Gelotology update for Hawaii
Jacob Schor ND, FABNO
Half a dozen years ago, the work of Hajime Kimata caught my interest and I wrote several articles summarizing his research. Hajime Kimata, is a Japanese allergist who had been researching the effects of laughter on allergic responses. In April 2010 NDNR posted an article I had written A link to that article is here: http://ndnr.com/autoimmuneallergy-medicine/laughter-and-allergies-the-work-of-hajime-kimata/
The Natural Medicine Journal had published an article that I had written on the same topic the previous January.
I lectured on this topic at the AANP conference that summer in Portland, Oregon.
I am going to speak on the medical benefits of laughter for the DocTalks conference this coming winter and am updating my notes. I want to take a few moments to write about these newer studies as well.
In 2015, Dr. Kimata was awarded an IgNoble Prize for the 2003 study he had done on kissing. This is kind of a dubious honor, a parody of the Noble Prizes. Prizes are given each year in mid-September, around the time the recipients of the genuine Nobel Prizes are announced, for ten achievements that "first make people laugh, and then make them think."
The Wall Street Journal reported that Kimata had “… confirmed that 30 minutes of kissing with a lover or spouse behind closed doors while listening to soft music can reduce allergic reactions among atopic and allergic patients.” Kimata had actually performed two studies on kissing. The first, published in 2003, measured the effect of kissing on allergen induced skin wheal responses and also on plasma neurotrophin levels in 30 normal and 30 patients with allergic rhinitis and 30 patients with atopic dermatitis. The allergic patients were all allergic to house dust mites and Japanese cedar pollen. The subjects spent 30 minutes kissing freely behind closed doors. Before and after this experimental exposure, skin prick tests were performed using allergens to both dust mites and cedar pollen, along with control solutions and the wheal responses of the study participants were measured to gauge severity of their allergic reactions. At the same time these tests were performed, blood samples were drawn and tested for plasma levels of neurotrophin, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and -4 (NT-4). “Kissing significantly reduced wheal responses induced by HDM and JCP, but not by histamine, and decreased plasma levels of NGF, BDNF, NT-3, and NT-4 in patients with AR or AD, while it failed to do so in normal subjects.” PMID: 14637240
In the second kissing study, published in 2006, Kimata looked at the effect of kissing on production of allergen-specific IgE and cytokines in atopic patients.
Responses in twenty-four patients with mild atopic eczema and 24 patients with mild allergic rhinitis took part in the study. Same routine, they kissed for 30 min and just before and immediately after kissing, blood samples were collected and blood mononuclear cells were separated, cultured and tested for allergen-specific immunoglobulin and cytokines. Kissing selectively decreased allergen-specific IgE production and skewed cytokine patterns toward Th1 type. PMID: 16650596
If a drug could trigger these sorts of changes in the human body it would be in high demand. That Dr. Kimata’s research became a target of ridicule is rather a sad commentary on our modern culture.
Perhaps this is why we do not see any newer publications coming from Dr Kimata related to laughter.
Others have taken over his research.
A 2011 study conducted in Israel reported on the effect of medical clowning on pregnancy rates after in vitro fertilization and embryo transfer. Apparently clowning around, in contrast to just fooling around, increases pregnancy rates. The research group reported, “… that the pregnancy rate in the intervention group was 36.4%, compared with 20.2% in the control group (adjusted odds ratio, 2.67; 95% confidence interval, 1.36-5.24). Medical clowning as an adjunct to IVF-ET may have a beneficial effect on pregnancy rates and deserves further investigation”
Another 2011 study, this one conducted in Korea, reported that four weekly sessions of laughter therapy reduced depression and increased cognitive function and sleep quality in seniors. (n=109)
Two other studies of interest were published in 2011. One tells us that laughter decreases post-partum fatigue in Korean women (n=67). A second study found that laughter therapy was associated with improved quality of life and resilience in breast cancer survivors (n=37). In the first of these studies, therapy consisted with 60-minute group sessions twice a week for two weeks, a total of 4 hours of treatment. In the breast cancer study, women had twice weekly 60-minute sessions for a total of eight hours of group therapy.
