample, we aim to explore the potential relationship between flow proneness and work-related depressive symptoms and burnout.


About 10,000 Swedish twins filled in the Swedish Flow Proneness Questionnaire, a subscale of the Hopkins Symptom Checklist (SCL) depression scale, and the Emotional Exhaustion subscale of the Maslach Burnout Inventory-General Survey. A higher score indicated more flow, less emotional exhaustion and less depression. The classical twin design and co-twin control analyses were applied.


Phenotypic correlations were .43 between depressive symptoms and flow proneness, .34 between burnout and flow proneness, and .62 between depressive symptoms and burnout. Broad-sense heritabilities (G) ranged between 33-35% for the three variables. Associations between the variables were due to significant genetic as well as non-shared environmental influences. Co-twin control analyses showed that associations remained significant when controlling for all genetic and shared familial factors, in line with a causal relationship.


Although the co-twin control design can test for consistency of associations with a causal relationship, it cannot unequivocally establish causality.


Genetic liability has a substantial influence on associations between flow proneness and emotional problems at work (depression, burnout). However, the presence of significant environmental correlations is in line with a (partly) causal relationship between flow and work related depression and burnout, which in turn may suggest that interventions which increase flow could potentially reduce emotional problems at work.


Emotional exhaustion; Intervention; Mental health; Twin; Well-being

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