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The relationship between, burnout, personality, and emotional intelligence in clown doctors

  • Alberto Dionigi

    Alberto Dionigi, PhD, is a cognitive-behavioral psychotherapist in Cattolica, Italy. He also works as clown doctor in hospital and as clown doctors trainer. Lecturing in the field of humor, he has delivered talks internationally on the subject at academic conferences and has published several articles related to the use of humor in various settings. He is Co-Editor-in-Chief of RISU – Rivista Italiana di Studi sull’Umorismo. E-mail:

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From the journal HUMOR


Despite increasing interest in healthcare clowning, especially to evaluate its effectiveness in a large variety of settings, no investigations have been oriented toward exploring the potential risks associated with burnout in clown doctors. This paper aims to investigate the relationship between personality traits, emotional intelligence, and burnout and to predict the burnout levels of 160 Italian clown doctors. The multiple linear regression findings showed that the best predictor for emotional exhaustion was neuroticism and for personal accomplishment were consciousness and emotional intelligence, while no correlations were found between the variables taken into account and depersonalization. These findings highlighted how specific personality traits are linked to different dimensions of job burnout and were discussed in the context of clown doctors’ burnout.

About the author

Alberto Dionigi

Alberto Dionigi, PhD, is a cognitive-behavioral psychotherapist in Cattolica, Italy. He also works as clown doctor in hospital and as clown doctors trainer. Lecturing in the field of humor, he has delivered talks internationally on the subject at academic conferences and has published several articles related to the use of humor in various settings. He is Co-Editor-in-Chief of RISU – Rivista Italiana di Studi sull’Umorismo. E-mail:


Adriaenssens, Jef, Véronique De Gucht & Stan Maes. 2015. Determinants and prevalence of burnout in emergency nurses: A systematic review of 25 years of research. International Journal of Nursing Studies 52(2). 649–661.10.1016/j.ijnurstu.2014.11.004Search in Google Scholar

Alarcon, Gene, Kevin J. Eschleman & Nathan A. Bowling. 2009. Relationships between personality variables and burnout: A meta-analysis. Work and Stress 23(3). 244–263.10.1080/02678370903282600Search in Google Scholar

Andrei, Federica, Martin M. Smith, Paola Surcinelli, Baldaro Bruno & Donald H. Saklofske. 2016. The trait emotional intelligence questionnaire: Internal structure, convergent, criterion, and incremental validity in an Italian sample. Measurement and Evaluation in Counseling and Development 49(1). 34–45.10.1177/0748175615596786Search in Google Scholar

Bakker, Arnold B., Karen I. Van Der Zee, Kerry A. Lewig & Maureen F. Dollard. 2006. The relationship between the big five personality factors and burnout: A study among volunteer counselors. The Journal of Social Psychology 135(5). 3–19.10.3200/SOCP.146.1.31-50Search in Google Scholar

Balch, Charles M., Tait D. Shanafelt, Lotte Dyrbye, Jeffrey A. Sloan, Thomas R. Russell, Gerald Bechamps & Jumie A. Freischlag. 2010. Surgeon distress as calibrated by hours worked and nights on call. Journal of the American College of Surgeons 211(5). 609–619.10.1016/j.jamcollsurg.2010.06.393Search in Google Scholar

Brackett, Mark A., Raquel Palomera, Justyna Mojsa-Kaja, Maria Regina Reyes & Peter Salovey. 2010. Emotion-regulation ability, burnout, and job satisfaction among British secondary-school teachers. Psychology in the Schools 47(4). 406–417.10.1002/pits.20478Search in Google Scholar

Bragard, Isabelle, Gilles Dupuis & Richard Fleet. 2015. Quality of work life, burnout, and stress in emergency department physicians: A qualitative review. European Journal of Emergency Medicine 22(4). 227–234.10.1097/MEJ.0000000000000194Search in Google Scholar

Bria, Mara, Adriana Baban & Dan Dumitrascu. 2012. Systematic review of burnout risk factors among European healthcare professionals. Cognition, Brain, Behavior: An Interdisciplinary Journal 16(3). 423–452.Search in Google Scholar

Bruck, Carly S. & Tammy D. Allen. 2003. The relationship between big five personality traits, negative affectivity, type A behavior, and work–family conflict. Journal of Vocational Behavior 63(3). 457–472.10.1016/S0001-8791(02)00040-4Search in Google Scholar

Bühler, K. E. & Tatjana Land. 2003. Burnout and personality in intensive care: An empirical study. Hospital Topics 81(4). 5–12.10.1080/00185860309598028Search in Google Scholar

