Letters To The Editor delirium over time. Thus, what the study results suggest is that the evolution over longer periods of time of delirium depends in part on the initial state (Markov states). Delirium may be a fluctuating state within both the micro-temporal and macro-temporal time frame. Our findings hint— although they do not prove this—at the possibility that a fractal dimension underlies the time course of delirium, which is a further step to be taken for scientific research on delirium. Armin von Gunten, M.D., M.Phil. Service of Old Age Psychiatry Department of Psychiatry Centre Hospitalier Universitaire Vaudois and University of Lausanne Lausanne, Switzerland Urs Peter Mosimann, M.D., Ph.D. Department of Old Age Psychiatry University Hospital of Psychiatry University of Bern Bern, Switzerland Jean-Philippe Antonietti, Ph.D. Institute of Psychology Geopolis University of Lausanne Lausanne, Switzerland References 1. Dosa D, Intrator O, McNicoll L, et al: Preliminary derivation of a nursing home confusion assessment method based on data from the minimum data set. J Am Geriatr Soc 2007; 55:1099e1105 2. Morris JN, Fries BE, Mehr DR, et al: MDS Cognitive Performance Scale. J Gerontol 1994; 49:M174eM182
Measuring Wisdom TO THE EDITOR: I welcome the recent article by Bangen and colleagues1 that reviewed definitions and measurement
Am J Geriatr Psychiatry 22:4, April 2014
approaches to wisdom. As noted by several authors, wisdom is an ancient topic currently enjoying an academic renaissance in part because its development and manifestation has profound implications for societal harmony and individual psychosocial health. Given Bangen et al.’s emphasis on rigor and precision in discussing this complex topic, the following factual and empirical points are important to clarify. First, the authors state that, aside from two approaches developed in Germany and Greece, “all measures were developed in the United States” (p 1256). In point of fact, this is incorrect. The Self-Assessed Wisdom Scale (SAWS2,3) was developed in Vancouver, Canada. This is an important point because it speaks to additional issues that the authors raise later in their article, namely, the cultural homogeneity of many samples used in scale construction. Again, the SAWS is an exception to this general trend as many participants identified as other than Caucasian; large numbers are Chinese and IndoCanadian, with several additional cultures represented. Second, outside a generic limitation assumed to be relevant to all questionnaires, the authors identify a single possible limit of the SAWS, which essentially contradicts statements made in an earlier paper.4 Specifically, Bangen et al.1 state that two factors of the SAWS (i.e., openness to experience, and humor) may be predictors or consequences of wisdom rather than essential elements. This is inconsistent with Jeste et al.,4 who found that both
of these two dimensions were rated by wisdom experts as distinct from both intelligence and spirituality, and integral to wisdom itself. Jeste et al. note further that four “additional items that were considered by the experts as more descriptive of wisdom than of intelligence or spirituality (emotional regulation, openness to new experiences, sense of humor, and maturity gained with experience) overlap with Webster’s2 Self-Assessed Wisdom Scale” (p 677). Moreover, a recent review of wisdom measures5 found that humor was an important element of wisdom missing from the majority of wisdom approaches. Third, it is important to be more precise when discussing the potential for social desirability in questionnaire measures of wisdom. Many reviews, including Bangen et al.,1 lump all questionnaire measures together, when in fact the SAWS has been shown not to be associated with social desirability. As noted by the authors, we are making great strides towards defining and measuring wisdom. Some of the shortcomings identified are currently being addressed and scales continue to accrue validity and reliability information. Webster et al.,3 using a large, lifespan sample of Dutch adults, illustrates developmental differences and nuanced associations with hedonistic and eudaimonic wellbeing. Although certainly not without its limitations, the SAWS appears to be one measure of wisdom with established psychometric properties and promise for future work, perhaps as an
421
Letters To The Editor outcome measure of the clinical work suggested by the authors. Jeffrey Dean Webster, M.Ed. Psychology Department Langara College Vancouver, Canada e-mail: [email protected] References 1. Bangen KJ, Meeks TW, Jeste DV: Defining and assessing wisdom: a review of the literature. Am J Geriatr Psychiatry 2013; 21: 1254e1266 2. Webster JD: Identity, wisdom, and critical life events in young adults, in Positive Psychology: Advances in Understanding Adult Motivation. Edited by Sinnott J. New York, Springer, 2013, pp 61e77 3. Webster JD, Westerhof GJ, Bohlmeijer ET: Wisdom and well-being across the lifespan. J Gerontol B Psychol Sci Soc Sci 2014; 69: 209e218 4. Jeste DV, Ardelt M, Blazer D, et al: Expert consensus on characteristics of wisdom: a Delphi method study. Gerontologist 2010; 50(5):668e680 5. Gluck J, Konig S, Naschenweng K, et al: How to measure wisdom: content, reli-
422
ability, and validity of five measures. Front Psychol 2013; 4:405
Response to Webster’s Letter to the Editor
experience, which were two of the nine components that we found to be common to several definitions of wisdom. Finally, the SAWS has been shown to not be associated with social desirability.
