Effect of Humor on Pain and Anxiety in Patients With Rheumatoid Arthritis: A Prospective, Randomized Controlled Study.

Humor can contribute to nursing practices for relieving pain and anxiety in patients with rheumatoid arthritis (RA) during intravenous (IV) biologic treatment. This study used a prospective, randomized controlled study design to investigate the effect of humor on pain and state anxiety in patients with RA receiving IV infusion therapy. Two sample groups were formed: the intervention group (watching a comedy movie) (n = 18) and the control group (usual care) (n = 18). Both groups received IV biologic therapy. A significant difference was found between the groups' pain mean scores, but the effect size was small (P < .001, η² = 0.032). The mean visual analog scale scores decreased in both groups after the treatment; however, it decreased more in the intervention group (P < .001, Md = 2.44) than in the control group (P = .017, Md = 0.83). No significant difference was found between the groups' mean state anxiety scores, and the effect size was irrelevant (P > .05, η² = 0.001). There was a significant decrease in the anxiety levels of both groups (P < .001). During IV biologic infusion therapy, watching comedy movies is recommended as a nursing care intervention for reducing pain in patients with RA in cooperation with other health professionals.

Medical assistants' comic styles and their potential for positive functioning at work: a cross-sectional study including a subgroup analysis.

BACKGROUND: Medical assistants are essential for the healthcare system. However, they face several working demands every day, for which they need resources to cope. While several studies show that humour can be a resource for healthcare professionals, studies on humour styles/comic styles in healthcare are scarce. But, as humour styles (e.g., light vs. dark) may have varying - and even negative - effects on positive psychological functioning, it is important to investigate their individual potential for medical assistants. Thus, this study investigates the relationships between medical assistants' comic styles and their positive psychological functioning at work. METHODS: Applying a cross-sectional design we assessed German medical assistants' eight comic styles (i.e., benevolent humour, fun, wit, nonsense, irony, satire, sarcasm, cynicism) and facets of positive psychological functioning (e.g., well-being, feeling of competence). We analysed relationships between the variables by means of Pearson correlations, ANCOVAs and hierarchical regressions. All analyses were conducted with the total sample (N = 608; completion rate 44%) as well as a large subsample of medical assistants working in general medicine (N = 263). RESULTS: While most of the light styles (e.g., benevolent humour) relate positively to most facets, the dark style sarcasm relates negatively. The other dark styles showed coefficients around zero or even slightly positive ones (e.g., satire). Most relationships were also prevalent in the subgroup of medical assistants working in general medicine. CONCLUSIONS: The eight comic styles might have varying potential for medical assistants' positive psychological functioning at work, with benevolent humour being most adaptive and sarcasm being maladaptive. This study points to the relevance of raising attention regarding the (mal-)adaptiveness of different comic styles of healthcare professionals. Trainings of professionals (e.g., vocational education and training of medical assistants) might integrate the topic of humour (i.e., foster benevolent vs. caution against sarcastic humour) to build and maintain this helpful resource which professionals can use as a tool to master various challenges of everyday work (e.g., cope with stressful situations).

Associations of humor, morale, and unit cohesion on posttraumatic stress disorder symptoms.

Military personnel experience many stressors during deployments that can lead to symptoms of posttraumatic stress disorder (PTSD). However, not all military personnel who are exposed to deployment stressors develop PTSD symptoms. Recent research has explored factors that contribute to military personnel resilience, a multifaceted and multidetermined construct, as a means to mitigate and prevent PTSD symptoms. Much of this research has focused on the effects of individual-level factors (e.g., use of coping strategies like humor, the morale of individual unit members), with some research focusing on unit-level factors (e.g., the cohesiveness of a unit). However, there is little research exploring how these factors relate to each other in mitigating or reducing PTSD symptoms. In this study, we examined the association between deployment stressors, perceived unit cohesion, morale, humor, and PTSD symptoms in a sample of 20,901 active-duty military personnel using structural equation modeling. Results indicated that perceived unit cohesion, humor, and morale were positively associated with each other and negatively associated with PTSD symptoms over and above the effect of deployment stressors. These findings highlight the influence of resilience factors on PTSD symptoms beyond their substantial overlap and have implications for future research as well as the potential development of interventions for military personnel.

