No laughing matter: Latinas' high quality of conversations relate to behavioral laughter

Latinx in the United States have greater life expectancy than other groups, in spite of their socioeconomic and psychosocial disadvantage. This phenomenon has been described as the Latinx health paradox. This investigation observed the interplay of cultural processes and social networks to shed light on this paradox. Latina (N = 26) and White-European (N = 24) mothers wore a digital recorder as they went about their daily lives. Four conversation styles were characterized from the recordings to measure the mothers' quality of their conversations (small talk and substantive conversations) within different social networks (with the father vs. other adults). As a positive indicator of well-being, laughter was assessed during the conversations. Results demonstrated that Latina mothers tend to laugh more than White-European mothers; and that this relation is mediated by substantive conversations with others. This suggests that Latinas' cultural processes afford meaningful conversations, which relates to more behavioral laughter, a process that may have positive implications on well-being.

Pharmaceutical interventions for emotionalism after stroke

BACKGROUND

Antidepressants may be useful in the treatment of abnormal crying associated with stroke. This is an update of a Cochrane Review first published in 2004 and last updated in 2010.

OBJECTIVES

To determine whether pharmaceutical treatment reduces the frequency of emotional displays in people with emotionalism after stroke.

SEARCH METHODS

We searched the trial register of Cochrane Stroke (last searched May 2018). In addition, we searched the Cochrane Central Register of Controlled Trials (CENTRAL; to May 2018), MEDLINE (1966 to 14 May 2018), Embase (1980 to 14 May 2018), CINAHL (1982 to 14 May 2018), PsycINFO (1967 to 14 May 2018), BIOSIS Previews (2002 to 14 May 2018), Web of Science (2002 to 14 May 2018), WHO ICTRP (to 14 May 2018), ClinicalTrials.gov (to 14 May 2018), and ProQuest Dissertations and Theses Database (to 14 May 2018).

SELECTION CRITERIA

Randomised controlled trials (RCTs) and quasi-RCTs comparing psychotropic medication to placebo in people with stroke and emotionalism (also known as emotional lability, pathological crying or laughing, emotional incontinence, involuntary emotional expression disorder, and pseudobulbar affect).

DATA COLLECTION AND ANALYSIS

Two review authors independently selected studies, assessed risk of bias, extracted data from all included studies, and used GRADE to assess the quality of the body of evidence. We calculated mean difference (MD) or standardised mean difference (SMD) for continuous data and risk ratio (RR) for dichotomous data with 95% confidence intervals (CIs). We assessed heterogeneity using the I² statistic. The primary emotionalism measures were the proportion of participants achieving at least a 50% reduction in abnormal emotional behaviour at the end of treatment, improved score on Center for Neurologic Study - Lability Scale (CNS-LS), Clinician Interview-Based Impression of Change (CIBIC) or diminished tearfulness.

MAIN RESULTS

We included seven trials with a total of 239 participants. Two trials were of cross-over design, and outcome data were not available from the first phase (precross-over) in an appropriate format for inclusion as a parallel randomised controlled trial (RCT). Thus, the results of the review are based on five trials with 213 participants. Treatment effects were observed on the following primary endpoints of emotionalism: There is very low quality of evidence from one small RCT that antidepressants increased the number of people who had 50% reduction in emotionalism (RR 16.50, 95% CI 1.07 to 253.40; 19 participants) and low quality evidence from one RCT of improved scores on Center for Neurologic Study - Lability Scale (CNS-LS) and Clinician Interview-Based Impression of Change (CIBIC) with antidepressants (RR 1.44, 95% CI 0.95 to 2.19; 28 participants). There was moderate quality evidence from three RCTS that they increased the number of people who had a reduction in tearfulness (RR 2.18, 95% CI 1.29 to 3.71; 164 participants); and low quality evidence from one RCT of improved scores on the Pathological Laughter and Crying Scale (PLCS) (MD 8.40, 95% CI 11.56 to 5.24; 28 participants).Six trials reported adverse events (death) and found no difference between the groups in death (RR 0.59, 95% CI 0.08 to 4.50; 6 RCTs, 172 participants, moderate-quality evidence).

AUTHORS' CONCLUSIONS

Antidepressants may reduce the frequency and severity of crying or laughing episodes based on very low quality evidence. Our conclusions must be qualified by several methodological deficiencies in the studies and interpreted with caution despite the effect being very large. The effect does not seem specific to one drug or class of drugs. More reliable data are required before appropriate conclusions can be made about the treatment of post-stroke emotionalism. Future trialists investigating the effect of antidepressants in people with emotionalism after stroke should consider developing and using a standardised method to diagnose emotionalism, determine severity and assess change over time; provide treatment for a sufficient duration and follow-up to better assess rates of relapse or maintenance and include careful assessment and complete reporting of adverse events.

