Burnout Clinical Subtypes Questionnaire (BCSQ-36): reliability and validity study in Latvia

1

ABSTRACT

The study aimed to test the validity of the burnout subtypes hierarchic model operationalized by the ‘Burnout Clinical Subtypes Questionnaire’ (BCSQ-36) and its applicability in other cultures. To that aim psychometric properties, factorial and convergent validity regarding the Maslach Burnout Inventory – General Survey (MBI-GS), and correlation with demographic factors were reviewed. A voluntary internet-based approach was used on a multi-occupational sample of adult Latvians (n = 394). The results of the internal consistency of the Latvian version of the BCSQ-36 exceeded .89 for all three subtypes. The CFA was used to test a hierarchical factorial model, and the analysis revealed an acceptable fit of the model to the data. Correlation analysis showed results as expected, similarly to the original sample – Underchallenged and Worn-out subtypes correlated with all MBI-GS scales, while Frenetic subtype did not correlate with the MBI-GS Cynicism scale. Besides, demographic data showed some correlation only on the subscale level. Overall research results provide support of the validity of the burnout subtypes hierarchical model and applicability in another culture.

KEYWORDS:

• Burnout
• burnout subtypes
• BCSQ-36
• factorial validity
• convergent validity

Introduction

Traditionally burnout is defined as a uniform condition with relatively consistent aetiology and symptoms resulting from prolonged exposure to chronic work stressors (Maslach, Schaufeli, & Leiter, 2001). Nevertheless, at the moment, there is no unified approach and consensus among researchers on how to measure burnout (Poghosyan, Aiken, & Sloane, 2009). According to recent estimates (Bianchi, Schonfeld, & Laurent, 2015), 78% of burnout studies used the ‘Maslach Burnout Inventory’ (Maslach & Jackson, 1981, 1986) which operationalizes burnout by the dimensions of exhaustion, cynicism, and professional efficacy (Maslach et al., 2001). Other measures, e.g. ‘Shirom-Melamed Burnout Survey’ (Melamed, Kushnir, & Shirom, 1992; Shirom, 1989), ‘Burnout Survey’ (Pines & Aronson, 1988), ‘Old Burnt Burning Survey’ (Demerouti & Bakker, 2008), are used as well (Bianchi et al., 2015).

Unfortunately, none of these surveys observe burnout as a separate aetiology phenomenon and do not address the specific need for burnout prevention; therefore, several approaches have recently been elaborated for measuring individual trajectories of burnout development (Leiter & Maslach, 2016). Such an approach is crucial for the development of individually-tailored interventions (Montero-Marín & García-Campayo, 2010; Montero-Marin, Prado-Abril, Demarzo, Garcia-Toro, & García- Campayo, 2016).

The ‘Burnout Clinical Subtype Questionnaire’ was created as a response to such need. This survey is based on the theoretical frame (Farber, 1999, 2000), which defines three types of burnout, Frenetic, Underchallenged and Worn-out, depending on the level of dedication individuals express toward work-related tasks (Montero-Marín, García-Campayo, Mosquera, & López, 2009; Montero-Marin et al., 2011). The model was originally tested in Spain and exploratory factor analysis (EFA) confirmed a three-factor model, which generally explained 68% of the variation (Montero-Marín, García-Campayo, & Andrés, 2008).

Frenetic subtype characterises employees who want to achieve success despite health and private life limitations. They work increasingly harder to the point of exhaustion. These workers are ambitious and highly involved in their work. The Ambition subscale responds to an individual’s great need for success and achievement at work; the Overload subscale reflects risking one’s health and personal life on behalf of good work results, and Involvement shows the investment of everyday effort to overcome difficulties related to work.

Individuals high on the Underchallenged burnout profile work in a monotonous and unstimulating work environment, which does not encourage personal development in their jobs. The Indifference subscale is a lack of interest and enthusiasm at work; Lack of Development is dissatisfaction with unnoticed talents, lack of personal growth experience, and a desire to do a different job more suited to the individual’s skills and interests; Boredom is experiencing work as routine and monotonous, with little variation in activities. The Worn-out profile is presented by employees who give up facing stress and absence of acknowledgement. Very often they are negatively influenced by organizational rigidity and experience a lack of control of their job results. Lack of Control is showing a feeling of helplessness as a result of dealing with many situations beyond the worker’s control. Lack of Acknowledgement is a belief that the organization does not acknowledge one’s work efforts and dedication; the Neglect subscale refers to one’s disregard for and giving up as a response to any difficulty at work.