Aggressive Humor and Social Connectedness: The Moderating Roles of Subjective Social Status and Gender.

Aggressive humor has been conceived as a maladaptive humor style that jeopardizes social relationships. However, past studies have yielded inconsistent findings regarding the detrimental effects of aggressive humor on social relationships. This study attempts to advance the existing literature by examining the gender difference in the moderating role of subjective social status in the association between aggressive humor and social connectedness. Participants were 228 (53.1% female) adults aged from 18 to 53 years (M = 23.19, SD = 6.43). The hypothesized moderated moderation effect was significant, suggesting that gender significantly moderated the moderating effect of subjective social status on the association between aggressive humor and social connectedness. Subjective social status significantly moderated the association between aggressive humor and social connectedness for men but not for women. For men, aggressive humor was negatively associated with social connectedness when subjective social status was low or medium, but the association was not significant when subjective social status was high. For women, aggressive humor was not associated with social connectedness regardless of subjective social status. Implications of the findings are discussed.

Dynamic cognitive processes of humor generation: activation and inhibition of information.

Humor is a lubricant of interpersonal relationships and is regarded as an important quality of individual creativity. Previous studies have mainly focused on passive humor appreciation and comprehension but ignored active humor generation, especially the cognitive process of humor generation. Based on the hypothesis that humor generation is similar to creative cognition, this study used humorous two-part allegorical sayings to explore whether humor generation involves the cognitive processes of the activation and inhibition of information. The experiment manipulated the duration (5/10 s) of the presentation of the first part of humorous two-part allegorical sayings, which are called "yinyu," and the type of subthreshold probe words (humorous probe words/usual probe words). The results showed that the interaction between the duration of the presentation of yinyu and the type of subthreshold probe words was significant; the correct number of humorous probe words reported was significantly lower than that of usual probe words when the yinyu was presented for 5 s, which reflected the widespread activation of information. The correct number of humorous probe words reported was significantly higher than that of usual probe words when the yinyu was presented for 10 s, which suggested the inhibition of non-humorous information. This study revealed the dynamic cognitive processes of humor generation and verified possible cognitive similarities between humor generation and creative cognition.

Is this a Joke? Altering the Derivation of Humor Behavior

Despite the vast number of studies analyzing humor and its relation to other psychological variables, there is no consensus regarding under which conditions humor emerges. The current study aims to explore in this direction using three experimental protocols designed to alter the context of several jokes: the Reality protocol, to respond as if being in the situation described in the joke; the Identification protocol, to take the perspective of the characters in the jokes; and the Discomfort protocol, to respond to aversive functions given to these characters. Twenty-three participants were assigned to one of two conditions: in the Experimental condition, the first three jokes were preceded by one of the experimental protocols, whereas in the Control condition, the same jokes were presented without any contextual manipulation. Then, all participants were re-exposed to the jokes with no manipulation in a second phase. Facial responses and self-reports were used as measures of humor. Results show that the experimental protocols altered the emergence of humor in a replicable manner (mainly with the Reality and the Discomfort protocols) by reducing the humor responses and affecting their agreement. However, a decrease in humor responses as well as variability in the agreement between measures was observed in both conditions when re-exposed to the same jokes. These findings are discussed according to the contextual components defining each experimental protocol and highlight the functions that might be derived according to the interaction between the jokes and the participants’ histories of relating events (AU)

[Humour in the time of Coronavirus]. / L'umorismo ai tempi del Coronavirus.

In this study, we measure psychological suffering and emotional coping using humour among a sample of adult people during Italian lockdown to contain SARS-CoV-2 virus during 2020. We hypothesize that humour is a protective factor against a depressive state development, with the exception of some kind of humour style as aggressive or self-defeating. We revealed important psychopathology levels among subjects, the humour, more precisely self-enhancing one, is a protective factor against most psychopathological disorder, while there we did not find a significant correlation with depression and other humour scales, finding correlation with other humour styles and hostility, paranoia, and psichoticism scales.

