Content uploaded by Rod A. Martin
Author content
All content in this area was uploaded by Rod A. Martin on Jan 05, 2015
Content may be subject to copyright.
The prevalence of sense of humor
in a large, unselected county population
in Norway: Relations with age, sex,
and some health indicators
SVEN SVEBAK, ROD A. MARTIN, and JOSTEIN HOLMEN
Abstract
A 3-item humor measure derived from the Sense of Humor Questionnaire
(SHQ: Svebak 1996) was included in a health survey of all adult residents
of a Norwegian county (study n ¼ 65,333). Health-related measures in-
cluded subjective health satisfaction, prevalence of common bodily complaints
(e.g., nausea, diarrhea, pounding heart, dyspnea, musculuskeletal pain),
blood pressure, and body mass index. SHQ mean scores were slightly
skewed toward high values. Overall, humor scores (metamessage sensitiv-
ity, liking of humor, laughter expressiveness) declined with age (r ¼.29)
and were slightly higher in males than females among younger age cohorts.
Sense of humor was positively correlated with overall health satisfaction
(r ¼ .21) and negatively related to systolic blood pressure (r ¼.14).
However, after controlling for age, only the partial correlation with subjec-
tive health satisfaction remained greater than .10 (partial r ¼ .12). Due to
the large number of participants, coe‰cients were statistically significant
despite very low explained variance. Overall, these data, comprising the
largest study of humor and health ever undertaken, provide very little evi-
dence for a direct relationship between sense of humor and physical health
parameters.
Keywords: Age; sex; blood pressure; health; sense of humor.
Introduction
The purpose of this study was to provide information about the distribu-
tion of sense of humor in a large, unselected adult county population and
Humor 17–1/2 (2004), 121–134 0933–1719/04/0017–0121
6 Walter de Gruyter
to examine relationships between sense of humor and age, sex, subjective
health, blood pressure, obesity, and some common bodily complaints.
More specifically, the study addressed the following questions: How is
sense of humor related to sex and age? Are subjective and objective hea lth
indicators correlated with sense of humor, and does age influence these
correlations?
It has been assumed for many generations that people with a greater
sense of humor tend to enjoy greater physical health. Several potential
mechanisms have been proposed for beneficial e¤ects of humor on health.
For example, there have been numerous claims that vigorous laughter
confers many physiological benefits, including exercising and relaxing
muscles, improving respiration and blood circulation, reducing blood
pressure, stimulati ng production of pain-killing endorphins, enhancing
immunity, and decreasing production of stress-related hormones. Since
individuals with a greater sense of humor pre sumably laugh more fre-
quently than others, they may also be more likely to experience these hy-
pothesized beneficial physiological e¤ects of laughter. It should be noted,
though, that there are many di¤erent causes of laughter, including even
some kinds of brain damage (Forabosco 1998 ). Thus, mirthfulness by
itself is not an adequate indicator of sense of humor.
Other potential mechanisms for health benefits of sense of humor relate
more to the cognitive, a¤ective, and social aspects of humor. For exam-
ple, a humorous and cheerful outlook on life may allow one to cope more
e¤ectively with stressful life experiences and thereby reduce the well-
known deleterious e¤ects of stress on physical health. Similarly, indivi-
duals with a greater sense of humor may be more soc ially skilled and
better able to negotiate interpersonal conflicts, resulting in more satisfying
and intimate relationships with others. Consequently, they may experi-
ence the well-known health benefits that result from higher levels of social
support (Martin 2001).
