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Journal of College Teaching & Learning December 2009 Volume 6, Number 8
Stress Management Strategies For Students:
The Immediate Effects Of Yoga, Humor,
And Reading On Stress
Denise Rizzolo, Seton Hall University, USA
Genevieve Pinto Zipp, Seton Hall University, USA
Doreen Stiskal, Seton Hall University, USA
Susan Simpkins, UT Southwestern Medical Center, USA
Background: Health science programs can be demanding and difficult for many students, leading
to high levels of stress. High levels of stress can have a negative effect on students and
subsequently the practicing clinician. Research suggests that yoga, humor, and reading are
simple, effective methods to help reduce stress. To date no research compares the acute effects of
yoga, humor, and reading in doctor of physical therapy and master’s of occupational therapy
students. Additionally, it is undetermined if one technique is more effective than the other in
reducing stress. Purpose: The purpose of this study was to compare the immediate effects of yoga,
humor, and reading on acute stress in students enrolled in doctor of physical therapy and master’s
of occupational therapy programs. It was hypothesized that following a 30-minute yoga, humor,
and reading intervention session, students would demonstrate a reduction of stress on the Daily
Stress Inventory (DSI) and a decrease in blood pressure and heart rate. Subjects: Twenty-two
students from the School of Graduate Medical Education Doctor of Physical Therapy (DPT)
program (n=14) and Master’s of Science in Occupational Therapy (OT) program (n=8)
volunteered to participate in the study. Methods: At baseline subjects completed a demographic
survey. All subjects participated in a yoga, humor, and reading intervention session, once a week
on the same day and at the same time for a total of three weeks. Intervention sessions were
randomized and counterbalanced across subjects. Before and after each intervention session,
stress was measured using the Daily Stress Inventory, systolic blood pressure (SBP), diastolic
blood pressure (DSP), and heart rate (HR). Results: A repeated one-way ANOVA indicated that
all three interventions significantly decreased SBP, DBP, and HR and no one intervention was
more effective than the other in reducing these dependent variables (p = . 058, p = .315 and p=
.180 respectively). There was no significant main effect or interaction of the yoga, humor, or
reading intervention session on the DSI scores (p = .362). Conclusions: The results of this study
indicate that one 30-minute session of yoga, humor, and reading had similar effects in decreasing
acute stress in health science students. This finding is important since these interventions resulted
in a significant reduction in stress in a relatively short amount of time, allowing educators to
begin to consider different stress management strategies to offer to students.
Keywords: stress, humor, yoga, reading
tress is a growing public health concern, affecting many individuals both physically and psychologically
(Sobel, 1995). Many individuals are able to cope with small exposures to stress, and some people even
become more productive when under pressure (Folkman, 1984; Rowe, 2006). However, it is problematic
when stress becomes overwhelming and a person begins to suffer from its adverse consequences including increased
anxiety and depression, multiple somatic complaints without an organic cause, or engaging in unhealthy behaviors
including smoking, poor dietary habits, and poor sleep habits( Friedman, Sobel, Myers, Caudill, & Benson, 1995;
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
Seyle, 1956; Sobel, 1995). Stress can equally affect all college students; however, the effects of stress are of
particular interest in students enrolled in health science programs. Students in health science programs have an
intensive academic curriculum and also participate in patient care which can cause an increase in their stress levels
(Malathi, & Damodaran, 1999; Mosley, Perrin, Neral, Dubbert, Grothues, & Pinto, 1994; O’Meara, Kostas,
Markland, & Previty 1994). While all programs in health science have their own unique stressors, it has been
suggested that increased levels of stress are commonly seen in physical therapy students (Frazer & Echternach,
1995; O’Meara, et al. 1994). For example, Frank and Cassady (2005) found mean stress levels to be higher on the
Perceived Stress Scale in 163 doctor of physical therapy (DPT) students compared to a general population of
working peers. Not only are levels of stress higher in DPT students, occupational therapy (OT) students experience
high levels of stress as well. Tyrell and Smith (1996) found that compared to a group of age matched working
adults, occupational therapy students had higher levels of psychological stress on the General Health Questionairre-
28 (43% compared to 5% respectively). PT and OT students consistently report the following factors increase their
stress levels: clinical rotations, long hours of studying, lack of free time, and the amount of class work they had to.
Furthermore, research suggests that as stress increases so do the number of reported incidences of illnesses,
infections, gastrointestinal complaints, neurological, and emotional disorders along with other health problems
complete (O’Meara, et al., 1994).
The inability of students to successfully cope with stress may lead to a cascade of negative consequences
on both a personal and professional level. Stress can lead to academic decline, poor relationships with peers and
family members, and overall dissatisfaction with life (Linn & Zeppa, 1984). It is postulated that stress begins during
the educational process and continues throughout one’s professional career (Rowe, 2006). It would therefore be
beneficial to encourage the use of stress management techniques at the start of a student’s education, thereby
assisting them in developing a foundation from which healthy behaviors can be created (Wolf & Kissling, 1984).
While a variety of techniques have been investigated to help reduce stress, three particular adjunctive stress
management techniques of interest are yoga, humor, and reading because they are relatively simple and easily
accessible. Given that individuals may prefer different stress management techniques or may have different ones
available to them assessing if a difference exists in the effectiveness of yoga, humor, and reading is imperative.
Furthermore, it would be counter-productive to recommend a technique for stress reduction if the student has no
interest in that activity.
Yoga is one of the most recognized forms of exercise, stretching, and mediation. Yoga has been found to
modify stress responses and a person’s attitude towards stress, while improving self-confidence, increasing one’s
sense of well-being, and creating a feeling of relaxation and calmness (Malathi, & Damodaran, 1999; Taylor, 2003).
