The interplay of personality traits and work-related stress in burnout: a retrospective study in inpatients with stress-related disorders

Background Burnout, characterized by emotional exhaustion, depersonalization, and reduced personal accomplishment, is particularly prevalent in stress-related disorders, such as depression, anxiety, adjustment disorders, and somatic symptom disorders. This is especially evident in inpatients treated for psychosomatic conditions arising from chronic somatic distress, emotional dysregulation, and personality vulnerabilities. Although alexithymia, narcissistic traits, and work-related stress have each been associated with burnout, their combined effects remain understudied. Objectives This study examined the associations between burnout and personality traits (narcissism, alexithymia, overcommitment) and work-related stress (effort–reward imbalance, ERI) in inpatients treated for stress-related disorders, and tested whether alexithymia moderates the relationship between narcissistic vulnerability and burnout severity. Methods A retrospective observational study was conducted using routinely collected psychometric data from adult inpatients treated for stress-related disorders at the clinic OBERWAID in Switzerland (April 2018–November 2024; N = 1239). Burnout was assessed using the Maslach Burnout Inventory. Multiple linear regressions, adjusted for age, sex, and psychological distress, tested main and interaction effects. Results Burnout was significantly predicted by alexithymia (b = 0.241, p < .001), ERI quotient (b = 0.431, p < .001), overcommitment (b = 0.063, p < .001), psychological distress (b = 0.025, p = .004), and age (b = −0.014, p < .001). Narcissistic vulnerability showed a trend toward significance (b = 0.124, p = .062). The alexithymia × narcissism interaction was significant (b = −0.207, p = .016), and the interaction model explained more variance (R 2 = 0.318) than the main model (R 2 = 0.302). Conclusions Burnout in inpatients treated for stress-related disorders reflects the joint impact of personality vulnerabilities and occupational stress. Alexithymia attenuates (buffers) the effect of narcissistic vulnerability on burnout at higher levels of alexithymia, highlighting the need for tailored interventions targeting emotional awareness and stress regulation.