There is something a bit sneaky about telling jokes. People who laugh lose their defense or resistance against persuasion. Thus an advertisement for a commercial product is more effective if it makes the viewer laugh. The researchers report that the effect of humor on resistance follows a two-step process: first via a cognitive mechanism and then via an affective mechanism. Humor first forestalls the development of negative brand associations because of its distractive properties (cognitive mechanism), and then engenders positive brand associations because of its positive emotional outcomes (affective mechanism). These effects of humor on brand associations jointly promote brand preference. The next time you find yourself laughing at a commercial, remember that the purpose wasn’t to entertain you, but to sell you something.
A Japanese study published in 2013 reported on a program that combined exercise with humor. The 27 people who took part were 60 years or older. They took part in once a week two hour sessions that combined both exercise and laughter for ten weeks. Bone mineral density increased significantly during the program while HbA1c decreased significantly. It’s hard to tell whether the laughter added anything to the benefits of the exercise.
Two studies from Loma Linda University in California suggest laughter improves short-term memory in older adults. The first was published in 2014 and enrolled 20 normal, healthy, older adults. Half of the participants watched their choice of 20 minute humorous videos (either Red Skeleton of America’s Home Videos) while the control groups sat quietly. Learning ability improved by 38.5% and 24.0% in the humor and control groups, respectively (P = .014). Delayed recall improved by 43.6% and 20.3% in the humor and control groups, respectively (P =.029). Within the humor group, delayed recall (43.6%) was significant compared with learning ability (38.5%) (P = .002). At 3 predetermined time points, significant decreases in salivary cortisol were observed in the humor group (P = .047, P = .046, and P = .062, respectively).
A second Loma Linda report was published in 2015, this time with 30 participants, but in this case 10 of the participants had type-2 diabetes. They were given the same choice of videos again for only a single twenty-minute viewing session. In the humor, diabetic, and control groups, (1) learning ability improved by 38.5%, 33.4%, and 24.0%, respectively (P = .025); (2) delayed recall improved by 43.6%, 48.1%, and 20.3%, respectively (P = .064); and (3) visual recognition increased by 12.6%, 16.7%, and 8.3%, respectively (P = .321).
Perhaps if a student has to cram for a test, watching something humorous might be a productive time investment?
Ten sessions of humor therapy was reported to improve treatment outcomes of schizophrenia patients.
Laughter helps us build friendships. Current theory suggests that laughter functions to build relationships between individuals and is linked to interpersonal behaviors that are important to building relationships. A study was set up to test whether laughing changed what are called ‘disclosing behaviors’ the willingness to disclose personal information, an act that seems to help develop social bonds. Watching a video that elicited laughter increased the disclosing behaviors in laughers.
A 2015 randomized controlled trial reported that in cancer patients undergoing radiation therapy, three hour long laughter sessions significantly reduced mood disturbances (n=62).
In randomized controlled trial of 64 middle aged severely depressed Chinese women, it took just ten laughter therapy sessions to significantly increase their serotonin levels and their quality of life measurements.
Some of the most significant work on laughter has been done in Australia. The effects of laughter and humor therapy was measured using observational methods in a large project known as the SMILE cluster randomized trial. Professionally trained “ElderClowns” conducted humor therapy sessions in 35 nursing homes in Sydney Australia. These 9-12 weekly humor therapy sessions were augmented by trained staff. Seventeen nursing homes (n=189) received the humore therapy interventions and 18 homes (n=209) received usual care. Over a six month period (26 weeks), those who participated in the humor therapy session were measurably less agitated and exhibited longer durations of happiness.
One possible contraindication to using laughter therapy has come up recently, chronic obstructive pulmonary disease, (COPD).
A study was conducted to see what effects laughter and humor had on lung function in 46 older patients with COPD. Sense of humor among patients with COPD is associated with positive psychological functioning and enhanced quality of life, but laughing aloud appeared to cause acute deterioration in pulmonary function secondary to worsened hyperinflation.
Physiol Behav. 2003 Nov;80(2-3):395-8.
Kissing reduces allergic skin wheal responses and plasma neurotrophin levels.
