Wisdom and Hard Times: The Ameliorating Effect of Wisdom on the Negative Association Between Adverse Life Events and Well-Being

The mediating role of health-related behavior in the relationship between wisdom and depressive symptoms in older Polish adults

OBJECTIVES

Although studies have shown that wisdom is positively related to mental health in older adults, little is known about its possible mechanisms. The current study examines whether health-related behavior can play a mediating role in the relationships between wisdom and geriatric depressive symptoms.

METHODS

The study included 334 Polish older adults aged 60-99 years (M = 71.91; SD = 7.01). The respondents completed the Geriatric Depression Scale, Three-Dimensional Wisdom Scale, Health-Related Questionnaire for Seniors, and a sociodemographic survey.

RESULTS

Three-dimensional wisdom and its three dimensions correlated negatively with geriatric depressive symptoms but positively with general health-related behavior and its factors. Health-related behavior acted partially as a mediator between wisdom and geriatric depressive symptoms.

CONCLUSION

Wiser seniors tend to take part in more health-promoting behavior, which may prevent depressive symptoms. The findings support the important role played by wisdom in mental health-promoting interventions for older adults.

Effects of Wisdom on Mental Health in Old Age: Exploring the Pathways Through Developmental Tasks Attainment and Self-Rated Health

Purpose

A number of studies indicate a relationship between wisdom and mental health in older adults, which can be explained by different pathways. However, the role of developmental task accomplishment, and of self-rated health in the relationships between wisdom and mental health in later life remain unclear. The aim of the current study is to explore the structure of the relationships between wisdom, developmental task attainment, self-rated health, and positive and negative mental health outcomes (viz. wellbeing and depressive symptoms) in older adults.

Methods

The study included 381 Polish older adults aged 60-86 (M= 67.33; SD = 5.08). The respondents completed the Personal Wellbeing Index, Geriatric Depression Scale, Three-Dimensional Wisdom Scale, Developmental Tasks Attainment Questionnaire for Seniors, self-rated health scale and sociodemographic survey.

Results

Three-dimensional wisdom, developmental task attainment and self-rated health scores were positive predictors of personal wellbeing and negative predictors of depressive symptoms in older adults. Structural equation modelling revealed that developmental tasks attainment and self-rated health partially mediated the relations between wisdom and mental health in older adults.

Conclusion

It can be assumed that wise older adults implement developmental tasks more efficiently and assess their subjective health more favorably, which may strengthen their personal wellbeing and prevent depression. The findings suggest that wisdom plays an important role in healthy aging.

[Similar wisdom strategies for different life problems]

OBJECTIVE

Wisdom can be understood as the ability to solve unsolvable problems. Wise persons are better in coping with difficult life situations. Wise strategies help them to do so. The question is whether the same or different wisdom strategies make sense for different life problems.

METHODS

A total of 416 persons (40.4 years old) read two situational vignettes, one about a work problem and one about a private problem. After each situational vignette, they were asked about their wisdom strategies regarding the respective situation. Wisdom strategies were measured by means of a self-rating wisdom scale.

RESULTS

People agreed similarly with wisdom strategies for both situations. For both situations, participants agreed most strongly to use factual and procedural knowledge, perception and acceptance of emotions, value relativism and relativization of problems and aspirations. The order of the remaining eight wisdom strategies was the same for both situations.

DISCUSSION AND CONCLUSION

People agreed similarly with wisdom strategies regardless of the situation type. Wisdom strategies seem to be meaningful across different life problems. This is of interest for the design of interventions to promote psychological resilience.

Wisdom and wellbeing in polish older adults: the mediating role of forgiveness

Objectives

Possible correlations between wisdom and wellbeing among older people have been extensively debated in psychology. At the same time, researchers emphasize that the effect of older adults' wisdom on their wellbeing depends on numerous mediators. A review of the literature suggests that forgiveness might be one such variable. Thus, this study aimed to investigate whether forgiveness mediated the relationship between wisdom and wellbeing in late adulthood.

Method

In total, 481 participants aged from 60 to 92 years (M = 68.84; SD = 6.31) were involved in the study. All older people participating in the study lived independently in their households. Four psychological instruments were used: (1) the Self-Assessed Wisdom Scale; (2) the Heartland Forgiveness Scale; (3) the Psychological Wellbeing Scale; and (4) the Satisfaction with Life Scale. Therefore, the measurement of the analyzed variables was self-reported.

