Die Wirkung eines gezielten Trainings der Humorfähigkeiten auf den Einsatz positiver Stressverarbeitungsstrategien bei Patienten mit Depression

Current studies reveal that the emergence of depression is often directly or indirectly related to stress (Stuke und Bermpohl 2016; Kendler et al. 1999; Mazure 1998; Paykel 2003; Colman et al. 2014). Patients suffering from depression tend to apply more maladaptive and fewer adaptive coping strategies (Mahmoud et al. 2012; Xu et al. 2013; Hori et al. 2014; Moritz et al. 2016; Thimm et al. 2018). It has been shown that stress coping behavior of individuals can be influenced by specific intervention (Fawzy 1990; McCarthy et al. 2017). Using humor as a coping strategy has been demonstrated to provide an effective strategy to manage stress (Labott und Martin 1987; Nezu et al. 1988; Abel 2002; Papousek und Schulter 2008; Beh-Pajooh et al. 2010; Labott und Martin 1987). However, there are only a few studies focusing on using humor as a coping strategy to treat depressive disorders. In order to make use of the positive effects of humor on well-being for the treatment of psychiatric disorders, a focused humor training, based on the 7- Humour-Habits-Programm introduced by Paul McGhee (2010), has been developed (Falkenberg et al. 2011). The present pilot study included 34 patients suffering from mild to moderate depressive episodes at the point the study was conducted. In addition, 28 healthy participants were recruited, who were matched according to level of education, age, and gender. The patients were examined before (time point t1) and after the end (time point t2), of a 7- week humor training (humor) or a standard cognitive-behavioral therapy (CBT), respectively. At both time points stress management was assessed on the basis of the stress management questionnaire (SVF-78, Janke et al. 1997); the use of humor as a coping strategy was evaluated according to the Coping Humor Scale(CHS, Martin 1996). It was expected that patients suffering from depression would apply adaptive coping strategies and humor to a lesser extent compared to healthy controls. In addition, it was predicted that the use of adaptive coping strategies would increase after the patients had participated in a focused intervention. Those patients who participated in a humor training were expected to increasingly use humor as a coping strategy. vii The hypotheses could be confirmed by means of the tests applied in this study: At time point t1, patients applied fewer positive strategies and more negative strategies for stress management compared to the healthy control group. Furthermore, they used humor as a coping strategy to a lesser extent. After the 7-week intervention, an increase of positive strategies and of using humor as a coping strategy as well as a decrease of negative strategies could be observed in the total patient group (CBT + humor). In the humor group, a significant change with regard to all three aspects could be observed. In the CBT-group, however, only the positive strategies changed significantly. Consequently, the results of the study provide further evidence that patients suffering from depression show less effective stress coping than healthy controls. In addition, the results indicate that stress management behavior may be improved by means of specific intervention, especially through humor training.