Laughter Frequency, Pain Perception, and Affect in Fibromyalgia Patients

Laughter Frequency, Pain Perception, and Affect in Fibromyalgia Patients by Deidre G. Molchan MA, University of Mary Hardin-Baylor, 2004 BS, Old Dominion University, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University November 2018 Abstract Fibromyalgia syndrome (FMS), a common chronic pain condition, is often incompletely treated by conventional medical therapies. It can cause disability, psychological distress, work-related absenteeism, increased use of healthcare resources, and result in the inability to carry out the tasks of daily living. The purpose of this quantitative, correlational study was to investigate the potential influence of laughter on affect and pain in individuals with FMS. Laughter produces beneficial effects on acute pain and on chronic pain in general and has been found to improve temporary affective states, but there have been no studies testing the effects of laughter on the pain and affect of fibromyalgia patients. Informing this study were the gate control and neuromatrix theories of pain, as well as the dynamic model of affect theory. The research questions addressed whether laughter frequency is associated with affect and or with perceived chronic pain levels in these individuals. Forty-one adult fibromyalgia patients documented all laughter episodes daily and assessed their pain and affective states 3 times per day for 14 days. Hierarchical regressions revealed that increased overall laughter frequency was significantly associated with decreases in overall pain and increases in overall positive affect but was not associated with measures of negative affect. Also, morning laughter frequency was predictive of increased afternoon and evening positive affect ratings, as well as with decreased afternoon pain ratings, but was not significantly associated with evening pain ratings. The knowledge gained from these results may have positive social change implications at the individual level, within those individuals’ larger social networks, and within the research and medical communities.Fibromyalgia syndrome (FMS), a common chronic pain condition, is often incompletely treated by conventional medical therapies. It can cause disability, psychological distress, work-related absenteeism, increased use of healthcare resources, and result in the inability to carry out the tasks of daily living. The purpose of this quantitative, correlational study was to investigate the potential influence of laughter on affect and pain in individuals with FMS. Laughter produces beneficial effects on acute pain and on chronic pain in general and has been found to improve temporary affective states, but there have been no studies testing the effects of laughter on the pain and affect of fibromyalgia patients. Informing this study were the gate control and neuromatrix theories of pain, as well as the dynamic model of affect theory. The research questions addressed whether laughter frequency is associated with affect and or with perceived chronic pain levels in these individuals. Forty-one adult fibromyalgia patients documented all laughter episodes daily and assessed their pain and affective states 3 times per day for 14 days. Hierarchical regressions revealed that increased overall laughter frequency was significantly associated with decreases in overall pain and increases in overall positive affect but was not associated with measures of negative affect. Also, morning laughter frequency was predictive of increased afternoon and evening positive affect ratings, as well as with decreased afternoon pain ratings, but was not significantly associated with evening pain ratings. The knowledge gained from these results may have positive social change implications at the individual level, within those individuals’ larger social networks, and within the research and medical communities. Laughter Frequency, Pain Perception, and Affect in Fibromyalgia Patients by Deidre G. Molchan MA, University of Mary Hardin-Baylor, 2004 BS, Old Dominion University, 2001 Dissertation Submitted in Partial Fulfillment of the Requirements for the Degree of Doctor of Philosophy Health Psychology Walden University November 2018 Dedication I dedicate this dissertation to my dad, Mervin West. Years ago (early 1990s), he experienced a heart attack and underwent a quadruple bypass operation. While recovering, he then suffered a cardiac arrest (which he was able to survive thanks to the speedy response of paramedics). He grew quite depressed during his subsequent time in the hospital and refused further lifesaving surgery. He remained hospitalized, and his cardiologist prescribed laughter therapy to lift his spirits. Each day, the medical staff provided him with funny videos to watch. Before long, he seemed to be feeling more positive and consented to the surgery. He continued his laughter therapy at home as he was recovering. Though he was not a big believer in talk therapy, something as simple as laughing more may have made all the difference in his recovery. My dad died from other health complications in 2007, so he, unfortunately, did not live long enough to see me complete this research. I would like to think he would be pleased to see that research is finding what he (and his doctor) already knew—that sometimes laughter really is the best medicine. RIP, Dad. Acknowledgments Firstly, I give thanks and credit to my sister, Heidi (who has fibromyalgia), for serving as the inspiration for this topic. And to my husband, Andrew, who has supported me in all ways throughout this process. Many thanks, as well, to Elizabeth Mesic, and the National Fibromyalgia Association (NFA) for helping me get to the finish line. Because Elizabeth agreed to post my flyer to the NFA Facebook page, I was able to come very close to reaching my needed sample size. Much appreciation goes to my chair, Dr. Ellen Levine, who has been a source of consistent support and guidance throughout this very long process. Thank you, also, to Dr. Debra Wilson, Dr. Hannah Lerman, and Dr. M. Bryant Howren for your invaluable feedback and for helping to ensure the quality of my work. Many thanks, also, to my mom, who helped hold me accountable to deadlines. Thanks, also, to my brother, Stuart, and my friends, Carolyn, Jake, Jillian, and Deepa, for listening and for always appearing to have great interest in what I was studying! Special thanks to Jake for developing my flyer and for helping me with computer formatting. Thanks, also, to my friend, Steph, who has literally walked this walk with me. Finally, to the participants—thank you so very much for disrupting your lives for 2 weeks in order to provide this important contribution to research. So much was asked of you, and despite your pain and the other demands on your time, you saw it through to completion. You have my most sincere appreciation.