The effect of kissing on allergen-induced skin wheal responses and plasma neurotrophin levels were studied in 30 normal subjects, 30 patients with allergic rhinitis (AR), and 30 patients with atopic dermatitis (AD). All of the patients with AR or AD are allergic to house dust mite (HDM) and Japanese cedar pollen (JCP). They are all Japanese and they do not kiss habitually. The subject kissed freely during 30 min with their lover or spouse alone in a room with closed doors while listening to soft music. Before and after kissing, skin prick tests were performed using commercial HDM allergen, JCP allergen, as well as histamine and control solution, and wheal responses were measured. Simultaneously, plasma levels of neurotrophin, including nerve growth factor (NGF), brain-derived neurotrophic factor (BDNF), neurotrophin-3 (NT-3) and -4 (NT-4) were measured. Kissing significantly reduced wheal responses induced by HDM and JCP, but not by histamine, and decreased plasma levels of NGF, BDNF, NT-3, and NT-4 in patients with AR or AD, while it failed to do so in normal subjects. These finding indicate that kissing have some implication in the study of neuroimmunology in allergic patients.
J Psychosom Res. 2006 May;60(5):545-7.
Kissing selectively decreases allergen-specific IgE production in atopic patients.
Stress enhanced allergic skin wheal responses and allergen-specific IgE production. In contrast, mothers' kissing caused relaxation in infants, and kissing by lovers or spouses to atopic patients reduced allergic skin wheal responses. I studied the effect of kissing on production of allergen-specific IgE and cytokines in atopic patients.
Twenty-four patients with mild atopic eczema and 24 patients with mild allergic rhinitis kissed with lovers or spouses freely for 30 min while listening to soft music. Just before and immediately after kissing, blood mononuclear cells were separated cultured for allergen, and production of allergen-specific immunoglobulin and cytokine was measured.
Kissing selectively decreased allergen-specific IgE production with skewing cytokine pattern toward Th1 type.
Kissing may alleviate allergic symptoms by decrease in allergen-specific IgE production.
PMID: 16650596 DOI: 10.1016/j.jpsychores.2005.09.007
[PubMed - indexed for MEDLINE]
Fertil Steril. 2011 May;95(6):2127-30. doi: 10.1016/j.fertnstert.2010.12.016. Epub 2011 Jan 6.
The effect of medical clowning on pregnancy rates after in vitro fertilization and embryo transfer.
Friedler S1, Glasser S, Azani L, Freedman LS, Raziel A, Strassburger D, Ron-El R, Lerner-Geva L.
1Infertility and IVF unit, Assaf Harofeh Medical Center, Zrifin, Israel. firstname.lastname@example.org
This experimental prospective quasi-randomized study examining the impact of a medical clowning encounter after embryo transfer (ET) after in vitro fertilization (IVF) found that the pregnancy rate in the intervention group was 36.4%, compared with 20.2% in the control group (adjusted odds ratio, 2.67; 95% confidence interval, 1.36-5.24). Medical clowning as an adjunct to IVF-ET may have a beneficial effect on pregnancy rates and deserves further investigation.
Copyright © 2011 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.
PMID: 21211796 DOI: 10.1016/j.fertnstert.2010.12.016
Geriatr Gerontol Int. 2011 Jul;11(3):267-74. doi: 10.1111/j.1447-0594.2010.00680.x. Epub 2011 Jan 17.
Effects of laughter therapy on depression, cognition and sleep among the community-dwelling elderly.
Ko HJ1, Youn CH.
To investigate the effects of laughter therapy on depression, cognitive function, quality of life, and sleep of the elderly in a community.
Between July and September 2007, the total study sample consisted of 109 subjects aged over 65 divided into two groups; 48 subjects in the laughter therapy group and 61 subjects in the control group. The subjects in the laughter therapy group underwent laughter therapy four times over 1 month. We compared Geriatric Depression Scale (GDS), Mini-Mental State Examination (MMSE), Short-Form Health Survey-36 (SF-36), Insomnia Severity Index (ISI) and Pittsburgh Sleep Quality Index (PSQI) between the two groups before and after laughter therapy.
