Upright posture improves affect and fatigue in people with depressive symptoms Carissa Wilkes a , Rob Kydd a , Mark Sagar b , Elizabeth Broadbent a, * a Dept of Psychological Medicine, The University of Auckland, Auckland, New Zealand b Bioengineering Institute, The University of Auckland, Auckland, New Zealand article info Article history: Received 9 February 2016 Received in revised form 25 May 2016 Accepted 28 July 2016 Available online 30 July 2016 Keywords: Depression Posture Psychological stress Fatigue Embodied emotion abstract Background and objectives: Slumped posture is a diagnostic feature of depression. While research shows upright posture improves self-esteem and mood in healthy samples, little research has investigated this in depressed samples. This study aimed to investigate whether changing posture could reduce negative affect and fatigue in people with mild to moderate depression undergoing a stressful task. Methods: Sixty-one community participants who screened positive for mild to moderate depression were recruited into a study purportedly on the effects of physiotherapy tape on cognitive function. They were randomized to sit with usual posture or upright posture and physiotherapy tape was applied. Participants completed the Trier Social Stress Test speech task. Changes in affect and fatigue were assessed. The words spoken by the participants during their speeches were analysed. Results: At baseline, all participants had significantly more slumped posture than normative data. The postural manipulation significantly improved posture and increased high arousal positive affect and fatigue compared to usual posture. The upright group spoke significantly more words than the usual posture group, used fewer first person singular personal pronouns, but more sadness words. Upright shoulder angle was associated with lower negative affect and lower anxiety across both groups. Limitations: The experiment was only brief and a non-clinical sample was used. Conclusions: This preliminary study suggests that adopting an upright posture may increase positive affect, reduce fatigue, and decrease self-focus in people with mild-to-moderate depression. Future research should investigate postural manipulations over a longer time period and in samples with clinically diagnosed depression. © 2016 Published by Elsevier Ltd. 1. Introduction Stooped posture is a feature of psychomotor retardation, and is an attribute of major depressive disorder (MDD) in many diagnostic classification systems (American Psychiatric Association, 2013; World Health Organization, 2009). Psychomotor disturbances were primary diagnostic indicators of depression in the neo- Kraeplin era, where it was noted that depressed patients appeared fatigued, took small steps, adopted a slumped posture, and were somewhat motionless and unresponsive (Kraeplin, 1968). In contemporary literature, psychomotor disturbances remain a method to distinguish melancholia from other depressive subtypes (Parker, 2007). There has been limited research into the role of posture in depressed samples, but work to date suggests a positive cross-sectional relationship between stooped posture and depres- sion severity (Canales, Cordas, Fiquer, Cavalcante, & Moreno, 2010; Nyboe-Jacobsen, Smith Lassen, Friis, Videbech, & Wentzer Licht, 2006). Psychomotor retardation shares a strong relationship with greater functional impairment, disability, and risk of falls in elderly samples (Alexopoulos et al., 1996; Hausdorff, Peng, Goldberger, & Stoll, 2004; Kiosses, Alexopoulos, & Murphy, 2000). Furthermore, in people with severe depression, gait patterns displaying slumped posture and swaying upper body movements are associated with dysphoric mood (Michalak et al., 2009). Embodied theories of cognition and emotion propose a bidi- rectional relationship between the physical body and psychological states (Niedenthal, 2007). It is thought that people make rapid, automatic and unconscious inferences from perceptions of their * Corresponding author. Dept of Psychological Medicine, Faculty of Medical and Health Sciences, The University of Auckland, Private Bag, 92019, Auckland, New Zealand. E-mail address: e.broadbent@auckland.ac.nz (E. Broadbent). Contents lists available at ScienceDirect Journal of Behavior Therapy and Experimental Psychiatry journal homepage: www.elsevier.com/locate/jbtep http://dx.doi.org/10.1016/j.jbtep.2016.07.015 0005-7916/© 2016 Published by Elsevier Ltd. J. Behav. Ther. & Exp. Psychiat. 54 (2017) 143e149