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Abstract

Introduction

Occupational therapy utilizes altruistically motivated activities, potentially influencing both frontal alpha asymmetry (FAA) associated with approach motivation and autonomic responses. This study examines the effects of altruistically motivated craft activities on FAA and autonomic activity.

Methods

Fifteen rehabilitation students (21.0 ± 0.4 years) performed a netcraft task under altruistic and selfish conditions. EEG and ECG were measured during the craft task, and FAA and autonomic indices were analyzed.

Results

FAA score was significantly higher in the altruistic condition (p = .040, d = 0.59), indicating increased approach motivation. Sympathetic activity was significantly lower in the altruistic condition (p = .018, r = −0.68), indicating reduced sympathetic activity.

Conclusions

Altruistically motivated craft activities increased relative left frontal cortical activity and decreased sympathetic activity, highlighting their potential benefit in occupational therapy. These findings are not only consistent with previous research, but also support the inclusion of altruistic activities in therapeutic interventions to improve mental health and well-being.

Keywords

Occupational therapy mental health autonomic activity frontal alpha asymmetry altruistic motivation craft

Introduction

Altruism is defined as an apparently unselfish behavior that provides benefit to others at some cost to the individual by American Psychological Association (American Psychological Association, 2018). Behaviors and activities based on altruism include, for example, giving way to a stranger on the street, helping someone in need, participating in volunteer activities, and making regular donations to charitable organizations. Whether these altruistic behaviors and activities are fair and free from selfish motives is debatable. In any case, behavior and activities based on altruistic motives are fundamental to human social interaction. It not only benefits the recipients but also promotes the well-being of the benefactors, including increased happiness (Dunn et al., 2008; Wheeler et al., 1998), reduced mortality (Brown et al., 2003), better health and longevity (Post, 2005), and stress buffering (Han et al., 2020). Compassion, the basis of altruism, has been linked to autonomic nervous system activity. For example, decreased heart rate (Eisenberg et al., 1989), increased parasympathetic activity (Stellar et al., 2015) and relatively decreased sympathetic activity (Correa et al., 2015) have been reported. In other words, it is suggested that altruism may have an autonomic modulatory effect, such as a decrease in relative sympathetic activity.

On the other hand, altruism has also been reported to be associated with cortical activity. One such measure is frontal alpha asymmetry (FAA), which measures the relative difference between left and right alpha power in the frontal cortex (Huffmeijer et al., 2012). Relative left frontal activity magnitude, i.e., alpha activity that is relatively stronger on the right, is associated with greater sensitivity to behavioral activation (Coan & Allen, 2003; Harmon-Jones & Allen, 1997), i.e., greater approach motivation, in Gray’s behavioral activation and inhibition system (Gray, 1987, 1990). Thus, since FAA is closely related to approach motivation (McGregor et al., 2022), and having a caring attitude toward others, such as altruism, has been associated with approach motivation (Kim et al., 2009), it is logical to consider FAA as a potential motivational measure of altruism.

Given that altruistic motivation is associated with autonomic activity and that altruistic motivation is associated with FAA, it would seem that autonomic activity and FAA are also related. In support of this, neurofeedback training that enhances left frontal activity has been reported to be promising in reducing negative emotions and anxiety (Mennella et al., 2017). Relatively higher right frontal activity at rest has also been associated with stronger physiological stress responses (Ma et al., 2021), and noise stress has been reported to increase relative right frontal cortical activity and cortisol levels (Alyan et al., 2021). Taken together, approach motivation and altruism may result in increased relative left cortical activity as indicated by the FAA, which in turn may have additional modulatory effects on stress and autonomic activity.

