TY - JOUR
PY - 2020//
TI - Outcomes of randomized clinical trials of interventions to enhance social, emotional, and spiritual components of wisdom: a systematic review and meta-analysis
JO - JAMA Psychiatry
A1 - Lee, Ellen E.
A1 - Bangen, Katherine J.
A1 - Avanzino, Julie A.
A1 - Hou, BaiChun
A1 - Ramsey, Marina
A1 - Eglit, Graham
A1 - Liu, Jinyuan
A1 - Tu, Xin M.
A1 - Paulus, Martin
A1 - Jeste, Dilip V.
SP - ePub
EP - ePub
VL - ePub
IS - ePub
N2 - 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.
Language: en
LA - en SN - 2168-622X UR - http://dx.doi.org/10.1001/jamapsychiatry.2020.0821 ID - ref1 ER -