All of these hypotheses would suggest that individual s with a greater
sense of humor should have better physical health, as indicated by
greater health satisfaction, fewer symptoms of ill health, such as chronic
pain and cardiovascular problems, and better physiological functioning
as indicated, for example, by lower blood pressure. However, a direct and
simple association between sense of humor (as measured by self-report
questionnaires) and good health has been di‰cult to establish so far (see
Martin 2001; Svebak and Martin 1997 for reviews). Some studies have
reported negative correlations between sense of humor and illness symp-
122 S. Svebak et al.
toms (e.g., Carroll and Shmidt 1992; Ruch et al. 1996; Simon 1990), but
others have not found any relationship between sense of humor and
overall health (e.g., Anderson and Arnoult 1989; Labott and Martin
1990; Porterfield 1987). Similarly, some small studies have found signifi-
cant positive correlations between sense of humor scores and salivary
immunoglobulin-A (S-IgA: e.g., Dillon et al. 1985; Dillon and Totten
1989), whereas other larger studies have failed to find any correlation be-
tween these variables (e.g., Lefcourt et al. 1990). Martin and Dobbin
(1988) found evidence for a moderating role of sense of humor in stress-
related immune system suppression. With regard to humor and pain,
Svebak and associates (2000) found a negative correlation between sense
of humor and pain associated with gallbladder stones. Alth ough there is
considerable experimental evidence of increased pain tolerance following
exposure to humorous videotapes (e.g., Weisenberg et al. 1998; Weisen-
berg et al. 1995), evidence of correlations between sense of humor mea-
sures and tolerance of experimentally-induced pain has been mixed (e.g.,
Zillman et al. 1993; Nevo et al. 1993). Finally, Clark et al. (2001) re-
ported on a study of 300 consecutive patients in a cardiological setting
and found some promising evidence of an inverse relation betwee n sense
of humor and prevalence of coronary heart disease.
Overall, then, the research evidence for correlations between sense of
humor and various indicators of physical health has been very inconclu-
sive. However, one potential problem with much of the past research is
that most of the studies have involved fairly small samples drawn from
highly selected populations, with a bias to ward university student sam-
ples. Associations of sense of humor with health indicators among young
adults may be weak because health problems are not frequent in this age
group. Variance in health measures is even more reduced in university
samples, since those with severe health problems are less likely to con-
tinue in school. Furthermore, university students generally may not have
had much experience with a broad range of life stressors, thus reducing
the likelihood of finding potential stress-bu¤ering e¤ects of humor on
health. Study of a much larger and more diverse sample of adults of all
ages drawn from the general population, with a broader range of poten-
tial health problems and life stressors, might allow for a more robust test
of possible relationships bet ween sense of humor and various indicators
of physical health and illness.
The present study represented a unique opportunity to investigate sense
of humor in a large-scale epidemiological study that took place in Nor-
Humor and health in a Norwegian county 123
way in 1995 to 1997. The entire population aged 20 and above in the
county of Nord-Trøndelag, Norway (N ¼ 92,808), was invited to take
part in the Nord-Trøndelag Health Study (HUNT). Thus, the present
report is based upon data from one of the largest population health
surveys in the world. Participants in the study completed a self-report
survey concerning the frequency and severity of a wide range of health
problems, including nausea, diarrhea, indigestion, cardio-respiratory
problems, chronic pain, and overall health satisfaction. In addition, the
participants underwent medical screening at an ambulatory medical cen-
ter where they were assessed for systolic and diastolic blood pressure,
height, and weight. The survey also included a 3-item self-report test of
sense of humor derived from the revised Sense of Humor Questionnaire
(Svebak 1996).
These data allowed us to examine the potential relat ionship between
sense of humor and these various health indicators in an entire adult
population of a county, thus avoiding the potential limitations of small
samples of selected populations found in past research. If there is a sim-
ple, direct relationship between sense of humor (as measured by this self-
report scale) and these various aspects of physical health, it should be
found in this study. In addition to the humor-health relationship, these
data also allowed us to examine the general prevalence and distribution
of sense of humor in this population and its relationship with age and sex.
Since we expected that health problems would increase in frequency and
severity with older age, it was also important to control for age in exam-
ining correlations between humor and health.