Cañadas-De la Fuente, Guilermo A., Cristina Vargas, Concepcion San Luis, Immaculada García, Gustavo R. Cañadas & Emilia I. De la Fuente. 2015. Risk factors and prevalence of burnout syndrome in the nursing profession. International Journal of Nursing Studies 52(1). 240–249.10.1016/j.ijnurstu.2014.07.001Search in Google Scholar

Chan, David W. 2006. Emotional intelligence and components of burnout among Chinese secondary school teachers in Hong Kong. Teaching and Teacher Education 22(8). 1042–1054.10.1016/j.tate.2006.04.005Search in Google Scholar

Cooper, Andrew & K. V. Petrides. 2010. A psychometric analysis of the trait emotional intelligence questionnaire–short form (TEIQue–SF) using item response theory. Journal of Personality Assessment 92(5). 449–457.10.1080/00223891.2010.497426Search in Google Scholar

Cooper, Cary L. & James Campbell Quick (eds.). 2017. The handbook of stress and health: A guide to research and practice. Chichester: John Wiley and Sons.Search in Google Scholar

Costa, Paul T. & Robert R. McCrae. 1992. Normal personality assessment in clinical practice: The NEO personality inventory. Psychological Assessment 4(1). 5–13.10.1037/1040-3590.4.1.5Search in Google Scholar

Davis, Sarah K. & Neil Humphrey. 2012. Emotional intelligence predicts adolescent mental health beyond personality and cognitive ability. Personality and Individual Differences 52(2). 144–149.10.1016/j.paid.2011.09.016Search in Google Scholar

Deary, Ian J., Raymond M. Agius & Andrew Sadler. 1996. Personality and stress in consultant psychiatrists. International Journal of Social Psychiatry 4(2). 112–123.10.1177/002076409604200205Search in Google Scholar

Deary, Ian J., Watson Roger & Richard Hogston. 2003. A longitudinal cohort study of burnout and attrition in nursing students. Journal of Advanced Nursing 43(1). 71–81.10.1046/j.1365-2648.2003.02674.xSearch in Google Scholar

Di Fabio, Annamaria & Letizia Palazzeschi. 2011. Proprietà psicometriche del trait emotional intelligence questionnaire short form (TEIQue-SF) nel contesto italiano. Counseling. Giornale Italiano Di Ricerca E Applicazioni 4(3). 327–336.Search in Google Scholar

Dionigi, Alberto. 2016. Personality of clown doctors. Journal of Individual Differences 37(1). 49–55.10.1027/1614-0001/a000187Search in Google Scholar

Dionigi, Alberto. 2017. Clowning as a complementary approach for reducing iatrogenic effects in pediatrics. AMA Journal of Ethics 19(8). 775–782.10.1001/journalofethics.2017.19.8.stas1-1708Search in Google Scholar

Dionigi, Alberto & Carla Canestrari. 2016. Clowning in health care settings: The point of view of adults. Europe’s Journal of Psychology 12(3). 473–488.10.5964/ejop.v12i3.1107Search in Google Scholar

Dionigi, Alberto, Willibald F. Ruch & Tracey Platt. 2014. Components and determinants of the shift between own persona and the clown persona: A hierarchical analysis. The European Journal of Humour Research 1(4). 58–80.10.7592/EJHR2013.1.4.dionigiSearch in Google Scholar

Eysenck, Michael W. & Manuel G. Calvo. 1992. Anxiety and performance: The processing efficiency theory. Cognition and Emotion 6(6). 409–434.10.1080/02699939208409696Search in Google Scholar

Fletcher, Ian, Peter Leadbetter, Andrew Curran & Helen O’Sullivan. 2009. A pilot study assessing emotional intelligence training and communication skills with 3rd year medical students. Patient Education and Counseling 76(3). 376–379.10.1016/j.pec.2009.07.019Search in Google Scholar

Francis, Leslie J., Stephen H. Louden & Christopher J. F. Rutledge. 2004. Burnout among Roman Catholic parochial clergy in England and Wales: Myth or reality? Review of Religious Research 46(1). 5–19.10.2307/3512249Search in Google Scholar

Frass, Michael, Robert P. Strassl, Helmut Friehs, Michael Müllner, Michael Kundi & Alan D. Kaye. 2012. Use and acceptance of complementary and alternative medicine among the general population and medical personnel: a systematic review. The Ochsner Journal 12(1). 45–56.Search in Google Scholar