For example, Schell, Allolio and Schonecke (1993) found that after 25 healthy adult females participated in a one-
hour session of hatha yoga (n=12) stress scores significantly decreased on the Stress Coping Questionnaire and their
heart also decreased compared to a control group (n=13). Malathi and Damadoran (1999) determined that a one-
hour yoga program, twice a week, for three months significantly decreased medical students’ (n= 25) anxiety levels
on the Spielberger’s Anxiety Scale compared to a control group (n=25). Students who participated in the yoga
group also reported improved concentration and an optimistic outlook on life.
While yoga can decrease stress, humor can be a stress modifier as well. The use of humor to help reduce
stress has received increased attention by both health care providers and the general public because of its
psychological and physiological benefits (Martin, 2001). Humor is defined as the capacity to perceive, appreciate, or
express what is funny, amusing, or ludicrous ( Accessed September 5, 2009). To determine the
effects of humor on stress, White and Camarena (1989) recruited 93 college students and compared the effects of
three different interventions on stress: laughter (n=26), relaxation training (n=36), and a control (n=33), all
performed for a period 90 minutes. After the students participated in the interventions for 6 weeks the researchers
found that the laughter group demonstrated a decrease in anxiety on the Spielberger State-Trait Anxiety scale, a
decrease in systolic blood pressure, and a decrease in heart rate compared to a comparable control group. Similar to
these findings, White and Winzelberg (1992) found that after 74 college students participated in 20-minutes of
laughter, relaxation training, or a control session, the laughter intervention was as effective as the relaxation session
in significantly reducing psychological stress on the Spielberger State Trait Anxiety Inventory and also clinically
decreased heart rate.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
While there have been many studies examining the effects of yoga and humor on stress very few have
looked at the effects reading has on stress. In one of the few studies on this topic, Jin (1992) found that after a
group of 24 healthy adults participated in a stressful task then read for 60-minutes, they experienced a significant
reduction in anxiety, heart rate, and blood pressure. Given the limited data on the affects of reading on stress
reduction future work investigating its effects are warranted.
Since researchers have determined that some students in health science graduate programs experience high
levels of stress which may affect their academic performance it is important for educators to identify a variety of
stress management techniques that students can use to manage the stress during graduate school and in the future.
Literature on yoga and humor suggests that individually these two methods decrease stress and strengthen coping
mechanisms; however, the findings are still limited and many have been equivocal. There has been even less
research on the effects of reading on stress. To date no research has compared the acute effects of yoga, humor, and
reading on stress in students enrolled in health science programs and more specifically on students enrolled in doctor
of physical therapy and master’s in occupational therapy programs. Additionally, no research has compared the
effects of yoga, humor, and reading on stress to determine if one method is more effective compared to another.
Therefore, the purpose of this study was two-fold: (1) to determine the acute effects of yoga, humor, and reading on
physical and psychological stress in students enrolled in doctor of physical therapy and master’s of occupational
therapy programs and (2) to determine if one intervention was more effective then the other in reducing stress. The
hypothesis was that immediately following one 30-minute session of yoga, humor, and reading, students would
demonstrate a reduction in systolic blood pressure, diastolic blood pressure, heart rate, and psychological stress.
The study was a quasi-experimental within subject repeated measure design.
All students from the Seton Hall University Doctor of Physical Therapy (DPT) and Masters of Science in
Occupational Therapy (OT) were asked to participate in this study. The Seton Hall University Institutional Review
Board (IRB) approved the research proposal.
Inclusion criteria consisted of any student enrolled in the SHU DPT or OT program. Exclusion criteria
included the following: (1) pregnancy, (2) baseline systolic blood pressure less than 90 mmHg and/or diastolic blood
pressure less than 60 mmHg, (3) a yes response to any question on the Physical Activity Readiness Questionnaire
(PAR-Q), (4) students who actively practiced in restorative hatha yoga exercises, similar to the yoga exercises
performed in the video instruction, or (5) any subjects with musculoskeletal conditions that would prevent them
from practicing light stretching techniques. Based on the above criteria a homogeneous sample of convenience of
22 subjects was recruited.
The dependent variables were psychological stress scores as measured by the Daily Stress Inventory and
SBP, DBP, and HR which were measured simultaneously using a Critikon Dinamap XL 9340 Vital Signs Monitor.
The independent variables were the 3 interventions: (1) yoga intervention, (2) humor intervention, and (3) reading
Demographic Data
The demographic survey collected general information from the students and obtained additional
sociodemographic data which could account for any confounding effects that were observed on the dependent
variables. Questions regarding prescription medication, over the counter medication, herbal supplements, along
with whether the student uses a rescue medication during and/or after exercise were included in the survey.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
Hypertensive agents, psychotropic agents and inhaled short-acting bronchodialators may or may not affect
psychological stress levels, blood pressure, and heart rate so it was important to determine if the students were using
any of these medications (American College of Sports Medicine, 2006).
Stress Survey
The Daily Stress Inventory (DSI) is a 58 item self-report measure that allows a person to indicate how often
a specific stressful event has affected him or her over the past 24 hours (Brantley, Waggoner, Jones, & Rappaport,
1987). After identifying which events occurred, the individual rates the stressfulness of those events on a Likert
scale from 1 (“occurred but was not stressful”) to 7 (“caused me to panic”). For the present study only the SUM
score was analyzed with the lowest and highest score possible being 0 to 406 respectively. The authors chose only to
analyze the SUM score since it demonstrates the total impact the stressors had on the individual in the past 24 hours
and subsequently the SUM score can be compared between subjects. The SUM measurement of the DSI is
significantly correlated to the Daily Hassles and Uplift Scale (0.57 for hassle frequency and 0.56 for hassles
intensity) demonstrating concurrent validity. The SUM measurement is correlated to the State-Trait Inventory
(0.42) supporting the construct validity of the SUM measurement. The reliability across items for the SUM is 0.87.
Higher scores on the scale indicate a greater psychological stress (Brantley, et al., 1987).
