Effect of integrated Yoga module on positive and negative emotions in Home Guards in Bengaluru: A wait list randomized control trial.

BACKGROUND: The beneficial aspect of positive emotions on the process of learning and the harmful affect of negative emotions on coping with stress and health are well-documented through studies. The Home Guards (HGs) are working in a very stressful situation during election, managing traffic and other crowded places. It is quite essential in present day circumstances that they have to manage their emotions and cope up with different stressful situations.
OBJECTIVE: To study the efficacy of integrated Yoga module (IYM) on emotions (positive and negative affect [PA and NA]) of HGs.
METHODS: A total of 148 HGs both males and females who qualified the inclusion and exclusion criteria were randomly divided into Yoga group (YG) and control groups (CG). The YG had supervised practice sessions (by trained experts) for 1 h daily, 6 days a week for 8 weeks along with their regular routine work whereas CG performing their routine work. Positive affect negative affect scale (PANAS) was assessed before and after 8 weeks using a modified version of PANAS.
RESULTS: PA in YG had significantly increased (P < 0.05) whereas it had decreased significantly (P < 0.05) in CG. Other positive effect in YG had significantly increased (P < 0.001), whereas it had decreased significantly (P < 0.001) in CG. NA in YG had significantly decreased (P < 0.001), whereas it had significantly increased (P < 0.001) in CG. Other NA in YG had significantly decreased (P < 0.001), whereas it had significantly increased (P < 0.01) in CG.
CONCLUSIONS: The results suggested that IYM can be useful for HGs to improve the PA and to decrease NA score. Moreover, IYM is cost-effective and helps HGs for coping up with emotions in stressful situations.

RCT Entities:   Population Interventions Outcomes

INTRODUCTION

Security and police personnel are playing a very important role in controlling law and order in the society and protected the country even in ancient days.[1] Today, Home Guards Organization (HGO) shares the above duty with the security and police personnel. HGO is an independent disciplined and uniformed body of volunteers constituted under Karnataka Home Guards (HGs) Act, 1962, under Karnataka Home Department. HGs’ Services have become indispensable during fairs, festivals, sports, elections, and for daily traffic control. Nowadays, Bengaluru HGs assist Bengaluru city Traffic Police, Regional Transport Office, Bangalore University, Food Corporation of India, Karnataka State Road Transport Corporation, and many more organizations.[2]

Normally, the HGs work in stressful situations; hence, facing the realities of life is tough for them. Stress is not viewed as a singular event, but as a transaction between an individual and the environment that makes demand on all available coping resources of the body-mind complex. This involves cognitive appraisal and coping processes. When these resources are taxed, and the responses exceed the coping abilities, it can result in distressful negative emotions.[3] These precipitate aggressive behaviors such as anger, fear, distress, and irritability. Stress and coping are closely related to affect or emotions because they are affected by cognitive appraisal.[4] Thus the heightened stress responses that result in negative affect (NA) and distress, are reflections of an inability to cope with demanding situations.[5]

An emotion is defined as a mental and physiological state associated with a wide variety of feelings, thoughts, and behaviors. It is a prime determinant of the sense of subjective well-being and appears to play a central role in many human activities.[6] Watson et al. measured these emotions under two major categories namely positive and NA. Pleasant emotions of different intensities may be grouped as “positive affectivity” (PA) and unpleasant emotions under “NA”.[7]

Negative affect

NA can be termed as a state of aversive mood and subjective distress. It is seen that self-esteem of a person is affected, and the quality of relationship with others gets deteriorated.[8] This not only leads to the cause of anxiety and depression but also narrows down the attention. The fear leads to withdrawal behavior where the situation demands for survival[8] depending on the capacity to cope up with different situations.[9] The characteristics of low NA[7] are calmness and contentment.

Positive affect

It is observed that people who are having tendencies to cope up through humor will have greater positive mood and have also shown increased levels of salivary immunoglobulin A, a vital immune system protein.[10] Positive emotions such as hope does contribute to over health benefits accrued by dispositional optimists.[5]

Remedial measures

The coping strategies in respect of occurrence and responding with positive emotions (e.g., positive reappraisal, problem-focused coping, and infusing every event with positive meaning) do help buffering against stress and depressed mood.[11] Such strategies will help the individuals to emerge from critical moments with all new coping skills establishing closer relationship and showing greater appreciation toward life. All such strategies predict an increase in psychological well-being.[12]

Through studies, the benefits of PA in prevention and rehabilitation of stress-related diseases such as hypertension,[13] gastrointestinal disorders,[14] coronary heart disease,[15] and diabetes have been established. It is also established through studies that the higher PA has shown lower levels of glycosylated hemoglobin in normal people, indicating the beneficial effect of PA on diabetic parameters.[16]