Results

The results showed that forgiveness mediated the relationships between wisdom and wellbeing in the older population. The indirect effects demonstrated that forgiveness mediated the relationships between wisdom and wellbeing. Wisdom related to higher forgiveness (β = 0.21; p < 0.01), which, in turn, was related to a higher level of psychological (β = 0.48; p < 0.01) and subjective (β = 0.36; p < 0.01) wellbeing.

Conclusion

These findings suggest that forgiveness is an important element of wisdom and wellbeing. The greater the wisdom the participants showed, the stronger the tendency to forgive and the better wellbeing they reported.

Social Support, Religiosity, Wisdom and Well-Being Among Older Adults in Indonesia

Purpose

As the population ages, it is critical to understand the elements that contribute to the well-being of older individuals. Prior research suggests that a better sense of mastery and purpose in life may explain at least some of the beneficial link between wisdom, religion, and subjective well-being. This current study seeks to identify a model of older persons' psychological well-being formation in a religious group. Whether psychosocial strengths such as religiosity, social support, and wisdom are directly related to psychological well-being. Self-acceptance, autonomy, positive interpersonal relationships, environmental mastery, personal growth, and a sense of life purpose are all components of psychological well-being.

Participants and Methods

This cross-sectional study included 261 participants, 42 men and 219 women aged 60 and up with normal cognitive, hearing, and/or speech functions. Participants lived in The boarding house in South Tapanuli-North Sumatra, Indonesia, for over 6 months. A backward translated Likert scales is used for data collection. The data were analyzed using Structural Equation Model (SEM).

Results

The results indicate that social support and religiosity have an effect on psychological well-being through wisdom as a mediator.

Conclusion

These findings emphasize the relevance of internal strengths for psychological well-being and give credence to the mediated path model's applicability to older adult communities in Indonesia.

Thirty Years of Psychological Wisdom Research: What We Know About the Correlates of an Ancient Concept

Psychologists have studied the ancient concept of wisdom for 3 decades. Nevertheless, apparent discrepancies in theories and empirical findings have left the nomological network of the construct unclear. Using multilevel meta-analyses, we summarized wisdom's correlations with age, intelligence, the Big Five personality traits, narcissism, self-esteem, social desirability, and well-being. We furthermore examined whether these correlations were moderated by the general approach to conceptualizing and measuring wisdom (i.e., phenomenological wisdom as indexed by self-report vs. performative wisdom as indexed by performance ratings), by specific wisdom measures, and by variable-specific factors (e.g., age range, type of intelligence measures, and well-being type). Although phenomenological and performative approaches to conceptualizing and measuring wisdom had some unique correlates, both were correlated with openness, hedonic well-being, and eudaimonic well-being, especially the growth aspect of eudaimonic well-being. Differences between phenomenological and performative wisdom are discussed in terms of the differences between typical and maximal performance, self-ratings and observer ratings, and global and state wisdom. This article will help move the scientific study of wisdom forward by elucidating reliable wisdom correlates and by offering concrete suggestions for future empirical research based on the meta-analytic findings.

Does wisdom moderate the relationship between burden and depressive symptoms among family caregivers of disabled older adults in China? A multiple-group path analysis

The present study investigated the moderator role of multidimensional wisdom (i.e. individuals' positive personality traits) on the association between caregiver burden and depressive symptoms among family caregivers of disabled older adults in China. A quota sampling was used to recruit 789 pairs of disabled older adults and their primary family caregivers in Shanghai, China, in 2013. Multiple-group path analysis was used to test the proposed model. Cognitive, reflective, and affective wisdom were found to moderate the association between burden and depressive symptoms. The association was statistically significant among those with relatively low levels of cognitive, reflective, and affective wisdom. These associations, however, were found to be statistically nonsignificant among those with relatively high levels of cognitive, reflective, and affective wisdom. The findings highlight the important role of multidimensional wisdom in the underlying mechanisms of family caregiving from the perspective of the stress process model. Policy and intervention implications are discussed.