Coping Surveys
The coping surveys were distributed during the screening session and the results were used as part of
another study. The Coping Humor Scale (CHS) is seven item self-reported scale that assesses the degree to which
subjects report using humor to cope with stress (Martin, 1996). The Coping Style Scale (CSS) is a 20- item self-
reported scale which is part of the Stress Profile published by Western Psychological Services (WPS) (Nowack,
1990; Nowack, 1999). The CSS lists common ways of coping with daily stressors, irritants, annoyances, and
Physiologic Measurements
Systolic blood pressure (SBP), diastolic blood pressure (DBP), and heart rate (HR), were taken before and after
the interventions simultaneously using an automatic Critikon Dinamap XL 9340 Vital Signs Monitor. SBP, DBP, and
HR were measured with the patient in a seated position both feet flat on the floor. Since laughter can initially stimulate
the sympathetic nervous system causing an immediate elevation in heart rate and blood pressure, a ten minute delay after
each intervention occurred before re-recording SBP, DBP, and HR (Forghieri-Santaella, et al; Fry, 1994).
All subjects participated once in each of the following three interventions over the course of three weeks
with each intervention session lasting 30-minutes.
Three sections from the Yoga for Meditation DVD, with Rodney Yee, developed by GAIAM, were used. The
entire 30-minutes of the DVD is narrated by Rodney Yee and includes soft music in the background. Only clips that
practiced restorative yoga, which included light stretching, deep breathing, and meditation were taken. The sections
of the DVD that included active aerobic types of yoga techniques were excluded.
The subjects selected one of the following videos to watch: The Best of Saturday Night Live with Will
Farrell, Chris Farley, or Jimmy Fallon.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
During the reading intervention session the subjects read articles about historical events and innovative
technology. Articles were taken from Newsweek and various internet sites. The material was non-provocative and it
did not relate to any health maintenance topics.
During a screening visit students completed the PAR-Q followed by blood pressure measurements to
determine inclusion status. If the student met the inclusion and exclusion criteria, they then completed the baseline
scales including the demographic survey, the Coping Style Scale, and Coping Humor Scale. Following the scales the
students were assigned to a different intervention session sequence to control for order effects.
During the three intervention sessions stress was initially assessed using the Daily Stress Inventory, SBP,
DSP, and HR. Immediately following the intervention the DSI was completed and 10 minutes later SBP, DSP, and
HR were recorded. Each subject was exposed to each of the independent variables and performance was compared
across treatment conditions within each subject to help control for intersubject differences. Over a three week
period each student participated each of three interventions. All data and intervention sessions were recorded and
performed on the same day of the week and at the same time of day in order to control for possible weekly and daily
fluctuations in SBP, DSP, HR and stress levels. Data collection occurred during the first four weeks of the semester
in attempt to avoid the confounding effects of midterms
Data Analysis
Frequency counts and descriptive statistics were used to analyze the demographic data. After mean
psychological stress scores were calculated from the DSI they were found to have a high standard deviation
suggestion there scores were extremely variable. Therefore the scores from the DSI were entered into a logarithmic
regression model in order to normalize the data prior to the ANOVA analysis. To determine the effect of yoga,
humor, and reading on stress a One-Way Within Subjects Repeated Measures ANOVA was computed using a p
value of less then 0.05 to determine significance (Munro, 2005; Portney & Watkins, 1993). The Statistical Package
for the Social Sciences (SPSS) software, version 15.0 for Windows (2007), was utilized for all computations.
Demographic Profile
Twenty-four full-time students with a mean age of 23 years (range 20 to 37 years) volunteered for the
study. After the initial screening visit, one student withdrew at the beginning of the first session for an unspecified
reason. One student did not complete the yoga intervention nor yoga post-tests due to cervical pain unrelated to the
present study. Eight students (36%) used prescription medications including birth control, cetirizine HCl (Zyrtec),
and one student took sertraline hydrochloride (Zoloft). Two students (9%) used over the counter medication, none
of the students used medication before or after exercise, and 2 (9%) students stated they used some form of herbal
supplements. Seventeen (77%) students exercised at least three days a week, for an average of 50 minutes per
session. Types of exercise included predominately running, walking, elliptical machine, and strength training. Only
3 students (14%) participated in an aerobic form of yoga once per week. The 12 students (54%) who reported
drinking alcohol on average consumed only one drink per week. The results indicated that the sample consisted of
healthy college students that exercise regularly, do not abuse alcohol nor smoke tobacco, and do not use medications
to control blood pressure. A summary of the remaining demographic and personal habits is presented in Table 1.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
Table 1: Demographic Data
Physical Therapy
Occupational Therapy
Marital Status
Alcohol intake
Read to Reduce Stress
Psychological and Physiological Measures
Calculated means and standard deviations for the DSI scores SBP, DBP, and HR appear in Table 2. The
mean blood pressure and heart rate levels indicate that these variables were normal to low at baseline, suggesting
that this sample consisted of healthy young students (Chobanian, et al. 2003).
Table 2: Summary of Pre and Post Mean DSI Scores, Blood Pressure and Heart Rate by Intervention
Mean (SD)
Mean (SD)
Mean (SD)
Pre DSI Score
58.64 (60.63)
65.41 (74.00)
61.00 (71.21)
Post DSI Score
39.36 (52.33)
74.00 (58.18)
49.27 (63.72)
Pre Systolic BP
117.00 (10.88)
113.95 (10.03)
110.68 (11.21)
Post Systolic BP
108.14 (11.42)
110.45 (12.08)
105.82 (12.88)
Pre Diastolic BP
68.09 (8.06)
70.05 (7.72)
65.18 (7.76)
Post Diastolic BP
64.77 (8.74)
65.09 (8.83)
62.05 (6.58)
Pre HR
73.73 (11.33)
77.41 (9.64)
70.09 (12.25)
Post HR
70.09 (10.64)
73.41 (8.75)
68.73 (9.94)
Note. BP=Blood pressure in mm/Hg
HR=Heart rate in beats/min
A repeated measures analysis of variances (ANOVA) indicated there was no significant main effect of
intervention on the DSI scores. A significant main effect of time on DSI scores was found (F (1) = 18.56, p = .000).