TO THE EDITOR: We thank Dr. Webster for pointing out some inaccuracies as well as making suggestions for useful additions to our review of definitions of and measurement instruments for assessing wisdom.1 We apologize for the errors noted. Accordingly, we are inserting the following addendum to the online version of our article: We want to make a few corrections to our article. The Self-Assessed Wisdom Scale (SAWS)2,3 was developed in Canada, and involved samples representing several cultures including large numbers of Chinese Canadian participants. The SAWS included the domains of humor and openness to new
Katherine J. Bangen, Ph.D. Thomas W. Meeks, M.D. Dilip V. Jeste, M.D. University of California, San Diego e-mail: [email protected]
References 1. Bangen KJ, Meeks TW, Jeste DV: Defining and assessing wisdom: a review of the literature. Am J Geriatr Psychiatry 2013; 21:1254e1266 2. Webster JD, Westerhof GJ, Bohlmeijer ET: Wisdom and well-being across the lifespan. J Gerontol B Psychol Sci Soc Sci 2012; Dec 28 [Epub ahead of print] 3. Webster JD: Measuring the character strength of wisdom. Int J Aging Hum Dev 2007; 65:163e183
Am J Geriatr Psychiatry 22:4, April 2014
Measuring Wisdom TO THE EDITOR: I welcome the recent article by Bangen and colleagues1 that reviewed definitions and measurement
Am J Geriatr Psychiatry 22:4, April 2014
approaches to wisdom. As noted by several authors, wisdom is an ancient topic currently enjoying an academic renaissance in part because its development and manifestation has profound implications for societal harmony and individual psychosocial health. Given Bangen et al.’s emphasis on rigor and precision in discussing this complex topic, the following factual and empirical points are important to clarify. First, the authors state that, aside from two approaches developed in Germany and Greece, “all measures were developed in the United States” (p 1256). In point of fact, this is incorrect. The Self-Assessed Wisdom Scale (SAWS2,3) was developed in Vancouver, Canada. This is an important point because it speaks to additional issues that the authors raise later in their article, namely, the cultural homogeneity of many samples used in scale construction. Again, the SAWS is an exception to this general trend as many participants identified as other than Caucasian; large numbers are Chinese and IndoCanadian, with several additional cultures represented. Second, outside a generic limitation assumed to be relevant to all questionnaires, the authors identify a single possible limit of the SAWS, which essentially contradicts statements made in an earlier paper.4 Specifically, Bangen et al.1 state that two factors of the SAWS (i.e., openness to experience, and humor) may be predictors or consequences of wisdom rather than essential elements. This is inconsistent with Jeste et al.,4 who found that both
of these two dimensions were rated by wisdom experts as distinct from both intelligence and spirituality, and integral to wisdom itself. Jeste et al. note further that four “additional items that were considered by the experts as more descriptive of wisdom than of intelligence or spirituality (emotional regulation, openness to new experiences, sense of humor, and maturity gained with experience) overlap with Webster’s2 Self-Assessed Wisdom Scale” (p 677). Moreover, a recent review of wisdom measures5 found that humor was an important element of wisdom missing from the majority of wisdom approaches. Third, it is important to be more precise when discussing the potential for social desirability in questionnaire measures of wisdom. Many reviews, including Bangen et al.,1 lump all questionnaire measures together, when in fact the SAWS has been shown not to be associated with social desirability. As noted by the authors, we are making great strides towards defining and measuring wisdom. Some of the shortcomings identified are currently being addressed and scales continue to accrue validity and reliability information. Webster et al.,3 using a large, lifespan sample of Dutch adults, illustrates developmental differences and nuanced associations with hedonistic and eudaimonic wellbeing. Although certainly not without its limitations, the SAWS appears to be one measure of wisdom with established psychometric properties and promise for future work, perhaps as an
421
Letters To The Editor outcome measure of the clinical work suggested by the authors. Jeffrey Dean Webster, M.Ed. Psychology Department Langara College Vancouver, Canada e-mail: [email protected] References 1. Bangen KJ, Meeks TW, Jeste DV: Defining and assessing wisdom: a review of the literature. Am J Geriatr Psychiatry 2013; 21: 1254e1266 2. Webster JD: Identity, wisdom, and critical life events in young adults, in Positive Psychology: Advances in Understanding Adult Motivation. Edited by Sinnott J. New York, Springer, 2013, pp 61e77 3. Webster JD, Westerhof GJ, Bohlmeijer ET: Wisdom and well-being across the lifespan. J Gerontol B Psychol Sci Soc Sci 2014; 69: 209e218 4. Jeste DV, Ardelt M, Blazer D, et al: Expert consensus on characteristics of wisdom: a Delphi method study. Gerontologist 2010; 50(5):668e680 5. Gluck J, Konig S, Naschenweng K, et al: How to measure wisdom: content, reli-
422
ability, and validity of five measures. Front Psychol 2013; 4:405
Response to Webster’s Letter to the Editor
experience, which were two of the nine components that we found to be common to several definitions of wisdom. Finally, the SAWS has been shown to not be associated with social desirability.
TO THE EDITOR: We thank Dr. Webster for pointing out some inaccuracies as well as making suggestions for useful additions to our review of definitions of and measurement instruments for assessing wisdom.1 We apologize for the errors noted. Accordingly, we are inserting the following addendum to the online version of our article: We want to make a few corrections to our article. The Self-Assessed Wisdom Scale (SAWS)2,3 was developed in Canada, and involved samples representing several cultures including large numbers of Chinese Canadian participants. The SAWS included the domains of humor and openness to new
Katherine J. Bangen, Ph.D. Thomas W. Meeks, M.D. Dilip V. Jeste, M.D. University of California, San Diego e-mail: [email protected]
References 1. Bangen KJ, Meeks TW, Jeste DV: Defining and assessing wisdom: a review of the literature. Am J Geriatr Psychiatry 2013; 21:1254e1266 2. Webster JD, Westerhof GJ, Bohlmeijer ET: Wisdom and well-being across the lifespan. J Gerontol B Psychol Sci Soc Sci 2012; Dec 28 [Epub ahead of print] 3. Webster JD: Measuring the character strength of wisdom. Int J Aging Hum Dev 2007; 65:163e183
Am J Geriatr Psychiatry 22:4, April 2014