Looking Beyond Linear: A Closer Examination of the Relationship Between Wisdom and Wellbeing

There has been some controversy about the relationship between wisdom and constructs of the well-being complex. Some wisdom researchers argue that the ability to maintain a high level of well-being, even in the face of very negative experiences, is a core characteristic of wisdom. Other researchers argue that the willingness of wise people to reflect on the darker sides of life might jeopardize well-being. Studies mostly found moderate positive correlations of well-being with self-report wisdom measures and negative, zero, or low positive correlations with open-ended measures of wisdom. This paper tests the hypothesis that the relationship between wisdom and well-being is triangular rather than linear, with highly wise people being high in well-being, but people high in well-being not necessarily being highly wise. A sample of 155 participants (age 23 to 90 years) completed four wisdom measures and three measures from the well-being complex. We analyzed both linear relationships (using correlations) and triangular relationships (using Necessary Condition Analysis). Correlations of well-being with open-ended measures of wisdom were mostly insignificant; correlations with self-report measures of wisdom were mostly significant. However, scatterplots showed the expected triangular relationships and Necessary Condition Analysis indicated medium to large effect sizes for both open-ended and self-report wisdom measures. In sum, our findings show that even if wise individuals think more deeply about difficult aspects of the human existence, they are still able to maintain high levels of well-being.

Determinants of quality of life and well-being in cognitively unimpaired older adults: a systematic review

OBJECTIVE

It is important to know the psychological variables that are related to quality of life and well-being in healthy elderly people. The main objective of the present review is to analyse which factors, through psychological variables, are determinant on the adaptive processes that acquire relevance in the last stage of life.

DATA SOURCES

An electronic search was conducted in WOS, Science Direct, PsycARTICLES, Psychology Database and Psycinfo.

STUDY SELECTION

The search terms used were derived from the combination of the following search string: (("Emotional Factors" OR "Emotional Effects") AND ("Emotional Intelligence" OR "Emotional Regulation") AND ("Quality of Life" OR "Personal Satisfaction") AND ("Healthy Old People" OR "Healthy Old Adults") AND ("Healthy Aging" OR "Successful Aging")).

DATA EXTRACTION

11th April 2021.

DATA SYNTHESIS

In total, 13 articles were selected.

CONCLUSIONS

The articles showed the importance of social support, proactive coping strategies (emotional regulation) and emotional intelligence as key factors in the elderly population for their positive influence on variables such as quality of life and well-being.

PROSPERO ID CRD42021224789

Negative Life Events, Social Ties, and Depressive Symptoms for Older Adults in China

Although it is widely acknowledged that older adults who have gone through negative life events are more likely to develop depression, there is limited evidence on whether and which type of social ties moderate this perceived relationship. Based on 2016 and 2018 waves of Chinese Longitudinal Aging Social Survey (4,466 individuals, 8,932 observations), we apply linear fixed effects models and confirm that negative life events are associated with depressive symptoms for older adults (Coef. = 0.35; 95% CIs 0.11–0.61), and social ties are negatively associated with depression (Coef. = −0.08; 95% CIs −0.10 to −0.07). Our study further suggests that the association between negative life events and depressive symptoms is significantly moderated by friendship ties (Coef. = −0.18, 95% CIs −0.30 to −0.07), rather than family ties (Coef. = −0.03, 95% CIs −0.09 to 0.15). Moreover, the buffering effects of friendship ties are more prominent for the less resilient and less privileged groups, namely male, rural, and less educated older adults. Our findings point to the importance of expanding and strengthening social networks for Chinese older adults in promoting their psychological health.

Association Between Wisdom and Psychotic-Like Experiences in the General Population: A Cross-Sectional Study

INTRODUCTION

Wisdom has been empirically researched as a complex psychological characteristic that is associated with many mental health outcomes. However, its association with psychotic-like experiences (PLEs) remains unclear. This is the first work to assess wisdom, explore its association with PLEs, and test its moderating effect on the relation between the frequency of PLEs and their associated distress in the general population.

METHODS

From January 29th to February 5th, 2021, our online self-administered survey recruited 927 participants (ages 14 to 65) from thirteen Chinese provinces. Convenience sampling was employed. We measured wisdom with the 12-item three-dimensional wisdom scale (3D-WS-12) and PLEs with the 15-item positive subscale of the Community Assessment of Psychic Experiences (CAPE-P15).

RESULTS

Using the cut-off value of 1.47 in the mean frequency score, we divided our participants into high-PLEs group (188, 22.1%) and low-PLEs group (663, 77.9%). Three-dimensional wisdom score was decreased in the high-PLEs group compared to the low-PLEs group (Kruskal-Wallis t = 59.9, p < 0.001). Wisdom was associated with less frequent PLEs (Spearman's rho = -0.21, p < 0.01) and lower distress related to PLEs (Spearman's rho = -0.28) in the high-PLEs group (all above p < 0.001), which were replicated in the low-PLEs group. Notably, wisdom significantly attenuated the distress associated with PLEs [coefficient = -0.018, Bootstrap 95% CI (-0.029, -0.008)], but only in the low-PLEs group.