This altruistically motivated behavior is also used as a therapeutic tool in occupational therapy (OT). OT is a rehabilitation profession that prioritizes the client’s needs and promotes health and well-being through meaningful activities (The World Federation of Occupational Therapists, 2012). Craft activities have long been used in psychiatry (Griffiths & Corr, 2007; Harris, 2007). Altruistically motivated craft activities, in particular, may enhance positive engagement such as sense of well-being (Haberman, 2013; Hatter & Nelson, 1987) and life satisfaction (Yuen et al., 2008). Crafting in OT has previously been reported to have a modulatory effect on autonomic activity (Orui et al., 2023; Shiraiwa et al., 2020). Given that altruism causes a decrease in relative sympathetic activity (Correa et al., 2015; Eisenberg et al., 1989), altruistically motivated crafting activities may have a further modulatory effect on autonomic activity.

In this study, we aim to elucidate the effects of altruistically motivated crafting activities on autonomic activity using electroencephalogram (EEG). Specifically, we hypothesize that such activities will increase FAA, indicating higher approach motivation, and decrease sympathetic activity, indicating a calmer state. By elucidating this, it would be possible to selectively and effectively use motivation to perform crafts as a rehabilitation tool.

Methods

Participants

The study included rehabilitation students between the ages of 18 to 25. The purposes and procedures of the experiment were explained in details to all participants, and written informed consent was obtained prior to the experiment. All participants were in good health, free of mental or physical illness based on self-reporting and medical history. Those with a history of significant stressful events or psychological treatment within the previous 6 months were excluded. Those participants currently taking medication, especially antidepressants or anti-anxiety medications, were also excluded. The study was approved by the Research Ethics Review Committee of the Graduate School of Rehabilitation Science, Osaka Metropolitan University (2023–217) and adhered to the Declaration of Helsinki.

Procedure

Participants engaged in a craft activity called netcraft, threading a needle through a perforated polyethylene canvas to make a bookmark, similar to previous studies (Orui et al., 2023; Shiraiwa et al., 2020). The netcraft used in this study involved threading a needle through 9*22 approximately 3 mm square holes in an approximately 4 cm*10 cm polyethylene canvas, skipping one square. The task is performed for only one row, and each time one line is knitted, the next line is knitted, for a total of 22 lines. The task was performed under two conditions: altruistic (“Make a piece to give to the person closest to you”) and selfish (“Make a piece to give to yourself”). In the altruistic condition, participants were asked to think of the “person closest to them” and, to make the altruistic motivation more specific, they were verbally asked before the experiment whether a specific person came to mind and what specific relationship they had with that person. The gender and age of the other person were not controlled for ethical reasons. A rest period of 1.5 min was allowed before and after each condition. To counterbalance potential order effects, the order of conditions presented was randomized. Participants were fitted with EEG and electrocardiogram (ECG) equipment and given practice with the tools before measurement (Figure 1).

Figure 1.

Details on each condition and procedure. In the altruistic condition, participants were taught to “make a piece of work to give to the person closest to you”, and in the selfish condition, they were taught to “make a piece of work to give to yourself”. There was a 1.5-min rest period before and after each condition, and the order of the conditions was counterbalanced.

Measurement indicators

In addition to age and gender, the following items were measured.

Task performance

The time (in seconds) required to complete 22 lines of netcraft was measured as a performance indicator. Task performance was measured to test whether differences in motivation had an impact on behavior.

EEG

The HARU-2 (PVG Co., Ltd) was used to measure the participant’s EEG activity during the crafts. The EEG had three channels, AFz, Fp1, and Fp2, according to the extended 10–20 method, with the reference electrode placed on the left mastoid, and the sampling rate set at 250 Hz. Impedance was measured in the “OK” contact status measurement system.