However, there was no significant interaction between intervention x time, indicating that no one intervention
reduced DSI scores more than another.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
There was a significant main effect of the intervention (F (2) = 5.27, p = .009) and time (F (1) = 32.12, p <
.05) on SBP. The interaction between intervention x time approached but did not reach significance (F (1.511) =
3.403, p = .056), indicating that no one intervention reduced SBP more than another.
There was a significant main effect of the intervention (F (2) = 3.48, p = .04) and time (F (1) = 41.90, p =
.000) on DBP. Yet, there was no significant interaction between intervention x time, indicating that no one
intervention reduced DBP more than another.
A significant main effect of the intervention (F (2) = 5.56, p = .008) and time (F (1) = 12.33, p = .002) on
HR was also found. Yet, there was no significant interaction between intervention x time, indicating that no one
intervention reduced HR more than another.
The results suggest that one 30-minute session of yoga, humor, and reading acutely reduced physiological
and psychological stress in students enrolled in graduate DPT and OT programs. Specifically, participation in a
single session of yoga significantly reduced students’ SBP, DSP, and HR. The observed change in the DSI scores
and the significant decrease in the physiologic variables noted after the yoga session could be attributed to the
decrease in sympathetic arousal that occurs when subjects participate in this type of activity (Schell & Allolio &
Schonecke, 1993). In the present study the light stretching and quiet mediation during the yoga intervention session
could have caused a decrease in physiologic parameters, which in turn may have contributed to a decrease in the
psychological perception of stress.
Similar to the decrease in stress seen after the yoga intervention session, the humor intervention
session clinically decreased psychological and physiologic stress. The results are consistent with some of the
findings White and Winzelberg (1992) who found that after a group of college students watched a humorous video
for 20 minutes a significant decrease on the State-Trait Anxiety Inventory (STAI) occurred along with an observed
but not significant reduction in blood pressure. The authors (1992) believed blood pressure did not significantly
decrease because during the laughter session, the subjects laughed for less then four minutes, which may have been
an insufficient amount of time to cause a decrease in sympathetic arousal. In comparison, in the present study, the
primary researcher observed that almost all the students laughed throughout the entire length of the 30-minute video
which could explain the significant decrease in SBP, DBP, and HR observed.
After the reading intervention session the students also had a decrease in the stress variables. These results
were not unexpected since over half the students admitted using reading to help reduce stress. However, even
though 12 of the 22 students read to reduce stress, this did not significantly influence the effect of any intervention
on the dependent variables (p = 0.66). The students may have found the neutral reading material to be relaxing,
thereby decreasing the sympathetic nervous system arousal and resulting in a reduction of stress. Since there are
limited studies on the effects of reading on stress, more research is needed to clearly determine why reading reduces
stress levels.
Findings from the present study on graduate health science students demonstrate that individually one 30-
minute yoga, humor, and reading session are equally effective in acutely reducing stress. Thus, supporting the notion
that there are multiple methods one can utilize to help reduce the negative effects of a stressful situation. Since time
constraints are one of the most frequently cited reasons for high stress levels reported by health science students, 30-
minutes of one of these techniques can be easily incorporated into their schedule without diverting a large amount of
time from their studies. Finally, the combination of a significant reduction in acute stress in a short amount of time is
of importance because yoga, humor, and reading can be suggested to students for immediate stress reduction before
examinations, practicals, presentations and even during a highly stressful day.
Limitations and Future Research
The author recognizes there are limitations to the present study. First, a sample of convenience was
recruited that included DPT and OT students from one university, thus limiting the generalizability of the results.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
The sample size was smaller than initially projected do to the limited recruitment period which was designed to
attempt to avoid the confounding effects of midterms. Although the study was done during the first four weeks of
class to account for increased stress levels as the semester progresses, it was impossible to control for outside
influences that may have increased or decreased the students’ stress levels. Additionally, an unequal number of
students from these two programs volunteered for the study, however, their stress levels were found to be similar at
baseline. In the future, physiological measurements should be taken throughout the intervention and after the
completion of the intervention to determine short and long-term effects of yoga, humor, and reading on stress.
Programs in health science place students in demanding, fast-paced, and stressful academic environments.
It is well known that students in health science programs perceive their academic environment to be stressful (Frazer
& Echternach, 1995; O’Meara et al., 1994). While professors teach students pathology, diagnosis, and treatment
they do not generally teach them how to cope with the stress frequently encountered in many health science
professions. The stress they face during their education may continue throughout their careers, ultimately leading to
burnout (Balogun et al., 2002). Given the high prevalence of burnout among physical therapists and occupational
therapists as a whole, it is important for programs to begin to focus their attention on the students stress so they can
learn how to cope and manage stress before they enter their professional fields (Rowe, 2006). In addition to
preparing students for their work as clinicians, educators should help student identify stressors. Early self
identification of stress is important in order to develop coping methods essential for managing the high stress
position of a professional practitioner. Hopefully by dealing with stress effectively as a student and then as a
practicing clinician, some of the adverse physiological and psychological effects of stress will be mitigated.
Dr. Rizzolo is an Assistant Professor at the Seton Hall Physician Assistant program. She received her PhD from the
Graduate Programs in Health Sciences at Seton Hall University in 2008. She currently works as a Physician
Assistant at the Care Station in Springfield, New Jersey. Her research interests focus on stress management and
adjunctive techniques to management specifically, yoga and humor.
Dr. Pinto Zipp is Associate Professor and Chair of the Department of Graduate Programs in Health Sciences at
Seton Hall University. She received her EdD from Teachers College Columbia University in 1996. She currently
teaches management of neuromuscular problems in the Doctor of Physical Therapy program. Her research interests
focus on, a) effects of performing dual tasks on walking performance and postural sway in children and adults, and
b) curriculum design issues including the use of mind mapping and video based cases in professional education for
the promotion of clinical decision making skills.