CONCLUSION

Our results implicated that wisdom could protect individuals from distressful subclinical psychotic symptoms and wiser individuals have better general mental health.

Gender Effect on Views of Wisdom and Wisdom Levels

Gender differences in wisdom are an important theme in mythology, philosophy, psychology, and daily life. Based on the existing psychological research, consensus and dispute exist between the two genders on the views of wisdom and in the levels of wisdom. In terms of the views of wisdom, the way men and women view wisdom is highly similar, and from the perspectives of both ordinary people and professional researchers of wisdom psychology, wise men and women are extremely similar. Regarding wisdom level, research has revealed that, although significant gender effects exist in the level of overall wisdom, reflective and affective dimension, and interpersonal conflict coping styles, the effect sizes were small, which indicated that these gender differences were not obvious. It would be desirable for future research to combine multiple wisdom measurements, strengthen research on the psychological gender effect of wisdom, and focus on the moderating role of age on the relationship between wisdom and gender.

Narrative Group Intervention to Rediscover Life Wisdom Among Hong Kong Chinese Older Adults: A Single-Blind Randomized Waitlist-Controlled Trial

BACKGROUND AND OBJECTIVES

We developed a new group practice using strength- and meaning-based narrative therapy (NT) for older Chinese living in Hong Kong (HK), to enhance their life wisdom. This paper reports on the intervention and its short- and longer-term effectiveness.

RESEARCH DESIGN AND METHODS

A randomized waitlist-controlled trial was conducted. A total of 157 older adults were randomly recruited, of whom 75 were randomly assigned to the intervention group which received four 2-hr biweekly NT sessions using the "Tree of Life" metaphor. The others were placed on a waitlist. Perceived wisdom was assessed using the Brief Self-Assessed Wisdom Scale. Assessment occurred at baseline (T0), end of treatment (T1), and 4 (T2) and 8 months later (T3). Overtime effects of NT on wisdom scores were assessed using latent growth curve models with time-invariant covariates for impact.

RESULTS

The intervention (NT) group showed significant, sustainable overtime within-group improvement in perceived wisdom. Furthermore, when compared to the control group, the NT group showed significant immediate improvements in perceived wisdom [F(2.726, p = .041)], which were maintained at all follow-up points. This effect remained after controlling for age, gender, and educational level (T ML(11) = 17.306, p = .098, root mean square error of approximation = 0.079, comparative fit index = 0.960). No adverse reaction was recorded.

DISCUSSION AND IMPLICATIONS

NT underpinned by a ToL methodology offers a new theory to understand, promote, and appreciate perceived wisdom in older Chinese living in HK. It contributes to psychotherapy and professional social work practice for older Chinese.

Cognitive and Neural Correlates of Loneliness and Wisdom during Emotional Bias

Loneliness and wisdom have opposing impacts on health and well-being, yet their neuro-cognitive bases have never been simultaneously investigated. In this study of 147 healthy human subjects sampled across the adult lifespan, we simultaneously studied the cognitive and neural correlates of loneliness and wisdom in the context of an emotion bias task. Aligned with the social threat framework of loneliness, we found that loneliness was associated with reduced speed of processing when angry emotional stimuli were presented to bias cognition. In contrast, we found that wisdom was associated with greater speed of processing when happy emotions biased cognition. Source models of electroencephalographic data showed that loneliness was specifically associated with enhanced angry stimulus-driven theta activity in the left transverse temporal region of interest, which is located in the area of the temporoparietal junction (TPJ), while wisdom was specifically related to increased TPJ theta activity during happy stimulus processing. Additionally, enhanced attentiveness to threatening stimuli for lonelier individuals was observed as greater beta activity in left superior parietal cortex, while wisdom significantly related to enhanced happy stimulus-evoked alpha activity in the left insula. Our results demonstrate emotion-context driven modulations in cognitive neural circuits by loneliness versus wisdom.

