Is laughter the best medicine?

Humor and Quality of Life in Adults With Chronic Diseases: A Systematic Review

Individuals grappling with chronic ailments often undergo a deterioration in their overall quality of life (QoL), encompassing psychological, social, and physical dimensions of well-being. Acknowledging that humor has demonstrated the potential to engender favorable effects on QoL, this systematic review endeavors to investigate the correlation between humor and QoL among adults contending with chronic health conditions. A comprehensive review of quantitative data was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. PubMed/MEDLINE, PsycINFO, and Cumulative Index to Nursing & Allied Health (CINAHL) were comprehensively searched from the establishment of each database up to June 22, 2023. Furthermore, reference lists of the included datasets and pertinent review articles were scrutinized exhaustively. The Newcastle-Ottawa Scale (NOS) was employed to assess the quality of eligible studies. A total of 18 studies satisfied the inclusion criteria. These studies encompassed a diverse spectrum of chronic disease categories (including cardiovascular diseases, various types of cancer, etc.) and collectively involved a participant cohort comprising 4,325 individuals. Remarkable findings surfaced, indicating a noteworthy association between distinct facets of humor-such as one's sense of humor, coping humor, humor styles, and laughter-and psychological QoL. Nonetheless, the relationship between humor and physical QoL exhibited a more intricate pattern, characterized by mixed outcomes. Despite the limited and inconsistent evidence across studies, humor appears to exhibit a positive association with QoL.

Humour's role in the relation between attributional style and dysphoria

The present study empirically investigated the role of adaptive and maladaptive components of humour in the relation between attributional style and dysphoria. Four hundred eighteen students (134 male, 282 female; 2 respondents did not indicate gender) completed questionnaires measuring attributional style, humour styles and depressive symptoms. Among men and women, higher levels of affiliative and self‐enhancing humour, and lower levels of self‐defeating humour, were each associated with fewer depressive symptoms. Additionally, higher levels of affiliative humour provided a buffer against the deleterious effects of a negative attributional style in men, but not women. Copyright © 2006 John Wiley & Sons, Ltd.

Empirical study of the influence of a Laughing Qigong Program on long-term care residents

AIM

To determine the psychological and physiological effects of a Laughing Qigong Program on an elderly population in an institutionalized setting.

METHODS

Participants were recruited from a long-term care institution in northern Taiwan. A total of 99 residents were interviewed and 66 enrolled, there were 33 control participants and 33 experimental participants. The participants were matched according to their abilities as measured by the Barthel Index of Activities for Daily Living. Experimental participants attended the Laughing Qigong Program, twice a week for 4 weeks. Comparisons were made on the Mini-Mental State Examination, Faces Scale, Geriatric Depression Scale and cortisol levels.

RESULTS

Psychometric measures for participants in the experimental group improved, whereas those in the control group decreased. The experimental group showed the following changes: improved Mini-Mental State Examination scores (Z=-2.28; P<0.05), improved mood states (Z=-4.47; P<0.001) and decreased Geriatric Depression Scale scores (Z=3.79; P<0.001). There were no significant changes for the experimental group in cortisol levels. By comparison, the control group showed: decreased mood states (Z=2.53; P<0.011), increased Geriatric Depression Scale scores (Z=4.34; P<0.001) and significant increases in cortisol levels (Z=2.62; P<0.009).

CONCLUSIONS

The Laughing Qigong Program has shown to be an effective, cost-effective non-pharmacological therapy for cognitive impairment, mood states and elderly depression.

Psychological, immunological and physiological effects of a Laughing Qigong Program (LQP) on adolescents

OBJECTIVES

One objective of this study was to assess the effects of laughter on the psychological, immunological and physiological systems of the body. Another objective was to introduce the Laughing Qigong Program (LQP), as a method of standardization for simulated laughter interventions.

DESIGN

A randomized, prospective, experimental study of the LQP was conducted in a group of adolescents (n=67) in Taiwan. During study-hall sessions, experimental subjects (n=34) attended the LQP for eight-weeks. Simultaneously, control subjects (n=33) read or did their homework. All subjects were tested before and after the intervention on the following: Rosenberg Self-Esteem scale (RSE), Chinese Humor Scale (CHS) and Face Scale (FS) as psychological markers; saliva cortisol (CS) as an immunological marker; blood pressure (BP), heart rate (HR), and heart rate variability (HRV) as physiological markers of the body's response to stress. Mood states (FS) were measured before/after each LQP session.

RESULTS

Mood states (p=.00) and humor (p=.004; p=.003) improved in the experimental group; no significant changes were found in the controls (p=69; p=60). The immunological marker of stress, cortisol levels, decreased significantly for those who participated in the LQP (p=.001), suggesting lower levels of stress after completion of the program.