In terms of convergent validity, the original study (Montero-Marín & García-Campayo, 2010) showed that the Frenetic subtype presented fewer relations with the MBI-GS dimensions: moderate for Exhaustion, insignificant for Cynicism and moderately low in a positive sense for Professional Efficacy. The Underchallenged subtype showed moderate level correlations with Exhaustion, very high with Cynicism and moderate negative with Professional Efficacy. The Worn-out subtype obtained the strongest relations with MBI-GS dimensions as the criterion. The relations were very strong with Exhaustion and Cynicism and moderately strong with Professional Efficacy in a negative sense. In that way, the burnout subtypes hierarchic model broadens conceptualization of this phenomena.

This study aimed to adapt and validate the ‘Burnout Clinical Subtypes Questionnaire’ (BCSQ-36) in a Latvian sample based on International Test Commission Guidelines for Translating and Adapting Tests 2nd Edition (7) and to test internal consistency, factorial and convergent validity. The adaptation process of the BCSQ-36 in Latvia was important for testing the burnout subtypes hierarchic model stability in another culture.

Method

Linguistic adaptation

After receiving approval from the author of the survey, J. Montero-Marin (3 October 2017), forward translation was done independently by three bilingual translators and minor differences were solved by the research team. The Latvian version of the BCSQ-36 was examined for understanding in a small sample (n = 11). Respondents were encouraged to make comments and suggestions on the clarity of the wording and difficulties during completion. After that back translation was done, discussed with the author of the survey and accepted.

Participants

A cross-sectional design was used in a multi-occupational sample of employed persons. The study included 394 adults aged 18–73 (M = 40.2 years, SD = 10.85), 78.9% female, married or living together with partner (67.2%) with children (67.3%), 84.9% with higher education. The participants represented different occupational fields (health and social care (24.1%), education (16.9%), IT and telecommunications (14.1%)); private sector (55.6%) and state/municipal institutions (42.2%); mainly specialist (63.5%) and mid-level managers (22.1%). The variance of working hours per week was six to 100 (M = 38), and 30.5% of participants worked less than 40 hours per week. Work experience ranged from several months to 55 years (M = 8.9 years), 34% respondents had work experience less than three years, 15% – three to five years, 16% – six to 10 years, 25.5% – 11 to 20 years, 9.5% – 21 and more years of work experience. Around 60% of participants had not taken time off from work during the past three months.

Procedure

Participants were recruited by distributing a letter of invitation through different channels: firstly, through Human Resource departments of different organizations, secondly, via social networks, e.g. Facebook, and thirdly, using a traditional electronic media site, Delfi.lv, where an article about burnout was published and followed by a link to the survey. The survey took place between February and May 2018 and the results were anonymously collected by Google Survey Forms. The survey started with a cover letter explaining the purpose of the study, the researchers’ affiliation and contact information, and clearly stating that the answers would be anonymous and treated confidentially.

Instruments

Burnout Clinical Subtype Questionnaire (BCSQ-36; Montero-Marín & García-Campayo, 2010) is a self-administered questionnaire that consists of 36 items, 12 items for each subtype. The Frenetic subtype scale consists of three subscales (4 items each): Ambition subscale (e.g. ‘I need to achieve great success in my work’); Overload subscale (e.g. ‘I risk my health when I pursue good results in my work’); Involvement subscale (e.g. ‘I react to difficulties in my work with greater participation’). The Underchallenged burnout subtype scale consists of three subscales (also four items each): Indifference subscale (e.g. ‘I have little interest for the tasks involved in my job’), Lack of Development subscale (e.g. ‘I would like to be doing a different job that is more challenging for my abilities’) and Boredom subscale (e.g. ‘I feel my work is mechanical and routine’). Another 12 items for the Worn-out burnout type scale include three subscales, (also four items for each): Lack of Acknowledgement subscale (e.g. ‘I think my dedication to my work is not acknowledged’), Neglect subscale (e.g. ‘I give up in the face of any difficulties in my work tasks’) and Lack of Control subscale (e.g. ‘I feel helpless in many situations in my work’). Subjects indicated their degree of agreement with each of the items using a Likert-type scale with seven response options, scored from one (totally disagree) to seven (totally agree).