Interplay of occupational stress, sense of humor, and health status among nurses working at hospitals in Ahvaz.

Sense of humor constitutes a part of everyday life and work and an indispensable part of healthcare. However, the relationship between sense of humor and nursing occupational health and stress is yet to be studied in Iran. This study aimed to analyze the interplay of demographic factors, occupational stress, sense of humor, and health status of nurses working at the hospitals affiliated with the Ahvaz Jundishapur University of Medical Sciences, Iran. In this descriptive-analytical study, the statistical population consisted of 203 nurses. Occupational stress was assessed using the Iranian version of the Effort-Reward-Imbalance (ERI) Questionnaire. The Sense of Humor Questionnaire (SHQ) and the Iranian version of the 12-item General Health Questionnaire (GHQ-12) were employed to assess the sense of humor and physio-psychological health, respectively. Data collected were analyzed using the Statistical Package for the Social Sciences (SPSS) software. 81% (n=164) of the participants had an "external effort" (E) and "reward" (R) ratio greater than 1, indicating very high occupational stress. 39% (n=79) nurses with high occupational stress displayed their commitment to the workplace. Approximately 42% (n=85) of nurses were suffering from health problems. The mean humor score of participants was 2.90±0.41. Major life events over the past 3 months (p<0.01), weekly working hours (p<0.01), high occupational stress (p<0.01), and sense of humor (p<0.01) were determined to be significant predictors of nurses' health problems. Decision-makers are recommended to reduce nursing working hours through work shift management in order to maintain nurses' health status and reduce their occupational stress. In addition, hospital directors should promote a sense of humor in hospital environments with the help of culture-building practices, comedy books, music CDs, and training courses.

A influência da prática de atividade física no estado de humor de mulheres adultas / The influence of physical activity on the mood of adult women

O objetivo do presente estudo foi comparar os níveis de estado de humor de mulheres adultas praticantes de atividade física regular com os de mulheres adultas sedentárias. Participaram do estudo 57 mulheres (53,36 ± 10,68 anos de idade), divididas em dois grupos: ativas e sedentárias. Utilizou-se um questionário para caracterização da amostra e a Escala de Humor de Brunel (BRUMS). Os resultados do presente estudo demonstraram que as mulheres ativas apresentaram estado de humor positivo, além de apresentaram baixos escores para o estado de humor negativo, quando comparadas aos escores das mulheres sedentárias. Pode-se concluir que a atividade física pode influenciar positivamente o estado de humor.

The aim of this study was to compare mood levels of adult women engaged in regular physical activity with those of sedentary adult women. Fifty-seven women participated in the study (53.36 ± 10.68 years' old), divided into two groups: active and sedentary. A questionnaire was used to characterize the sample, and the Brunel Mood Scale (BRUMS) was also applied. The results demonstrated that active women had a positive mood state in addition to having low scores for negative mood state when compared to the scores of sedentary women. It can be concluded that physical activity can have a positive influence on mood state.

Antagonism between brain regions relevant for cognitive control and emotional memory facilitates the generation of humorous ideas.

The ability to generate humor gives rise to positive emotions and thus facilitate the successful resolution of adversity. Although there is consensus that inhibitory processes might be related to broaden the way of thinking, the neural underpinnings of these mechanisms are largely unknown. Here, we use functional Magnetic Resonance Imaging, a humorous alternative uses task and a stroop task, to investigate the brain mechanisms underlying the emergence of humorous ideas in 24 subjects. Neuroimaging results indicate that greater cognitive control abilities are associated with increased activation in the amygdala, the hippocampus and the superior and medial frontal gyrus during the generation of humorous ideas. Examining the neural mechanisms more closely shows that the hypoactivation of frontal brain regions is associated with an hyperactivation in the amygdala and vice versa. This antagonistic connectivity is concurrently linked with an increased number of humorous ideas and enhanced amygdala responses during the task. Our data therefore suggests that a neural antagonism previously related to the emergence and regulation of negative affective responses, is linked with the generation of emotionally positive ideas and may represent an important neural pathway supporting mental health.