The EEG data were band-pass filtered between 8–14 Hz using EEGLAB (v2021.1) in MATLAB. Artifact regions were reconstructed using the Artifact Subspace Reconstruction (ASR) algorithm in EEGLAB. ASR parameters were determined for reproducibility and proper artifact removal. ASR identifies clean data regions and calculates the standard deviation using principal component analysis. Data exceeding 10 times the standard deviation were rejected. The power values (μV²) in the α band (8–13 Hz) of AFz, Fp1, and Fp2 were then calculated using EEGLAB’s Darbeliai v2022.12.21.1 plug-in, with an FFT window length of 2 s and spectral steps in 1 Hz of 10. In calculating the FAA score, we applied a logarithmic transformation to the power values of the selected electrodes to normalize the data, following previous research (Jang et al., 2020). Furthermore, by normalizing the value obtained by subtracting the left frontal alpha power from the right frontal alpha power and dividing by the sum of the two, it is possible to exclude individual differences in EEG (Allen et al., 2004). For this reason, the FAA score in this study was calculated using the following formula. A larger positive FAA score calculated using this formula indicates that alpha activity in the left frontal region is relatively low, i.e., that activity in the left frontal region is relatively high.

F A A = \frac{\log (F p 2 α p o w e r) - \log (F p 1 α p o w e r)}{\log (F p 2 α p o w e r) + \log (F p 1 α p o w e r)}

Heart rate

A WHS-1 wearable heart rate sensor (Union Tool Co., Ltd) was attached to the participant’s left chest to measure the RR interval (RRI) [ms] during the craft task. The sampling rate was 1000 Hz. In this study, Lorenz plot analysis (Toichi et al., 1997) was used to calculate indices of autonomic activity. Lorenz plot analysis allows the calculation of the cardiac sympathetic index (CSI) as a measure of sympathetic activity and the cardiac vagal index (CVI) as a measure of parasympathetic activity. This analysis is a valuable tool for analyzing autonomic activity during manual work because it is less affected by respiratory components (Penttilä et al., 2001) and more sensitive (Gamelin et al., 2006). Participants ' RRIs were visually inspected for artifacts and missing data in Physiozoo (v1.7.1) (Behar et al., 2018) and SD1 and SD2 values were calculated for the first and second half of each participant’s time to complete the task. The Lorenz plot is a scatterplot with the nth RRI on the horizontal axis and the n + 1th RRI on the vertical axis, where SD1 represents the standard deviation in the vertical direction and SD2 represents the standard deviation in the parallel direction relative to the line of identity of the distribution. L and T are four times the values of SD1 and SD2 and CSI is calculated as the L/T ratio and CVI is calculated as the common logarithm of L*T (Toichi et al., 1997). L and T, CSI and CVI were calculated using the following formula.

L = S D 2 * 4, T = S D 1 * 4

C S I = \frac{L}{T}, C V I = \log 10 (L * T)

The CSI and CVI were calculated for the first half and the second half. The amount of change was calculated by subtracting the first half data from the second half data of CSI and CVI. In other words, the first half of the crafting task in each condition was calculated as the baseline. This allows us to compare changes during the task between conditions rather than differences in baseline.

Because both the EEG and the ECG were wireless, participants were able to focus on the task and participate in the experiment without worrying about wires.

Statistical analysis

Task completion time, FAA scores, and changes in CSI and CVI were assessed for normality using the Shapiro-Wilk test and compared between conditions using paired t-tests or Wilcoxon signed-rank tests, depending on the normality of the data distribution. Effect sizes were calculated using Cohen’s d for the paired t test and Wilcoxon’s r for the Wilcoxon signed-rank test. The effect size is a measure that is not sensitive to sample size and was calculated to supplement the small sample size. Confidence intervals were reported to provide additional context for the results. Statistical analyses were performed using jamovi (version 2.4.0) (Kerby, 2014; R Core Team, 2021; The jamovi project, 2023) with a significance level of 0.05.

Results

Data from 15 participants (21.0 ± 0.4 years, 4 females) were analyzed (Table 1, Figure 2).

Table 1.

Inter-condition comparison of task performance and FAA scores and autonomic activity.