There were no significant differences in baseline characteristics between the two groups. Before laughter therapy, the GDS scores were 7.98 ± 3.58 and 8.08 ± 3.96; the MMSE scores were 23.81 ± 3.90 and 22.74 ± 4.00; total scores of SF-36 were 54.77 ± 17.63 and 52.54 ± 21.31; the ISI scores were 8.00 ± 6.29 and 8.36 ± 6.38; the PSQI scores were 6.98 ± 3.41 and 7.38 ± 3.70 in laughter therapy group and control groups, respectively. After laughter therapy, the GDS scores were 6.94 ± 3.19 (P=0.027) and 8.43 ± 3.44 (P=0.422); the MMSE scores were 24.63 ± 3.53 (P=0.168) and 23.70 ± 3.85 (P=0.068); total scores of SF-36 were 52.24 ± 17.63 (P=0.347) and 50.32 ± 19.66 (P=0.392); the ISI scores were 7.58 ± 5.38 (P=0.327) and 9.31 ± 6.35 (P=0.019); the PSQI scores were 6.04 ± 2.35 (P=0.019) and 7.30 ± 3.74 (P=0.847) in both groups, respectively.
Laughter therapy is considered to be useful, cost-effective and easily-accessible intervention that has positive effects on depression, insomnia, and sleep quality in the elderly.
J Korean Acad Nurs. 2011 Jun;41(3):294-301. doi: 10.4040/jkan.2011.41.3.294.
[Effects of laughter therapy on postpartum fatigue and stress responses of postpartum women].
[Article in Korean]
Shin HS1, Ryu KH, Song YA.
The purpose of this study was to examine the effects of laughter therapy on postpartum fatigue and stress responses of postpartum women.
The research design was a nonequivalent control group non-synchronized design. The participants were 67 postpartum women who agreed to participate in this study, selected by convenience sampling: (experiment group-33 and control group-34). The data were collected from August 5 to September 30, 2010. The experimental group received laughter therapy from a laughter therapy expert for 60 min, twice a week for 2 weeks, a total of 4 sessions. To evaluate the effects of laughter therapy, postpartum fatigue by self-report questionnaire and cortisol concentration in breast milk were measured. The data were analyzed using the SPSS WIN 13.0 Program.
The first hypothesis that "the degree of postpartum fatigue in the experimental group participating in laughter therapy would be lower than that of the control group" was accepted. These findings indicate that laughter therapy has a positive effect on decreasing postpartum fatigue.
The finding provides evidence for use of complementary and alternative nursing in Sanhujori facilities and obstetric units to reduce postpartum women's fatigue.
PMID: 21804338 DOI: 10.4040/jkan.2011.41.3.294
[PubMed - indexed for MEDLINE] Free full text
J Korean Acad Nurs. 2011 Jun;41(3):285-93. doi: 10.4040/jkan.2011.41.3.285.
[Effects of laughter therapy on depression, quality of life, resilience and immune responses in breast cancer survivors].
[Article in Korean]
Cho EA1, Oh HE.
In this study, the effects of laughter therapy on levels of depression, quality of life, resilience and immune responses in breast cancer survivors were examined.
A quasi-experimental nonequivalent control group, pretest-posttest design was used. Participants (n=37) included breast cancer survivors who finished chemotheraphy and radiation therapy: 16 in the experiment group and 21 in the control group. Data were collected from August to November 2009. The experimental group participated in laughter therapy eight times, twice a week for 60 min per session. Questionnaires were used to measure pretest and posttest levels of depression, quality of life and resilience. A blood test was used to analyze changes in Total T cell, T helper, T suppressor, Th/Ts ratio, Total B cell, T cell/B cell ratio and NK cell for immune responses.
The results showed that laughter therapy was effective in increasing the quality of life and resilience in breast cancer survivors. but depression and immune responses did not differ significantly between the groups.
The results of the study indicate that laughter therapy may be an effective nursing intervention to improve quality of life and resilience in breast cancer survivors.
[PubMed - indexed for MEDLINE]
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J Exp Psychol Appl. 2012 Jun;18(2):213-23. doi: 10.1037/a0028534. Epub 2012 May 7.
Those who laugh are defenseless: how humor breaks resistance to influence.
Strick M1, Holland RW, van Baaren RB, van Knippenberg A.