Method
Subjects
In 1995 to 1997 the entire population aged 20 and above in the county of
Nord-Trøndelag, Norway (N ¼ 92,808), was invited to take part in the
HUNT Study. The overall participation rate of the population in the
survey phase of the study was 70.4 percent (males ¼ 66.7 percent;
females: 75.5 percent). Thus, a total of 65,333 inhabitants took part. Due
to missing data on some variables, sample sizes vary in the analyses re-
ported here.
124 S. Svebak et al.
Survey measures and procedure
A questionnaire was mailed to every inhabitant aged 20 and above with
the invitation to take part in the survey. Those who agreed to participate
in the study completed the questionnaire and brought it to the ambu la-
tory medical center at the time given for a medical screening.
Assessment of sense of humor. All participants completed an extensive
set of survey measures addressing a range of health issues. Given the va-
riety of questions on the survey and the need for brevity to ensure a high
level of participation, we were able to include only a brief measure of
sense of humor. Consequently, humor was assessed using three items
from the three-dimensional Sense of Humor Questionnaire (SHQ: Svebak
1996). In particular, the item with the highest factor loading was selected
from each dimension. They were as follows: (1) ‘‘Do you easily recognize
a mark of humorous intent?’’ (meta-message humor sensitivity: MM); (2)
‘‘Persons who are always out to be funny are really irresponsible types
not to be relied upon’’ (social liking of humor: SL); and (3) ‘‘Do you
consider yourse lf to be a mirthful person?’’ (laughter expressiveness: LE).
Participants responded to each item using 4-point scales (labeled for the
three items respectively: very sluggishly — very easily; yes indeed — not at
all; not at all — yes indeed). Data were analyzed using each of the three
items separately, as well as summing them to make an overall index of
sense of humor (SHQ). The full version of the SHQ has been shown to
have acceptable reliability and validity and has been used extensively in
past research on humor and well-being (see Lefcourt and Martin 1986;
Svebak 1996; Svebak and Martin 1997).
Assessment of bodily complaints. Overall satisfaction with one’s own
health was rated using a 4-point scale (1 ¼ poor; 4 ¼ very good). To
assess the prevalence of a number of common bodily complaints, partic-
ipants were asked, ‘‘To what extent are you or have you been troubled
with these complaints over the last twelve months?’’ This question was
followed by a list of complaints, including nausea, acid heartbu rn, diar-
rhea, constipation, pounding heart, and dyspnea. Participants responded
to each complaint using a 3-point scale (1 ¼ not at all troubled, 2 ¼
somewhat tro ubled, 3 ¼ much troubled). In addition, musculoskeletal
pain was assessed separately for various parts of the body, including the
neck, shoulders, low back, and extremities, using a 2-point rating scale
Humor and health in a Norwegian county 125
(0 ¼ no, 1 ¼ yes). Five indexes were computed for bodily complaints: (1)
dyspepsia (nausea, heartburn), (2) indigestion (diarrhea, constipation), (3)
cardio-respiratory (pounding heart, dyspnea), (4) neck and shoulder pain,
and (5) pain in lower back and extremities.
Assessment of blood pressure, height, and weight. Blood pressure was
measured by specially trained nurses or technicians using a Dinam ap
845XT (Critikon) based on oscillometry. Cu¤ size was adjusted after
measuring the arm circumference. The Dinamap was started after the
participant had been seated for two minutes with the cu¤ on the arm and
the arm resting on a table. Blood pressure was measured three times at
one-minute intervals: Blood pressure reported in this paper is the mean of
the seco nd and third systolic (SBP) and diastolic (DBP) blood pressures,
respectively (for details, see Lund-Larsen 1997). Measurements were also
taken of participants’ height and weight. Body mass index (BMI) was
computed by taking body weight in kilograms divided by the squared
body height in meters.