Client laughter in psychodynamic psychotherapy: Not a laughing matter

We studied 814 client laughter events nested within 330 sessions nested within 33 clients nested within 16 therapists at one community clinic in which doctoral student therapists provided psychodynamic psychotherapy to adult community clients. Each laughter event in Sessions 1 to 5 and 16 to 20 was rated for cheerfulness, politeness, reflectiveness, contemptuousness, and nervousness. Across all clients, there was an average of about one laughter even per session. The average laughter event lasted 3.5 seconds, and was characterized primarily by politeness and reflectiveness. Overall amount of client laughter and the characteristics of client laughter did not change across sessions. Most of the variance in the laughter characteristics was at the session level, with less variance attributable to clients and therapists. When client attachment avoidance was high, laughter was less cheerful and more contemptuous. When client attachment anxiety was high, laughter was more nervous. Sessions with more reflective laughter were evaluated more positively by clients, and therapists whose clients had more reflective laughter had more positive client session evaluations. Furthermore, within a therapist's caseload, clients with the most nervous and contemptuous laughter evaluated sessions most positively. Implications are discussed. (PsycINFO Database Record

The past is present: The role of maltreatment history in perceptual, behavioral and autonomic responses to infant emotional signals

In the current study associations between parents' experiences of childhood maltreatment and their perceptual, behavioral and autonomic responses to infant emotional signals were examined in a sample of 160 parents. Experienced maltreatment (both physical and emotional abuse and neglect) was reported by the participants and, in approximately half of the cases, also by their parents. During a standardized infant vocalization paradigm, participants were asked to squeeze a handgrip dynamometer at maximal and at half strength while listening to infant crying and laughter sounds and to rate their perception of the sounds. In addition, their heart rate (HR), pre-ejection period (PEP), and vagal tone (RSA) were measured as indicators of underlying sympathetic and parasympathetic reactivity. Results indicated that participants did not differ in their perceptions of the infant vocalizations signals according to their maltreatment experiences. However, maltreatment experiences were associated with the modulation of behavioral responses. Experiences of neglect during childhood were related to more handgrip force during infant crying and to less handgrip force during infant laughter. Moreover, a history of neglect was associated with a higher HR and a shorter PEP during the entire infant vocalization paradigm, which may indicate chronic cardiovascular arousal. The findings imply that a history of childhood neglect negatively influences parents' capacities to regulate their emotions and behavior, which would be problematic when reacting to children's emotional expressions.

Reduced Laughter Contagion in Boys at Risk for Psychopathy

Humans are intrinsically social animals, forming enduring affiliative bonds [1]. However, a striking minority with psychopathic traits, who present with violent and antisocial behaviors, tend to value other people only insofar as they contribute to their own advancement [2, 3]. Extant research has addressed the neurocognitive processes associated with aggression in such individuals, but we know remarkably little about processes underlying their atypical social affiliation. This is surprising, given the importance of affiliation and bonding in promoting social order and reducing aggression [4, 5]. Human laughter engages brain areas that facilitate social reciprocity and emotional resonance, consistent with its established role in promoting affiliation and social cohesion [6, 7, 8]. We show that, compared with typically developing boys, those at risk for antisocial behavior in general (irrespective of their risk of psychopathy) display reduced neural response to laughter in the supplementary motor area, a premotor region thought to facilitate motor readiness to join in during social behavior [9, 10, 11]. Those at highest risk for developing psychopathy additionally show reduced neural responses to laughter in the anterior insula. This region is implicated in auditory-motor processing and in linking action tendencies with emotional experience and subjective feelings [10, 12, 13]. Furthermore, this same group reports reduced desire to join in with the laughter of others—a behavioral profile in part accounted for by the attenuated anterior insula response. These findings suggest that atypical processing of laughter could represent a novel mechanism that impoverishes social relationships and increases risk for psychopathy and antisocial behavior.

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Psychopathic traits are associated with a lack of enduring affiliative bonds

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Listening to human laughter engages brain areas that facilitate emotional resonance

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Boys at risk of psychopathy have reduced neural/behavioral responses to laughter

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This could reflect a mechanism underpinning reduced social connectedness

Towards a social functional account of laughter: Acoustic features convey reward, affiliation, and dominance