A Self-Compassion and Mindfulness-Based Cognitive Mobile Intervention (Serene) for Depression, Anxiety, and Stress: Promoting Adaptive Emotional Regulation and Wisdom

Introduction: Many individuals and families are currently experiencing a high level of COVID-19-related stress and are struggling to find helpful coping mechanisms. Mindfulness-based interventions are becoming an increasingly popular treatment for individuals experiencing depression and chronic levels of stress. The app (Serene) draws from scholarly evidence on the efficacy of mindfulness meditations and builds on the pre-existing apps by incorporating techniques that are used in some therapies such as cognitive behavioral therapy and mindfulness-based cognitive therapy. Methods: Participants were randomly assigned to a 4-week mindfulness and self-compassion-based cognitive smartphone intervention (Serene) or a wait-list control group. They were instructed to engage in self-compassion and mindfulness practices and a cognitive restructuring task. They also completed measures that evaluated their levels of depression, stress, anxiety, self-compassion, wisdom, psychological well-being, and subjective well-being. The intervention group was also instructed to track their weekly engagement with the app. Standardized effect sizes for between-group differences were calculated using Cohen's d for complete case analyses. Results: Complete case analyses from baseline to the end of this randomized controlled trial demonstrated significant moderate between-group differences for depressive symptoms (d = -0.43) and decisiveness (d = 0.34). Moderate between-group differences were also found for self-compassion (d = 0.6) such that significant improvements in self-kindness, common humanity, mindfulness and decreases in self-judgement, isolation, and overidentification were observed. A small between-group difference was found for emotional regulation (d = 0.28). Moreover, a significant moderate within-group decrease in stress (d = -0.52) and anxiety symptoms (d = -0.47) was also observed in the intervention group. Conclusions: Serene is an effective intervention that promotes increased levels of self-compassion and emotional regulation. Engaging with Serene may help reduce depressive symptoms through mindfulness, self-compassion, and cognitive restructuring which help reduce overidentification with one's negative emotions. As individuals rebalance their thinking through cognitive restructuring, they can identify the varying stressors in their life, develop action plans and engage in adaptive coping strategies to address them. Serene may promote greater self-understanding which may provide one with a more balanced perspective on their current upsetting situations to positively transform their challenges during the pandemic.

Association of Loneliness and Wisdom With Gut Microbial Diversity and Composition: An Exploratory Study

Loneliness and wisdom have opposite effects on health and well-being. Loneliness is a serious public health problem associated with increased morbidity and mortality. Wisdom is associated with better health and well-being. We have consistently found a strong negative correlation between loneliness and wisdom. The present study aimed to investigate the association of loneliness and wisdom with the gut microbiome. One hundred eighty-four community-dwelling adults (28-97 years) completed validated self-report-based measures of loneliness, wisdom, compassion, social support, and social engagement. Fecal samples were collected and profiled using 16S rRNA sequencing. Linear regression analyses, controlling for age and body mass index, revealed that lower levels of loneliness and higher levels of wisdom, compassion, social support, and social engagement were associated with greater phylogenetic richness and diversity of the gut microbiome. Partial least squares (PLS) analysis to investigate multivariate relationships extracted two composite variables. Linear regression model predicting alpha-diversity with PLS components revealed that a linear combination of all psychosocial predictors (with negative loading for loneliness and positive loadings for all others, including wisdom, compassion, social support, and social engagement) was significantly associated with alpha-diversity. For beta-diversity, compassion and wisdom accounted for a significant proportion of variance in overall microbial community composition. Findings may have implications for interventions to reduce loneliness and possibly its health-related adverse consequences. Future research should explore whether increasing compassion and wisdom may improve loneliness and overall well-being as well as microbial diversity.

Adverse events of repetitive transcranial magnetic stimulation in older adults with depression, a systematic review of the literature

OBJECTIVE

In the last decade, repetitive transcranial magnetic stimulation (rTMS) has been introduced as a non-invasive neuromodulation therapy for depression. Little is known, however, about (serious) adverse events (AE) of rTMS in older adults with a depression. In this article, we want to study what is known about (serious) AE of rTMS in older adults (>60 years) with late-life depression (LLD).

METHODS

A systematic search has been performed according to the PRISMA guidelines in PubMed, EMBase and PsycInfo. We have screened 622 articles for eligibility. Eleven studies, evaluating 353 patients in total, were included in this review.

RESULTS

AE were reported in 12.4% of the older adults with a LLD treated with rTMS, serious AE in 1.5%. Headache (6.9%) and discomfort at the stimulation site (2.7%) are the most commonly reported AE. Serious AE reported are: psychiatric hospitalization (three times), a combination of posterior vitreous detachment and retinal tear, and increased suicide ideation (both once).