Three experiments illustrate that humor in advertisements prevents the development of negative brand associations due to resistance. Previous research on humor in advertising suggested that humor can counter negative responses during ad processing, but less is known about the effect of humor on the development of negative brand associations in memory. Brand associations are important because there is often a time delay between ad exposure and brand decisions. We separately manipulated two typical aspects of humor processing, that is, distraction and positive affect, and examined their effects on the development of respectively negative and positive brand associations. All experiments were conducted with university students as participants. The results showed that resistance causes negative brand associations (Experiments 1 and 2), and humor prevents the development of these negative brand associations more than nondistracting positive stimuli and neutral stimuli (Experiment 2 and 3). The prevention of negative brand associations was caused by the distractive properties of humor. Irrespective of resistance, the positive affect engendered by humor enhanced positive brand associations. Experiment 3 showed that distraction and positive affect in humor uniquely contribute to brand preference. Together, these results illustrate that the effect of humor on resistance follows a two-step process: humor forestalls the development of negative brand associations because of its distractive properties (cognitive mechanism), and engenders positive brand associations because of its positive emotional outcomes (affective mechanism). These effects of humor on brand associations jointly promote brand preference.
PMID: 22564085 DOI: 10.1037/a0028534
Geriatr Gerontol Int. 2013 Jan;13(1):152-60. doi: 10.1111/j.1447-0594.2012.00877.x. Epub 2012 Jun 7.
Effects of a laughter and exercise program on physiological and psychological health among community-dwelling elderly in Japan: randomized controlled trial.
Hirosaki M1, Ohira T, Kajiura M, Kiyama M, Kitamura A, Sato S, Iso H.
To examine the effects of a once-weekly laughter and exercise program on physical and psychological health among elderly people living in the community. As a regular exercise program can be difficult to maintain, we provided a more enjoyable program to enhance adherence to exercise.
A total of 27 individuals aged 60 years or older, without disabilities, were randomly assigned to either an immediate treatment group (n=14) or a delayed treatment group (n=13). The intervention was a 120-min session consisting of laughter and exercise, carried out once a week for 10 consecutive weeks. Measurements taken at baseline, 3 and 6 months included bodyweight, height, body fat, lean mass, bone mineral density, hemoglobin A1c (HbA(1c)), glucose, high-density lipoprotein and low-density lipoprotein cholesterol, and triglycerides, as well as self-rated health and psychological factors.
All participants completed the 3-month program. Bone mineral density increased significantly in the immediate treatment group compared with the delayed treatment group during the first 3 months (P<0.001). In addition, HbA(1c) decreased significantly (P=0.001), and self-rated health increased significantly (P=0.012).
The combination of a laughter and exercise program might have physiological and psychological health benefits for the elderly. Laughter might be an effective strategy to motivate the elderly to participate in physical activity.
© 2012 Japan Geriatrics Society.
PMID: 22672359 DOI: 10.1111/j.1447-0594.2012.00877.x
[PubMed - indexed for MEDLINE]
Adv Mind Body Med. 2014 Spring;28(2):16-24.
The effect of humor on short-term memory in older adults: a new component for whole-person wellness.
Bains GS, Berk LS, Daher N, Lohman E, Schwab E, Petrofsky J, Deshpande P.
For older adults, the damaging effects of aging and stress can impair the ability to learn and sustain memory. Humor, with its associated mirthful laughter, can reduce stress and cortisol, a stress hormone. Chronic release of cortisol can damage hippocampus neurons, leading to impairment of learning and memory.
The primary goal of this study was to determine whether watching a humorous video had an effect on short-term memory in an older population.
The research team designed a randomized, controlled trial.
The study took place at Loma Linda University in Loma Linda, California.
The research team recruited 20 normal, healthy, older adults, 11 males and 9 females.
The humor group (n = 10, mean = 69.3 ± 3.7 y) self-selected 1 of 2 humorous videos--a Red Skelton comedy or a montage of America's Funniest Home Videos--and watched it for 20 min. A control group (n = 10, mean = 68.7 ± 5.5 y) sat calmly for 20 min and were not allowed to read, sleep, or talk on a cell phone.
