- Email: [email protected]
Can sadness alter posture?
Journal of Bodywork & Movement Therapies (2013) 17, 328e331
Available online at www.sciencedirect.com
journal homepage: www.elsevier.com/jbmt
OBSERVATIONAL STUDY
Can sadness alter posture? ´ Luı´s Pimentel do Rosa ´rio, PT, PhD*, Jose ´genes, MD, PhD , Maria Suely Bezerra Dio ´ Roberto Leite, PhD Rita Mattei, PhD , Jose Federal University of Sa˜o Paulo, UNIFESP, Department of Psychobiology, Rua Botucatu, 862, 1o. Andar, Vila Clementino, Sa˜o Paulo, SP, CEP 04023062, Brazil Received 3 September 2012; received in revised form 23 November 2012; accepted 30 November 2012
KEYWORDS Posture; Sadness; Emotion; Postural assessment; Analog scales
Summary The present study investigated the existence of a relationship between subjective sadness and body posture in 28 women, aged between 20 and 39 years, who had a normal body mass indices (or were underweight) and an absence of neurological, psychiatric or musculoskeletal disorders. The postural parameter photographed was protraction of the shoulder. The degree of sadness was rated by analog scales representing current and usual sadness. The results indicated that a relationship exists between protraction of the shoulder and usual sadness (p Z 0.05). However, there was no relationship between current sadness and the shoulder position. In conclusion, the usual sadness can lead to shoulder protraction. ª 2012 Elsevier Ltd. All rights reserved.
Introduction Posture and emotions, empirically, have a strong connection. However, scientific evidence for a relationship between these two human characteristics has not yet been reported. Emotions affect the muscles in many ways including the following: the effect of anxiety on heart rate and its rhythm generating a tachycardia; the diaphragm and respiratory rate and hyperventilation; and the skeletal muscles in general. Another example is the effect of slow
* Corresponding author. Rua das Rosas 620, Mirando ´polis, Sa ˜o Paulo, SP, CEP 04048-001, Brazil. Tel.: þ55 42 9992 9992. E-mail address: [email protected] (J.L.P. do Rosa ´rio).
breathing to reduce anxiety (Darwin, 1899; Garbossa et al., 2009). Emotion involves a complex set of interactions mediated by neurohormonal systems, which can give rise to affective experiences, generate cognitive processes, activate widespread physiological adjustments to elicit conditions and affect behavior (Kleinginna and Kleinginna, 1981). Emotions affect attention, behavior and responses to events, as well as activating relevant associative networks in memory (Izard, 1991). A painful or traumatic experience is encoded in the central nervous system by the amygdala as a nonverbal memory and stored in patterns of muscle contractions and neurovegetative sensations by the autonomic nervous system, which connects emotions to organic functions (Schulz, 1998). It is important to consider that each emotion is the integration of specific neurochemical and
1360-8592/$ - see front matter ª 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jbmt.2012.12.001
Posture and emotion motor processes, and it can be considered as the primary motivational system in humans (Izard, 1991). The emotion of sadness can be seen as a reaction to the failure to achieve or maintain a goal (Stein and Trabasso, 1992). A differentiation seems to exist between males and females in terms of the embodiment of emotions. Females are better at showing some emotions, as well as the associated postures and facial expressions. Among four commonly studied emotions (love, happiness, anger and sadness) females obtained higher scores than males in tests of all emotions except anger (Kevrekidis et al., 2008). The study of human posture is relatively new compared to other areas of medical science, and refers to the alignment and maintenance of body segments in certain positions (Rosa ´rio et al., 2004). Some postural deviations may adversely affect muscular efficiency, predispose individuals to pain and pathological musculoskeletal conditions and provoke unaesthetic alterations (Rosa ´rio et al., 2004; Liebenson, 2008; James et al., 2009; Wallden, 2009). The specific focus on posture is very important since it is related to quality of life, a fact that has stimulated interest in different areas. Wilhelm Reich was a pioneer in correlating body posture and muscle contraction (muscular armoring), which in turn is related to emotional aspects (Reich, 1942). A program could exist in humans, at the level of the nervous system, which establishes a connection between specific emotions and certain muscle movements. This correspondence would be invariable (Ekman et al., 1983). Based on a literature review, emotional changes can, with proper stimulation, affect any human being and cause muscle changes coherent with the emotional state. In this context, posture can be an important tool in terms of the diagnosis and treatment of emotional problems. However, there are still very few studies in the literature that have investigated this correlation. The aim of the present study was to investigate the existence of a relationship between the posture represented by protraction of the shoulder and the sadness emotion.