CONCLUSIONS

rTMS in older adults with LLD was concluded overall to be safe due to the low frequency of AE reported in trials and observational studies. In case-reports, however, more serious AE have been described. To tailor use of rTMS in older adults with LLD, more research is needed in larger samples to optimize tolerance.

Is spirituality a component of wisdom? Study of 1,786 adults using expanded San Diego Wisdom Scale (Jeste-Thomas Wisdom Index)

OBJECTIVE

Wisdom has gained increasing interest among researchers as a personality trait relevant to well-being and mental health. We previously reported development of a new 24-item San Diego Wisdom Scale (SD-WISE), with good to excellent psychometric properties, comprised of six subscales: pro-social behaviors, emotional regulation, self-reflection (insight), tolerance for divergent values (acceptance of uncertainty), decisiveness, and social advising. There is controversy about whether spirituality is a marker of wisdom. The present cross-sectional study sought to address that question by developing a new SD-WISE subscale of spirituality and examining its associations with various relevant measures.

METHODS

Data were collected from a national-level sample of 1,786 community-dwelling adults age 20-82 years, as part of an Amazon M-Turk cohort. Participants completed the 24-item SD-WISE along with several subscales of a commonly used Brief Multidimensional Measure of Religiousness/Spirituality, along with validated scales for well-being, resilience, happiness, depression, anxiety, loneliness, and social network.

RESULTS

Using latent variable models, we developed a Spirituality subscale, which demonstrated acceptable psychometric properties including a unidimensional factor structure and good reliability. Spirituality correlated positively with age and was higher in women than in men. The expanded 28-item, 7-subscale SD-WISE total score (called the Jeste-Thomas Wisdom Index or JTWI) demonstrated acceptable psychometric properties. The Spirituality subscale was positively correlated with good mental health and well-being, and negatively correlated with poor mental health. However, compared to other components of wisdom, the Spirituality factor showed weaker (i.e., small-to-medium vs. medium-to-large) association with the SD-WISE higher-order Wisdom factor (JTWI).

CONCLUSION

Similar to other components as well as overall wisdom, spirituality is significantly associated with better mental health and well-being, and may add to the predictive utility of the total wisdom score. Spirituality is, however, a weaker contributor to overall wisdom than components like pro-social behaviors and emotional regulation. Longitudinal studies of larger and more diverse samples are needed to explore mediation effects of these constructs on well-being and health.

POSITIVE PSYCHIATRY INTERVENTIONS IN GERIATRIC MENTAL HEALTH

PURPOSE OF REVIEW

Positive psychiatry shifts the focus of geriatric mental healthcare beyond studying disorders and psychopathology to studying factors that contribute to mental well-being and successful aging. An increasing number of interventional studies are using treatments that target modifiable positive psychosocial characteristics (PPCs) and study their impact on mental health. Here we provide an overview of the literature on positive psychiatry interventions using illustrative examples of interventions targeting social connectedness, meaning in life, wisdom, and resilience.

RECENT FINDINGS

There is growing evidence that PPCs are modifiable constructs that may be associated with improved well-being, physical health, and mental health outcomes.

SUMMARY

The preliminary evidence summarized in this narrative review indicates that positive psychiatry interventions targeting social connectedness, meaning in life, wisdom, and resilience can improve overall well-being and other positive health outcomes amongst older adults. The effect sizes of these interventions reported in RCTs and meta-analyses are typically small to medium, but occasionally large effect sizes are also reported. Current literature is restricted by heterogeneous methodology, limiting clinicians' abilities to extrapolate these principles of positive psychiatry into everyday practice. With the expanding body of evidence, positive psychiatry may have the potential to transform the landscape of geriatric mental health.

