Recent behavioral studies have shown the clinical relevance of meditation in the treatment of stress-related physiological and psychological illnesses. Kabat-Zinn et al. (1998) found that audio-induced mindfulness meditation reduced stress and increased the rate of healing of psoriatic lesions in patients with psoriasis. Krisanaprakornkit et al. (2006) reviewed a variety of meditation techniques on the effect of stress-related anxiety disorders and found that most meditation approaches can help patients self-regulate anxiety symptoms in a variety of anxiety conditions. In an extensive literature review comprising hundreds of studies conducted in the past 20 years, Jacobs (2001) also found that relaxation techniques and mind-body interventions are clinically effective in the treatment of a variety of health problems associated with stress. For example, meditation has been shown to improve prognosis in coronary heart disease, enhance the immune response, and restore homeostasis. Furthermore, meditation was found to be more effective than antidepressant medication in the treatment of major depression. However, Jacobs stresses that meditation therapies are more effective when used as adjuvants to standard medical care.
Tsai (2004) studied the long-term effect of audio-visual relaxation therapy (AVRT) in conjunction with meditation in the treatment of anxiety in cardiac patients and found that AVRT combined with meditation reduced anxiety, improved sleep and promoted relaxation in this group of patients. Chen et al. (2009) examined the efficacy of progressive muscle relaxation training in the treatment of anxiety in patients with acute schizophrenia and found the effectiveness of this therapy depended on the quality of the patient’s mental status at the time of intervention.
Meditation can induce various physiological and biochemical changes some of which enable the intrinsic human potential to visualize light (Brown, Forte & Dysart, 1984) and people with extensive meditation training are able to more readily perceive this innate light. Virtual Light and Sound Machine (VLSM) meditation therapy introduces patients to the experience of veteran meditators while conferring immediate therapeutic benefits.
Q1. What is the effect of VLSM therapy on state anxiety levels, as measured by the STAI?
Q2. What is the effect of VLSM therapy on perceived stress levels, as measured by the PSS?
This will be a prospective, randomized, controlled clinical trial designed to examine the effects of VLSM meditation therapy (Solfanelli, 2010) on state anxiety levels and perceived stress levels. As previously noted, state anxiety will be operationally defined as scores on Spielberger’s State-Trait Anxiety Inventory (STAI), whereas stress will be operationally defined as scores on the Perceived Stress scale (PSS).
Audio-visual stimulation (AVS) therapy was selected over other popular forms of meditation therapy, including therapies such as Joacobson’s Progressive Muscle Relaxation (Conrad & Roth, 2006), mindfulness-based stress reduction (MBSR) therapy (Brady et al, 2012) and Paced Breathing Meditation (PBM) therapy (Prasad et al, 2011).
This decision was based upon the fact that although there is subsequent muscle relaxation with AVS, AVS seems to more closely approximate the experience of mindfulness mediation (MM), as AVS appears to elicit a meditative experience, via a momentary suspension of any mental intending (Budzynski, 2006).
Utilizing G*Power software (Faul, Erdfelder, Lang, Buchner, 2007), it was determined that an alpha level of 95%, a confidence interval of 15, and an adequate will require a sample size of 135 volunteer subjects. The subjects will be randomly assigned to one of three treatment groups; namely, a TBD VLSM group, a TBD VLSM group, and a control group. All groups will complete a pre- and post-test of the STAI and PSS to determine their state anxiety and perceived stress levels.
The STAI was chosen as an assessment instrument for this research, since it is a well-researched scale that is the most relied upon self-report measure of anxiety (Spielberger, et al., 1995). Additionally, the STAI has shown positive test-retest reliability (Spielberger, Gorsuch, & Lushene, 1970). The PSS was also chosen as an assessment instrument for this research, since it is constructed to determine the extent to which an individual evaluates their life experiences as stressful events. The PSS’s 10-item subjective questionnaire has an index that has been empirically corroborated (Cohen, Kamarch, & Mermelstein, 1983).
Informed consent will be obtained from all participants and Institutional Review Board approval will be obtained from both the originating research institution and the university from which subjects will be selected (United States National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978).
Subjects from the general pool of adult male and female student volunteers from a small northeastern Pennsylvania university will be randomly assigned to a TBD VLSM experimental group, a TBD VLSM experimental group, and a control group. Volunteers will be selected from both the school's traditional (day program) and non-traditional (evening program) programs, and the age of the volunteers will range from 20 to 60.
VLSM was designed to entrain brainwaves with precisely timed, flickering lights, and there exists a risk that flickering lights might induce seizures in subjects undergoing VLSM therapy; therefore, in adherence with the Belmont Report’s ethical principles and guidelines for the protection of human subjects of research (United States National Commission for the Protection of Human Subjects of Biomedical and Behavioral Research, 1978), all subjects will be pre-screened for the rare possibility of a diagnosis of photosensitive seizure disorder or photosensitive epilepsy (Erba, n.b.). According to Erba (n.b.) there is an overall risk of 0.0005% for an undiagnosed person to experience this type of adverse medical reaction to flickering lights and those diagnosed with photosensitive seizure disorder or photosensitive epilepsy experience their first light-induced seizure before age 20.
The VLSM experimental group will be seated with their eyes closed in a dimly lit and quiet room two feet away from their respective computer monitors and exposed to VLSM therapy for a period of 10 minutes. The software pulses the monitor so that the flickering is experienced behind the subjects’ closed eyelids and its effect is to induce a feeling of deep relaxation within a few minutes. The subjects will experience the effects of the VLSM meditation software (independent variable) preset to the theta-4-y setting.
The mindfulness meditation experimental group will listen to a pre-recorded mindfulness meditation for approximately fifteen minutes. The audio meditation will be publicly accessed from the University of North Carolina at Chapel Hill website: ftp://ftp.unc.edu/pub/dsa/shs/cws/cws_relax4.mp3. The control group will be seated in a quiet waiting room and told they have been wait listed for the next opportunity to participate. The dependent variable is the subjects' responses to the STAI and PSS.
This research will contribute to theory insomuch as it will support or reject results from previous research that demonstrated that flicking lights have the ability to create a reduction in state anxiety (Brignolo, 2007).
The Statistical Package for the Social Sciences (SPSS version 17) will be used to analyze STAI and PSS scores. Statistical analyses will include a two-tailed distribution for independent sample means and a between-group repeated measures multiple analysis of covariance (MANCOVA). The hypothesis is that VLSM meditation will induce relaxation and thus improve STAI and PSS scores in healthy volunteers.
All participants of this research study will be administered pre- and post-test, self-report measures of stress, trait anxiety, and state anxiety by means of the following instruments: the Perceived Stress Scale (PSS) and Spielberger’s State-Trait Anxiety Inventory (STAI).
The Perceived Stress Scale (PSS) is constructed to determine the extent to which an individual evaluates their life experiences as stressful events. It consists of a 10-item subjective questionnaire, which has an index that has been empirically corroborated in other studies (Cohen, Kamarch, & Mermelstein, 1983).
Spielberger’s State-Trait Anxiety Inventory (STAI) consists of two subscales; one measures state anxiety, the other measures trait anxiety. This subjective instrument relies upon a string of scores ranging from 20 to 80. The greater scores are indicative of a higher level of experienced anxiety. The STAI demonstrates concurrent validity with its anxiety scale and other standardized instruments that measure anxiety. For example, the Anxiety Scale Questionnaire (ASQ) has a positive correlation score of 0.73, while the Manifest Anxiety Scales (MAS) has a 0.85 correlation (Spielberger, et al., 1995). According to Rule and Traver (1983), the STAI has also shown positive test-retest reliability.
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