Chapter 3

METHODOLOGY

3.0 Introduction

This chapter includes a description of the methodology used to investigate each of the following research questions:

• Do meditation and contemporary theatre have a measurable effect on higher cognitive functions?

• Do meditation and contemporary theatre have a measurable effect particularly on the attention component of WM as described by Engle (in press)?

• If this is the case, do meditation and contemporary theatre produce similar effects?

• Do meditation and contemporary theatre produce measurable differences on different sub-tests in the CANTAB battery?

• If this is the case, on which CANTAB sub-tests are the differences measured?

• Does the amount of practice in meditation or contemporary theatre make any difference on higher cognitive functions, especially on the attention component of WM?

The methodology includes a description of participants, materials used and the procedure.

3.1 Participants

Four paired samples were identified corresponding to the selected criteria. These were a group of actors, with a matched control group and a group of meditators with their respective control group. The variables of age, gender and level of education were taken as matching criteria.

The actors group form part of the Mediterranean Institute Theatre Programme (MITP). The training which these actors engage in satisfies the criteria for ergotropic arousal, that is, being fully attentive to the intense physical exercise or activity whilst being engaged in it. The training of these contemporary actors is physically vigorous and involves being fully attentive to their creative process.

The meditators group was chosen from the Ananda Marga (AM) yoga and meditation school. The meditators in this group satisfied criteria for trophotropic arousal, that is being fully concentrated on a single object or thought whilst the body is not engaged in movement. These meditators focus their attention on repeating a mantra whilst sitting down motionless.

Both the actors and meditators had to have a minimum of one year regular training in their respective domains to be selected for the study. One year of training for the actors group was equivalent to 312 hours, or three weekly 2-hour sessions (six hours per week). For the meditators the minimum requirement was of 365 hours, or a twice daily 30-minute meditation session (seven hours per week).

The other two participant groups were control groups paired to the actors and meditators groups respectively. Participants in the control groups had never practised meditation or trained in contemporary theatre. Each control participant was matching a particular actor or meditator on the variables of age, gender and level of education. Each of these factors was considered to be relevant in this study. The upper and lower age limits were set at 49 and 18 years respectively, whilst all participants had to have a secondary level of education. Equal numbers of males and females were selected, and all participants had to be free of mental health problems up to the time of testing. Exclusion of participants who did not meet these inclusion criteria resulted in a total sample of 48 participants.

50% of the participants were male and 50% female, and their mean age was 30.27, ranging from 19 to 45. 12.5% of the total sample had a secondary level of education, and 8.33% had a post-secondary level of education. All these participants were employed in skilled labour. 37.5% of the sample were students at a tertiary level, and 45.83% were graduates in professional employment.

Although nationality was not an exclusion criterion, it should be noted that 7 of the participants, or 14.58% of the whole sample were not of a Maltese nationality. All these had been living in Malta at least for the six months prior to the taking of the test. All participants, Maltese and foreign, could communicate well in the English language.

Gender, age and level of education characteristics in each group were as follows:

Within the actors group (n = 12) 50% were male and 50% were female. Their mean age was 23.75 and ranged from 19 to 30. One individual or 8.33% of the actors group had a post-secondary education, whilst 25.0% were graduate professionals and 66.67% were University students.

Since the actors control group was matched on these characteristics it also had 50% males and 50% females (n = 12). The controls mean age was 24.00 and ranged from 20 to 30. One individual (8.33%) also had a post-secondary education, whilst 25.0% were graduate professionals and 66.67% were University students.

In the meditators group (n = 12) 50% were males and 50% females. Their mean age was 37.00 and the range was from 20 to 45. 25% of the meditators group had a secondary level of education, whilst a single individual (8.33%) had a post-secondary level of education. Another participant (8.33%) was a University student, whilst 58.33% were graduates in professional employment.