Not Taking a Joke: The Influence of Target Status, Sex, and Age on Reactions to Workplace Humor.

The current study tasked undergraduates with serving as hypothetical human resource workers to evaluate complaints of offensive and inoffensive humor used by male and female employees in a fictitious company who varied in employment status and age. Offensive humor was deemed more problematic in its usage, particularly among female perceivers. Contrary to hypotheses, its usage was more problematic for male and older employees than for female and younger employees. In addition, participants were more averse to both offensive and inoffensive humor from high-status and older men relative to women with similar characteristics. We frame results with consideration of recent social trends.

From "Aha!" to "Haha!" Using Humor to Cope with Negative Stimuli.

Humor has been considered an effective emotion regulation strategy, and some behavioral studies have examined its superior effects on negative emotion regulation. However, its neural mechanisms remain unknown. Our functional magnetic resonance imaging study directly compared the emotion regulation effects and neural bases of humorous coping (reappraisal) and ordinary reappraisal following exposure to negative pictures. The behavioral results suggested that humorous reappraisal was more effective in downregulating negative emotions and upregulating positive emotions both in the short and long term. We also found 2 cooperative neural pathways involved in coping with negative stimuli by means of humor: the "hippocampal-thalamic-frontal pathway" and the "amygdala-cerebellar pathway." The former is associated with the restructuring of mental representations of negative situations and accompanied by an insightful ("Aha!") experience, while the latter is associated with humorous emotional release and accompanied by an expression of laughter ("Haha!"). Furthermore, the degree of hippocampal functional connectivity with both the thalamus and frontal cortex was positively correlated with changes in positive emotion, and this result implied that the degree of emotion regulation could be strongly directly related to the depth of cognitive reconstruction. These findings highlight that regulating negative emotions with humor involves cognitive restructuring and the release of positive emotions.

El humor como intervención enfermera / Humor as a nursing intervention

OBJETIVOS: Describir el uso del humor en la práctica enfermera y los conocimientos sobre esta intervención; analizar factores asociados a su utilización y al nivel de conocimientos. MÉTODO: Estudio observacional, descriptivo, transversal, realizado mediante encuesta distribuida por correo electrónico y redes sociales, con variables sociodemográficas y otras relacionadas con el humor como intervención enfermera. El análisis descriptivo se realiza mediante frecuencia de categorías y media con desviación estándar o mediana y percentiles 5-95. Para el análisis bivariante se utilizan correlaciones de Pearson-Spearman, T de Student, ANOVA de un factor y Chi-Cuadrado. Todas son pruebas bilaterales, nivel de significación p < 0.05, realizadas con el programa SPSS V.21.0. RESULTADOS: Participaron 224 enfermeras, 75,4 % mujeres, con 42 (±10) años y 19,8 (±9.5) de experiencia. El 84,9 %, en función asistencial y el 46,4 %, de ámbito hospitalario. El 99,1 % opina que el humor influye positivamente en la salud y un 72,3 %, que existe evidencia al respecto; mientras que un 59,4 % describe poca evidencia disponible sobre el efecto positivo del humor como intervención enfermera. El 95,3 % refiere utilizarlo con compañeros, y un 87,3 %, con pacientes. El 63,8 % no reconoce el humor como intervención de la clasificación Diagnósticos de Enfermería Nanda (NIC). Sobre los conocimientos relacionados con sus actividades, la media de aciertos fue de 11,3 (±1.7) sobre 15. El análisis bivariado indica significación estadística en la asociación de distintas variables. CONCLUSIONES: Este estudio representa una aproximación a la utilización del humor en nuestro contexto profesional, donde destaca un uso habitual por parte de las enfermeras. Sin embargo, existe desconocimiento sobre su pertenencia a la NIC