The Maslach Burnout Inventory General Survey (MBI-GS; Maslach & Jackson, 1981, 1986) is a scale, which consists of 16 items grouped into three dimensions. Responses were arranged in a Likert-type scale with seven options, scored from zero (never) to six (every day). The Exhaustion dimension has five items (e.g. ‘I feel emotionally drained from my work’), the Cynicism dimension consists of five items (e.g. ‘I’ve become more callous toward people since I took this job’) and the Professional Efficacy dimension with six items (e.g. ‘I deal very effectively with the problems of my work’). Leiter and Schaufeli (1996) found Cronbach’s alpha coefficients ranging from .84 to .90 for Exhaustion, .74 to .84 for Cynicism, and from .70 to .78 for Professional Efficacy. In this study, the Latvian language version (Caune, 2004) was used.

A socio-demographical data survey was used to measure the participant’s sex, age, relationship status, work experience, working hours per week, work absenteeism during the last three months, education, occupational field, and work position.

Data analysis

As a measure of reliability, the internal consistency of the BCSQ-36-LV subscales was examined by computing a Cronbach’s alpha coefficient for each subscale and subtype. Cronbach’s alpha assesses the degree of inter-item consistency and a value larger than .70 is considered satisfactory (Tabachnik & Fidell, 2013).

In order to examine if the BCSQ-36-LV corresponds to the hierarchical three (secondary) and nine (primary) factor structure of the original BCSQ-36, we used confirmatory factor analysis (CFA) on the dataset of the 394 subjects who completed the survey. To confirm the legitimacy of the analysis, we confirmed that the KMO index had a value >.70 and that Bartlett’s sphericity test provided a significant result. Besides, the criterion of a factorial weight higher than .40 was used to determine which items were allocated to a specific factor (Leech, Barrett, & Morgan, 2015). CFA was performed using ‘lavaan’ (0.5–23) for R (Rosseel, 2012). Univariate and multivariate normality was assessed using the ‘MVN’ package (5.7) for R (Korkmaz, Goksuluk, & Zararsiz, 2014).

Convergent validity was also evaluated by comparing BCSQ-36-LV scores with MBI-GS scores and by examining its relation with the socio-demographic data. Missing cases did not exceed 2% in any of the comparisons. Cronbach’s alphas, Spearman correlation, and the Mann-Whitney test were computed, as appropriate. All statistical tests were two-tailed, and results were considered significant at p < .05. The data analysis was performed with the SPSS version 22 statistics software package.

Results

The CFA tested a hierarchical factorial model, suggested by J. Montero-Marin (Montero-Marín & García-Campayo, 2010). Shapiro-Wilk test values varied from .80 to .94, p < .001, indicating univariate non-normality. Mardia’s test value for skewness was 17 315.35, p < .001, and for kurtosis it was 61.16, p < .001. Henze-Zirkler test value was 1.01, p < .001. Both tests indicated a deviance of data from being multivariate normally distributed. Therefore, the model fit was assessed using maximum likelihood estimation with robust standard errors and Satorra-Bentler scaled test statistics (Satorra & Bentler, 1994). The original model demonstrated the following fit indices: χ²(581) = 1279.53, p < .001, AGFI = .78, CFI = .91, TLI = .90, RMSEA = .055 (90% CI from .052 to .059, p = .010), SRMR = .09. The scaling correction factor value was 1.27. The main weakness of the model was a negative variance estimate of Involvement in Frenetic subtype.

Considering the negative estimate as a sign of model structural misspecification (e.g. Kolenikov & Bollen, 2012), we have tested modification indices associated with Involvement. Focusing on the particular subscale provided minimal modifications in the original model. As a result, Overload was assigned to be loaded on Item 6 (modification index was 33.83). The analysis of the modified model revealed its acceptable fit to data (Hu & Bentler, 1999): χ²(581) = 1251.73, p < .001, AGFI = .91, CFI = .91, TLI = .90, RMSEA = .054 (90% CI from .050 to .058, p = .032), SRMR = .09. The scaling correction factor value remained 1.27. Comparative fit indexes were no lower than .90; while the assessment of errors confirmed RMSEA lower than .07. Figure 1 demonstrates the significant factorial loadings and covariance among factors.