HIV and three dimensions of Wisdom: Association with cognitive function and physical and mental well-being: For: Psychiatry Research

Wisdom is a unique human personality trait with cognitive, affective or compassionate, and reflective dimensions. We evaluated relationships of three specific dimensions of wisdom with cognitive function and physical and mental well-being in people with HIV (PWH) and HIV-negative (HIV-) participants. Subjects included 138 adults (61 PWH, 77 HIV-) from the San Diego community. Validated measures were used to assess wisdom and well-being. Cognitive function was assessed via the Montreal Cognitive Assessment. We conducted multivariate linear regressions to evaluate the associations of wisdom dimensions with cognitive function and physical and mental well-being. Compared to the HIV- group, PWH had lower mean scores on cognitive function, and physical and mental well-being, and cognitive and reflective dimensions of wisdom, but similar scores on affective or compassionate wisdom. Among PWH, higher total wisdom scores were associated with older age, lower likelihood of substance dependence, greater mental well-being, better cognitive function, higher resilience, social support, and optimism scores, as well as lower levels of perceived stress and nadir CD4 count. Our findings of an association of different dimensions of wisdom with physical and/or mental well-being in PWH would point to a possibility that enhancing these dimensions of wisdom might improve health outcomes in PWH.

Outcomes of Randomized Clinical Trials of Interventions to Enhance Social, Emotional, and Spiritual Components of Wisdom: A Systematic Review and Meta-analysis

Importance

Wisdom is a neurobiological personality trait made up of specific components, including prosocial behaviors, emotional regulation, and spirituality. It is associated with greater well-being and happiness.

Objective

To evaluate the effectiveness of interventions to enhance individual components of wisdom.

Data Sources

MEDLINE and PsycINFO databases were searched for articles published through December 31, 2018.

Study Eligibility Criteria

Randomized clinical trials that sought to enhance a component of wisdom, used published measures to assess that component, were published in English, had a minimum sample size of 40 participants, and presented data that enabled computation of effect sizes were included in this meta-analysis.

Data Extraction and Synthesis

Random-effect models were used to calculate pooled standardized mean differences (SMDs) for each wisdom component and random-effects meta-regression to assess heterogeneity of studies.

Main Outcomes and Measures

Improvement in wisdom component using published measures.

Results

Fifty-seven studies (N = 7096 participants) met review criteria: 29 for prosocial behaviors, 13 for emotional regulation, and 15 for spirituality. Study samples included people with psychiatric or physical illnesses and from the community. Of the studies, 27 (47%) reported significant improvement with medium to large effect sizes. Meta-analysis revealed significant pooled SMDs for prosocial behaviors (23 studies; pooled SMD, 0.43 [95% CI, 0.22-0.3]; P = .02), emotional regulation (12 studies; pooled SMD, 0.67 [95% CI, 0.21-1.12]; P = .004), and spirituality (12 studies; pooled SMD, 1.00 [95% CI, 0.41-1.60]; P = .001). Heterogeneity of studies was considerable for all wisdom components. Publication bias was present for prosocial behavior and emotional regulation studies; after adjusting for it, the pooled SMD for prosocial behavior remained significant (SMD, 0.4 [95% CI, 0.16-0.78]; P = .003). Meta-regression analysis found that effect sizes did not vary by wisdom component, although for trials on prosocial behaviors, large effect sizes were associated with older mean participant age (β, 0.08 [SE, 0.04]), and the reverse was true for spirituality trials (β, -0.13 [SE, 0.04]). For spirituality interventions, higher-quality trials had larger effect sizes (β, 4.17 [SE, 1.07]), although the reverse was true for prosocial behavior trials (β, -0.91 [SE 0.44]).

Conclusions and Relevance

Interventions to enhance spirituality, emotional regulation, and prosocial behaviors are effective in a proportion of people with mental or physical illnesses and from the community. The modern behavioral epidemics of loneliness, suicide, and opioid abuse point to a growing need for wisdom-enhancing interventions to promote individual and societal well-being.

Cross-Temporal Exploration of the Relationship Between Wisdom-Related Cognitive Broadening and Subjective Well-Being: Evidence From a Cross-Validated National Longitudinal Study

How do intraindividual changes in wisdom-related characteristics of cognitive broadening—open-minded reflection on challenging situations, consideration of change, and epistemic humility—relate to subjective well-being over time? To test this relationship, we performed cross-lagged panel analyses from three waves of the national U.S. sample taken across 20 years, utilizing a cross-validation approach: (i) conduct exploratory analyses on a random subset of data, (ii) preregister hypotheses and methods, and (iii) cross-validate preregistered hypotheses on the other random subset of the data. We found that broadening attitudes predicted greater affect balance and life satisfaction in later years, but not vice-versa. The effect was robust when controlling for trait-level broadening well-being associations, as well as sociodemographic characteristics, openness, and general cognitive abilities. The direction of the positive longitudinal relationship between broadening attitudes and subjective well-being has implications for major existing theories of adult development and subjective well-being.

