Simulated laughter, perceived stress, and discourse in adults with aphasia

ABSTRACT

Background

Several studies have revealed an association between stress and language in nonclinical and aphasia groups. Laughter is considered to be an important contributor to physical and mental health including physiological and self-reported perceived stress. Simulated laughter programs, such as Laughter Yoga (LY), are a way to engage a person in the act of laughter without a humorous stimulus. The importance of laughter in aphasia therapy has been underexplored.

Aims

The current study investigated the effects of a simulated laughter program based in LY techniques on discourse measures and perceived stress for adults with aphasia. Qualitative feedback regarding the LY program was also collected from participants to assess their perception of the program. Additionally, the convergent validity of the Simple Aphasia Stress Scale (SASS) was explored. SASS measures were correlated with discourse measures in post hoc analyses to contribute to the growing literature examining the relation between perceived stress and language performance.

Methods

A waitlist crossover design was conducted across nine participants all with stroke and mild to moderate aphasia. All participants participated in a 3-day intervention period in which they engaged in a 20-minute simulated laughter program and a 3-day comparison condition in which they engaged in a 20-minute sitting session. Pre- and post- measures of self-reported perceived stress and discourse were taken on days 1 and 3 of each condition. Qualitative feedback on the simulated laughter program was also gathered.

Outcomes & results

No significant changes were noted in discourse measures or perceived stress in relation to the LY intervention. Responses regarding enjoyment of the simulated laughter program were primarily positive, however, some responses revealed an unfavorable opinion of the experience. The SASS demonstrated good convergent validity by significantly correlating with the Single-Item Stress Measurement (SISM) and Self-Assessment Manikin (SAM)-Arousal. Post-hoc analysis revealed associations between the SASS and certain measures of discourse dysfluency and productivity.

Conclusions

The simulated laughter program proved ineffective at differentially changing discourse dysfluency, productivity, or perceived stress in adults with aphasia when compared to a sitting condition. The SASS’ convergent validity is encouraging for its use as a measure of perceived stress by clinicians and researchers. Perceived stress correlated with certain discourse dysfluency and productivity measures adding to a growing body of literature in the area of stress and aphasia.

KEYWORDS:

• Aphasia
• laughter
• yoga
• stress
• discourse
• language

Acknowledgments

We want to thank the participants. Also, thanks to Dr. Ken Rice for his manuscript feedback.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This study was funded in part by the Center for the Study of Stress, Trauma, and Resiliency at Georgia State University.