OBJECTIVES: To describe the use of humor in nursing practice and the knowledge about this intervention; to analyze factors associated with their use and the level of knowledge. METHOD: Observational, descriptive, cross-sectional study, carried out using a survey distributed by email and social networks, with socio-demographic variables and others related to humor as a nurse intervention. The descriptive analysis is made by the frequency of categories and means with standard deviation or median and percentiles 5-95. For the bivariate analysis Pearson-Spearman correlations, Student's T, one-factor ANOVA and Chi-square are used. All are bilateral tests, level of significance p <0.05. RESULTS: 224 nurses participated, 75.4 % of them were women, they were 42 (± 10) years old and had 19.8 (± 9.5) years of experience. 84.9 % work in professional care and 46.4 %, in the hospital setting. 99.1 % think that humor positively influences health and 72.3 %, that there is evidence, while 59.4 % describe little evidence available on the positive effect of humor as a nurse intervention. 95.3 % reported using it with colleagues and 87.3 %, with patients. 63.8 % do not recognize humor as an intervention of the NIC classification. Regarding knowledge related to NANDA Nursing Diagnoses (NIC) activities, the mean of correct answers was 11.3 (± 1.7) out of 15. The bivariate analysis indicates statistical significance in the association between different variables. CONCLUSIONS: This study can be an approximation of the use of humor in our professional context, highlighting its frequent use by nurses. However, there is a lack of knowledge about their listing in the NIC classification

Beyond the motor account of amyotrophic lateral sclerosis: Verbal humour and its relationship with the cognitive and pragmatic profile.

BACKGROUND: Amyotrophic Lateral Sclerosis (ALS) was traditionally described as a disease restricted to the motor system. However, recent findings suggested that it also affects cognition, especially executive functions, social cognition, language and pragmatics. A relevant issue in current research is thus the description of the cognitive phenotype of ALS and the identification of the most vulnerable aspects. AIMS: The focus was on a communicative phenomenon placed at the crossroads of pragmatic and other cognitive domains, namely humour, which till now has been poorly explored in ALS. The first aim was to investigate whether ALS is associated with impairments in understanding and appreciating jokes. The second aim was to explore the predictors of humour comprehension and appreciation in patients, to confirm the involvement of pragmatic skills and to explore the role of other cognitive and clinical aspects. METHODS & PROCEDURES: A total of 30 non-demented patients with ALS and 27 controls were assessed with a task of verbal humour comprehension and appreciation, including two types of jokes: phonological and mental. We also administered a battery of pragmatic and other language tasks, and cognitive and socio-cognitive tasks. Mixed-effects models were used to test differences in the humour task between the two groups. Multiple regressions determined the best predictors of humour comprehension and appreciation in patients. OUTCOMES & RESULTS: Patients obtained lower comprehension accuracy scores than controls in the humour task, independently of the type of joke. Conversely, patients and controls did not differ in joke appreciation and both rated mental jokes as funnier than the phonological ones. Patients' comprehension accuracy was predicted by pragmatic skills and ALS severity, whereas appreciation was predicted by several clinical variables and, to a smaller extent, by language skills. CONCLUSIONS & IMPLICATIONS: The findings suggest that humour is a very vulnerable aspect in ALS, and that impairment in humour comprehension might be part of the larger cognitive impairment, being linked to pragmatic impairment. Clinical variables were also important, especially in relation to humour appreciation. More generally, these data speak in favour of pragmatics as a relevant aspect to sketch the cognitive phenotype of ALS. On the practical level, these findings point to the need of supporting communication at large, not only motor-related aspects such as dysarthria but also social-pragmatic aspects such as understanding jokes, to increase well-being in ALS. What this paper adds What is already known on this subject The literature of the last decades has shown that ALS comes with impairment in several cognitive domains, affecting especially executive functions as well as language. There is also initial evidence that the pragmatics of communication and humour comprehension are impaired, although non-serious talk has been documented in conversational interaction among people with ALS. What this paper adds to existing knowledge This study offers compelling evidence of an impairment in the comprehension of jokes in ALS, whereas the appreciation of joke funniness seems to be spared. The study also highlights the interplay of cognitive factors (especially pragmatics) and clinical factors (related to disease severity) in predicting the patients' performance in the humour task. What are the potential or actual clinical implications of this work? The study's findings call for the need of increased awareness among scholars as well as practitioners and caregivers of the profile of humour comprehension and appreciation in ALS. On a practical level, we highlight the need of assessing humour comprehension and adapting the communicative style accordingly. Second, we recommend that intervention programmes targeting communication in ALS go beyond speech-related difficulties and include pragmatic aspects such as humour. Considering the important communicative and social function of humour, as well as its use as a coping strategy, humour interventions are key to improve the quality of life of individuals with ALS.