Assessment of 3-dimensional wisdom in schizophrenia: Associations with neuropsychological functions and physical and mental health

Recent decades have seen growing empirical research in wisdom as a complex, trait-based psychological characteristic. Wisdom has been shown to possess individual and societal benefits through associations with health and well-being, but it has not yet been evaluated in people with schizophrenia (PwS). In the current study, we administered a widely used, validated 3-dimensional wisdom scale that includes three interrelated dimensions: cognitive, reflective, and affective. We examined group differences in wisdom, as well as relationships between wisdom and sociodemographics, clinical symptoms, neurocognitive and functional performance, and mental and physical health in 65 stable adult outpatients with chronic schizophrenia or schizoaffective disorder and 96 non-psychiatric comparison participants (NPCPs). Results showed that PwS had lower wisdom scores than NPCPs and that wisdom moderated relationships between diagnostic group and neurocognitive and functional performance; PwS with higher levels of wisdom demonstrated better cognitive performance than did PwS with lower levels of wisdom. In addition, wisdom was positively correlated with performances on multiple neurocognitive tasks in PwS, but not in NPCPs. Finally, reflective wisdom - representing accurate/unbiased introspection and perspective-taking - correlated with all mental health variables in PwS. Our results were limited by a cross-sectional design, but suggest that wisdom, especially reflective wisdom, may be associated with better cognitive performance and better physical and mental health in PwS. It is conceivable that interventions to enhance wisdom may have broad cognitive and mental and physical health benefits in individuals with chronic psychotic disorders.

The Emerging Empirical Science of Wisdom: Definition, Measurement, Neurobiology, Longevity, and Interventions

After participating in this activity, learners should be better able to:• Assess the empirical literature on wisdom• Evaluate a proposed model of wisdom development ABSTRACT: This article seeks to provide an overview of the empirical literature on wisdom in terms of its definitions and measurements, possible neurobiological basis, and evolutionary value, as well as changes with aging and potential clinical interventions to enhance components of wisdom. Wisdom may be defined as a complex human trait with several specific components: social decision making, emotion regulation, prosocial behaviors, self-reflection, acceptance of uncertainty, decisiveness, and spirituality. These components appear to be localized primarily to the prefrontal cortex and limbic striatum. Emerging research suggests that wisdom is linked to better overall health, well-being, happiness, life satisfaction, and resilience. Wisdom likely increases with age, facilitating a possible evolutionary role of wise grandparents in promoting the fitness of the species. Despite the loss of their own fertility and physical health, older adults help enhance their children's well-being, health, longevity, and fertility-the "Grandma Hypothesis" of wisdom. We propose a model of wisdom development that incorporates genetic, environmental, and evolutionary aspects. Wisdom has important implications at both individual and societal levels, and warrants further research as a major contributor to human thriving. There is a need for a greater emphasis on promoting wisdom through our educational systems from elementary to professional schools.

A new scale for assessing wisdom based on common domains and a neurobiological model: The San Diego Wisdom Scale (SD-WISE)

Wisdom is an ancient concept that has gained new interest among clinical researchers as a complex trait relevant to well-being and healthy aging. As the empirical data regarding wisdom have grown, several measures have been used to assess an individual's level of wisdom. However, none of these measures has been based on a construct of wisdom with neurobiological underpinnings. We sought to develop a new scale, the San Diego Wisdom Scale (SD-WISE), which builds upon recent gains in the understanding of psychological and neurobiological models of the trait. Data were collected from 524 community-dwelling adults age 25-104 years as part of a structured multi-cohort study of adult lifespan. Participants were administered the SD-WISE along with two existing measures of wisdom that have been shown to have good psychometric properties. Factor analyses confirmed the hypothesized measurement model. SD-WISE total scores were reliable, demonstrated convergent and discriminant validity, and correlated, as hypothesized, negatively with emotional distress, but positively with well-being. However, the magnitudes of these associations were small, suggesting that the SD-WISE is not just a global measure of mental state. The results support the reliability and validity of SD-WISE scores. Study limitations are discussed. The SD-WISE, with good psychometric properties, a brief administration time, and a measurement model that is consistent with commonly cited content domains of wisdom based on a putative neurobiological model, may be useful in clinical practice as well as in bio-psycho-social research, especially investigations into the neurobiology of wisdom and experimental interventions to enhance wisdom.