The studies have also shown that individuals often adopt complementary health approaches to improve their health and well-being[1718] or to get relieved from symptoms associated with chronic diseases or the side-effects of use of conventional medicine.[1920]

Yoga

The ancient Yoga from India dating back to thousands of years is now getting the popularity all over the world as a practice of mind-body medicine. Its practices have the potential to promote PA. In the recent survey conducted by the National Center for Complementary and Alternative Medicine in 2015 has shown that overall 34% of adults used complementary and alternative therapies and Yoga in 2012.[21] The whole of person's life including physical, mental, emotional, and spiritual aspects are addressed by Yoga for prevention of disease and overall well-being of the person. It is also observed that the practice of Yoga do benefit the individual for overcoming his negative emotions, which in turn will improve the quality of life of healthy people with increased immunity,[10] better pulmonary functions,[22] and increased life-span.[23]

Yoga and physical health

It was observed that practice of Yoga improved joint flexibility,[24] respiratory endurance, and strengthening of muscles[25] in young. Yoga practice also improved the dexterity in students.[26] The other documented physical health benefits of Yoga are reduction in body fat, improved shoulder flexibility in elderly females,[27] improvement in immunological tolerance,[28] noticeable and favorable changes in neuro-endocrine functions including melatonin and cortisol secretions,[293031] lower perceived exertion after exhaustive exercise.[32]

Yoga for positive mental health

Continued practice of Yoga for 10–30 days has shown increased visual perception,[33] better learning skills,[34] and increased spatial and verbal memory.[35] The integrated practice of Yoga has also shown improved cognitive functions in children and adults.

Yoga for positive emotional health

In the studies made for assessing the emotional states of the individual by “Profile of Mood States” after practice of Yoga have shown significant improvements in negative emotions such tension, anxiety, depression, dejection, anger, hostility, fatigue, inertia, confusion, and bewilderment.[36] 10 h practice of Iyengar Yoga has shown improvement in the emotional states of the individual with regard to depression, anxiety, negative mood, and fatigue in young adults[37] as reported by the practitioners. In the study to compare African dance and Hatha Yoga, showed reduced perceived stress and NA with both these practices but the Hatha Yoga showed reduced cortisol levels also.[30] Hence, the benefits of Yoga practice is that it improves mood and differential effects which may be related to its influence on physiological states of arousal[30] through establishing stable autonomic balance.[38]

Thus, reducing NA and increasing PA is one of the main concerns in management of emotions.

In the present study, we examined the positive and NA outcomes HGs who attended integrated Yoga module (IYM) for 2 months; daily 60 min of practice; 6 days a week.

METHODS

Subjects

Five hundred HGs attended motivational lectures. 148 of them volunteered to be in study group. The subjects were randomly divided into Yoga group (YG) (n = 75) and control groups (CG) (n = 73) using random number table.[39] The subjects were selected from field working HGs from various parts of Bangalore Rural District.

Based on a previous study,[40] the effect size was calculated as 0.456, fixing alpha = 0.05, power = 0.95 and hence the sample size of this study was (n = 75). This calculation was done using G power.

We have included the subjects of both gender, normal healthy field working HGs and age between 20 and 45 years. Similarly, we have excluded the subjects with any ailments, consuming alcohol, and smoking and those who already practicing Yoga.

The Institutional Ethical Committee of S-VYASA approved the study proposal. The informed consent was taken from all subjects before enrolling them in the study.

Design

This is a prospective, randomized, single-blind, control study to measure and compare the positive and NA thereby anxiety and depression of the HGs allotted to YG and CG. The researcher deputed instructors to deliver introductory lectures to the HGs for motivating them to join the study. Gruha Rakshaka Bhavan (HG Administrative office at Bengaluru, Karnataka, was the venue for Yoga classes).

Both the groups (YG and CG) were performing their routine work such as maintaining law and order, managing the traffic and public in different government organization such as RTO and Vidhana Soudha and participated in weekly mandatory parades as per HG schedules.

The YG besides doing their normal routine work also did 1 h of IYM practices, 6 days a week for 8 weeks. Daily attendance was taken for all the subjects; Yoga trained experts taught IYM to YG. The CG did their normal routine work. The CG was given an option to join Yoga classes after the study completion.

Evaluation

The tests were self-administered by examiners before and after 8 weeks of IYM in a disturbance free quiet room.

Masking

The invigilators coded and saved the answered questionnaires response sheets (QRS) for scoring latter. A psychologist not involved in group formation or class supervision valued the coded QRSs. Another person decoded the QRSs only after noting the scores both before and after data was completed.