		Altruistic		Selfish		p	95% CI		Effect size
	^a	Mean	SD	Mean	SD		Lower	Upper
	^b	Median	IQR	Median	IQR		Lower	Upper
Time [s]	^b	180.00	51.00	180.00	35.00	0.233	−19.000	20.500	0.37
FAA	^a	0.03	0.03	0.02	0.03	0.040	0.001	0.021	0.59
AFz alpha power [μFz	^a	11.34	5.46	12.19	5.99	0.212	−2.233	0.541	−0.34
CSI change	^b	−0.26	0.61	0.23	0.82	0.018	−0.885	−0.095	−0.68
CVI change	^a	−0.01	0.12	0.06	0.17	0.197	−0.189	0.043	−0.35
RRI change [ms]	^a	−0.68	18.41	−6.23	21.65	0.387	−7.793	18.912	0.23

CI: confidence interval, SD: standard deviation, IQR: interquartile range, FAA: frontal alpha asymmetry, CSI: cardiac sympathetic index, CVI: cardiac vagal index, RRI: RR interval.

^aMean and standard deviation are presented, p-values are from the paired t test, and effect sizes are presented as Cohen’s d.

^bMedian and interquartile range are presented, p-values are from the Wilcoxon signed rank test, and effect size is Wilcoxon’s r.

Figure 2.

Results of FAA and CSI changes. Panel (a) shows a comparison of FAA between conditions. It was significantly greater in the positive direction in the altruistic condition than in the selfish condition. Error bars are standard errors. (p = .040) (paired t test). Panel (b) shows the comparisons between conditions on the CSI change. It was significantly lower in the altruistic condition than in the selfish condition. (p = .018) (Wilcoxon signed-rank test).

Task performance

The time to complete the task did not differ significantly between the altruistic (180.0 [174.0–225.0] seconds) and selfish (180.0 [168.5–203.5] seconds) conditions (p = .233).

FAA

FAA scores were significantly higher in the altruistic condition (0.03 ± 0.03) compared to the selfish condition (0.02 ± 0.03) (p = .040, d = 0.59).

Autonomic activity

CSI change was significantly greater in the selfish condition (0.23 [−0.32 to 0.50]) compared to the altruistic condition (−0.26 [−0.64 to −0.02]) (p = .018, r = −0.68). CVI change did not differ significantly between conditions (p = .197). There was no significant difference between the altruistic condition (2.09 ± 0.91) and the selfish condition (2.33 ± 0.85) at baseline (p = .198, d = 0.35).

Discussion

This study investigated the effects of altruistically motivated craft activities on autonomic nervous system activity using EEG. We found that FAA scores were significantly higher in the altruistic condition with a moderate effect size, indicating greater left frontal activity, which is associated with increased approach motivation and altruism. The fact that significant differences between conditions were found in such a short period of time, even though the crafts were performed for approximately 3 minutes in both conditions and the tasks performed in both conditions were identical, is considered important evidence that differences in motivation to perform crafts in OT clinical situations may lead to neurophysiological changes. Furthermore, and importantly, there was no difference in task performance between the two conditions. In other words, it can be interpreted that the difference in motivation, rather than the behavioral change, caused the physiological change. Given the limitations in sample size and EEG channels, this study provides preliminary evidence that highlights the need for further research with more comprehensive methodologies.