Methods Twenty-eight women, aged between 20 and 39 years, who had a normal body mass indices between 16 and 24.9 kg/m2 were assessed (WHO, 1998). The women could not be in their menstrual period at the time of the assessment. The exclusion criteria included any psychiatric, neurological or musculoskeletal disorders. The present study received approval from the Human Research Ethics Committee of the UNIFESP under protocol number 1391/05 and the participants signed a statement of informed consent. The volunteers were subjected to the same assessment protocol which included demographic data (age, weight in kilograms and height in meters). A digital camera (Canon Power Shot A400) was used for the documentation of the subject’s standing right lateral view. The image was transferred to an Intel Core 2 Duo computer and the angle of protraction of the shoulder was examined by Corel Draw (Fig. 1), as described by Munhoz et al. (2005). The first step was to draw a parallel line to the ground. Then, another line was drawn perpendicular to the first line, which had
329
Figure 1 Lateral photograph with tracings of the angle of protrusion of the shoulder.
the same function as a plumb line. This line was positioned in the photo, at the very back of the heel of the subject. Another line was drawn from this heel point to the most anterior part of the shoulder. The angle between these two lines, with the heel as the fulcrum, revealed the shoulder’s protrusion angle. The temperature in the assessment room was kept at a constant 25 C to avoid possible influences on posture. Analog scales were used to assess the degree of subjective sadness (Williams et al., 2010), which facilitated an assessment of usual sadness (a chronic feeling) and current sadness (momentary feeling present at the time of assessment). The scales were characterized by a 10 cm line, with the words: “no sadness at all” to the extreme left and “Utter despair” to the extreme right, numbered from 0 to 10 (Fig. 2). The volunteers were instructed to make a dash at the place of the line that best described their emotional state. The usual sadness scale sheet, designed to help the subjects to understand, said “you always feel” right above the numbers. The current sadness scale sheet reads “How you are feeling at this exact moment”. The linear regression technique and the effect of sample size were calculated using the ‘Statistical Package for the Social Sciences’ (SPSS) software. The level of significance for the linear regression was set at p < 0.05. The power of
330
J.L.P. Rosa ´rio et al. Usual sadness (you always feel)
0
1
No sadness at all
2
3
4
5
6
7
8
9
10
Utter despair
Figure 2 Example of the analog scales used in the present study e a value of 0 signifies an absence of the emotion studied whereas a value of 10 would be the strongest possible feeling related to that emotion.
the sample had a small effect if r Z 0.10 (explained 1% of the total variance), a medium effect if r Z 0.30 (explained 9% of the total variance) and a large effect if r Z 0.50 (explained 25% of the total variance). For a better understanding of the results, Fig. 3 shows a scatter graph of the variable current sadness. Fig. 4 shows the same graph for usual sadness, which is closer than current sadness to the protrusion shoulder line as seen in Fig. 5.
Figure 4 Scatter graph showing the distribution of the usual sadness values and the resulting line.