CONCLUSIONS

The LQP is a non-pharmacological and cost-effective means to help adolescents mitigate stresses in their everyday life.

Personal experience of osteoarthritis and pain questionnaires: mapping items to themes

PURPOSE

The aim of this study was to examine the correspondence between qualitative and quantitative methods of coding experience of pain reported by participants with osteoarthritis (OA) of the knee.

METHODS

A mapping grid was produced to record the correspondence between subthemes that emerged from thematic analysis of interviews with 24 participants with knee OA, and from questionnaire items which were used in a study of 192 knee OA participants. Items were rated according to their degree of correspondence between subthemes and questionnaire items, and an overall correspondence score was produced for each subtheme and questionnaire measure.

RESULTS

The subthemes that corresponded well with the questionnaire items were those that related to socio-emotional functioning, the overall experience of pain and the impact of pain on physical functioning. The questionnaire items did not relate to participants' knowledge about their condition and their experience of the medical system.

CONCLUSIONS

The study indicated that many aspects of pain experience reported by patients in qualitative interviews are also assessed by commonly used questionnaire outcome measures for people with pain. However, although participants reported that knowledge about their condition and their experience of the medical system were important aspects of the overall pain experience, these are rarely used as outcome measures. Questionnaires that address these additional aspects of the pain experience could be useful to further evaluate the experience of pain and may help to address important concerns raised by patients with OA of the knee.

The use of humor in serious mental illness: a review

There is now a relatively good understanding of the broad range of direct and indirect effects of humor and laughter on perceptions, attitudes, judgments and emotions, which can potentially benefit the physical and psychological state. This article presents a review and discussion of the use of humor and laughter in treating people with serious mental illness, distinguishing between clinical papers on individual and group psychotherapy, and empirical research reports describing humor and laughter interventions. In spite of the exponential growth of the field over the last 30 years, I conclude that empirical studies are still lacking, the studies that do exist have major methodological shortcomings, and the field is in dire need of further investigation.

The use and reporting of cluster analysis in health psychology: a review

PURPOSE

Cluster analysis is a collection of relatively simple descriptive statistical techniques with potential value in health psychology, addressing both theoretical and practical problems. There are many methods of cluster analysis from which to choose, with no clear guidelines to aid researchers. In the absence of guidelines it is likely that methods already reported by published researchers will be adopted, and so clear reporting of statistical methodology, while always important, is particularly crucial with cluster analysis. The aim of this review is to describe and evaluate the reporting of cluster analysis in health psychology publications.

METHODS

Electronic searches of 18 health psychology journals identified 59 articles using cluster analysis published between 1984 and 2002. Articles were submitted to systematic evaluation against published criteria for the reporting of cluster analysis.

RESULTS

Just 27% of the papers reviewed met all five criteria, although 61% met at least four. Details of the similarity measure and the computer program used were most frequently omitted. Furthermore, while researchers usually reported the procedures employed to determine the number of clusters and to validate the clusters, these procedures were often lacking in rigour, and were reported in insufficient detail for replication.

CONCLUSIONS

The reporting of cluster analysis was found to be generally unsatisfactory, with many studies failing to provide enough information to allow replication or the evaluation of the quality of the research. Clear guidelines for conducting and reporting cluster analyses in health psychology are needed.

Cellular and humoral immunity, mood and exam stress: the influences of self-hypnosis and personality predictors

The effects of self-hypnosis training on immune function and mood were examined in medical students at exam time. Hypnosis involved relaxation and imagery directed at improved immune function and increased energy, alertness and concentration. Hypotheses were made about activated and withdrawn personality differences. Eight high and eight low hypnotically susceptible participants were given 10 sessions of hypnosis, one live and nine tape-recorded, and were compared with control subjects (N=12). CD3, CD4, CD8, CD19 and CD56 NK cells and blood cortisol were assayed. Life-style, activated vs. withdrawn temperament, arousal and anxiety questionnaires were administered. Self-hypnosis buffered the decline found in controls in NK (P<0.002) and CD8 cells (P<0.0.07) and CD8/CD4% (P<0.06) (45-35% order of magnitude differences) while there was an increase in cortisol (P<0.05). The change in NK cell counts correlated positively with changes in both CD8 cells and cortisol. Results were independent of changes in life-style. Energy ratings were higher after hypnosis (P<0.01), and increased calmness with hypnosis correlated with an increase in CD4 counts (P<0.01). The activated temperament, notably the cognitive subscale (speaking and thinking quickly), was predictive of exam levels of T and B lymphocytes (P&z.Lt;0.08-P<0.02), and reaching r=0.72 (P<0.001) in the non-intervention control group. The sizeable influences on cell-mediated immunity achieved by a relatively brief, low cost psychological intervention in the face of a compelling, but routine, stress in young, healthy adults have implications for illness prevention and for patients with compromised immunity.