Gerits, Linda, Jan J. Derksen, Anna B. Verbruggen & Michael Katzko. 2005. Emotional intelligence profiles of nurses caring for people with severe behaviour problems. Personality and Individual Differences 38(1). 33–43.10.1016/j.paid.2004.03.019Search in Google Scholar

Gervais, Nicole, Bernie Warren & Peter Twohig. 2006. Nothing seems funny anymore: Studying burnout in clown-doctors. In A. D. Litvack (ed.), Making sense of stress, humour and healing, 71–82. Oxford, UK: Inter-Disciplinary Press – Publishing Creative Research.Search in Google Scholar

Gomez-Cantorna, Cristina, Miguel Clemente, Emilio Fariña-Lopez, Gabriel J. Estevez-Guerra & Manuel Gandoy-Crego. 2015. The effect of personality type on palliative care nursing staff stress levels. Journal of Hospice and Palliative Nursing 17(4). 342–347.10.1097/NJH.0000000000000172Search in Google Scholar

Görgens-Ekermans, Gina & Tamari Brand. 2012. Emotional intelligence as a moderator in the stress–burnout relationship: A questionnaire study on nurses. Journal of Clinical Nursing 21(15–16). 2275–2285.10.1111/j.1365-2702.2012.04171.xSearch in Google Scholar

Hudek-Knežević, Jasna, Barbara Kalebić Maglica & Nada Krapić. 2011. Personality, organizational stress, and attitudes toward work as prospective predictors of professional burnout in hospital nurses. Croatian Medical Journal 52(4). 538–549.10.3325/cmj.2011.52.538Search in Google Scholar

Hunter, Elaine C. M., Mauricio J. Sierra & Anthony S. David. 2004. The epidemiology of depersonalisation and derealisation. Social Psychiatry and Psychiatric Epidemiology 39(1). 9–18.10.1007/s00127-004-0701-4Search in Google Scholar

John, Oliver P. & Sanjay Srivastava. 1999. The big five trait taxonomy: History, measurement, and theoretical perspectives. Handbook of Personality: Theory and Research 2. 102–138.Search in Google Scholar

Koller, Donna & Camilla Gryski. 2008. The life threatened child and the life enhancing clown: Towards a model of therapeutic clowning. eCAM 5(1). 17–25.10.1093/ecam/nem033Search in Google Scholar

Komarraju, Meera & Steven J. Karau. 2005. The relationship between the big five personality traits and academic motivation. Personality and Individual Differences 39(3). 557–567.10.1016/j.paid.2005.02.013Search in Google Scholar

Landa, Josè Maria Augusto, Esther López-Zafra, M. Pillar Berrios-Martos & Maria Carmen Aguilar-Luzón. 2008. The relationship between emotional intelligence, occupational stress and health in nurses: A questionnaire survey. International Journal of Nursing Studies 45(6). 888–901.10.1016/j.ijnurstu.2007.03.005Search in Google Scholar

Laschinger, Heather K. S., Carol A. Wong, Greta G. Cummings & Ashley L. Grau. 2014. Resonant leadership and workplace empowerment: The value of positive organizational cultures in reducing workplace incivility. Nursing Economics 32(1). 5–15.Search in Google Scholar

Law, Kenneth S., Chi-Sum Wong & Lynda J. Song. 2004. The construct and criterion validity of emotional intelligence and its potential utility for management studies. Journal of Applied Psychology 89(3). 483–496.10.1037/0021-9010.89.3.483Search in Google Scholar

Le Pine, Jeffrey A., Le Pine Marcie & Christine L. Jackson. 2004. Challenge and hindrance stress: Relationships with exhaustion, motivation to learn, and learning performance. Journal of Applied Psychology 89(5). 883–891.10.1037/0021-9010.89.5.883Search in Google Scholar

Leiter, Michael P. 1993. Burnout as a developmental process: Consideration of models. In W. B. Schaufeli, C. Maslach & T. Marek (eds.), Professional burnout: Recent developments in theory and research, 237–250. Washington, DC: Taylor and Francis.Search in Google Scholar

Leiter, Michael P. & Christina Maslach. 1988. The impact of interpersonal environment on burnout and organizational commitment. Journal of Organizational Behavior 9(4). 297–308.10.1002/job.4030090402Search in Google Scholar

Leiter, Michael P. & Christina Maslach. 2000. Burnout and health. In A. Baum, T. Revenson & J. Singer (eds.), Handbook of health psychology, 415–426. Hillsdale, NJ: Lawrence Erlbaum.Search in Google Scholar