The FAA score calculated by the formula in this study indicates that higher values indicate a relatively higher alpha power value for Fp2 than for Fp1, i.e., a condition of relatively higher activity in the left frontal region. Higher left frontal activity than right frontal activity has been reported to be associated with higher behavioral activation sensitivity (Coan & Allen, 2003; Harmon-Jones & Allen, 1997) and increased altruism (Huffmeijer et al., 2012). The results of this study support previous findings that FAA is associated with altruism. In this study, the altruistic condition was a situation in which the participant gave a gift to the closest person, although the other person recalled by the participant was not controlled. It is possible that the FAA score increased because the FAA score was increased by recalling others who were close to them, which increased their approach motivation toward the others. In any case, the FAA scores provided evidence that altruistic motivation elicits more relative left cortical activity than selfish motivation. In terms of autonomic activity, CSI change was significantly lower in the altruistic condition, with larger effect sizes, suggesting reduced sympathetic activity. This finding supports previous research indicating that altruism is associated with lower sympathetic dominance and a calmer state (Correa et al., 2015; Eisenberg et al., 1989; Stellar et al., 2015), particularly parasympathetic activity (Bornemann et al., 2016; Stellar et al., 2015). Sympathetic activity is associated with rapid responses to acute stressors and has a shorter reaction time (Weissman & Mendes, 2021), whereas parasympathetic activity is more gradual and sustained as it is associated with maintaining organ function and regulating responses to stimuli (Munoz-Allen, 2023). The lack of significant change in CVI in the present study may be due to the short duration of the task, which primarily elicited immediate sympathetic responses. The finding that altruistic motivation leads to a predominance of parasympathetic activity in the previous study and a decrease of sympathetic activity in the present study seems to be consistent. According to previous research, the positive relationship between the FAA and positive emotions is supported by findings showing that left frontal activation correlates with successful emotion regulation and positive emotional states (Kelley & Hughes, 2019). It has also been shown that people with active left frontal activity have a high degree of flexibility in emotional expression, which is crucial for social interaction and mental health, and it has been suggested that people with this neural pattern are better at regulating their emotions, contributing to more positive emotional experiences (Shangguan et al., 2023). It has also been reported that positive psychological interventions can increase subjective well-being, which is associated with a relative increase in left frontal activity (Xu et al., 2018). In other words, the increase in left frontal activity indicated by FAA may be closely related to positive emotions, such as increased subjective well-being and decreased depression and anxiety. The increase in FAA and decrease in sympathetic nerve activity observed in this study are consistent with the positive emotion-related aspects of these previous studies, and may shed light on the importance of motivation when using occupational therapy tasks.

The results of this study were based on the use of the netcraft task, which is a simple, structured task that is widely used in occupational therapy clinical settings and is also a task that has been used in previous studies (Orui et al., 2023, 2024) that have examined the effects of activities and groups in the context of occupational therapy. Since occupational therapy does not only use netcraft as a task, it is necessary to examine the effects of other tasks as well, but if the task can be assumed to be a gift to others, such as coloring, sewing, knitting, or leatherwork, there is a possibility that the same effects will occur. In this respect, the results of this study could be a guide for future research. In addition, although this study only measured the benefits of altruistic activities using measures of frontal EEG and autonomic nervous system activity, other measures may be needed. For example, measures of participants’ subjective mood and sense of happiness, or measures of their altruistic tendencies in natural observation situations, or physiological indicators such as cortisol levels might also be candidates. In future research, it may be possible to clarify the broader effects of altruistic motivation by incorporating these additional measures.

The use of craft activities in OT, particularly those that are altruistically motivated, may have important implications for mental health interventions. Increased relative left frontal activity, as indicated by the FAA, may be interpreted as a neurophysiological marker of increased positive affect and goal-directed behavior, which are important components in therapeutic settings aimed at improving mental health and emotional well-being. For example, increasing left frontal cortical activity through altruistic tasks could be strategically used to increase client motivation and engagement in the therapeutic process and promote a more positive approach to rehabilitation. The reduction in sympathetic activity also suggests that these activities may be a valuable tool for managing stress and anxiety, which are common comorbidities of many chronic conditions treated by occupational therapists. By promoting a calmer physiological state, altruistically motivated activities may improve clients’ overall well-being, make them more receptive to other therapeutic interventions, and increase the effectiveness of OT treatment plans.