Similar characteristics were evident in the meditators control group (n = 12). 50% were male and the rest female, whilst the mean age was 36.33% ranging from 20 to 45. The level of education was also matched accordingly with 25% having a secondary level of education, 8.33% a post-secondary level of education, a further 8.33% students in tertiary education, and 58.33% graduates.

3.2 Apparatus

In this section a description of the materials used for measurement and data collection will be described.

Eight weeks before the actual tests were run, separate checklists were distributed amongst the actors and meditators populations (Appendices Ia and Ib). Items on the checklists included gender, age, level of education, occupation, any health problems (physical or mental), years they had been practising their respective disciplines, how often they meditate or train in contemporary theatre and the length of each meditation or training session.

The aim of the checklist was twofold. Primarily to gather demographic information so that the two matched control groups could be formed, but also to gain information regarding the amount of training each of the participants had undergone. The checklist also included information regarding the research, the planned experimental procedure, and clarified that filling-in the checklist did not bind the prospective participant to undergo the WM tests which would be held at a later date. Prospective participants were asked to remain anonymous, and were assured of confidentiality.

Six weeks before the WM tests were run, similar checklists were distributed among prospective control participants (Appendix Ic). Items on the checklist included gender, age, level of education, occupation, any physical or health problems, and whether they had ever practised meditation or trained in contemporary theatre. A brief description of these two terms was also included. Any prospective participant who had previously trained in these activities was excluded.

The single-page checklist also included a covering letter with an invitation to participate in the study and a description of the experimental procedure. The prospective participants were also assured of confidentiality.

Each of the prospective actors, meditators and controls was sent a letter two weeks before the WM tests were run in which they were thanked for their interest in participating in the study and invited to undergo the tests (Appendix II). The letter also included a brief description of the experimental procedure and the participants were reminded that participation in the tests was on a voluntary basis and they had a right to withdraw their participation at any time. They were also urged to direct any queries to myself and were notified that the testing procedure was part of a psychology dissertation that had been officially approved.

The letter also included details about the venue for the tests, the length of time they were expected to take and the time slot in which the prospective participant was invited to undergo the tests.

This was a one-page typed form (Appendix III) which was signed by both the participant and myself.

Each of the participants was asked to fill in a data checklist (Appendix IV) similar to the checklists they had filled before. Each individual was also coded on the second sheet of the checklist in which empty tables were prepared, where the main results of the tests could be inputted immediately after each participant finished all their tests. The aim of this checklist was to have the records of any particular participant, including demographics and results obtained, in a single document.

Participants were debriefed at the conclusion of the experiment. The one-page typed debriefing statement (Appendix V) served to give further information regarding the purpose of the research, the experimental hypotheses and the important role of the participants in it. Participants were again reassured regarding confidentiality and thanked for their collaboration.

The standardised assessment to be used in this research had to have the following characteristics:

• An attention component, and therefore specific attention tasks to be used together with WM tests measuring WM capacity and investigating the sub-systems as described by Baddeley (1986).

• High sensitivity to changes in higher cognitive functions, including WM and attention, within the normal range.

• Easy to administer, but having high validity and reliability.

• Culture-fair and therefore not based on language or any other dimension where there could be evidence of cultural bias.

The CANTAB (Cambridge Neuropsychological Test Automated Battery), first developed by CeNeS Cognition in 1987, is a computerised battery of neuropsychological tests. It has been shown in more than 100 published studies to be sensitive to cognitive changes in a variety of brain disorders and normal subjects. Twelve tests form its 'Attention Battery', 'Visual Memory Battery' and 'Working Memory and Planning Battery.' It provides for the assessment of a variety of cognitive functions, including working memory, attention, learning and problem solving, as well as tests of executive function and vigilance (Pantelis & Maruff, 1998). CANTAB also has four Parallel Batteries were different versions of the tests in the main batteries can be used.

