Yoga as a Psychosocial Intervention for Anxiety and Depression in Adults with Intellectual Disability
: a Feasibility Study Testing Laughter Yoga versus Vinyasa Yoga as a Group Based Adjunct Therapy

  • Louise Claire Gates

    Student thesis: Doctoral ThesisDoctor of Philosophy


    Background: Adults with intellectual disabilities (ID) experience mental health conditions at twice the rate of the
    non-disabled population (Cooper et al, 2007). There is limited evidence for the effectiveness of complementary,
    group-based interventions as an adjunct to usual care explicitly targeting the mental wellbeing of adults with ID.
    Group-based, psychosocial interventions provide for social interaction, which is often lacking for this population
    group. The present study aimed to identify the scientific benefits of laughter yoga (LY) as a psychosocial
    intervention for adults experiencing depression and anxiety secondary to ID. Alongside two systematic reviews, it
    focused on testing LY in comparison with vinyasa yoga (VY) as a specific, group-based intervention using both
    quantitative and qualitative methods. LY involves simulated laugher made possible via laughter exercises. To date,
    no studies have examined the effect of any style of yoga on anxiety and depression in adults with ID. This study is
    the first to assess two different styles of yoga as psychosocial interventions for adults with ID.
    Method: Two systematic reviews were carried out prior to the feasibility study design. Both quantitative (mood
    rating scales, blood pressure, salivary cortisol) and qualitative data (participant interviews) was collected. This
    provided preliminary quantitative and qualitative data in addition to the main feasibility data examining the data
    collection methods. In the mixed-methods, feasibility study (with a one-month follow-up), LY was compared to VY
    with the goal of isolating and identifying the effect of laughter. The feasibility of the intervention was assessed using
    five methods: the evaluation of recruitment capability and resulting sample characteristics, assessment and
    refinement of data-collection procedures and outcome measures, evaluation of the acceptability and suitability of
    the intervention and study procedures, evaluation of the resources and ability to manage and implement the study,
    and intervention and preliminary evaluation of participant responses to intervention. Thirteen participants were
    randomly assigned to the LY intervention (n=4), the VY intervention (n=4), and the control group (n=5). The
    participants in the LY and VY groups took part in six weekly yoga sessions, with a one-month follow-up. The
    participants completed the Glasgow mood rating scales adapted for ID at baseline (T0), week three (T1), week six
    (T2), and one month post-intervention at week 10 (T3). Salivary-cortisol samples and blood-pressure
    measurements were taken at baseline (T0), before and after each session and at the follow-up (T3).
    Findings: Both systematic reviews found that no study has examined yoga on mental health in adults with disability
    and that the recommend research approach was to undertake a feasibility study. The feasibility results evidenced
    by the evaluation of the acceptability and suitability of the intervention and study procedures, show that LY is a
    plausible intervention for adults with ID. The preliminary quantitative data showed no significant relationship
    between group and time was found for anxiety, depression, blood pressure, or salivary cortisol. Similarly, no
    significant main effect of group was found for anxiety, depression, blood pressure, or salivary cortisol. However, a
    significant main effect of time was found for anxiety (F(3, 24) = 4.369; p =.014). Five themes emerged from the
    qualitative data through thematic analysis, with two of these themes highlighting positive views of the intervention
    and reflections of the participants' positive emotional state.
    Conclusion: A full-scale, randomised control trial to explore LY for adults with ID would be beneficial if the
    recommended future directions were followed and modifications were made to the intervention and study design.
    The findings of this thesis enhance understanding of how yoga can be made a feasible psychosocial intervention
    for adults with ID. These findings also contribute to a better understanding of the recruitment challenges faced
    when undertaking research with this vulnerable population group.
    Date of AwardJul 2021
    Original languageEnglish
    Awarding Institution
    • Coventry University
    SupervisorPablo Domene (Supervisor), Derek Renshaw (Supervisor) & Laurence J Baldwin (Supervisor)

    Cite this