Dr. Simpkins is Associate Professor in the Department of Physical Therapy,UT Southwestern Medical Center. She
received her EdD from Teachers College Columbia University in 2000. She currently teaches management of
pediatrics neuromuscular problems in the Physical Therapy program. Her research interests focus on, a) effects of
obstacles on walking performance in children, and b) curriculum design issues.
Dr. Stiskal-Galisewski is an Associate Professor and Chair of the Seton Hall University Physical Therapy Program.
She received her PhD from the Graduate Programs in Health Sciences at Seton Hall University in 2003. Her
research interests are in osteoarthritis, rheumatoid arthritis, and the effects on Tai Chi on these conditions.
1. American College of Sports Medicine. (2006). Resource Manual for Guidelines for Exercise Testing and
Prescription (5th ed). Baltimore, MD: Lippincott Williams & Wilkins.
2. Brantley, P. J., Waggoner, C. D., Jones, G. N., & Rappaport, N. B. (1987). A daily stress inventory:
development, reliability, and validity. Journal of Behavioral Medicine, 10(1), 61-74.
3. Balogun, J.A., Titiloye, V., Balogun, A., Oyeyemi, A., & Katz, J. (2002). Prevalence and determinants of
burnout among physical and occupational therapists. Journal of Allied Health, 31(3), 131-139.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
4. Chobanian, A. V., Bakris, G. L., Black, H. R., Cushman, W. C., Green, L. A., Izzo, J. L. et al., (2003)
Seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high
blood pressure. Hypertension, 42, 1206-1252.
5. Folkman, S. (1984). Personal control and stress and coping processes: a theoretical analysis. Journal of
Personality and Social Psychology, 46, 839-852.
6. Forghieri-Santaella, D., Aparecida-Araujo, E., Coelho-Ortega, K., Tinucci, T., Mion, D., Negrao, C.E., &
Lucia de Moraes-Forjaz, C. (2006). After effects of exercise and relaxation on blood pressure. Clinical
Journal of Sports Medicine, 19(4), 341-347.
7. Frank, L.M. & Cassady, S.L. (2005). Health and wellness in entry-level physical therapy students: are
measures of stress , anxiety, and academic perfromance related? Cardiopulmonary Physical Therapy
Journal, 16, 5-16.
8. Frazer, G. H, & Echternach, J. L. (1991). Response of physical therapy students to stress indicators.
Journal of Physical Therapy Education, 5, 72-77.
9. Friedman, R., Sobel, D., Myers, P., Caudill, M., & Benson, H. (1995). Behavioral medicine, clinical health
psychology, and cost offset. Health Psychology, 14(6), 509-518.
10. Fry, W. F. (1994). The biology of humor. Humor, 7(2), 111-126. (2009). Definitions of
humor. Retrieved September 7, 2009 from
11. Jin, P. Efficacy of tai chi, brisk walking, meditation, and reading in reducing mental and emotional stress.
Journal of Psychosomatic Research, 36(4), 361-370.
12. Linn, B. S., & Zeppa, R. (1984). Stress in junior medical students: Relationship to personality and
performance. Journal of Medical Education, 59(1), 7-12.
13. Malathi, A., & Damodaran, A. (1999). Stress due to exams in medical students-role of yoga. Indian Journal
of Physiology and Pharmacology, 43(2), 218-24.
14. Martin, R. A. (1996). The situational humor response questionnaire and coping humor scale: a decade of
research findings. Humor, 9, 251-272.
15. Martin, R. A. (2001). Humor, laughter and physical health: methodological issues and research findings.
Psychological Bulletin, 127(4), 504-519.
16. Mosley, T. H., Perrin, S. G., Neral, S. M., Dubbert, P. M., Grothues, C. A., & Pinto, B. M. (1994). Stress,
coping, and well-being among third year medical students. Academic Medicine, 69(9), 765-767.
17. Munro, B. H. (2005). Statistical Methods for health care research. 5th ed. Philadelphia, PA, Lippincott
Williams & Williams.
18. Newman, M. G., & Stone, A. A. (1996). Does humor moderate the effects of experimentally-induced
stress? The Society of Behavioral Medicine. 18(2), 101-109.
19. Nowack, K. M. (1990). Initial development of an inventory to assess stress and health risk. American
Journal of Health Promotion, 4, 173-180.
20. Nowack, K. M. (1999) Stress Profile Manual. Western Psychological Services, Los Angeles, CA.
21. O’Meara, S., Kostas, T., Markland, F., and Previty, J. C. (1994). Perceived academic stress in physical
therapy students. Journal of Physical Therapy Education, 8, 71-74.
22. Portney, L.G., & Watkins, M.P. (1993). Foundations of clinical research. 1st ed. Stanford, CT: Appleton &
23. Rowe, M. M. (2006). Four-year longitudinal study of behavioral changes in coping with stress. American
Journal of Health Behavior, 30(6), 602-612.
24. Schell, E. J., Allolio, B., & Schonecke, W. (1993) Physiological and psychological effects of hatha-yoga
exercise in healthy women.International Journal of Psychosomatics, 41, 46-52.
25. Selye, H. (1956). Stress of Life. New York, NY: McGraw-Hill Bock Company.
26. Sobel, D. S. (1995). Rethinking medicine: improving health outcomes with cost-effective psychosocial
interventions. Psychosomatic Medicine, 57, 234-244.
27. Statistical Package for the Social Sciences, 15.0 for Windows (2007). Chicago Illinois: SPSS, Inc.
28. Taylor, M. J. (2003). Yoga Therapeutics: an ancient, dynamic systems theory. Techniques in Orthopedics,
18(1), 115-125.
29. Tyrrell, J. & Smith, H. (1996). Levels of psychological distress among occupational therapy students.
British Journal of Occupational Therapy, 59(8), 365-371.