It was possible to confirm a statistically significant association between protrusion of the shoulder and usual subjective sadness. These results are similar to those of other authors who have stated that emotions are related to patterns of contraction of the facial muscles (Ekman et al., 1969, 1983) and body posture (Grammer et al., 2004). These results demonstrated that there are postures taken by the body in response to the experience of a specific
emotion. There were no statistically significant associations between protrusion of the shoulder and current subjective sadness at the time of testing. The absence of associations between current sadness and protrusion of the shoulder may have occurred because of the environment where the assessments took place. In a neutral situation, an event that causes transient sadness to the subject may not have as strong an influence at the time of assessment. If this sadness was not experienced with the relevant intensity when the photo was taken, this could explain why the shoulders do not protrude significantly in response. On the other hand, chronic sadness feelings have an influence on the postural muscles for lengthy periods, sometimes for years, and may leave traces that are not easily hidden because of resulting muscle shortening. Darwin wrote about posture and depression in his book ‘The Expression of Emotion in Man and Animals’ (1899). According to the author, individuals fall into a depressive state after suffering a problem or sorrow when its cause remains. The same occurs with prolonged pain. There is no desire for action in this state and as a result, the circulation becomes weaker and slower, the muscles become flabby, the eyelids fall, the head is hung on the contracted chest, and the lips and chin slide down with their own weight. If ‘contracted chest’ can also be described as protraction of the shoulders, this is similar to the findings of the present study, since sadness is one of the symptoms of depression (Wakefield et al., 2010). Canales et al. (2010) found that, during episodes of depression, individuals with major depressive disorder
Figure 3 Scatter graph showing the distribution of the current sadness values and the resulting line.
Figure 5 Scatter graph showing the distribution of the protrusion of the shoulder values and the resulting line.
Results Table 1 displays the data obtained from the calculation of the linear regression between the postural and emotional variables. It is possible to notice a clear correlation between Usual Sadness (p Z 0.05) and protrusion of the shoulders. The power of the sample value was r Z 0.544, which indicated a large sample size effect. For the correlation between protrusion of the shoulders and Current Sadness (p Z 0.20), the hypothesis of equality could not be rejected, and a small sample size was obtained (r Z 0.120).
Discussion
Posture and emotion
331
Table 1 Assessment of the angle of protrusion of the shoulder and the respective degrees of usual and current sadness of adult women (N Z 28). Variables
Mean SD P 0.05
Protrusion of the 5.53 1.2 shoulder (degrees) Current sadness 2.28 2.3 Usual sadness 3.63 1.9
Dependent variable 0.20 0.05*
r Dependent variable 0.120 0.544
(*) Statistically significant compared to the protrusion of the shoulder (p 0.05).
experience alterations in posture: increased head flexion, thoracic kyphosis, a trend toward left pelvic retroversion and abduction of the left scapula. In the present study, shoulder protraction is an angular measurement, which is more precise since there is no need to convert the picture measurement to a real measurement. However, a disadvantage of this method is that it does not isolate the torso. Thus, it is possible that increased thoracic kyphosis would increase the value of the shoulder protraction angle. The results of the present study corroborate the findings of Canales et al. (2010). An angle that could isolate the shoulder position itself would be interesting in further research. The head flexion angle, as observed by Sir Charles Darwin (1899) and assessed by Canales et al. (2010), is another important measurement worth studying. It is worth remembering that sadness is an important component of depression but it is not depression itself and posture involved is not necessarily the same. Totton and Edmondson (2009) stated that a caved chest with the shoulders slumped down and forward is an image of defeat and that people who are stuck in this posture, protecting the heart, have generally given up, probably due to constant frustration. The same authors suggest some exercises which free the shoulders and can lead to an emotional improvement. The aim of the present study was not to find an emotional treatment for posture problems or a postural treatment based on cultivating positive emotions. However, since a correlation was detected between emotions and postural deviations, further studies of this treatment are suggested.
Conclusion A significant association was found in the present study between protraction of the shoulder and usual sadness. No associations were found with current sadness. These data may be useful for clinical practice by helping to identify a patient’s emotional condition even without verbalization. They also possibly suggest a new method for treating a sadness component of depression through postural correction, or vice versa, by helping to correct posture in the case of an emotional improvement. Further studies of this topic should be conducted in order to map and trace postural changes related to emotional states and mood disorders, with proper application in clinical practice.
