A new scale for assessing wisdom based on common domains and a neurobiological model: The San Diego Wisdom Scale (SD-WISE)
Introduction
Wisdom is an ancient concept (Birren and Svensson, 2005, Jeste and Vahia, 2008) that has gained new interest among clinical researchers as a complex trait relevant to general physical and mental health (Ardelt, 2000, Ardelt, 2003, Jeste et al., 2013, Roháriková et al., 2013, Thomas et al., 2017, Webster et al., 2014), well-being (Ardelt and Jeste, 2016), happiness (Bergsma and Ardelt, 2012, Etezadi and Pushkar, 2013, Thomas et al., 2017, Zacher et al., 2013), life satisfaction (Ardelt, 1997, Ardelt, 2000, Ferrari et al., 2011, Le, 2011, Thomas et al., 2017), personal mastery (Ardelt, 2003, Etezadi and Pushkar, 2013, Thomas et al., 2017), and resilience (Jeste et al., 2013). These studies suggest that wisdom is a useful construct with important implications for individuals as well as society. For empirical studies of a personality trait, it is necessary to define it, measure it in a reliable and valid manner, and understand its underlying bio-psycho-social basis. Below we summarize evolution of the concept of wisdom, including attempts to define and measure it and to decipher its underpinnings.
The concept of practical (as opposed to theoretical) wisdom has been discussed since the times of Aristotle (McKeon, 1941), but is used in recent years to refer to knitting together the cognitive, social, and emotional processes involved in everyday decision making – i.e., actual decisions and choices one might make rather than the abstraction of a ‘wise’ person (Nusbaum, 2016). Erikson (1959) proposed the last stage of psychosocial development culminating in wisdom. Beginning in the 1970s, Baltes and others initiated empirical research on wisdom, focusing on cognitive abilities (Baltes et al., 1992, Clayton and Birren, 1980). Subsequently, several investigators drew attention to the importance of emotional regulation (Ardelt, 2003, Staudinger and Glück, 2011, Sternberg, 1990), and Vaillant, Cloninger, and Blazer stressed the potential role of wisdom in well-being (Blazer and Kinghorn, 2015, Cloninger, 2012, Vaillant and Mukamal, 2001).
Based on a review of empirically based definitions of wisdom published in peer-reviewed journals (Bangen et al., 2013), mostly from western countries, we identified six most commonly included components of wisdom: (1) general knowledge of life and social decision making - ability to give good advice, life knowledge, and life skills; (2) emotional regulation - affect regulation and self-control; (3) pro-social behaviors - e.g., empathy, compassion, altruism, and a sense of fairness; (4) insight - the ability and desire to understand oneself and one's actions at a deep level; (5) value relativism (tolerance for divergent values) - being nonjudgmental and accepting of other value systems; and (6) decisiveness - the ability to make quick and effective decisions (Bangen et al., 2013, Meeks and Jeste, 2009). Current thinking in wisdom research considers the entity of wisdom not as a collection of distinct traits, but rather as a higher-order construct that includes various domains such as prosocial behaviors, emotional regulation, and others listed above (Ardelt, 2003, Bangen et al., 2013). Thus, overall wisdom is greater than the sum of its parts in terms of its utility to the self and the society.
In a separate survey study using the Delphi method, international researchers in the field agreed that the components mentioned above were key to defining wisdom (Jeste et al., 2010). Finally, a mixed-methods study of wisdom in the Bhagavad Gita, a scripture written in India several thousand years ago, suggested that most of those components had also characterized the ancient Indian construct of wisdom (Jeste and Vahia, 2008). The same seems to hold true for the Books of Wisdom in the Bible and documents in most other religions. Whereas the relative emphasis on specific components of wisdom has varied across cultures and times, there have been more similarities than differences among different postulated concepts of wisdom over the centuries and around the world, suggesting that there is an underlying biological substrate of wisdom that influences and is influenced by life experiences.
By examining the neurobiology of consistently identified components of wisdom, one can begin to hypothesize how such a complex human characteristic may be orchestrated within the human brain. Accordingly, we reviewed studies focusing on neuroimaging/brain localization and neurotransmitters associated with individual components of wisdom (Meeks and Jeste, 2009). Prefrontal cortex and amygdala seemed to be the main brain regions related to all of these components. The prefrontal cortex figures prominently in emotional regulation, social decision making, and value relativism, primarily via top-down regulation of limbic (amygdala) and striatal regions. The dorsolateral prefrontal cortex facilitates calculated, reason-based decision making, whereas the ventromedial prefrontal cortex is implicated in emotional valence and prosocial attitudes/behaviors. Reward neurocircuitry (ventral striatum, nucleus accumbens) also appears important for promoting prosocial attitudes/behaviors.