Linge, Lotta. 2008. Hospital clowns working in pairs—in synchronized communication with ailing children. International Journal of Qualitative Studies on Health and Well-being 3(1). 27–38.10.1080/17482620701794147Search in Google Scholar

Martins, Alexandra, Nelson C. Ramalho & Estelle M. Morin. 2010. A comprehensive meta-analysis of the relationship between emotional intelligence and health. Personality and Individual Differences 49(6). 554–564.10.1016/j.paid.2010.05.029Search in Google Scholar

Maslach, Christina. 1982. Burnout: The cost of caring. Englewood Cliffs, NJ: Prentice-Hall.Search in Google Scholar

Maslach, Christina. 1993. Burnout: A multidimensional perspective. In W. B. Schaufeli, C. Maslach & T. Marek (eds.), Professional burnout: Recent developments in theory and research, 19–32. Washington, DC: Taylor and Francis.10.4324/9781315227979-3Search in Google Scholar

Maslach, Christina & Susan E. Jackson. 1981. The measurement of experienced burnout. Journal of Occupational Behavior 2. 99–113.10.1002/job.4030020205Search in Google Scholar

Maslach, Christina & Susan E. Jackson. 1984. Patterns of burnout among a national sample of public contact workers. Journal of Health and Human Resources Administration 7. 189–212.Search in Google Scholar

Mayer, John D., Peter Salovey & David R. Caruso. 2004. Emotional intelligence: Theory, findings, and implications. Psychological Inquiry 15(3). 197–215.10.1207/s15327965pli1503_02Search in Google Scholar

McCrae, Robert R. & Paul T. Costa Jr. 1997. Personality trait structure as a human universal. American Psychologist 52(5). 509–516.10.1037/0003-066X.52.5.509Search in Google Scholar

Michielsen, Helen J., Tineke M. Willemsen, Marcel A. Croon, De Vries Jolanda & Guus L. Van Heck. 2004. Determinants of general fatigue and emotional exhaustion: A prospective study. Psychology & Health 19(2). 223–235.10.1080/08870440310001627135Search in Google Scholar

Mikolajczak, Moira, Clementine Menil & Oliver Luminet. 2007. Explaining the protective effect of trait emotional intelligence regarding occupational stress: Exploration of emotional labour processes. Journal of Research in Personality 41(5). 1107–1117.10.1016/j.jrp.2007.01.003Search in Google Scholar

Moss, Marck, Vicky S. Good, David Gozal, Robert Kleinpell & Curtis N. Sessler. 2016. An official critical care societies collaborative statement—burnout syndrome in critical care health-care professionals: A call for action. Chest 150(1). 17–26.10.4037/ajcc2016133Search in Google Scholar

Moustaka, Aleni & Theodoros C. Constantinidis. 2010. Sources and effects of work-related stress in nursing. Health Science Journal 4(4). 210–216.Search in Google Scholar

Nelis, Delphine, Jordi Quoidbach, Moira Mikolajczak & Michel Hansenne. 2009. Increasing emotional intelligence: (How) is it possible? Personality and Individual Differences 47(1). 36–41.10.1016/j.paid.2009.01.046Search in Google Scholar

Petrides, K. V. & Adrian Furnham. 2000. On the dimensional structure of emotional intelligence. Personality and Individual Differences 29(2). 313–320.10.1016/S0191-8869(99)00195-6Search in Google Scholar

Schaufeli, Wilmar B., Christina Maslach & Tadeusz Marek (eds.). 2017. Professional burnout: Recent developments in theory and research. Washington, DC: Taylor and Francis.Search in Google Scholar

Schutte, Nicola S., John M. Malouff, Einar B. Thorsteinsson, Navjot Bhullar & Sally E. Rooke. 2007. A meta-analytic investigation of the relationship between emotional intelligence and health. Personality and Individual Differences 42(6). 921–933.10.1016/j.paid.2006.09.003Search in Google Scholar

Shimizutani, Masahiro, Yuko Odagiri, Yumiko Ohya, Teruichi Shimomitsu, Tage S. Kristensen, Toshimasa Maruta & Makio Iimori. 2008. Relationship of nurse burnout with personality characteristics and coping behaviors. Industrial Health 46(4). 326–335.10.2486/indhealth.46.326Search in Google Scholar

Sirigatti, Saulo & Cristina Stefanile. 1993. Adattamento italiano MBI–Maslach Burnout Inventory. Firenze: Organizzazioni Speciali.Search in Google Scholar