References Canales, J.Z., Corda ´s, T.A., Fiquer, J.T., Cavalcante, A.F., Moreno, R.A., 2010. Posture and body image in individuals with major depressive disorder: a controlled study. Revista Brasileira de Psiquiatria 32 (4), 375e380. Darwin, C.R., 1899. The Expression of the Emotions in Man and Animals. Appleton and company, New York. Ekman, P., Sorenson, E.R., Friesen, W.V., 1969. Pan-cultural elements in facial displays of emotion. Science 164, 86e88. Ekman, P., Levenson, R.W.E., Friesen, W.V., 1983. Autonomic nervous system activity distinguishes between emotions. Science 221, 1208e1210. Garbossa, A., Maldaner, E., Mortari, D.M., Biasi, J., Leguisamo, C.P., 2009. Effects of physiotherapeutic instructions on anxiety of CABG patients. Revista Brasileira de Cirurgia Cardiovascular 24 (3), 359e366. Grammer, K., Fink, B., Oberzaucher, E., Atzmu ¨ller, M., Blantar, I., Mitteroecker, P., 2004. The representation of self reported affect in body posture and body posture simulation. Collegium Antropologicum 28, 159e173. Izard, C.E., 1991. The Psychology of Emotions. Plenum Press, New York. James, H., Castaneda, L., Miller, M.E., Findley, T., 2009. Rolfing structural integration treatment of cervical spine dysfunction. Journal of Bodywork and Movement Therapies 13 (3), 229e238. Kevrekidis, P., Skapinakis, P., Damigos, D., Mavreas, V., 2008. Adaptation of the emotional contagion scale (ECS) and gender differences within the Greek cultural context. Annals of General Psychiatry 21, 7e14. Kleinginna, P.R., Kleinginna, A.M., 1981. A categorized list of emotion definitions, with suggestions for a consensual definition. Motivation and Emotion 5 (4), 345e379. Liebenson, C., 2008. Postural correction. Journal of Bodywork and Movement Therapies 12 (4), 318e319. Munhoz, W.C., Marques, A.P., Siqueira, J.T.T., 2005. Evaluation of global body posture in individuals with internal temporomandibular joint derangement. The Journal of Craniomandibular Practice 23 (4), 1e9. Reich, W., 1942. The Function of the Orgasm. Orgone Institute Press, New York. Rosa ´rio, J.L.P., Marques, A.P., Maluf, S.A., 2004. Aspectos Clı´nicos do Alongamento: uma revisa ˜o de literatura. Revista Brasileira de Fisioterapia 8 (1), 83e88. Schulz, M.L., 1998. Despertando a intuic ¸a ˜o e usando a sintonia entre mente e corpo para o entendimento e a cura. Objetiva, Rio de Janeiro. Stein, N.L., Trabasso, T., 1992. The organization of emotional experience: creating links among emotion, thinking and intentional action. Cognition and Emotion 6, 225e244. Totton, N., Edmondson, E., 2009. Reichian Growth Work e Melting the Blocks to Life and Love. PCCS Books, Ross-on-Wye. Wakefield, J.C., Baer, J.C., Schmitz, M.F., 2010. Differential diagnosis of depressive illness versus intense normal sadness: how significant is the ‘clinical significance criterion’ for major depression? Expert Review of Neurotherapeutics 10 (7), 1015e1018. Wallden, M., 2009. The neutral spine principle. Journal of Bodywork and Movement Therapies 13 (4), 350e361. World Health Organization e WHO, 1998. Preventing and Managing the Global Epidemic. World Health Organization, Geneva, Switzerland. Williams, V.S.L., Morlock, R.J., Feltner, D., 2010. Psychometric evaluation of a visual analog scale for the assessment of anxiety. Health and Quality of Life Outcomes 8, 57e63.