Figure 1. CFA for hierarchical factorial model of BCSQ-36-LV

Reliability

The reliability analysis of the BCSQ-36-LV showed good results (see Table 1). For the Frenetic subtype Cronbach’s alpha was .89, and for its subscales Ambitions, Overload and Involvement it was .88, .87 and .75 respectively, which suggests good internal consistency for the Frenetic subtype and its subscales. For the Underchallenged subtype Cronbach’s alpha was .94, and for its subscales Indifference, Lack of Development and Boredom it was .87, .89 and .89 respectively, which suggests good internal consistency for the Underchallenged subtype and its subscales. For the Worn-out subtype, Cronbach’s alpha was .89, and for its subscales Lack of Acknowledgement, Neglect, and Lack of Control it was .84, .87 and .80 respectively, which suggests good internal consistency for the Worn-out scale and its subscales.

Table 1. Cronbach’s alphas of BCSQ-36-LV and Spearman correlation coefficients with MBI-GS Latvian version

			MBI-GS
BSCQ-36-LV	M (SD)	Cronbach’s α	Exhaustion	Cynicism	Professional Efficacy
Frenetic	56.74 (11.63)	.89	.24**	.07	.13**
Ambition	20.42 (4.39)	.88	.00	−.10*	.21**
Overload	16.77 (5.61)	.87	.40**	.23**	−.01
Involvement	19.55 (3.97)	.75	.14**	−.00	.17**
Underchallenged	32.53 (15.82)	.94	.39**	.58**	−.40**
Lack of Development	12.68 (6.28)	.89	.38**	.53**	−.31**
Indifference	9.30 (4.91)	.87	.37**	.58**	−.47**
Boredom	10.54 (5.94)	.89	.32**	.49**	−.36**
Worn-out	35.97 (12.46)	.89	.55**	.62**	−.45**
Neglect	9.31 (4.07)	.87	.31**	.38**	−.45**
Lack of Acknowledgement	13.33 (5.65)	.84	.53**	.63**	−.33**
Lack Control	13.33 (5.14)	.80	.51**	.50**	−.40**

Notes: N = 394, **p < .01, *p < .05. BCSQ-36-LV – Burnout Clinical Subtypes Questionnaire 36 Item Latvian Version, MBI-GS – Maslach Burnout Inventory General Survey.

Convergent validity

The Maslach Burnout Inventory was used to test convergent validity, and the results are shown in Table 1. Correlation with it differentiated the three subtypes in a dimensional pattern and were almost identical to the results of the original study (Montero-Marín & García-Campayo, 2010). The strongest correlation pattern was found with the Worn-out subtype. The correlation was high for Exhaustion (r = .55; p < .01), very high for Cynicism (r = .62; p < .01), and moderately high in a negative sense for Professional Efficacy (r = −.45; p < .01). The Underchallenged subtype showed a moderate correlation pattern. The correlation was high for Cynicism (r = .58; p < .01) and moderate for Exhaustion (r = .39; p < .01) and Professional Efficacy (negative correlation) (r = −.40; p < .01). In turn less correlation was found with the Frenetic subtype. The correlation was moderately low for Exhaustion (r = .24; p < .01), insignificant for Cynicism (r = .07, p > .05), and low positive for Professional Efficacy (r = .13; p < .01).

Relation with demographic factors

Correlation with age and sex differences was calculated. The Spearman coefficient showed minor correlations between age and Frenetic subscales Ambition (r_s = −.25, p < .01) and Overload (r_s = .11, p < .01). A weak correlation with age was found for Underchallenged subtype (r_s = −.12, p < .01) and with its subscales Lack of Development (r_s = −.14, p < .01) and Boredom (r_s = −.10, p < .05) as well. There was no correlation between age and Worn-out subtype and its subscales. Men compared to women showed slightly higher results only in the Underchallenged subtype. The Mann-Whitney test showed negligible, but still significant, differences in the Underchallenged subtype (U = 10 530.50, p = .01) and two of its subscales: Lack of Development (U = 10 460.50, p = .01) and Boredom (U = 10 436.00, p = .01).

Discussion

The aim of this study was to adapt and validate BCSQ-36 in a Latvian sample. The result of the study supports the reliability of the Latvian version of the BCSQ-36; internal consistencies showed excellent results in both subtype and subscale level. This is the first adaptation of the BCSQ-36 in another language published so far and provides support for the validity and reliability of this measure in another culture. As expected, it was found that the BSCQ-36-LV correlation pattern with MBI-GS dimensions was almost identical with the original validation study data.