Stordeur, Sabine, William D’hoore & Christian Vandenberghe. 2001. Leadership, organizational stress, and emotional exhaustion among hospital nursing staff. Journal of Advanced Nursing 35(4). 533–542.10.1046/j.1365-2648.2001.01885.xSearch in Google Scholar

Strollo, Maria Rosaria, Alessandra Romano & Gabriella Rea. 2015. Social commitment of volunteering in clown-therapy: An empowering empirical research. Ricerche di Pedagogia e Didattica. Journal of Theories and Research in Education 10(3). 45–79.Search in Google Scholar

Sutton, Rosemary E. & Elaine Harper. 2009. Teachers’ emotion regulation. In Lawrence J. Saha & Anthony G. Dworkin (eds.), International handbook of research on teachers and teaching, 389–401. New York: Springer.10.1007/978-0-387-73317-3_25Search in Google Scholar

Swider, Brian W. & Rian Zimmerman. 2010. Born to burnout: A meta-analytic path model of personality, job burnout, and work outcomes. Journal of Vocational Behavior 76(3). 487–506.10.1016/j.jvb.2010.01.003Search in Google Scholar

Takemura, Keiko, Mao Hasegawa, Saori Tamura, Yukie Takishita, Tomoko Matsuoka, Yoko Iwawaki & Ryuya Yamanaka. 2015. The association between burnout syndrome and personality in Japanese nursing students. International Journal of Recent Scientific Research 6(7). 5545–5549.Search in Google Scholar

Taris, Toon W., Joan E. van Horn, Wilmar B. Schaufeli & P. J. G. Schreurs. 2004. Inequity, burnout and psychological withdrawal among teachers: A dynamic exchange model. Anxiety, Stress and Coping 17(1). 103–122.10.1080/1061580031000151620Search in Google Scholar

Tomaschewski-Barlem, Jamila G., Valeria L. Lunardi, Guilherme L. Lunardi, Luiz D. Barlem, Rosemary S. D. Silveira & Danielle Adrianne Silvera Vidal. 2014. Burnout syndrome among undergraduate nursing students at a public university. Revista Latino-americana De Enfermagem 22(6). 934–941.10.1590/0104-1169.3254.2498Search in Google Scholar

Ubbiali, Alessandro, Carlo Chiorri, Patricia Hampton & Deborah Donati. 2013. Psychometric properties of the Italian adaptation of the Big Five Inventory (BFI). Bollettino Di Psicologia Applicata 266. 37–48.Search in Google Scholar

Van Dusseldorp, Loes R., Berno K. van Meijel & Jan J. Derksen. 2011. Emotional intelligence of mental health nurses. Journal of Clinical Nursing 20(3–4). 555–562.10.1111/j.1365-2702.2009.03120.xSearch in Google Scholar

Warren, Bernie & Peter Spitzer. 2013. Smiles are everywhere: Integrating clown-play into healthcare practice. New York, NY: Routledge.10.4324/9780203768686Search in Google Scholar

Watson, David & Lee A. Clark. 1984. Negative affectivity: The disposition to experience aversive emotional states. Psychological Bulletin 96(3). 465–490.10.1037/0033-2909.96.3.465Search in Google Scholar

Wayne, Julie H., Nicholas Musisca & William Fleeson. 2004. Considering the role of personality in the work–family experience: Relationships of the big five to work–family conflict and facilitation. Journal of Vocational Behavior 64(1). 108–130.10.1016/S0001-8791(03)00035-6Search in Google Scholar

Weng, Hui-Ching, Hung-Chi Chen, Han-Jung Chen & Shin Yuan Hung. 2008. Doctors’ emotional intelligence and the patient–doctor relationship. Medical Education 42(7). 703–711.10.1111/j.1365-2923.2008.03039.xSearch in Google Scholar

Zellars, Kelly L., Pamela L. Perrewe & Wayne A. Hochwarter. 2000. Burnout in health care: The role of the five factors of personality. Journal of Applied Social Psychology 30(8). 1570–1598.10.1111/j.1559-1816.2000.tb02456.xSearch in Google Scholar

Zhang, Yongfu, Yuan Yang, Wing Y. T. Lau, Samradhvi Garg & Jianxin Lao. 2017. Effectiveness of pre-operative clown intervention on psychological distress: A systematic review and meta-analysis. Journal of Paediatrics and Child Health 53(3). 237–245.10.1111/jpc.13369Search in Google Scholar

Published Online: 2019-09-07
Published in Print: 2020-02-25

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