Available online at www.sciencedirect.com
journal homepage: www.elsevier.com/jbmt
OBSERVATIONAL STUDY
Can sadness alter posture? ´ Luı´s Pimentel do Rosa ´rio, PT, PhD*, Jose ´genes, MD, PhD , Maria Suely Bezerra Dio ´ Roberto Leite, PhD Rita Mattei, PhD , Jose Federal University of Sa˜o Paulo, UNIFESP, Department of Psychobiology, Rua Botucatu, 862, 1o. Andar, Vila Clementino, Sa˜o Paulo, SP, CEP 04023062, Brazil Received 3 September 2012; received in revised form 23 November 2012; accepted 30 November 2012
KEYWORDS Posture; Sadness; Emotion; Postural assessment; Analog scales
Summary The present study investigated the existence of a relationship between subjective sadness and body posture in 28 women, aged between 20 and 39 years, who had a normal body mass indices (or were underweight) and an absence of neurological, psychiatric or musculoskeletal disorders. The postural parameter photographed was protraction of the shoulder. The degree of sadness was rated by analog scales representing current and usual sadness. The results indicated that a relationship exists between protraction of the shoulder and usual sadness (p Z 0.05). However, there was no relationship between current sadness and the shoulder position. In conclusion, the usual sadness can lead to shoulder protraction. ª 2012 Elsevier Ltd. All rights reserved.
Introduction Posture and emotions, empirically, have a strong connection. However, scientific evidence for a relationship between these two human characteristics has not yet been reported. Emotions affect the muscles in many ways including the following: the effect of anxiety on heart rate and its rhythm generating a tachycardia; the diaphragm and respiratory rate and hyperventilation; and the skeletal muscles in general. Another example is the effect of slow
* Corresponding author. Rua das Rosas 620, Mirando ´polis, Sa ˜o Paulo, SP, CEP 04048-001, Brazil. Tel.: þ55 42 9992 9992. E-mail address: [email protected] (J.L.P. do Rosa ´rio).
breathing to reduce anxiety (Darwin, 1899; Garbossa et al., 2009). Emotion involves a complex set of interactions mediated by neurohormonal systems, which can give rise to affective experiences, generate cognitive processes, activate widespread physiological adjustments to elicit conditions and affect behavior (Kleinginna and Kleinginna, 1981). Emotions affect attention, behavior and responses to events, as well as activating relevant associative networks in memory (Izard, 1991). A painful or traumatic experience is encoded in the central nervous system by the amygdala as a nonverbal memory and stored in patterns of muscle contractions and neurovegetative sensations by the autonomic nervous system, which connects emotions to organic functions (Schulz, 1998). It is important to consider that each emotion is the integration of specific neurochemical and
1360-8592/$ - see front matter ª 2012 Elsevier Ltd. All rights reserved. http://dx.doi.org/10.1016/j.jbmt.2012.12.001
Posture and emotion motor processes, and it can be considered as the primary motivational system in humans (Izard, 1991). The emotion of sadness can be seen as a reaction to the failure to achieve or maintain a goal (Stein and Trabasso, 1992). A differentiation seems to exist between males and females in terms of the embodiment of emotions. Females are better at showing some emotions, as well as the associated postures and facial expressions. Among four commonly studied emotions (love, happiness, anger and sadness) females obtained higher scores than males in tests of all emotions except anger (Kevrekidis et al., 2008). The study of human posture is relatively new compared to other areas of medical science, and refers to the alignment and maintenance of body segments in certain positions (Rosa ´rio et al., 2004). Some postural deviations may adversely affect muscular efficiency, predispose individuals to pain and pathological musculoskeletal conditions and provoke unaesthetic alterations (Rosa ´rio et al., 2004; Liebenson, 2008; James et al., 2009; Wallden, 2009). The specific focus on posture is very important since it is related to quality of life, a fact that has stimulated interest in different areas. Wilhelm Reich was a pioneer in correlating body posture and muscle contraction (muscular armoring), which in turn is related to emotional aspects (Reich, 1942). A program could exist in humans, at the level of the nervous system, which establishes a connection between specific emotions and certain muscle movements. This correspondence would be invariable (Ekman et al., 1983). Based on a literature review, emotional changes can, with proper stimulation, affect any human being and cause muscle changes coherent with the emotional state. In this context, posture can be an important tool in terms of the diagnosis and treatment of emotional problems. However, there are still very few studies in the literature that have investigated this correlation. The aim of the present study was to investigate the existence of a relationship between the posture represented by protraction of the shoulder and the sadness emotion.