Results
To examine relationships betwee n age and humor, the sample was div-
ided into age cohorts in ten-year intervals and means and standard devi-
ations for the total SHQ, and three humor items were computed for each
group. Di¤erences across groups were computed using one-way analysis
of variance. As shown in Table 1, the mean scores for total sense of
humor on average declined across the age cohorts from highest score in
the 20s to lowest score among those aged 70 and above (F ¼ 952:7,
p <:0004). As shown in Table 2, the simple correlation between age and
total SHQ was .29. The scores were slightly skewed toward the high end
of the scale (around 9 on a scale from 3 to 12). This trend across age co-
horts was consistent across the th ree SHQ items with the strongest e¤ect
being found for laughter expressiveness (F ¼ 630:1, p <:0004; r ¼:23),
followed by social liking of humor (F ¼ 614: 6, p <:0004; r ¼:22) and
meta-message sensitivity ( F ¼ 170:4, p <:0004; r ¼:13).
To examine sex di¤erences and interactions between age and sex, two-
way analyses of variance (sex by age) were computed (see Table 1 for
means and standard deviations). These analyses revealed that total SHQ
scores were slightly higher in males than females (F ¼ 12:8, p <:0004).
126 S. Svebak et al.
This small main e¤ect for sex was qualified, however, by a weak interac-
tion between age and sex (F ¼ 9:96, p <:0004), with slightly higher SHQ
total scores occurring for males than females only among the younger
adults. The sex di¤erence was strongest for scores on meta-message sen-
sitivity (F ¼ 175:9, p <:0004), whereas a relativel y weak sex di¤er ence
was seen in the laughter expressiveness dimension (F ¼ 8:2, p <:004),
and a non-significant e¤ect of sex was found in scores on social liking of
humor (F ¼ 0:14, ns). Sex also interacted with age on the single items to
yield the highest e¤ect for meta-message sensitivity (F ¼ 18:6, p <:0004),
due to the fact that mean scores dropped more among males than among
females over the age cohorts. The corresponding F-scores for the age by
sex interaction were 6.3 ( p <:003) for social liking of humor and 9.0
( p <:0004) for laughter expressiveness.
Pearson correlations were computed to examine relationships between
sense of humor and the various indicators of physical health. Since cor-
relations as weak as .01 are statistically significant with this sample size,
we focused on abs olute magnitudes of the coe‰cients rather than signifi-
Table 1. Means (and standard deviations) of sense of humor total and item scores by age
cohort and sex (male n ¼ 26850; female n ¼ 28550; total n ¼ 55400)
SHQ-items Age-cohorts
20–29 30–39 40–49 50–59 60–69 70þ
SHQ total:
Total sample 9.85 (1.27) 9.70 (1.27) 9.47 (1.28) 9.23 (1.29) 8.96 (1.32) 8.65 (1.40)
Males 9.96 (1.30) 9.76 (1.30) 9.48 (1.34) 9.23 (1.32) 8.97 (1.32) 8.61 (1.39)
Females 9.77 (1.24) 9.66 (1.25) 9.46 (1.24) 9.23 (1.26) 8.95 (1.33) 8.69 (1.41)
MM:
Total sample 3.26 (0.54) 3.24 (0.54) 3.19 (0.52) 3.15 (0.51) 3.11 (0.51) 3.07 (0.53)
Males 3.33 (0.54) 3.29 (0.54) 3.23 (0.53) 3.15 (0.51) 3.12 (0.50) 3.06 (0.53)
Females 3.20 (0.54) 3.20 (0.54) 3.15 (0.51) 3.13 (0.50) 3.09 (0.51) 3.07 (0.53)
SL:
Total sample 3.43 (0.67) 3.48 (0.66) 3.43 (0.69) 3.34 (0.72) 3.17 (0.80) 2.95 (0.90)
Males 3.45 (0.68) 3.47 (0.67) 3.40 (0.71) 3.34 (0.72) 3.19 (0.78) 2.95 (0.88)
Females 3.42 (0.66) 3.49 (0.65) 3.45 (0.66) 3.34 (0.72) 3.16 (0.81) 2.94 (0.92)
LE:
Total sample 3.16 (0.66) 2.98 (0.67) 2.85 (0.69) 2.74 (0.69) 2.68 (0.71) 2.64 (0.72)
Males 3.18 (0.67) 3.00 (0.68) 2.84 (0.72) 2.72 (0.71) 2.66 (0.72) 2.59 (0.73)
Females 3.15 (0.64) 2.97 (0.66) 2.86 (0.67) 2.76 (0.68) 2.70 (0.69) 2.68 (0.72)
SHQ ¼ Sense of Humor Questionnaire; MM ¼ Metamessage Sensitivity; SL ¼ Social Lik-
ing of Humor; LE ¼ Laughter Expressiveness.