CANTAB is very easy to administer, running under DOS 6.0 on a 486DX processor with 4MB RAM, with a touch-sensitive screen or a mouse. The version used in this dissertation is 2.35 released by CeNeS Cognition in August 1998. All twelve tests are language free, making CANTAB highly suitable in multinational studies, as indeed was the sample tested in this research. Data is stored automatically and then analysed and summarised in a simple easy to use format.

CANTAB is especially sensitive to cognitive changes even when traditional cognitive measures have proven insensitive (Robbins, 1998). It can be used across all ages, with psychiatrically disturbed or dementing subjects, but also with normal healthy individuals (Harrison, 1998).

CANTAB has been used and validated in hospitals and neuroscientific research groups across four continents. Over 2000 subjects have been tested with CANTAB and their data has been used to determine norms for both patients and normal control subjects. The norms commonly used are given by age, gender and IQ (CeNeS Cognition, 1998). The major division is by age, with bands for subjects less than 35, age from 35-49, then by decade up to 70 and a band for 70 and over. In this research the participants all fell under the under-35 and 35 to 49 age bands.

Within the different age bands, the norms are divided into three bands of IQ: less than 110, 110 to 119 and 120+. In the standardised norms, IQ is estimated from the National Adult Reading Test (NART). Nevertheless since this test would have proved inappropriate for this sample were most participants are not native English speakers, a fourth IQ in each of the age bands was used where all IQ scores are collapsed. The minor division within each age/IQ band is gender. CANTAB tests, with the exception of some spatial measures have been shown not to be sensitive to gender. Reference to these norms can assist in the interpretation of data with comparatively small samples and even individuals. CANTAB has also been shown to have test-re-test reliability and therefore the battery is reliable over time (Shah, 1998).

This validation, reliability and sensitivity shows CANTAB to be a highly effective method of psychological assessment, especially for this research. Thus particular tests were chosen to be the main experimental tools for this study. Four tests were chosen: Intra/Extra-Dimensional Shift (IED), and Rapid Visual Information Processing (RVP) from the Attention Battery; Paired-Associates Learning (PAL) from the Visual Memory Battery; and Spatial Working Memory (SWM) from the Working Memory and Planning Battery.

Each of these tests was selected for their accuracy in measuring the particular cognitive functions which were relevant to this research, but also for their avoidance of 'floor' and 'ceiling' effects. This factor was especially relevant to this research in view of the fact that only healthy individuals were tested and thus easier tests in the CANTAB would not have distinguished between more or less able participants in the sample. The IED, PAL and SWM are designed such that initial problems can be solved by almost all subjects, whereas later stage problems test the abilities of even very competent subjects. The RVIP on the other hand is challenging to even the most able of subjects, notwithstanding the fact that its structure does not permit distinction between easy problems and harder ones.

A description of each of the chosen tests will now follow, together with the particular cognitive functions they measure. The task and display of each test is available in Appendix VI.

This test measures the subject's ability to attend to the specific attributes of compound stimuli, and to shift that attention when required. The actors' and meditators' training in attention, was expected to differentiate their performance from that of their respective controls. The actors' particular training in focusing attention on an activity was expected to differentiate their performance even from the meditators who are trained in keeping their attention focused on a single, constant object.

The RVP is a test of sustained attention with a small working memory component. The actors and meditators' performance was expected to be significantly better than their controls', since their respective disciplines train them in sustained attention.

The test is a form of delayed response procedure, which tests two different aspects of the ability to form visuo-spatial associations. First, the number of patterns placed correctly on the first presentation of each trial gives an index of 'list memory', which can also be described as WM capacity. Second, the number repeat-reminder presentations needed for the subject to learn all the associations provides a measure of list learning. It was expected that the actors and meditators groups do significantly better on this test than the control groups.

As the name implies this is a test of spatial working memory, with a planning and attention component. The actors, due to their training in using the body as a medium in space, were expected to do overall significantly better in this test. Nevertheless with their training in attention, the meditators were also expected to do significantly better than their controls.