Methods Twenty-eight women, aged between 20 and 39 years, who had a normal body mass indices between 16 and 24.9 kg/m2 were assessed (WHO, 1998). The women could not be in their menstrual period at the time of the assessment. The exclusion criteria included any psychiatric, neurological or musculoskeletal disorders. The present study received approval from the Human Research Ethics Committee of the UNIFESP under protocol number 1391/05 and the participants signed a statement of informed consent. The volunteers were subjected to the same assessment protocol which included demographic data (age, weight in kilograms and height in meters). A digital camera (Canon Power Shot A400) was used for the documentation of the subject’s standing right lateral view. The image was transferred to an Intel Core 2 Duo computer and the angle of protraction of the shoulder was examined by Corel Draw (Fig. 1), as described by Munhoz et al. (2005). The first step was to draw a parallel line to the ground. Then, another line was drawn perpendicular to the first line, which had
329
Figure 1 Lateral photograph with tracings of the angle of protrusion of the shoulder.
the same function as a plumb line. This line was positioned in the photo, at the very back of the heel of the subject. Another line was drawn from this heel point to the most anterior part of the shoulder. The angle between these two lines, with the heel as the fulcrum, revealed the shoulder’s protrusion angle. The temperature in the assessment room was kept at a constant 25 C to avoid possible influences on posture. Analog scales were used to assess the degree of subjective sadness (Williams et al., 2010), which facilitated an assessment of usual sadness (a chronic feeling) and current sadness (momentary feeling present at the time of assessment). The scales were characterized by a 10 cm line, with the words: “no sadness at all” to the extreme left and “Utter despair” to the extreme right, numbered from 0 to 10 (Fig. 2). The volunteers were instructed to make a dash at the place of the line that best described their emotional state. The usual sadness scale sheet, designed to help the subjects to understand, said “you always feel” right above the numbers. The current sadness scale sheet reads “How you are feeling at this exact moment”. The linear regression technique and the effect of sample size were calculated using the ‘Statistical Package for the Social Sciences’ (SPSS) software. The level of significance for the linear regression was set at p < 0.05. The power of
330
J.L.P. Rosa ´rio et al. Usual sadness (you always feel)
0
1
No sadness at all
2
3
4
5
6
7
8
9
10
Utter despair
Figure 2 Example of the analog scales used in the present study e a value of 0 signifies an absence of the emotion studied whereas a value of 10 would be the strongest possible feeling related to that emotion.
the sample had a small effect if r Z 0.10 (explained 1% of the total variance), a medium effect if r Z 0.30 (explained 9% of the total variance) and a large effect if r Z 0.50 (explained 25% of the total variance). For a better understanding of the results, Fig. 3 shows a scatter graph of the variable current sadness. Fig. 4 shows the same graph for usual sadness, which is closer than current sadness to the protrusion shoulder line as seen in Fig. 5.
Figure 4 Scatter graph showing the distribution of the usual sadness values and the resulting line.