Humor and health in a Norwegian county 127
cance levels, using r ¼ :10 as a minimally meaningful correlation (ac-
counting for 1 percent of the variance). As shown in Table 2, using the
total SHQ score as the measure of humor, the highest correlation was
found for general satisfaction with one’s own health (r ¼ :2 1), with high
health satisfaction being associated with high sense of hum or. All the re-
maining correlations with total SHQ, while being in the expected direc-
tion, were below .10, except for systolic and diastolic blood pressure
(r ¼:14 and .10, respectively). The correlations between health in-
dicators and the separate items of the SHQ indicated that the highest co-
e‰cient occurred for the association between laughter expressiveness and
overall health satisfaction (r ¼ :20). Also, meta-message sensitivity
(r ¼ :14) and social liking of humor (r ¼ :11) yielded coe‰cients above
.10 in relation to overall health satisfaction. In addition, systolic blood
pressure tended to be lower in those scoring higher on social liking of
humor (r ¼:14). Most of the other correlation coe‰cients were also
statistically highly significant, due to the large number of subjects in-
volved, despite the fact that they reflected only trivial sha red variance of
health indicators with sense of humor scores.
As seen previously in the analyses of variance as well as the correla-
tions with age shown in Table 2, scores on sense of humor were sig-
Table 2. Pearson correlation between sense of humor and various health indicators
Health indicators Humor measures
SHQ total MM SL LE
Overall satisfaction .21 .14 .11 .20
Dyspepsia .04 .03 .02 .03
Indigestion .06 .05 .01 .05
Cardio-respiratory .05 .03 .02 .05
Neck-shoulders .04 .02 .01 .04
Lowback-extremities .07 .04 .03 .06
Systolic blood pressure .14 .05 .14 .09
Diastolic blood pressure .10 .03 .08 .08
Body mass index .04 .00 .06 .02
Age .29 .13 .22 .23
Correlations at or above .02: p < .0004 (n ¼ 43,277).
SHQ ¼ Sense of Humor Questionnaire; MM ¼ Metamessage Sensitivity; SL ¼ Social
Liking of Humor; LE ¼ Laughter Expressiveness; Dyspepsia ¼ nausea/acid burns; Indi-
gestion ¼ diarrhea/constipation; Cardio-respiratory ¼ pounding heart/dyspnea; Neck-
shoulders ¼ pain in neck/shoulders; Lowback-extremities ¼ pain in lower back/extremities.
128 S. Svebak et al.
nificantly lower for the higher age cohorts. Also (although not shown in
the tables), health problems tended to increase with age. This holds for
subjective as well as objective health indicators. It is possible, therefore,
that the associations between scores on sense of humor and health are
confounded with age e¤ects. For this reason, partial correlations were
computed to control for the e¤ect of age upon associations between
scores on sense of humor and health indicators. The results of these
analyses are given in Table 3.
As can be seen in Table 3, the association of total SHQ scores with
overall health satisfaction dropped after eliminating the e¤ect of age
(partial r ¼ :12), as did the correlations for each of the three humor
items, particularly social liking of humor and laughter expressiveness.
However, due to the large sample size, the partial correlation with total
SHQ still remained highly significa nt ( p <:0004), despite the fact that
not much shared variance was accounted for in this coe‰cient (1.44 per-
cent). Overall, the correlations between the humor scores and the other
health indicators were also lowered when controlling for age. This was
particularly evident with the correlations for systolic and diastolic blood
pressure, which dropped to around zero. Thus, after controlling for age,
only overall health satisfaction showed correlations greater than .10 with
sense of humor.