The present study is an important contribution to the burnout research field because for the first time we have empirically validated the full hierarchical model of the burnout subtypes (Montero-Marín & García-Campayo, 2010), which is a different conceptualization of burnout phenomena. That means this hierarchical model scale provides an opportunity to measure burnout manifestation not differentiated by the widely used Maslach’s model.

First, the Frenetic subtype might not be recognized as burnout in spite of a high level of Exhaustion, because Professional efficacy remains high. That means an employee can cope with his/her duties appropriately, but chronic overload and unrealistic ambitions, which are core characteristics of this subtype (Montero-Marin et al., 2016), lead to a decrease in performance in the long term. These workers are not identified as being at burnout risk either by a supervisor (because they express dedication and positive attitudes towards their job), or by themselves (because unrealistic standards of timeless engagement demand that they continue to work at the expense of unmet personal needs). Second, two different subtypes can be distinguished among those recognized as burnout according to Maslach’s model. The Worn-out subtype showed the strongest correlation with the criterion, which means, it can be easily recognized as the individual who needs support. The Underchallenged subtype showed moderate correlation with Exhaustion, and strong correlations with other burnout dimensions, which means they could be attributed to burnout as well. Their main differences are related to the available internal resources. Worn-out is characterized by a low level of available resources which can be related to major depression symptoms. In turn, Underchallenged has enough resources and potential which is not fully used because of external (e.g. job requirement routine and strict procedure regulation) and internal (e.g. low sense of purpose of their work) reasons. All these burnout subtypes can benefit from different intervention strategies (Montero-Marin et al., 2016) which correspond to their needs better than a unified approach.

There were weak correlations with age showing that younger employees had higher rates in Ambitions, Lack of Development and Boredom, but older employees had higher rates in Overload. Men compared to women showed slightly higher results in the Underchallenged subtype. The correlation pattern with demographic variables corresponds to data found in a previous study in a gender-balanced sample (Montero-Marín et al., 2011).

This study raises several tasks for further research. During testing of the hierarchical model, Item 6 ‘I get very involved in solving work-related problems’ corresponded to the Overload subscale better than to the Involvement subscale which contradicts the original structure. A possible explanation can be found in the linguistic adaptation, because ‘problem-solving’ has a negative connotation in the Latvian language, relating to a negative affected, unsolvable, frustrating situation rather than a task-oriented activity. A more neutral formulation (e.g. ‘task-related issues’) could resolve this discrepancy and should be tested in future studies.

Generalisation of the results is limited for different reasons. First, it is important to mention that the sample should have been more widely represented. A study in a large, population-based sample would be necessary to generalize the obtained results more accurately. In this research several occupational fields were represented, but a more balanced sample in terms of demographical and occupational characteristics would have given more reliable results. Second, it is possible to assume there were more Frenetic representatives (there was a higher means in the Frenetic subtype scale), than the other two subtypes in this sample. A feasible explanation for that might be related to the recruitment procedure based on voluntary participation – more responsive people with a higher interest in work-related issues were willing to participate. To overcome this limitation, it is suggested to use data from regular work-related assessments. Also, two-thirds of the participants who responded work more than 40 hours per week, which is a predictive factor for the Frenetic subtype according to the previous studies (Montero-Marín et al., 2011).

The third limitation is related to the sample selection among internet users. The invitation was distributed only electronically and might not reach people with lower computer literacy or those who do not use electronic communication channels daily.

Fourth, this was exclusively a self-report survey, and in future studies, external validity criteria should be used to overcome this limitation.

Conclusion

To conclude, this paper demonstrates that the Latvian version of the BCSQ-36 has psychometric properties similar to those of the original version of the scale, demonstrating good reliability, factorial, and convergent validity. Empirical support for the burnout subtypes hierarchic model encourages extending knowledge on burnout phenomena. This evidence could stimulate further research on this important occupational health issue.

Disclosure statement

No potential conflict of interest was reported by the authors.