Assessments

Assessment was done using the positive affect negative affect scale (PANAS) questionnaire developed by Watson et al.[7] The PANAS is a 20-item questionnaire designed to measure PA and NA. It has ten questions each to measure positive and negative emotions, referred to as PA and NA. The internal reliability (Cronbach's coefficient alpha) is 0.86–0.96 for PA and 0.84–0.87 for NA of the PANAS.[7] Narasimhan et al. in her study has added nine (four positive and five negative) questions for his study, which are referred as other PA (OPA) and other NA (ONA).[40] The PANAS, OPA, and ONA domain scores were analyzed and interpreted separately since the questions that were added had not been tested earlier for validity and reliability.

Data extraction

The participants rated all questions on a 5-point scale of 0–4. (0-not at all, 1-a little, 2-moderately, 3-quite a bit, and 4-extremely) reflecting the extent to which they experienced the emotion during the past 1 week. All 29 questions were intermixed in the questionnaire. They were carefully isolated for obtaining the individual scores for the four domains, i.e. PA, NA, OPA, and ONA. Incomplete answer sheets were discarded.

Intervention

Yoga group

The YG HGs besides doing their routine work participated in Yoga practice also. They were given IYM from the integrated set of Yoga practices used in earlier studies on the effects of Yoga for positive health.[41] The basis of developing the integrated approach is ancient Yoga texts[42] for total physical, mental, emotional, social, and spiritual levels[43] developments. The techniques include physical practices (Kriyās, Āsanās, a healthy Yogic diet), breathing practices with body movements and Pranayama, meditation, lectures on Yoga, stress management, and life-style change through notional corrections for blissful awareness under all circumstances (action in relaxation). Qualified Yoga teachers taught Yoga. They taught the group the IYM [Table 1] for 2 months; daily 60 min of practice; 6 days a week.

Table 1

Details of the IYM practices

Control group

The CG did no Yoga practice but did their routine work only. However, the CG subjects could opt for Yoga classes as part of the study after study duration.

Statistical analysis

Data were analyzed using R-Statistical software. This calculation was done using G power.[44]

Data at baseline were assessed for normal distribution using Shapiro–Wilk's test in both the groups. The independent sample t-test was performed to assess the significant difference between the groups and paired samples t-test for within the group.

RESULTS

Demographic data

There were 75 subjects in YG and 73 subjects in CG. The age range was between 20 and 50 years. They were 36 females in YG and 31 in CG, 39 males in YG and 42 in CG. There were 49 married people in both YG and CG. There were 26 unmarried in YG and 24 in CG.

The educational qualification of the subjects were up to SSLC, SSLC to PUC, and graduates [Table 2].

Table 2

Demographic data of subjects

Changes in positive affect negative affect scale after Yoga in Yoga group

There was a significant improvement in PA after yoga at a P < 0.01 and P < 0.001 showing 5.53% and 22.86% changes in PA and OPA, respectively. The NA decreased after yoga at a P < 0.001, with 22.23% and 24.92% reduction in NA and ONA, respectively.

Changes in positive affect negative affect scale in control group

There was a significant reduction in PA after yoga at a P < 0.05 and P < 0.001 showing 7.83% and 18.50% changes in PA and OPA, respectively. There was a significant increase in NA and ONA P < 0.001, P < 0.01 with 23.23% and 11.71% improvement in NA and ONA, respectively.

In general, the PA in YG has significantly increased from 19.92 ± 3.89 to 21.02 ± 3.76 (P < 0.01), whereas it has decreased significantly from 19.79 ± 3.88 to 18.24 ± 6.38 (P < 0.05) in CG [Table 2a and Figure 1].

Table 2a

Pre- and post-data of PA, OPA, NA, and ONA in YG and CG

Figure 1

Changes in positive affect

Other positive affect

The OPA in YG has significantly increased from 8.44 ± 2.42 to 10.37 ± 2.86 (P < 0.001), whereas it has decreased significantly from 9.97 ± 2.48 to 8.17 ± 3.27 (P < 0.001) in CG [Table 2a and Figure 2].

Figure 2

Changes in other positive affect

In general, the NA in YG had significantly decreased from 16.76 ± 7.71 to 13.03 ± 6.63 (P < 0.001), whereas it had increased significantly from 17.86 ± 5.29 to 22.01 ± 7.53 (P < 0.01) in controlled group [Table 2a and Figure 3].

Figure 3

Changes in negative affect

Other negative affect

In general, the ONA in Yoga has significantly decreased from 10.07 ± 3.85 to 7.56 ± 3.95 (P < 0.001), whereas it has increased significantly from 10.84 ± 2.82 to 12.11 ± 3.76 (P < 0.01) in CG [Table 2a-d and Figure 4].

Table 2d

Changes in individual items of NA

Figure 4

Changes in other negative affect

Further individual question in the PANAS was analyzed.

This table shows the changes in individual items of PA domains (PA and OPA). There was an increase ranging from 0% to 20.73% in the individual items of PA with a negative change − 3.35% in the question “Proud.” There was 5.32–39.29% increase in the OPA scores. Question number 15 (“content”) indicating the degree of contentment showed the highest degree of improvement (39.29%) in YG. However, in CG, there was a decrease ranging from 0% to 24.30% in the individual items of PA with a positive change 14.45% in the question “Strong.” There was 14.38–39.07% decrease in the OPA scores. Question number 8 “pleased” with positive improvement.