Table 3. Partial correlations between sense of humor and various health indicators control-
ling for age
Health indicators SHQ-items
SHQ-total MM SL LE
Overall satisfaction .12 .10 .02 .12
Dyspepsia .04 .03 .02 .03
Indigestion .05 .05 .01 .05
Cardio-respiratory .04 .03 .01 .05
Neck-shoulders .01 .01 .01 .03
Lowback-extremities .02 .02 .01 .03
Systolic blood pressure .01 .03 .03 .04
Diastolic blood pressure .02 .02 .01 .01
Body mass index .01 .02 .02 .03
Correlations at or above .02: p < .0004 (n ¼ 43,277).
SHQ ¼ Sense of Humor Questionnaire; MM ¼ Metamessage Sensitivity; SL ¼ Social
Liking of Humor; LE ¼ Laughter Expressiveness; Dyspepsia ¼ nausea/acid burns; Indi-
gestion ¼ diarrhea/constipation; Cardio-respiratory ¼ pounding heart/dyspnea; Neck-
shoulders ¼ pain in neck/shoulders; Lowback-extremities ¼ pain in lower back/extremities.
Humor and health in a Norwegian county 129
Discussion
The descriptive data on sense of humor suggest that, on average, people
tend to present themselves with a sense of humor that is above the scale
midpoint. Also, older people tend on average to score lower th an younger
people do. This e¤ect of age was more pronounced for the social liking of
humor and laughter expressiveness dimensions than for the meta-message
sensitivity dimension. Thus, older people, as compared to younger peo-
ple, tend to express less mirth and laughter, tend to like humor less, and,
to a smaller degree, are less likely to notice humor in the environment.
With regard to sex, sense of humor scores for males were very slightly
higher than for females overall. However, the age by sex interaction
indicated that this weak sex di¤erence was only present in the younger
age groups, with males showing a greater decline in humor scores than
females ove r the age span. It is important to note that these sex e¤ects,
though statistically significant, were too weak to have any meaningful
relevance. It is also important to recognize that these cross-sectional data
do not allow us to determine whether humor declines with age within in-
dividuals or whether these age di¤erences are due to a cohort e¤ect (e.g.,
those born in an earlie r era may have been socialized to appreciate and
express humor less).
With regard to the humor-health relationship, these findings provided
no support for a strong association between sense of humor and various
health indicators, including overall satisfaction with one’s health, the ex-
perience of common bodily complaints (e.g., ind igestion, cardiorespir-
atory complaints, musculoskeletal pain and discomfort), and obj ective
indicators of cardiovascular health (systolic and diastolic blood pressure)
as well as obesity (body mass index). Since health problems tend to in-
crease with age, while sense of humor scores were found to be negatively
associated with age, it was important to partial out the e¤ects of age upon
the association of sense of humor with health parameters. This correction
caused a drop in almost every correlation. Most notably, the weak nega-
tive correlations between sense of humor and both systolic and diastolic
blood pre ssure were completely eliminated when age was taken into
account.
After controlling for age, only the association between sense of humor
and overall subjective health satisfaction remained at a magnitude of about
.10. Thus, individuals with greater senses of humor, as measured by the
total SHQ score as well as metamessage sensitivity and liking of humor
130 S. Svebak et al.
items, tend to report greater levels of subjective satisfaction with their
health. However, more objective indicators of health status are unrelated
to sense of hum or, suggesting that any direct links between hum or and
health may have more to do with subjective perceptions of well-being
than with actual e¤ects of humor or laughter on physical health. Of
course, the correlational nature of these data precludes us from identify-
ing the direction of causality between sense of humor and health satis-
faction. It may be that a greater sense of humor causes people to take a
more cheerful and optimistic perspective on any health problems they
may have, and therefore to express a greater level of satisfaction with
their overall health. On the other hand, it is also possible that greater
satisfaction with one’s health causes one to feel more cheerful and conse-
quently to take a more humorous perspective on life. From a public
health point of view, even such low correlations may reflect interest ing
associations of sense of humor with health satisfaction despite the fact
that they are poor predictors of individual health.