30. White, S. & Camarena P. (1989). Laughter as a stress reducer in small groups. Humor, 2(1), 73-79.
31. White, S. & Winzelberg, A. (1992). Laughter and stress. Humor,5(4), 343-355.
Journal of College Teaching & Learning December 2009 Volume 6, Number 8
32. Wolf, T. M., & Kissling, G. E. (1984). Changes in life style characteristics, health, and mood of freshman
medical students. The Journal of Medical Education, 58, 806-814.
... Similarly, humor generation (i.e., producing a humorous narrative to a stressful film) has been found to moderate the effects of, both psychological and physiological stress more reliably than generating an informative narrative 5 . However, Rizzolo and colleagues 8 observed merely a reduction in the physiological markers of stress (i.e., heart rate and blood pressure) after a 30-min humorous intervention but report no effects on daily stressors scores, i.e., on psychological markers. Taken together, the evidence seems to point towards a beneficial effect of humor on stress, either directly or as a moderator. ...
... Taken together, the evidence seems to point towards a beneficial effect of humor on stress, either directly or as a moderator. However, in most studies the humorous intervention occurs simultaneously to stress-inducing measures 5 or in succession 6 but 4 , is rather time-consuming 8 and stress is primarily assessed on the psychological level 3,4 but 5 . Therefore, it still remains an open question, whether a short humorous intervention suffices to counteract the adverse effects of both psychological and physiological stress even before the stressful event occurs. ...
... Third, most studies investigating humor and stress assess stress solely psychologically, i.e., subjects were asked for anxiety ratings or ratings on daily stressors or hassles 3,6 . Only some of these studies additionally obtained data on physiological stress, with an emphasis on markers affecting the nervous system, such as heart rate, skin conductance response or blood pressure (or a combination of those) 5,8 . They consistently reported a decrease in these variables in the humor condition, however, only Newman & Stone 5 induced a specific physiological stress response whereas Rizollo and colleagues 8 looked at general physiological stress levels. ...
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Presentation of humor simultaneously with a stressful event has been shown to dampen the psychological and physiological responses of stress. However, whether a relatively short humorous intervention can be utilized to prevent the subsequent stress processing is still underinvestigated. Furthermore, it is unknown, whether such a humor intervention changes stress processing at a cost of cognitive functioning. According to the broaden-and-build theory inducing positive emotions may subsequently impact cognitive performance. Here, we investigated whether humor protects against subsequent stressors by attenuating both, psychological and physiological stress levels and whether this affects cognitive performance. Participants watched either a humorous or a neutral movie, underwent stress induction and performed in a visual search task. Compared to the control group, psychological stress levels and salivary cortisol levels were lower in the humor group, yet no differences were found in response times and accuracy rates for the visual search task. Our results demonstrate that a short humorous intervention shields against subsequent psychological stress leaving cognitive performance intact, thus making it highly applicable to improve mental and physical health in everyday life situations.
... Even mild stress or pressure can have a significant negative effect on one's well-being. Among young adults, stress is usually the reason for the decline in academic attainment, low self-efficacy, and poor social relationships (Rizzolo et al., 2009). Furthermore, Rizzolo et al. (2009) claimed that the inability to cope with stress can lead to a variety of potential consequences at both personal and professional levels among working adults. ...
... Among young adults, stress is usually the reason for the decline in academic attainment, low self-efficacy, and poor social relationships (Rizzolo et al., 2009). Furthermore, Rizzolo et al. (2009) claimed that the inability to cope with stress can lead to a variety of potential consequences at both personal and professional levels among working adults. ...
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There are various benefits of having books at home as it supports cogni tive growth to later succeed academically by enhancing literacy, numeracy and technological skills. However, there are not many studies examining the relationship between the number of books available at home and how it is affecting an individual’s psychological well-being. The aim of this study is to examine this relationship among Malaysians. A total of 1306 survey was distributed to residents living in the western part of Malaysia in an attempt to measure the psychological well-being and the number of books at the respondents’ home. After analyzing the responses, it was found that respondents with very few to no books were related to experiencing anger more frequently than the other two groups with 11-100 and 100 and more books. We also found similar linkages for depression, stress, and worry. Interestingly, we found that the positive psychological well-being items revealed that the group with more than 51 books or more were related to experiencing more enjoyment rather than those with a lesser number of books. The finding of the present study reinforces the importance of books in one’s life, particularly the psychological state and experiences. Keywords: anger, books, depression, happiness, psychological well- being, stress, worry
... Previous research provides preliminary evidence for the effectiveness of such therapies, including yoga, in the reduction of symptoms related to stress and fear arousal (Staples, Hamilton, & Uddo, 2013). For instance, Rizzolo et al. (2009) demonstrated that a short-term yoga intervention (30 minutes of yoga, one day per week for three weeks) acutely reduced both physiological (systolic/diastolic blood pressure (SBP/DSP) and heart VOLUME --| ISSUE -| 2021 | 3 rate (HR)) and psychological stress in college students. In other words, a single yoga intervention significantly reduced SBP, DBP, and HR (Rizzolo, Zipp, Stiskal, & Simpkins, 2009). ...
... For instance, Rizzolo et al. (2009) demonstrated that a short-term yoga intervention (30 minutes of yoga, one day per week for three weeks) acutely reduced both physiological (systolic/diastolic blood pressure (SBP/DSP) and heart VOLUME --| ISSUE -| 2021 | 3 rate (HR)) and psychological stress in college students. In other words, a single yoga intervention significantly reduced SBP, DBP, and HR (Rizzolo, Zipp, Stiskal, & Simpkins, 2009). Further, Vinay et al. demonstrated that a 4-week intervention consisting of a 1-hour yoga session six days per week resulted in increased HRV with greater parasympathetic activity ( AV Vinay, Venkatesh, & Ambarish, 2016). ...
... There has been one experimental study with a small sample of university students, which found 30-minutes of reading lead to decreases in perceived stress, blood pressure and heart rate. 13 This provides further evidence that reading may be a tool that could be used to immediately improve mental health. The current research aimed to extend these findings by exploring whether recreational reading is protective for mental health over longer periods of time in university students. ...