In YG, it is noteworthy that the degree of changes in the NA is better, in the range of 11.14–38.01%, than the increase in the items on PA. The ONA descriptor “Disappointed” showed the maximum reduction of 38.01%. There is a positive change in questions Jittery, Guilty, and Hostile in YG.

In CG, there is an increase in NA range of 4.19–42.15%, descriptor “Jittery” showed the maximum increase of 42.15%. The ONA also increase with a range of 0.52–38.40%, with a “Miserable” showed maximum increase 38.40%.

DISCUSSION

The descriptive of negative emotions, “Distressed” and “Disappointed” showed 37.40% and 38.01% reduction, respectively, in YG. Since the HGs are volunteers and they do not have job security, they were in a mood of distress and disappointment. The beneficial effect of the IYM in unwinding the distress and disappointed feeling in HG's that too within a short period of time may be considered as an important contribution of this study.

IYM meant to develop better mastery over the modifications of the mind through introspective awareness to calm down the mind may have increased their level of confidence to make a resolve to change their lifestyle and approached to their life to overcome their guilt, shame, and the related complexes. Similar changes have been reported in a study after Vipassana meditation in Tihar Jail. The inmates of the jail showed reduced hostility, anxiety, and depression with improved sense of well-being and hope for the future in those with or without psychiatric problems.[45] Reduction in aggressive behavior has been demonstrated in normal young volunteers after 12 weeks of integrated Yoga program similar to the practices used in this study.[46]

In this study, it has been noticed that negative emotions such as fear, hatredness, and nervousness, which are other forms of anxiety, which leads to stress have reduced drastically. Many studies have shown the stress reducing effect of Yoga,[474849] which supports the observations of our study. The relaxation response after yoga may offer the ability to face the situations in a relaxed state of mind and perform with utter ease and effortlessness. Yoga is considered as a special skill of action in relaxation. This was observed with Yoga practices in musicians with the relative reduction in performance anxiety, musculoskeletal conditions, and mood and flow experience.[50] Yoga practices prior to exams in medical students showed improved concentration, improved efficiency, increased attentiveness, and significant reduction in number of failures.[51]

“Disappointed, upset, irritable, hostile” are different facets of anger resulting from unsatisfied desires or the inability to cope. All this is described in the Bhagavadgita as violent speed of mind resulting in anxiety or depression. These have shown reduction in this study. Benefits of Yoga practices for rapid stress reduction and anxiolysis among distressed women,[52] betterment of mood in psychiatric inpatients,[36] and reduction in symptoms of depression[37] are reported.

The perception of vigor “Active” and “Pleased” (q. 25, 8) have increased by 9.85% and 25.35%, respectively. The feeling of wellness was contributed by Asanas and loosening exercises, which increases spinal flexibility,[24] dexterity,[26] and stamina.[25]

The integrated Yoga program taught in this camp included lectures and practice of bhakti Yoga (devotional sessions) that are meant for direct handling of emotions by nurturing the positive emotions of pure love and surrender to the divine as tools for stress reduction and positive health.[53] Similar thinking is expressed by a study, which said that spirituality (faith, selfless service, and pure love) promotes a healthier coping style.[54] An increase in PA “contentment” by 39.29% reflects the calming effect of yoga.

The increase in PA and decrease in NA in YG may be due to better mastery over modification of the mind and calming down of the mind. The yogic techniques have helped the HGs to increase their level of confidence and hence it has become easy for them to overcome NAs.

The other aspect of yoga is relaxation which might have given the ability to the HGs to face the situation in the field in a relaxed state of mind and perform duty in relaxed and effectiveness way, which means relaxation in action and efficiency in outcome.

The results obtained in our study is almost similar to the results of one of the earlier studies Narasimhan et al.[40] The other 9 questions OPA and ONA, which was taken from Narasimhan et al.[40] variable can be validated.

The strength of our design is the IYM for HGs. It is first test of its kind in HGs where they have been exposed to IYM practice, which shown the beneficial effect to HGs.

CONCLUSION

The results have shown that IYM has increased the PA in HGs and reduced the NA. Further Yoga is very cost effective and recommended to HGs. Hence, this study is a solution to train HGs to calm their mind and help them to increase their positive thinking and decrease negative mindset. By this, their service to public will improve and in turn the image of the Department will also go up.

This study is the continuation and suggestion given one of the earlier studies done by Lakshmi et al. There was no control in that study and it was suggested to have a CG in future study, which was carried out in our study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

Table 2b

Results of integrated yoga practices in YG and CG

Table 2c

Changes in individual items of PA