Some limitations of this study have to do with the measurement of
sense of hum or. First, the limited reliability of a 3-item measure of humor
may have attenuated the observed correlations between humor and health
parameters. However, the unreliability of measurement is o¤set by the
extremely large sample size, making this concern less salient. Second,
conclusions from this study are limited to the definition of sense of
humor reflected in the SHQ. The SHQ is based on a broad-base d three-
dimensional theoretical model of humor (Svebak 1974), and the full ver-
sion of this measure has been widely used in past humor research (see
Lefcourt and Martin 1986; Svebak 1996; Svebak and Martin 1997). It has
demonstrated good validity in relation to many variables commonly
associated with sense of humor (e.g., peer ratings of humor, ability to
generate humorous comments, cheerfulness, etc.) and is quite highly cor-
related with other wi dely used measures of sen se of humor. Thus, al-
though there may be some dimensions of humor that are not well tapped
by th is measure (e.g., distinctions between negative and positive uses of
humor: see Martin et al. 2003), it does captu re a broad definition of
humor that corresponds well to popular conceptions and is consistent
with past humor research.
This study was also limited to examination of direct associations be-
tween sense of humor and health parameters. Since th ere was no measure
of stressful life events in this large-scale population survey, we were un-
able to examine possible stress-bu¤ering e¤ects of humor on health. Thus,
Humor and health in a Norwegian county 131
this study does not exclude the possibility that sense of humor may be a
significant bu¤ering personality component in sub-samples of individuals
who are exposed to particular types of stressful life events. In fact, some
previous reports from empirical research have supported the hypothesis
that sense of humor may help people cope with the stresses of everyday
life in a way that bu¤ers related health hazards (Martin and Lefcourt
1983; see Martin 2001; and Svebak and Martin 1997, for reviews). None-
theless, in light of these findings based on a very large population sample,
there is no reason to assume that sense of humor is strongly associated
with health in a general population. There was no support given in these
data to a simplistic view that ‘‘laughter is the best medicine.’’
Norwegian University of Science and Technology and
University of Western Ontario
Note
Correspondence address: Sven Svebak, MTFS, INM, NTNU, NO-7489 Trondheim, Nor-
way; sven.svebak@medisin.ntnu.no
The Nord-Trøndelag Health Study (The HUNT Study) is a collaboration of The HUNT
Research Center, Faculty of Medicine at The Norwegian University of Science and Tech-
nology (NTNU), Verdal, Norwegian Institute of Public Health, and the Nord-Trøndelag
County Council.
References
Anderson, Craig A., and Lynn H. Arnoult
1989 An examination of perceived control, humor, irrational beliefs, and positive
stress as moderators of the relation between negative stress and health. Basic
and Applied Social Psychology 10, 101–117.
Carroll, James, and Jerry Shmidt
1992 Correlations between humorous coping style and health. Psychological Re-
ports 70, 402.
Clark, Adam, Alexander Seidler, and Michael Miller
2001 Inverse association between sense of humor and coronary heart disease. In-
ternational Journal of Cardiology 80, 87–88.
Dillon, Kathleen M., Brian Mincho¤, and Katherine H. Baker
1985 Positive emotional states and enhancement of the immune system. Interna-
tional Journal of Psychiatry in Medicine 15, 13–18.
Dillon, Kathleen M., and Mary C. Totten
1989 Psychological factors, immunocompetence, and health of breast-feeding
mothers and their infants. Journal of Genetic Psychology 150, 155–162.