 

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Table

	Pilnīgi nepiekrītu	Nepiekrītu	Pārsvarā nepiekrītu	Neesmu pārliecināts(a)	Pārsvarā piekrītu	Piekrītu	Pilnīgi piekrītu
1. Man ir iekšēja nepieciešamība gūt lielus panākumus darbā.	O	O	O	O	O	O	O
2. Es domāju, ka es veltu sevi darbam vairāk, nekā vajadzētu, lai tas būtu veselīgi.	O	O	O	O	O	O	O
3. Darbā es pielieku vajadzīgās pūles tik ilgi, līdz pārvaru grūtības.	O	O	O	O	O	O	O
4. Es tiecos sasniegt nozīmīgus rezultātus darbā.	O	O	O	O	O	O	O
5. Es atstāju novārtā personisko dzīvi, tiecoties pēc nozīmīgiem sasniegumiem darbā.	O	O	O	O	O	O	O
6. Es esmu ļoti iesaistījies ar darbu saistīto problēmu risināšanā.	O	O	O	O	O	O	O
7. Es izjūtu vajadzību darbā īstenot nozīmīgus mērķus.	O	O	O	O	O	O	O
8. Es pakļauju riskam savu veselību, dzenoties pēc labiem rezultātiem darbā.	O	O	O	O	O	O	O
9. Ja es darbā nesasniedzu gaidāmo rezultātu, es piepūlos vairāk, lai to sasniegtu.	O	O	O	O	O	O	O
10. Man ir spēcīga vajadzība pēc nozīmīgiem sasniegumiem darbā.	O	O	O	O	O	O	O
11. Es atsakos no savām vajadzībām, lai izpildītu darba prasības.	O	O	O	O	O	O	O
12. Es reaģēju uz grūtībām darbā ar vēl lielāku darbošanos.	O	O	O	O	O	O	O
13. Es jūtu vienaldzību pret savu darbu, un man ir maza vēlme gūt panākumus tajā.	O	O	O	O	O	O	O
14. Es gribētu veikt citu darbu, kas būtu lielāks izaicinājums manām spējām.	O	O	O	O	O	O	O
15. Es jūtu, ka mans darbs ir mehānisks un vienveidīgs.	O	O	O	O	O	O	O
16. Man ir maza interese par maniem darba uzdevumiem.	O	O	O	O	O	O	O
17. Es jūtu, ka mans darbs ir šķērslis manu spēju attīstībai.	O	O	O	O	O	O	O
18. Mans darbs nepiedāvā man lielu darbību dažādību.	O	O	O	O	O	O	O
19. Mans darbs mani neaizrauj.	O	O	O	O	O	O	O
20. Es gribētu veikt citu darbu, kur es varētu labāk attīstīt savus talantus.	O	O	O	O	O	O	O
21. Mans darbs nedara mani laimīgu, jo veicamie uzdevumi ir monotoni.	O	O	O	O	O	O	O
22. Es darbā uzvedos neieinteresēti un negribīgi.	O	O	O	O	O	O	O
23. Mans darbs nesniedz man iespēju attīstīt savas spējas.	O	O	O	O	O	O	O
24. Es darbā jūtos garlaikots(a).	O	O	O	O	O	O	O
25. Cilvēki, kuriem nepieciešami mani pakalpojumi, neizrāda pateicību vai atzinību par maniem pūliņiem.	O	O	O	O	O	O	O
26. Kad darba neiet tik labi, kā vajadzētu, es pārstāju censties.	O	O	O	O	O	O	O
27. Es jūtos bezpalīdzīgs(a) daudzās situācijās darbā.	O	O	O	O	O	O	O
28. Profesionālā atzinība nav atkarīga no darbā ieguldītajām pūlēm.	O	O	O	O	O	O	O
29. Es padodos, saskaroties ar grūtībām darbā.	O	O	O	O	O	O	O
30. Es jūtos neaizsargāts atsevišķās situācijās darbā.	O	O	O	O	O	O	O
31. Organizācija, kurā es strādāju, nepamana manu piepūli un nodošanos darbam.	O	O	O	O	O	O	O
32. Es padodos, saskaroties ar jebkurām grūtībām darba uzdevumos.	O	O	O	O	O	O	O
33. Es jūtu, ka mana darba rezultāti ir ārpus manas kontroles.	O	O	O	O	O	O	O
34. Es domāju, ka mans ieguldījums darbā netiek novērtēts.	O	O	O	O	O	O	O
35. Kad pūles, ko es ieguldu darbā ir nepietiekamas, es padodos.	O	O	O	O	O	O	O
36. Man ir darīšana ar daudzām situācijām darbā, kuras ir ārpus manas kontroles.	O	O	O	O	O	O	O

Note: Item 6 formulation „Es esmu ļoti iesaistījies ar darbu saistīto jautājumu risināšanā” is recommended.