... As university counseling centers become increasingly burdened by the growing rates of mental health programs, offering recreational reading materials to students who seek these services may help them to relax or destress. 1,13 Recreational reading is not a replacement for mental health services, but it may be a cost-effective tool to help buffer against the intense distress that many students face. ...
Objective: Reading is often cited as beneficial for one’s mental health, but the research on this topic is limited. The goal of the present research was to examine whether recreational reading is beneficial for mental health during college, and to determine what motivates recreational reading. Participants: Participants were 231 university students from a large Canadian University.Methods: A longitudinal design was employed and students completed online surveys on recreational reading, motivation, psychological distress and need frustration at the beginning and end of the academic year. Results: Recreational reading was associated with reduced psychological distress over the school year. Recreational reading seemed to buffer against the frustration of one’s basic psychological needs which led to improved mental health over the school year. Students who were more autonomously motivated reported reading more books recreationally. Conclusion: Recreational reading is a simple and cost-effective tool to help college students cope with mental health problems.
... These proposed mechanisms are concordant with our findings where participants described their perceptions of the program impact as increasing self and body awareness, finding a personal oasis, and a sense of calm and relaxation. Some researchers have suggested that yoga practice enhances coping mechanisms that allow practitioners to deal with stress more effectively, thereby reducing stress [109,110]. This hypothesis is consistent with our finding of a significant increase in coping self-efficacy of yoga group participants in comparison to the control group after six weeks. ...
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Background: The outbreak of COVID-19 and its associated measures has resulted in a sizeable working population transitioning to working from home (WFH), bringing additional challenges, and increasing work-related stress. Research has indicated that yoga has promising potential in reducing stress in the workplace. However, there are very few studies exploring the impact of online streamed yoga on stress management for people-WFH. Objective: To investigate the feasibility and outcome of an online streamed yoga intervention on stress and wellbeing of people-WFH during COVID-19. Methods: A six-week pilot randomized controlled trial (RCT) yoga intervention was designed with yoga (n = 26) and a wait-list control group (n = 26). A mixed two-way ANOVA was used to assess changes in standardised outcome measures at baseline and post-intervention. Likert and open-ended questions assessed enjoyment, acceptability and perceived benefits of the program, which were analysed thematically. Results: Compared with the control, the yoga group reported significant improvements in perceived stress, mental wellbeing, depression and coping self-efficacy, but not stress and anxiety. Participants experienced physical and mental health benefits and reported high acceptability and enjoyment of the intervention. Conclusions: An online yoga intervention can help people WFH manage stress and enhance wellbeing and coping abilities.
... Lieberman et al. (2018) suggested that graduate students (GS) might experience greater levels of stress than undergraduate students (UGS) because of factors such as increased financial concerns and reduced "academic support and guidance" (p. 1). Additionally, GS in clinically oriented programs, such as CSD, not only have to deal with the stresses of challenging coursework, they also have to deal with the stresses placed on them by their clinical experiences (Lieberman et al., 2018;Rizzolo, Zipp, Stiskal, & Simpkins, 2009;Sleight, 1985). ...
An electronic survey was sent to the Midwest Clinic Directors’ Listserv requesting they distribute it to students in their CSD programs. The survey collected information about demographics, and students’ top three stressors and stress management practices. Students were also asked to complete the 10-item Perceived Stress Scale (PSS; Cohen, 1994) and the Almost Perfect Scale-Revised (APS-R; Slaney, Rice, Mobley, Trippi, & Ashby, 2001). A total of 278 CSD undergraduate and graduate students from 15 Midwest institutions responded to the survey. No differences were found between undergraduate and graduate responses to the PSS and the APS-R. Twenty-six percent of the respondents were classified as nonperfectionists, 33% as adaptive perfectionists, and 41% as maladaptive perfectionists. A relationship was found between perceived stress and perfectionism such that respondents with higher levels of perceived stress tended to be classified as maladaptive perfectionists and those with lower levels of perceived stress tended to be classified as adaptive perfectionists. Similarities and differences were found between undergraduates and graduate students in terms of stressors; close to 45% engaged in a stress management practice. Importance of such practices is discussed.
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Purpose: Sentiment Analysis (SA) or Opinion Mining (OM) is the field of study for a broader topic of Natural Language Processing. SA seeks to understand people's opinions, feelings, assessments, attitudes and emotions through text to generate knowledge and relevant information on a particular subject, in the business world with a greater focus on understanding the evaluation of products. We can often resume to an interpretation of attitude behind the text whether it is positive, negative or neutral. The growing importance of SA coincides with the growth of social networks, opinions, criticism, forum discussions, blogs, among others. With this exponential evolution of data has arisen the need to apply SA in almost all social and commercial domains, because opinions are key in almost all activities and are one of the influencing factors in human and social behaviors, beliefs and perceptions of our own choices. As the opinion is one of the main influencing factors in the people's choice has made the spectrum of analysis broader for organizations making this a very relevant topic these days. This paper revealed that although there some advances for algorithms, techniques and frameworks to help SA implementations there is still a gap towards identifying benefits for business applications. The need for a systematic review arises from the requirement to summarize all relevant information about application and creation of value for SA implementations in organizations. Design/methodology/approach: Include the main method(s) used for the research. In order to draw a general conclusion about this phenomenon we will evaluate individual studies that could help us understand the main features of this field. Findings: In summary, we learned that although there some advances for algorithms, techniques and frameworks to help SA implementations there is still a gap towards identifying benefits for business applications. We believe that the results of our systematic review will help to advance future studies to search for these gaps. Originality/value: Summarize all relevant information about application and creation of value for SA implementations in organizations. KEYWORDS: Sentiment Analysis, Opinion Mining, Text Mining, case study, application