132 S. Svebak et al.
Forabosco, Giovannantonio
1998 The ill side of humor: Pathological conditions and sense of humor. In Ruch,
Willibald (ed.), The Sense of Humor: Explorations of a Personality Charac-
teristic. Berlin: Mouton de Gruyter, 271–292.
Labott, Susan M., and Randall B. Martin
1990 Emotional coping, age, and physical disorder. Behavioral Medicine 16, 53–
61.
Lefcourt, Herbert M., Karina Davidson-Katz, and Karen Kueneman
1990 Humor and immune system functioning. Humor: International Journal of
Humor Research 3 (3), 305–321.
Lefcourt, Herbert M., and Rod A. Martin
1986 Humor and Life stress: Antidote to Adversity. New York: Springer-Verlag.
Lund-Larsen, P. G.
1997 Blood pressure measured with sphygmomanometer and with Dinamap under
field conditions: A comparison. Norwegian Journal of Epidemiology 7, 235–
241 (English summary).
Martin, Rod A.
2001 Humor, laughter, and physical health: Methodological issues and research
findings. Psychological Bulletin 127, 504–519.
Martin, Rod A., and James P. Dobbin
1988 Sense of humor and immunoglobulin A: Evidence for a stress-moderating
e¤ect of humor. International Journal of Psychiatry in Medicine 18, 93–105.
Martin, Rod A., and Herbert M. Lefcourt
1983 Sense of humor as a moderator of the relation between stressors and moods.
Journal of Personality and Social Psychology 45, 1313–1324.
Martin, Rod A., Patricia Puhlik-Doris, Gwen Larsen, Jeanette Gray, and Kelly Weir
2003 Individual di¤erences in uses of humor and their relation to psychological
well-being: Development of the Humor Styles Questionnaire. Journal of Re-
search in Personality 37, 48–75.
Nevo, Ofra, Giora Keinan, and Mina Teshimovsky-Arditi
1993 Humor and pain tolerance. Humor: International Journal of Humor Re-
search 6 (1), 71–88.
Porterfield, Albert L.
1987 Does sense of humor moderate the impact of life stress on psychological and
physical well-being? Journal of Research in Personality 21, 306–317.
Ruch, Willibald, Gabriele Kohler, and Christoph van Thriel
1996 Assessing the humorous temperament: Construction of the facet and stan-
dard trait forms of the State-Trait-Cheerfulness-Inventory — STCI. Humor:
International Journal of Humor Research 9(3/4), 303–339.
Simon, Jolene M.
1990 Humor and its relationship to perceived health, life satisfaction, and morale
in older adults. Issues in Mental Health Nursing 11, 17–31.
Svebak, Sven
1974 A theory of sense of humor. Scandinavian Journal of Psychology 15, 99–107.
1996 The development of the Sense of Humor Questio
nnaire: From SHQ to
SHQ-6. Humor: International Journal of Humor Research 9(3/4), 341–361.
Svebak, Sven, and Rod A. Martin
1997 Humor as a form of coping. In Svebak, Sven, and Michael J. Apter (eds.),
Stress and Health: A Reversal Theory Perspective. Washington, DC: Taylor
& Francis, 173–184.
Humor and health in a Norwegian county 133
Svebak, Sven, Karl Søndenaa, Trygve Hausken, Odd Søreide, A
˚
sa Hammar, and Arnold
Berstad
2000 The significance of personality in pain from gallbladder stones. Scandinavian
Journal of Gastroenterology 35, 759–764.
Weisenberg, Matisyohu, Tal Raz, and Tamar Hener
1998 The influence of film-induced mood on pain perception. Pain 76, 365–375.
Weisenberg, Matisyohu, Inbal Tepper, and Joseph Schwartzwald
1995 Humor as a cognitive technique for increasing pain tolerance. Pain 63, 207–
212.
Zillman, Dolf, Steve Rockwell, Karla Schweitzer, and S. Shyam Sundar
1993 Does humor facilitate coping with physical discomfort? Motivation and
Emotion 17, 1–21.
134 S. Svebak et al.