In addition, one of the mental health conditions targeted by OT is depression. Depression is associated with asymmetric activity in the prefrontal cortex at rest, with relatively less activity in the left prefrontal cortex (Schaffer et al., 1983), and cortisol levels, an indicator of stress, are associated with relatively greater right than left frontal cortical activity (Buss et al., 2003). Brain stimulation such as repetitive Transcranial Magnetic Stimulation (rTMS) has exploited this finding, and rTMS for depression has been effective not only in improving depressive symptoms but also in correcting autonomic imbalances through a relative decrease in sympathetic activity (Lee et al., 2023). The present study was counterbalanced, and all participants performed both the altruistic and selfish conditions, and comparisons were made between conditions. In other words, the FAA scores and autonomic activity data obtained do not reflect individual differences, but only show differences between conditions. The significant differences in FAA scores and autonomic activity data between conditions suggest that incorporating altruistically motivated craft activities into OT interventions may be beneficial for mental health, potentially reducing physiological stress levels and contributing to the treatment of conditions such as depression. In light of these findings, incorporating altruistically motivated craft activities into OT interventions may enhance approach motivation and promote relaxation by modulating sympathetic nervous activity. This electrophysiological evidence may further support the holistic aspect (Haberman, 2013; Hatter & Nelson, 1987; Yuen et al., 2008) of the evidence that such interventions increase life satisfaction and well-being in OT settings through altruistically motivated craft activities.

Limitations

The small sample size and demographic homogeneity limited generalizability of the study findings. Failure to account for the gender and age of the “closest person” in the altruistic condition may introduce confounding variables. Use of only three EEG channels limits spatial resolution. Further research with larger sample sizes and diverse participants, along with detailed EEG configurations, is needed to validate and extend the findings. The study did not distinguish between altruistic and selfish motives, which may have confounded the results. Self-report measures of motivation and emotion may provide a more complete understanding of the observed effects. In this study, other than asking participants to think about the person closest to them before the craft activity, no additional measures were taken to ensure that the activity would be altruistic. Therefore, in the future, it will be necessary to assess participants’ altruistic motivation during the task by including a questionnaire to confirm the operation after the task is completed. In addition, it cannot be ruled out that the results obtained here are due to altruistic motivation or simply thinking about others. Therefore, future research should include additional goal conditions in which participants complete the task for themselves while thinking about others. In our measurements, we set the autonomic nervous activity index of the first half of the task as the baseline. However, because it includes the task portion, there is a possibility that the interpretation may differ from the true baseline before the task begins. To make our findings more robust, it is essential to measure and analyze the physiological data at the baseline before the task begins. In addition, future studies in clinical populations should further explore these findings through longitudinal and interventional research.

Conclusion

This study provides preliminary evidence that altruistically motivated craft activities can modulate neural and autonomic responses, supporting their holistic benefits in OT. Our findings highlight the potential for incorporating altruistic activities into therapeutic interventions to enhance mental health and well-being. Further research with larger, more diverse samples and robust methodologies is essential to confirm and extend these findings.

Footnotes

Acknowledgements

We thank the participants who participated in this study and all those who assisted in the collection of physiological data (TO, RY, TO, and HY).

Declaration of conflicting interests

The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Funding

The author(s) disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: This research was supported by Japan Society for the Promotion of Science (JSPS) KAKENHI Grant Numbers JP22K11453, JP23K10521, but the funding agency was not implicated in the conduct of the research or preparation of the article.

ORCID iDs

Junya Orui

Ryouhei Ishii

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Neurophysiological effects of altruistically motivated craft activities in occupational therapy: A pilot study using frontal EEG and heart rate variability analysis

Abstract

Introduction

Methods

Results

Conclusions

Keywords

Introduction

Methods

Participants

Procedure

Measurement indicators

Task performance

EEG

Heart rate

Statistical analysis

Results

Task performance

FAA

Autonomic activity

Discussion

Limitations

Conclusion

Footnotes

Acknowledgements

Declaration of conflicting interests

Funding

ORCID iDs

References