Recent work has identified the physical features of smiles that accomplish three tasks fundamental to human social living: rewarding behavior, establishing and managing affiliative bonds, and negotiating social status. The current work extends the social functional account to laughter. Participants (N = 762) rated the degree to which reward, affiliation, or dominance (between-subjects) was conveyed by 400 laughter samples acquired from a commercial sound effects website. Inclusion of a fourth rating dimension, spontaneity, allowed us to situate the current approach in the context of existing laughter research, which emphasizes the distinction between spontaneous and volitional laughter. We used 11 acoustic properties extracted from the laugh samples to predict participants’ ratings. Actor sex moderated, and sometimes even reversed, the relation between acoustics and participants’ judgments. Spontaneous laughter appears to serve the reward function in the current framework, as similar acoustic properties guided perceiver judgments of spontaneity and reward: reduced voicing and increased pitch, increased duration for female actors, and increased pitch slope, center of gravity, first formant, and noisiness for male actors. Affiliation ratings diverged from reward in their sex-dependent relationship to intensity and, for females, reduced pitch range and raised second formant. Dominance displayed the most distinct pattern of acoustic predictors, including increased pitch range, reduced second formant in females, and decreased pitch variability in males. We relate the current findings to existing findings on laughter and human and non-human vocalizations, concluding laughter can signal much more that felt or faked amusement.

Using Health Conditions for Laughs and Health Policy Support: The Case of Food Allergies

Health conditions are sometimes included in entertainment media comedies as a context for and as a source of humor. Food allergies are a typical case in point: They are potentially life-threatening yet may be used in humorous contexts. We conducted a content analysis of food allergies in entertainment media and tested the effects of humorous portrayals from an exemplar entertainment program. The content analysis confirmed that when food allergies were portrayed in television and the movies, it was most frequently in a humorous context and often contained inaccurate information. A follow-up experiment showed viewing a humorous portrayal of food allergies had an indirect negative effect on related health policy support via decreased perceived seriousness of food allergies. Inclusion of an educational video eliminated this effect on reduced policy support, with cognitive dissonance as a mediator. Findings support the hypothesis that portraying a health condition in a humorous context may reduce perceptions of seriousness and willingness to support public health policies to address risks associated with the condition, supporting and extending prior research findings.

Laughter, Humor, and Cancer: Delicate Moments and Poignant Interactional Circumstances

Conversation analysis is employed to examine transcribed excerpts drawn from a subsample of 75 naturally occurring and video recorded interviews between cancer patients and 30 doctors. Close examination is provided of how cancer patients initiate, and doctors respond, to laughter and humor during oncology interviews. Interactions demonstrate that communication about the disease "cancer" shares qualities similar to other medical areas (e.g., primary care): the tendency for patients to initiate laughter or humor to address troubling and challenging circumstances; and that during moments when patients address personal matters, doctors are not invited and do not reciprocate with shared laughter and humor. Prominent in talk about cancer are various precarious circumstances, awkward and delicate moments mirroring the lived experiences of cancer patients (e.g., when patients attempt to minimize fears, justify that they are well when threatened with sickness, claim normality in the midst of chronic conditions, and take stances that weight loss and gain are not problematic). These examples provide a compelling case that routine cancer care involves many poignant situations managed through laughter and humor. Implications are raised for how quality care might be improved through grounded understandings of laughter, humor, and cancer.

Anxious laughter: Mauron's Renversement and Gogol's Overcoat

Inside and outside of psychoanalysis, laughter has often been thought of as relating to anxiety, with the usual line being that laughter can be a response to anxiety or a way of dealing with it. This article argues that laughter cannot be said to eradicate or 'deal with' anxiety and that laughter is always unsettling precisely because it contains anxiety and indicates its continuing threat. The article discusses Freud and Lacan on anxiety, as well as Charles Mauron, an understudied writer whose Psychocritique du Genre Comique was the only sustained study of psychoanalysis and comedy until very recently. I argue here that Mauron's idea of renversement holds a key to understanding the relationship between laughter and anxiety. Rather than using a collection of isolated examples to illustrate individual points, in the second half of the article I provide a more sustained discussion of these ideas in relation to Nicolai Gogol's short story "The Overcoat."

Student life - When laughter is the best medicine - and when it is not

As you progress through your placements, you will witness the extremes of the human condition.

Facial Feedback and Social Input: Effects on Laughter and Enjoyment in Children with Autism Spectrum Disorders

Both social input and facial feedback appear to be processed differently by individuals with autism spectrum disorder (ASD). We tested the effects of both of these types of input on laughter in children with ASD. Sensitivity to facial feedback was tested in 43 children with ASD, aged 8-14 years, and 43 typically developing children matched for mental age (6-14), in order to examine whether children with ASD use bodily feedback as an implicit source of information. Specifically, children were asked to view cartoons as they normally would (control condition), and while holding a pencil in their mouth forcing their smiling muscles into activation (feedback condition) while rating their enjoyment of the cartoons. The authors also explored the effects of social input in children with ASD by investigating whether the presence of a caregiver or friend (companion condition), or the presence of a laugh track superimposed upon the cartoon (laugh track condition) increased the children's self-rated enjoyment of cartoons or the amount of positive affect they displayed. Results showed that the group with ASD was less affected by all three experimental conditions, but also that group differences seemed to have been driven by one specific symptom of ASD: restricted range of affect. The strong relationship between restricted affect and insensitivity to facial feedback found in this study sheds light on the implications of restricted affect for social development in ASD.