The experimental procedure is described in the next section.

3.3 Procedure

This section describes the implementation of the research and the process of data collection utilising the materials described in the previous section.

The respective authorities of the actors and meditators groups, the Mediterranean Institute Theatre Programme (MITP) co-ordinator and Ananda Marga (AM) co-ordinator, were contacted, and eight weeks before the actual tests were run, they were handed a number of separate checklists which were distributed in their respective groups.

Filling-in the checklist was strictly on a voluntary basis. Of the 25 checklists distributed in the meditators group, 16 were returned, although 3 participants later decided not to undergo the WM tests and a fourth did not meet inclusion criteria. 15 checklists were distributed in the actors group and 10 were returned. Two further actor participants decided to join the study and filled the checklist at a later date.

Prospective participants were asked to remain anonymous, and were assured of confidentiality. However they gave their particulars (name, address, contact number and/or electronic mail) to the co-ordinator of the respective organisations with whom the author was directly in touch.

Six weeks before the WM tests were run, similar checklists were distributed among prospective control participants. Around 50 of these checklists were circulated via electronic mail, and 30 others by post. Each of the prospective participants was debriefed about the experimental procedure and confidentiality was assured. Those who were interested in participating in the study were invited to send an e-mail back or to post a hard copy of it. However they were informed that filling in the checklist did not guarantee that they would be chosen as participant controls, since they had to match specific criteria, and nor were they bound to undergo the tests if they later chose not to participate.

Two weeks before the experimental procedure, each of the prospective actors, meditators and controls was contacted again via a letter and invited to attend at a specific time to undergo the tests themselves. In the following days, individual arrangements were made with each participant as well.

Prior to the experimental sessions, a pilot test was conducted. This was done to ensure familiarisation with the experimental procedure, to check that all instructions were clear and any extraneous variables accounted for, and to establish the duration of the test.

Four individuals who had volunteered as controls, but whose age, gender or level of education could not be directly matched with those of any actor or meditator, piloted the study and were tested on the chosen tests from the CANTAB. The conditions for the pilot study were the same as in the experiment. Completion time for the test was determined to be between 30 to 40 minutes. The participants, who still conformed to the inclusion criteria, experienced no difficulties in performing the test.

The experiment was conducted in a constant environment, and any extraneous variables were accounted for. The tests were conducted in the same room. Testing was carried out on an individual basis, over five consecutive days, with a random allocation of participants to time of testing.

The tests were administered in the following order, with tests from the Attention Battery being administered first, followed by a test each from the Visual Memory Battery and Working Memory and Planning Battery:

• Intra/Extra-Dimensional Shift

• Rapid Visual Information Processing - Training

• Rapid Visual Information Processing - Test

• Paired Associates Learning

• Spatial Working Memory

The standardised instructions for each test were read slowly to each participant from the CANTAB manuals (Appendix VI).

There were two main sources of data: the checklist, which each participant filled on the day of the experiment, and the CANTAB tests themselves.

An estimate of the total hours of formal practice for both actors and meditators was obtained from two sets of question items from the checklist. A quantitative measure was computed from:

• the number of years each participant has been engaged in acting/meditation;

• how frequently they practice acting/meditation (on average, twice daily for meditators, three times weekly for actors);

• how long each training/meditation session takes (on average, 30 minutes for meditators, 120 minutes for actors).

In the CANTAB data is stored automatically and then analysed and summarised according to the variables of age and gender. A summary table is given for each test where the score, standard score (Z-score) and percentile of the main items being measured is recorded. More detailed descriptions of the subject's performance on each test are also given. The main data items for each test are available in Appendix VI.

Finally all the information obtained from the checklist - age, gender, level of education, training history and total hours of training for the actors and meditators groups - together with the scores obtained from the CANTAB tests, were inputted into a data file for SPSS Version 7.5 (computer program) analysis.