The Rey Auditory Verbal Learning Test was used to assess short-term memory--learning ability, delayed recall, and visual recognition. Salivary cortisol levels were measured at predetermined times.
Learning ability improved by 38.5% and 24.0% in the humor and control groups, respectively (P = .014). Delayed recall improved by 43.6% and 20.3% in the humor and control groups, respectively (P =.029). Within the humor group, delayed recall (43.6%) was significant compared with learning ability (38.5%) (P = .002). At 3 predetermined time points, significant decreases in salivary cortisol were observed in the humor group (P = .047, P = .046, and P = .062, respectively).
The study's findings suggest that humor can have clinical benefits and rehabilitative implications and can be implemented in programs that support whole-person wellness for older adults. Learning ability and delayed recall are important to these individuals for a better quality of life--considering mind, body, spirit, social, and economic aspects. Older adults may have age-associated memory deficiencies. However, medical practitioners now can offer positive, enjoyable, and beneficial humor therapies to improve these deficiencies.
Altern Ther Health Med. 2015 May-Jun;21(3):16-25.
Humors Effect on Short-term Memory in Healthy and Diabetic Older Adults.
Bains GS, Berk LS, Lohman E, Daher N, Petrofsky J, Schwab E, Deshpande P.
With aging, the detrimental effects of stress can impair a person's ability to learn and sustain memory. Humor and its associated mirthful laughter can reduce stress by decreasing the hormone cortisol. Chronic release of cortisol can damage hippocampal neurons, leading to impairment of learning and memory. Objectives • The study intended to examine the effect of watching a humor video on short-term memory in older adults. Design • The research team designed a randomized, controlled trial.
The study took place at Loma Linda University in Loma Linda, CA, USA.
The study included 30 participants: 20 normal, healthy, older adults-11 males and 9 females-and 10 older adults with type 2 diabetes mellitus (T2DM)-6 males and 4 females.
The study included 2 intervention groups of older adults who viewed humorous videos, a healthy group (humor group), aged 69.9 ± 3.7 y, and the diabetic group, aged 67.1 ± 3.8 y. Each participant selected 1 of 2 humorous videos that were 20 min in length, either a Red Skeleton comedy or a montage of America's Funniest Home Videos. The control group, aged 68.7 ± 5.5 y, did not watch a humor video and sat in quiescence.
A standardized, neuropsychological, memory-assessment tool, the Rey Auditory Verbal Learning Test (RAVLT), was used to assess the following abilities: (1) learning, (2) recall, and (3) visual recognition. The testing occurred twice, once before (RAVLT1) and once after (RAVLT2) the humorous video for the humor and diabetic groups, and once before (RAVLT1) and once after (RAVLT2) the period of quiescence for the control group. At 5 time points, measurements of salivary cortisol were also obtained. The Kruskal-Wallis test was used to measure significance of the data based on the 3 groups.
In the humor, diabetic, and control groups, (1) learning ability improved by 38.5%, 33.4%, and 24.0%, respectively (P = .025); (2) delayed recall improved by 43.6%, 48.1%, and 20.3%, respectively (P = .064); and (3) visual recognition increased by 12.6%, 16.7%, and 8.3%, respectively (P = .321). For levels of salivary cortisol, the research team found significant and borderline decreases for the humor group between baseline and (1) post-RAVLT1 (P = .047), (2) postvideo (P = .046), and (3) post-RAVLT2 (P = .062). The diabetic group showed significant decreases between baseline and (1) post-RAVLT1 (P = .047), (2) postvideo (P = .025), and (3) post-RAVLT2 (P = .034). The study found no significant changes for the control group.
The research findings supported potential clinical and rehabilitative benefits for humor that can be applied to whole-person wellness programs for older adults. The cognitive components-learning ability and delayed recall-become more challenging as individuals age and are essential to older adults for providing a high quality of life: mind, body, and spirit. Because older adults can experience age-related memory deficits, complementary, enjoyable, and beneficial humor therapies should be implemented for them.
J Psychiatr Res. 2014 Dec;59:174-8. doi: 10.1016/j.jpsychires.2014.09.010. Epub 2014 Sep 19.
Effectiveness of humor intervention for patients with schizophrenia: a randomized controlled trial.