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Purpose: This research aims to study the determinants of Portuguese companies’ capital structure. These results can be useful: 1) as guidelines for capital structure optimization and 2) as a support for efficient decisions in what concerns to capital structure. The literature shows that classical determinants of capital structure present statistical significance and pursue the expected sign for different econometric models tested. Method: The study follows a quantitative design research, with data collected in Amadeus from 500 SME`S in Portugal. The data spans from 2009 to 2018 totaling 4500 observations. We consider three dependent variables, i.e., total, medium and long term and short-term debt. In addition, we also employ seven independent variables (dimension; growth; liquidity; profitability; tangibility; profitability and business risk and singularity). We used a panel data approach based on fixed effects (FE) and of random effects models (RE). Findings: We found that there is no significant divergence of the experimental results obtained in the OLS model, with the fixed effects model and the random effects model, and the expected signals for some independent variables are generally the hypotheses formulated. If we compared both econometric models, it is verified that regardless of the model used, or of the dependent variable analyzed, some of the independent variables are statistically significant in all analyzed models. Furthermore, we also found evidence that the same expected signals are in agreement with the standard financial theory. These empirical findings may suggest good indicators for making more efficient decisions about the determinants of the capital structure. Research limitations/implications: The main contribution of this work is mainly in which econometric models had best results (according to existing theories) to analyse capital structures of companies. We found that the econometric model chosen for the analysis of the variables must be analysed insofar as some of the independent variables are sensitive to the expected signal and statistical significance, depending on the selected model. Practical implications: These findings will be very useful to top managers in the process of deciding the optimal structure of capital without neglecting the long run financial sustainability of the companies. Originality/value: This study is different because go beyond the classical capital structure determinants and also shows a comparison between different econometric models. KEYWORDS: Debt, capital Structure, econometric models, expected sign, statistical significance
Engaging in creative activities is known to increase well-being by reducing levels of stress, anxiety, and improve life satisfaction. Similarly, virtual reality has emerged as an effective method for decreasing negative emotions and enhancing aspects of mental health. aspects of mental disorders. The primary aim of the current study was to compare 2-dimensional and 3-dimensional art-making on measures of stress, anxiety, and mood in a non-clinical college student sample. Forty-four participants were randomly assigned to a classic art-making intervention in 2-dimensions, a novel art-making intervention in 3-dimensional virtual reality, or a non-artistic control intervention in virtual reality in order to examine the beneficial outcomes of each method. Both physiological (heart rate, skin conductance, & alpha amylase) and self-report measures (stress, anxiety, & mood) were recorded before and after the interventions. Results show that all groups demonstrated a similar ability to reduce anxiety and enhance mood. More specifically, the virtual reality art making group displayed the greatest decrease in heart rate. Also, significant correlations emerged between salivary alpha amylase and the self-report measures (anxiety and negative affect). We discuss a common quality of these groups which may provide insight for future studies regarding art making interventions and health outcomes.
The sample included 1090 fourth graders from which we gathered data in four waves between the fall of 2010 and spring of 2012. The results of latent growth modeling (LGM) showed that the initial level of self-regulated learning had a significantly positive effect on the levels of later reading habits and well-being. Additionally, a faster rate of increase in self-regulated learning was associated with faster increases in levels of reading habits and well-being over time. These findings suggest that supporting children’s development of self-regulated learning can be effective in helping children maintain regular reading habits and increase their level of well-being.
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The Situational Humor Response Questionnaire (SHRQ) and the Coping Humor Scale (CHS) are self-report measures of different aspects of the sense of humor that were developed in the context of an investigation of the stress-moderating effects of humor. The SHRQ assesses the degree to which subjects laugh and smile in a wide variety of situations, and the CHS measures the degree to which respondents make use of humor in coping with stress in their lives. Both scales have been translated into more than 10 languages, and a fairly large body of research findings has accumulated, providing evidence for the reliability and construct validity of these measures. This article reviews research on these scales with regard to (1) the stress-moderator hypothesis, (2) correlations with coping-related variables, and (3) the factor space occupied by the measures. The paper addresses the range of usefulness of both measures, as well as their limitations as measures of sense of humor.
All published research examining effects of humor and laughter on physical health is reviewed. Potential causal mechanisms and methodological issues are discussed. Laboratory experiments have shown some effects of exposure to comedy on several components of immunity, although the findings are inconsistent and most of the studies have methodological problems. There is also some evidence of analgesic effects of exposure to comedy, although similar findings are obtained with negative emotions. Few significant correlations have been found between trait measures of humor and immunity, pain tolerance, or self-reported illness symptoms. There is also little evidence of stress-moderating effects of humor on physical health variables and no evidence of increased longevity with greater humor. More rigorous and theoretically informed research is needed before firm conclusions can be drawn about possible health benefits of humor and laughter.
This study measured levels of psychological distress among a sample of Irish occupational therapy students. Students from all four undergraduate classes (n=102) were surveyed, using the General Health Questionnaire (GHQ-28). Over 40% of the students scored as having a ‘just significant clinical disturbance’ on the GHQ-28. Mean GHQ scores (or symptom levels) varied throughout the 4-year course and were highest just before examinations and during fieldwork placements. Students who had unhealthy diets or who smoked had significantly higher levels of psychiatric symptomatology. The prevalence of psychological distress among occupational therapy students was similar to that found in students from four other disciplines; however, the university students had much higher levels of symptomatology than the non-university peer group. The article concludes with some suggestions for dealing with stressful aspects of professional education and some recommendations for further research.
An overview is presented of important issues having to do with relationships between humor and biology, including those having to do with the genetic origin of the sense of humor, physiology of mirthful response to humor, impacts on health of humor physiology. Discussion is provided on theoretical implications derived from the complex relationship between humor and biology.
To investigate the effectiveness of laughter as a stress reducer, 93 students were randomly assigned to one of three groups: laughter, control, and relaxation training. Each group met for 1.5 hours each week for six weeks. Measures of heart rate, blood pressure, mood, and anxiety were taken as indices of changes in stress level. While the laughter group did not experience significantly reduced stress, it did show consistent decreases in stress levels for the two psychological measurements as compared to the control group.