Significant increases in the intensity of psychological burnout among leaders of local Department of Veterans Affairs (VA) medical centers occurred from 1989 to 1997. This longitudinal study was designed to analyze which demographic and behavioral variables were associated with the intensity of burnout. Responses of 83 Medical Center Directors, Associate Directors, and Chiefs of Staff to questionnaires sent in 1989, 1992, and 1997 were analyzed using path analysis. Burnout was assessed by the Maslach Burnout Inventory and the phase model for analysis. Questions also assessed antecedents (e.g., role characteristics and job support) and consequences (e.g., job satisfaction) of burnout. The presence of high levels of burnout rose from 25.3% in 1989 to 38.1% in 1997. Burnout phase in 1997 was directly related to burnout phase in 1992 and inversely related to the respondent's age. Phase in 1992 was inversely related to both resource availability and role clarity in 1989 if only accepted antecedents of burnout were included in the model. If consequences and antecedents were included in the model, burnout phase in 1997 was inversely related to job satisfaction and resource availability and directly related to intent to stay in the VA in 1989. Findings demonstrated that specific demographic and job site characteristics are associated with high levels of burnout in the VA. These could form the basis for interventional efforts.