It was possible to confirm a statistically significant association between protrusion of the shoulder and usual subjective sadness. These results are similar to those of other authors who have stated that emotions are related to patterns of contraction of the facial muscles (Ekman et al., 1969, 1983) and body posture (Grammer et al., 2004). These results demonstrated that there are postures taken by the body in response to the experience of a specific
emotion. There were no statistically significant associations between protrusion of the shoulder and current subjective sadness at the time of testing. The absence of associations between current sadness and protrusion of the shoulder may have occurred because of the environment where the assessments took place. In a neutral situation, an event that causes transient sadness to the subject may not have as strong an influence at the time of assessment. If this sadness was not experienced with the relevant intensity when the photo was taken, this could explain why the shoulders do not protrude significantly in response. On the other hand, chronic sadness feelings have an influence on the postural muscles for lengthy periods, sometimes for years, and may leave traces that are not easily hidden because of resulting muscle shortening. Darwin wrote about posture and depression in his book ‘The Expression of Emotion in Man and Animals’ (1899). According to the author, individuals fall into a depressive state after suffering a problem or sorrow when its cause remains. The same occurs with prolonged pain. There is no desire for action in this state and as a result, the circulation becomes weaker and slower, the muscles become flabby, the eyelids fall, the head is hung on the contracted chest, and the lips and chin slide down with their own weight. If ‘contracted chest’ can also be described as protraction of the shoulders, this is similar to the findings of the present study, since sadness is one of the symptoms of depression (Wakefield et al., 2010). Canales et al. (2010) found that, during episodes of depression, individuals with major depressive disorder
Figure 3 Scatter graph showing the distribution of the current sadness values and the resulting line.
Figure 5 Scatter graph showing the distribution of the protrusion of the shoulder values and the resulting line.
Results Table 1 displays the data obtained from the calculation of the linear regression between the postural and emotional variables. It is possible to notice a clear correlation between Usual Sadness (p Z 0.05) and protrusion of the shoulders. The power of the sample value was r Z 0.544, which indicated a large sample size effect. For the correlation between protrusion of the shoulders and Current Sadness (p Z 0.20), the hypothesis of equality could not be rejected, and a small sample size was obtained (r Z 0.120).
Discussion
Posture and emotion
331
Table 1 Assessment of the angle of protrusion of the shoulder and the respective degrees of usual and current sadness of adult women (N Z 28). Variables
Mean SD P 0.05
Protrusion of the 5.53 1.2 shoulder (degrees) Current sadness 2.28 2.3 Usual sadness 3.63 1.9
Dependent variable 0.20 0.05*
r Dependent variable 0.120 0.544
(*) Statistically significant compared to the protrusion of the shoulder (p 0.05).
experience alterations in posture: increased head flexion, thoracic kyphosis, a trend toward left pelvic retroversion and abduction of the left scapula. In the present study, shoulder protraction is an angular measurement, which is more precise since there is no need to convert the picture measurement to a real measurement. However, a disadvantage of this method is that it does not isolate the torso. Thus, it is possible that increased thoracic kyphosis would increase the value of the shoulder protraction angle. The results of the present study corroborate the findings of Canales et al. (2010). An angle that could isolate the shoulder position itself would be interesting in further research. The head flexion angle, as observed by Sir Charles Darwin (1899) and assessed by Canales et al. (2010), is another important measurement worth studying. It is worth remembering that sadness is an important component of depression but it is not depression itself and posture involved is not necessarily the same. Totton and Edmondson (2009) stated that a caved chest with the shoulders slumped down and forward is an image of defeat and that people who are stuck in this posture, protecting the heart, have generally given up, probably due to constant frustration. The same authors suggest some exercises which free the shoulders and can lead to an emotional improvement. The aim of the present study was not to find an emotional treatment for posture problems or a postural treatment based on cultivating positive emotions. However, since a correlation was detected between emotions and postural deviations, further studies of this treatment are suggested.
Conclusion A significant association was found in the present study between protraction of the shoulder and usual sadness. No associations were found with current sadness. These data may be useful for clinical practice by helping to identify a patient’s emotional condition even without verbalization. They also possibly suggest a new method for treating a sadness component of depression through postural correction, or vice versa, by helping to correct posture in the case of an emotional improvement. Further studies of this topic should be conducted in order to map and trace postural changes related to emotional states and mood disorders, with proper application in clinical practice.
