Abbreviated San Diego Wisdom Scale (SD-WISE-7) and Jeste-Thomas Wisdom Index (JTWI)

Remotely-administered resilience and self-compassion intervention targeting loneliness and stress in older adults: a single-case experimental design

OBJECTIVES

Loneliness and chronic stress are prevalent issues for older adults that have been linked to adverse health outcomes. We conducted a remote resilience and self-compassion intervention targeting loneliness and chronic stress.

METHODS

This study utilized a multiple-phase-change single-case experimental design with three consecutive 6-week phases: control, intervention, follow-up. Assessments and biomarker collection (blood pressure, inflammation, sleep actigraphy) were conducted at each phase. Participants completed a 6-week remotely-administered resilience and self-compassion intervention using techniques from cognitive behavioral therapy and resilience training. Repeated measures ANOVAs were conducted over the 12-week period from control (week 0) to intervention completion (week 12) and over the 18-week period from control (week 0) to follow-up (week 18) in supplemental analyses.

RESULTS

Participants reported a reduction in stress (p < 0.001; ηp2 = 0.15), depression (p =  0.02; ηp2 = 0.08), and loneliness (p = 0.003; ηp2 = 0.18), and an increase in self-compassion (p  =  0.01; ηp2 = 0.13) from control to intervention completion (weeks 0-12). Post-hoc tests revealed that stress reduced significantly during the intervention phase (weeks 6-12) and loneliness reduced significantly during the control phase (weeks 0-6). Some improvements in blood pressure, inflammation, and sleep quality were noted in a subsample of participants.

CONCLUSION

Findings indicate that our remote resilience and self-compassion intervention for older adults targeting loneliness and chronic stress was efficacious.

Resting state default mode network is associated with wise advising

Default mode network (DMN) may be associated with wisdom (i.e., mature understanding of life featured by perspectival metacognition) when advising from a self-referential perspective due to the involvement of the DMN in reflecting on personal life experiences. After a resting-state functional MRI scan, 52 adults advised some youths going through life dilemmas, half from a second-person perspective and half from a third. After advising each youth, participants indicated the psychological distance they felt between themselves and the youth. The amplitude of low-frequency fluctuation (ALFF) was measured in the DMN during resting states. Moreover, trained raters rated the participants' advice on wisdom criteria (i.e., metacognitive humility (MH), meta-level flexibility, and perspective-taking). The results showed that participants felt a significantly smaller psychological distance from the youth when advising from the second- than the third-person perspective. Moreover, only when advising from the second-person perspective was MH associated with ALFF in regions within the DMN (i.e., right rostral anterior cingulate cortex (ACC) and left dorsomedial prefrontal cortex). The right rostral ACC showed a significantly greater association with MH from the second- than the third-person perspective. Therefore, resting-state DMN activities may be important for self-involved wisdom performance (e.g., giving advice directly to others).

Going beyond ourselves: the role of self-transcendent experiences in wisdom

Having good moral character often involves shifting one's focus of attention from the self to others and the world. Across three studies (N  =  605 adults), we found converging evidence that self-transcendent experiences, specifically awe and flow, enabled the expression of wisdom, as captured by wise reasoning and epistemic humility measures. Study 1 found that dispositionally awe- and flow-prone people have stronger wise reasoning and epistemic humility abilities, over and above dispositional happiness. Consistent with Study 1, Study 2 found that, across diverse recalled experiences, individuals who experienced more awe showed greater wise reasoning, and those who experienced more flow showed greater epistemic humility. In Study 3, using situated interventions, we induced awe (watching a video involving vast nature scenes) and flow (composing a song using an online music maker) and compared them with neutral and amusement experiences. Compared to these control conditions, eliciting awe and flow facilitated one's (1) ability to address interpersonal conflicts with wise reasoning, (2) ability to acknowledge one's epistemic gaps, and (3) willingness to improve those aspects and one's general moral character. Altogether, these findings reveal the promising role of self-transcendent experiences in motivating people to appreciate others' perspectives beyond one's own.

Mental health care for older adults: recent advances and new directions in clinical practice and research

The world's population is aging, bringing about an ever-greater burden of mental disorders in older adults. Given multimorbidities, the mental health care of these people and their family caregivers is labor-intensive. At the same time, ageism is a big problem for older people, with and without mental disorders. Positive elements of aging, such as resilience, wisdom and prosocial behaviors, need to be highlighted and promoted, both to combat stigma and to help protect and improve mental health in older adults. The positive psychiatry of aging is not an oxymoron, but a scientific construct strongly informed by research evidence. We champion a broader concept of geriatric psychiatry - one that encompasses health as well as illness. In the present paper, we address these issues in the context of four disorders that are the greatest source of years lived with disability: neurocognitive disorders, major depression, schizophrenia, and substance use disorders. We emphasize the need for implementation of multidisciplinary team care, with comprehensive assessment, clinical management, intensive outreach, and coordination of mental, physical and social health services. We also underscore the need for further research into moderators and mediators of treatment response variability. Because optimal care of older adults with mental disorders is both patient-focused and family-centered, we call for further research into enhancing the well-being of family caregivers. To optimize both the safety and efficacy of pharmacotherapy, further attention to metabolic, cardiovascular and neurological tolerability is much needed, together with further development and testing of medications that reduce the risk for suicide. At the same time, we also address positive aging and normal cognitive aging, both as an antidote to ageism and as a catalyst for change in the way we think about aging per se and late-life mental disorders more specifically. It is in this context that we provide directions for future clinical care and research.