Upright Posture Influences Emotions and Stress Response in Mild to Moderate Depression

Abstract

Depression is a concerning global health issue that has high social and economic costs. Psychomotor disturbances are a neglected area in depression literature, despite being an objective indicator of depressive psychopathology that is linked to impairment in daily functioning. Initial research suggests body posture is associated with depression in crosssectional research. This study investigated the causal relationship between posture and emotion in a depressed sample. The primary aim was to investigate whether or not an intervention that uses physiotherapy taping to obtain an upright posture can improve affect in people with mild-to-moderate depression. Sixty-one people with mild-to-moderate depression indicated by the Beck Depression Inventory-II participated in a 45-minute laboratory experiment. Participants completed baseline measures of demographics, affect, mood, self-esteem, physiology, and posture. They were then randomly allocated to the upright posture intervention or usual posture control group. Physiotherapy tape was applied to maintain an upright posture or allow their usual posture. Participants then completed mood and affect measures, and participated in writing and speaking tasks. Physiology, mood, affect and self-esteem were measured after the speaking task. Eight hours after commencing the laboratory session, participants completed mood, affect, and reported physiotherapy tape discomfort measures in an online questionnaire, and were instructed to remove the tape. The writing and speech content were analysed using Linguistic Inquiry and Word Content analysis and posture using Video Image Tracking technology. At baseline, participants in the current sample displayed slumped shoulder and back angles compared to normative data from a healthy community sample (p < .001). Manipulation checks indicated that the intervention group maintained an upright posture throughout the laboratory session. Following the intervention, there was an immediate influence of upright posture on positive affect and a reduction in fatigue compared to the control group (p < .05). The intervention group wrote and spoke more words than the control group for the writing and speaking tasks (p < .05). The intervention group also used fewer personal pronouns and more sadness-related words than the control group (p < .05). Upright shoulders displayed a relationship with less negative affective emotions and anxiety, lower systolic blood pressure, and increased ingestion words during the speech task (p < .05). The findings suggest that an upright posture intervention can improve positive affect, reduce fatigue, and decrease self-focus compared to a usual posture control group for people with mild-to-moderate depression. Future research should investigate the role of posture and other psychomotor disturbances in a clinically depressed sample over a longer duration with cortisol as a marker of stress reactivity. While these results are preliminary, there are potential clinical implications. Changing posture may be useful alongside other psychotherapeutic interventions for depression.