References Canales, J.Z., Corda ´s, T.A., Fiquer, J.T., Cavalcante, A.F., Moreno, R.A., 2010. Posture and body image in individuals with major depressive disorder: a controlled study. Revista Brasileira de Psiquiatria 32 (4), 375e380. Darwin, C.R., 1899. The Expression of the Emotions in Man and Animals. Appleton and company, New York. Ekman, P., Sorenson, E.R., Friesen, W.V., 1969. Pan-cultural elements in facial displays of emotion. Science 164, 86e88. Ekman, P., Levenson, R.W.E., Friesen, W.V., 1983. Autonomic nervous system activity distinguishes between emotions. Science 221, 1208e1210. Garbossa, A., Maldaner, E., Mortari, D.M., Biasi, J., Leguisamo, C.P., 2009. Effects of physiotherapeutic instructions on anxiety of CABG patients. Revista Brasileira de Cirurgia Cardiovascular 24 (3), 359e366. Grammer, K., Fink, B., Oberzaucher, E., Atzmu ¨ller, M., Blantar, I., Mitteroecker, P., 2004. The representation of self reported affect in body posture and body posture simulation. Collegium Antropologicum 28, 159e173. Izard, C.E., 1991. The Psychology of Emotions. Plenum Press, New York. James, H., Castaneda, L., Miller, M.E., Findley, T., 2009. Rolfing structural integration treatment of cervical spine dysfunction. Journal of Bodywork and Movement Therapies 13 (3), 229e238. Kevrekidis, P., Skapinakis, P., Damigos, D., Mavreas, V., 2008. Adaptation of the emotional contagion scale (ECS) and gender differences within the Greek cultural context. Annals of General Psychiatry 21, 7e14. Kleinginna, P.R., Kleinginna, A.M., 1981. A categorized list of emotion definitions, with suggestions for a consensual definition. Motivation and Emotion 5 (4), 345e379. Liebenson, C., 2008. Postural correction. Journal of Bodywork and Movement Therapies 12 (4), 318e319. Munhoz, W.C., Marques, A.P., Siqueira, J.T.T., 2005. Evaluation of global body posture in individuals with internal temporomandibular joint derangement. The Journal of Craniomandibular Practice 23 (4), 1e9. Reich, W., 1942. The Function of the Orgasm. Orgone Institute Press, New York. Rosa ´rio, J.L.P., Marques, A.P., Maluf, S.A., 2004. Aspectos Clı´nicos do Alongamento: uma revisa ˜o de literatura. Revista Brasileira de Fisioterapia 8 (1), 83e88. Schulz, M.L., 1998. Despertando a intuic ¸a ˜o e usando a sintonia entre mente e corpo para o entendimento e a cura. Objetiva, Rio de Janeiro. Stein, N.L., Trabasso, T., 1992. The organization of emotional experience: creating links among emotion, thinking and intentional action. Cognition and Emotion 6, 225e244. Totton, N., Edmondson, E., 2009. Reichian Growth Work e Melting the Blocks to Life and Love. PCCS Books, Ross-on-Wye. Wakefield, J.C., Baer, J.C., Schmitz, M.F., 2010. Differential diagnosis of depressive illness versus intense normal sadness: how significant is the ‘clinical significance criterion’ for major depression? Expert Review of Neurotherapeutics 10 (7), 1015e1018. Wallden, M., 2009. The neutral spine principle. Journal of Bodywork and Movement Therapies 13 (4), 350e361. World Health Organization e WHO, 1998. Preventing and Managing the Global Epidemic. World Health Organization, Geneva, Switzerland. Williams, V.S.L., Morlock, R.J., Feltner, D., 2010. Psychometric evaluation of a visual analog scale for the assessment of anxiety. Health and Quality of Life Outcomes 8, 57e63.