Laughing in the Face of Fear (of Disease Detection): Using Humor to Promote Cancer Self-Examination Behavior

This research examines the possible benefit of using humor to reduce anxiety associated with performing cancer self-examination behaviors. In Study 1, 187 undergraduates read a humorous public service announcement (PSA) script promoting either breast or testicular self-exams. Results suggest that perception of humor reduced anxiety about self-exams, which, in turn, related to more positive self-exam attitudes. Simultaneously, humor perception associated with greater message processing motivation, which, in turn, associated with more supportive self-exam attitudes. Self-exam attitudes also positively associated with self-exam intentions. These results were largely replicated in Study 2. Further, self-exam intentions predicted self-exam behavior 1 week later. However, consistent with past research, the humorous and serious messages did not generate differences in subsequent self-exam behavior, though the intention-behavior relationship was stronger and significant for those exposed to the humorous versus the serious messages. In light of these findings, and given that humor has the advantage of attracting and holding attention in real message environments, the use of carefully constructed humor appeals may be a viable message strategy to promote health detection behaviors.

Seriously clowning: Medical clowning interaction with children undergoing invasive examinations in hospitals

This qualitative study examined the subjective experience of children undergoing an invasive examination in the hospital when accompanied by a medical clown. In-depth semi-structured interviews were conducted with nine such children and nine of their accompanying parents. The children were patients in two outpatient departments (Pediatric Gastroenterology and a Center for the Sexually Abused) in a hospital in Israel. Interviews were coded thematically using an Atlas.ti software program. Analysis of the interviews indicated that the intervention of the clown positively changed the children's perceptions of the hospital, of experiencing the examination, and of their life narrative. Medical clowns thus appear to be a central, meaningful, and therapeutic source for children undergoing invasive examinations in hospital, as well as for their parents. Therefore, it may be advisable to incorporate medical clowns as an integral part of medical teams performing invasive procedures and to include the clowns in all stages of the hospital visit.

Short alleles, bigger smiles? The effect of 5-HTTLPR on positive emotional expressions

The present research examined the effect of the 5-HTTLPR polymorphism in the serotonin transporter gene on objectively coded positive emotional expressions (i.e., laughing and smiling behavior objectively coded using the Facial Action Coding System). Three studies with independent samples of participants were conducted. Study 1 examined young adults watching still cartoons. Study 2 examined young, middle-aged, and older adults watching a thematically ambiguous yet subtly amusing film clip. Study 3 examined middle-aged and older spouses discussing an area of marital conflict (that typically produces both positive and negative emotion). Aggregating data across studies, results showed that the short allele of 5-HTTLPR predicted heightened positive emotional expressions. Results remained stable when controlling for age, gender, ethnicity, and depressive symptoms. These findings are consistent with the notion that the short allele of 5-HTTLPR functions as an emotion amplifier, which may confer heightened susceptibility to environmental conditions.

Handgrip force of maltreating mothers in reaction to infant signals

Handgrip force responses to infant signals were examined in a sample of 43 maltreating and 40 non-maltreating mothers. During a standardized handgrip paradigm, mothers were asked to squeeze a handgrip dynamometer at maximal and at half of their maximal handgrip strength while listening to infant crying and laughter sounds. Maltreating mothers used excessive force more often while listening to infant crying and laughter than non-maltreating mothers. Of the maltreating mothers, only neglectful mothers (n=20) tended to use excessive force more often during crying than non-maltreating mothers. Participants did not rate the sounds differently, indicating that maltreating mothers cannot be differentiated from non-maltreating mothers based on their perception of infant signals, but show different behavioral responses to the signals. Results imply that, in response to infant signals (i.e., crying or laughing), maltreating mothers may be insufficiently able to regulate the exertion of physical force.

Is Laughing at the Expense of Victims and Offenders a Red Flag? Humor and Secondary Traumatic Stress

Those who work with human trauma often use humor to handle job stressors. Research has demonstrated that lighthearted humor is related to lower secondary traumatic stress scores, while gallows humor has the inverse relationship. This work explores how three types of humor relate to secondary traumatic stress: (a) humor at the expense of victims, (b) humor at the expense of offenders, and (c) humor containing sexual innuendo. Internet crimes against children taskforce personnel completed questionnaires about secondary traumatic stress and coping techniques. Humor at the expense of victims was rarely used, but when it was, it was indicative of higher secondary traumatic stress. There were no relationships between secondary traumatic stress and the use of humor at the expense of offenders or humor containing sexual innuendo.