Are humor styles predictors of hope? sex and age differences in Italian adolescents and young adults

The study analyzed relationships among humor styles and hope and deepen the role of humor styles as predictors of hope in 582 Italian adolescents and young adults (with age ranged between 14 and 27). Sex and age differences were observed. The Humor Styles Questionnaire was used to assess the inclination to adopt positive (affiliative/self-enhancing) and negative (aggressive/self-defeating) humor styles, and Hope Scale was used to evaluate the general level of hope ("overall" hope score) and its two components (agency/pathways). Significant differences for sex and age-groups were found. Correlation analyses pointed out that positive humor styles were positively related to hope, and self-defeating humor was negatively associated to hope. Linear regressions displayed that self-enhancing and affiliative styles positively influenced hope while self-defeating negatively affected hope. The emerged relationships suggested that promoting the use of humor to amuse the others facilitate interpersonal relationships especially in developmental age

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The effects of watching comedy videos on anxiety and vital signs in surgical oncology patients.

BACKGROUND: Cancer, a disease as old as recorded human history, causes patients pain and psychological problems. Watching comedy videos can distract these patients, relieving psychological issues without causing any further harm. METHODS: This randomized clinical trial was conducted on patients who were candidates for oncologic surgery at a university hospital in Turkey. The sample of the study consisted of 88 patients. Before surgery, patients in the experimental group (n = 44) watched comedy videos while those in the control group (n = 44) received no intervention. The Patient Introduction and Registration Form and the State and Trait Anxiety Inventory (STAI) were used as data collection tools. Anxiety, measured by the STAI, and vital signs (blood pressure, pulse, respiration, and oxygen saturation) were measured before and after the experimental protocol. Descriptive statistics, chi-square and t-test were used in the analysis of the data. RESULTS: The pretest of STAI scores and vital signs were similar in both groups (p  >  0.05). After video watching, the mean state anxiety score of the patients was 43.36 ± 9.76 in the experimental group and 47.13 ± 5.76 in the control group. The difference between the mean anxiety scores of the two groups was statistically significant (p < 0.05). However, there were no significant differences in vital signs across groups (p > 0.05). Within group pre- versus post-treatment comparisons showed significant reduction in anxiety, diastolic and systolic blood pressures in the video group (p<0.05), while in controls, there was no significant improvement in anxiety and physiologic values. CONCLUSIONS: The results suggest that watching comedy videos has a beneficial effect on pre-operative anxiety and blood pressure in surgical oncology patients.

"Wonderful! We've just missed the bus." - Parental use of irony and children's irony comprehension.

Irony is one of the linguistic means in which intended and expressed meaning diverge. It serves social-communicative functions, requires the understanding of the speaker's mental state and its comprehension takes place at an advanced stage of language acquisition. In the present study, we investigated 8-year old's irony comprehension and social skills and asked their parents about their preferred use of irony towards their children. We then compared children with the highest scores in irony comprehension test with those with lower scores. The full sample included 46 families from Poland. Results show positive associations between children's levels of irony comprehension and levels of mothers irony use. No such relations were found for fathers. No differences were found in ToM scores between proficient and non-proficient irony comprehenders. Our findings provide a base for future studies to study the use of irony in child-parent talk in more diverse culturally and linguistically diverse populations.