We also approached the putative neurobiology of wisdom by examining behavioral effects of localized brain damage (Meeks and Jeste, 2009). Severe damage to the above-mentioned areas, especially the prefrontal cortex, either through trauma or disease, results in a loss of personality characteristics associated with wisdom. A number of cases have been described, starting with the well-known case of Phineas Gage, in whom damage to frontostriatal and frontolimbic circuits resulted in loss of behaviors listed as components of wisdom (Cato et al., 2004). A noteworthy example is the behavioral variant of frontotemporal dementia, with brain atrophy restricted to anterior portions of the prefrontal lobes (Miller et al., 2001), which is associated with dramatic changes in personality as the patients become impulsive, socially inappropriate, and emotionally inept, with behaviors antithetical to wisdom.
Our review of wisdom measures showed nine published scales (Bangen et al., 2013). Each measure has strengths and limitations. Measures with significant strengths include the Three-Dimensional Wisdom Scale (3D-WS) (Ardelt, 2003) with its rigorous development and good psychometric properties and the Self-Assessed Wisdom Scale (SAWS) (Webster, 2003) with demonstrations of several types of validity across samples. However, these scales are only moderately correlated (Taylor et al., 2011), and focus on different domains of wisdom.
We aimed to develop a new scale (San Diego Wisdom Scale or SD-WISE) that more closely aligns with the existing body of empirical research on wisdom by assessing each of the above-mentioned six commonly cited content domains with postulated neurobiological basis. We hypothesized that these six lower-order factors representing the content domains would indicate a single, higher-order wisdom factor. Our model of wisdom is based on a multidimensional structure, and thus, we attempt to acknowledge fine-grained components while focusing our overall measure on the more general construct. Our second aim was to determine whether the subscales of this new measure, along with subscales from existing measures of wisdom (3D-WS and SAWS) measure the same general trait. We also hypothesized that SD-WISE total scores would correlate with several measures of well-being.
Section snippets
Design and sample
Participants were recruited from the University of California, San Diego (UCSD) Successful AGing Evaluation (SAGE) study (Jeste et al., 2013, Thomas et al., 2016), a structured multi-cohort investigation of community-dwelling adults recruited using list-assisted random digit dialing. Exclusion criteria were: 1) residence in a nursing home or need for daily skilled nursing care, 2) self-reported diagnosis of dementia, 3) terminal illness or need for hospice care, and 4) lack of fluency in
Demographics of the sample
The mean age of participants was 58 years (SD = 19) with a range of 25–104 years; 51% (269) were women. Seventy-six percent (397) reported their race/ethnicity as non-Latino white, 16% (86) as Latino, 7% (35) as Asian-American, 4 (1%) as African American, and 3 (1%) as another ethnic background. Twenty-seven percent (133) participants had a post-graduate degree, 63% (308) had some college education or had a bachelor's degree, and 10% (47) reported completing education through a high school
Discussion
We developed a new measure of wisdom, the SD-WISE, based on six content domains of wisdom commonly cited in the literature (Bangen et al., 2013) and also identified through a Delphi consensus survey of international experts in wisdom research (Jeste et al., 2010) as well as a mixed-methods study of the concept of wisdom in the an ancient religious document from India (Jeste and Vahia, 2008). These domains form the basis of a putative neurocircuitry model of wisdom (Meeks and Jeste, 2009).
Conclusion
Wisdom is a complex personality trait with several content domains. The SD-WISE is unique in focusing on commonly cited domains, drawing inspiration from both modern western scientific and ancient eastern religious conceptualizations of wisdom, and defining wisdom in a manner that lends itself well to putative neurobiological models. The SD-WISE may be a useful instrument that could play a role in future studies on wisdom.
Declaration of interest
None to declare.
Funding/support
Research reported in this publication was supported, in part, by NIMH R01 MH094151-05, R01 MH099987-04, and K23 MH102420, a VA Clinical Science Research & Development Award (Career Development Award-2 1IK2CX000938 to KJB), and the Stein Institute for Research on Aging.
Role of funder/sponsor
The funding organizations had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript; and decision
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