Cai C1, Yu L2, Rong L3, Zhong H3.
The primary aim of this pilot study was to evaluate the possible therapeutic effects of a 10-session humor intervention program in improving rehabilitative outcomes and the effects of the intervention on patients' sense of humor among patients with schizophrenia.
Thirty subjects were randomly assigned into either the intervention (humor skill training) group (n = 15) or the control (doing handwork) group (n = 15). The results were analyzed using descriptive statistics, t-tests and ANOVA.
Repeated measures analysis of variance (ANOVA) tests were conducted to examine the differences across conditions and time. A group by time interaction effect was observed on all of the outcomes, except positive symptoms of PANSS. The time main effect was also significant on the total score (p < 0.005) and the negative symptoms score (p < 0.001) of the PANSS.
The implementation of humor skill training in a mental health service can improve rehabilitative outcomes and sense of humor for schizophrenia patients who were in the rehabilitation stage.
Copyright © 2014 Elsevier Ltd. All rights reserved.
China; Humor skill training; Schizophrenia
Hum Nat. 2015 Mar;26(1):28-43. doi: 10.1007/s12110-015-9225-8.
Laughter's influence on the intimacy of self-disclosure.
Gray AW1, Parkinson B, Dunbar RI.
If laughter functions to build relationships between individuals, as current theory suggests, laughter should be linked to interpersonal behaviors that have been shown to be critical to relationship development. Given the importance of disclosing behaviors in facilitating the development of intense social bonds, it is possible that the act of laughing may temporarily influence the laugher's willingness to disclose personal information. We tested this hypothesis experimentally by comparing the characteristics of self-disclosing statements produced by those who had previously watched one of three video clips that differed in the extent to which they elicited laughter and positive affect. The results show that disclosure intimacy is significantly higher after laughter than in the control condition, suggesting that this effect may be due, at least in part, to laughter itself and not simply to a change in positive affect. However, the disclosure intimacy effect was only found for observers' ratings of participants' disclosures and was absent in the participants' own ratings. We suggest that laughter increases people's willingness to disclose, but that they may not necessarily be aware that it is doing so.
PMID: 25762120 DOI: 10.1007/s12110-015-9225-8
[PubMed - indexed for MEDLINE]
J Altern Complement Med. 2015 Apr;21(4):217-22. doi: 10.1089/acm.2014.0152.
The effects of laughter therapy on mood state and self-esteem in cancer patients undergoing radiation therapy: a randomized controlled trial.
Kim SH1, Kook JR, Kwon M, Son MH, Ahn SD, Kim YH.
To investigate whether laughter therapy lowers total mood disturbance scores and improves self-esteem scores in patients with cancer.
Randomized controlled trial in a radio-oncology outpatient setting.
Sixty-two patients were enrolled and randomly assigned to the experimental group (n=33) or the wait list control group (n=29).
Three laughter therapy sessions lasting 60 minutes each.
Mood state and self-esteem.
The intention-to-treat analysis revealed a significant main effect of group: Experimental group participants reported a 14.12-point reduction in total mood disturbance, while the wait list control group showed a 1.21-point reduction (p=0.001). The per-protocol analysis showed a significant main effect of group: The experimental group reported a 18.86-point decrease in total mood disturbance, while controls showed a 0.19-point reduction (p<0.001). The self-esteem of experimental group was significantly greater than that of the wait list control group (p=0.044).
These results indicate that laughter therapy can improve mood state and self-esteem and can be a beneficial, noninvasive intervention for patients with cancer in clinical settings.
PMID: 25875938 DOI: 10.1089/acm.2014.0152
[PubMed - indexed for MEDLINE]
J Korean Acad Nurs. 2015 Apr;45(2):221-30. doi: 10.4040/jkan.2015.45.2.221.
[Effect and Path Analysis of Laughter Therapy on Serotonin, Depression and Quality of Life in Middle-aged Women].
[Article in Korean]
Cha MY1, Hong HS2.
This study was done to examine how laughter therapy impacts serotonin levels, QOL and depression in middle-aged women and to perform a path analysis for verification of the effects.
A quasi-experimental study employing a nonequivalent control group and pre-post design was conducted. Participants were 64 middle-aged women (control=14 and experimental=50 in 3 groups according to level of depression). The intervention was conducted five times a week for a period of 2 weeks and the data analysis was conducted using repeated measures ANOVA, ANCOVA and LISREL.
Results showed that pre serotonin and QOL in women with severe depression were the lowest. Serotonin in the experimental groups increased after the 10th intervention (p=.006) and the rise was the highest in the group with severe depression (p=.001). Depression in all groups decreased after the 5th intervention (p=.022) and the biggest decline was observed in group with severe depression (p=.007). QOL of the moderate and severe groups increased after the 10th intervention (p=.049), and the increase rate was highest in group with severe depression (p<.006). Path analysis revealed that laughter therapy did not directly affect depression, but its effect was indirectly meditated through serotonin variation (p<.001).
Results indicate that serotonin activation through laughter therapy can help middle-aged women by lessening depression and providing important grounds for depression control.
Depression; Laughter therapy; Middle-aged women; Quality of life; Serotonin
[PubMed - indexed for MEDLINE]
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J Am Med Dir Assoc. 2014 Aug;15(8):564-9. doi: 10.1016/j.jamda.2014.03.017. Epub 2014 May 9.
The effects of humor therapy on nursing home residents measured using observational methods: the SMILE cluster randomized trial.
Low LF1, Goodenough B2, Fletcher J2, Xu K2, Casey AN2, Chenoweth L2, Fleming R3, Spitzer P4, Bell JP5, Brodaty H2.
To evaluate the effects of humor therapy assessed using observational methods on agitation, engagement, positive behaviors, affect, and contentment.
Single-blind cluster randomized controlled trial.
A total of 35 Sydney nursing homes.
All eligible residents within geographically defined areas within each nursing home were invited to participate.
Professional "ElderClowns" provided 9 to 12 weekly humor therapy sessions, augmented by resident engagement by trained staff "LaughterBosses." Controls received usual care.
The Behavior Engagement Affect Measure (BEAM) touchpad observational tool was used to capture real-time behavioral data. The tool assesses the duration in seconds of agitation, positive behavior toward others, engagement, and affect (angry, anxious, happy, neutral, sad).
Seventeen nursing homes (189 residents) received the intervention and 18 homes (209 residents) received usual care. Over 26 weeks, in comparison with controls, the humor therapy group decreased in duration of high agitation (effect size = 0.168 and 0.129 at 13 and 26 weeks, respectively) and increased in duration of happiness (effect size = 0.4 and 0.236 at 13 and 26 weeks, respectively).
We confirmed that humor therapy decreases agitation and also showed that it increases happiness. Researchers may consider evaluating impacts of nonpharmaceutical interventions on positive outcomes. Computer-assisted observational measures should be considered, particularly for residents with dementia and when the reliability of staff is uncertain.
Copyright © 2014 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.
Dementia; behavior; long-term care; observational data
Heart Lung. 2011 Jul-Aug;40(4):310-9. doi: 10.1016/j.hrtlng.2010.07.010.
Effects of humor and laughter on psychological functioning, quality of life, health status, and pulmonary functioning among patients with chronic obstructive pulmonary disease: a preliminary investigation.
Lebowitz KR1, Suh S, Diaz PT, Emery CF.
Previous research indicates the beneficial effects of humor among healthy adults. Little is known about the physical and psychological effects of sense of humor and laughter among patients with chronic obstructive pulmonary disease (COPD).
Patients with COPD (n = 46; mean age ± SD, 66.9 ± 9.9 years) completed assessments of sense of humor, depression, anxiety, quality of life, and recent illness. A subset of patients (n = 22) completed a laughter induction study and were randomly assigned to view either a humorous or a neutral video. Pulmonary function, mood state, and dyspnea were assessed before and after the video.
Sense of humor was associated with fewer symptoms of depression and anxiety and an enhanced quality of life. However, the induction of laughter led to lung hyperinflation.
Sense of humor among patients with COPD is associated with positive psychological functioning and enhanced quality of life, but laughing aloud may cause acute deterioration in pulmonary function secondary to worsened hyperinflation.
Copyright © 2011 Elsevier Inc. All rights reserved.