(for professional readers, and very interested test-takers)
Foundation in Theory and Research:
THE HISTORY AND SCIENCE BEHIND THE APW
How and Why the TAW Evolved as it Has
The APW evolved from an older test written in 1969 by Dr. William Backus at the University of Minnesota1. Under the supervision of a former American Psychological Association president, his test measured seven personality traits that were considered unhealthy (vanity, envy, resentment, greed, laziness, lust, and gluttony - the seven deadly sins). He called it the Sinful Attitudes Inventory, and his research indeed found many statistically significant correlations between these traits and mental health. People scoring high on these traits were significantly more likely to be mentally ill, and vice versa. Dr. Backus decided not to publish his test because of its religious intonations. But he encouraged and assisted Dr. Schmidt in developing a more extensive test for publication, the Character Assessment Scale (CAS)2.
The CAS was published in 1981, measuring the same seven traits which Dr. Backus had examined, and had proven to be connected with various mental disorders. It added scales for healthy attitudes that would counteract the seven toxic ones, plus an eighth pair of traits that also affect health (honesty versus denial). It was normed on 600 people from all 50 states and all seven Canadian provinces. The following year it was presented to the American Psychological Association convention in Los Angeles.3 Three decades later, it was described in the APA Handbook of Testing and Assessment in Psychology4. It was sold at cost to people in thirteen countries in four continents, and then sold out of its second printing.
The CAS remains out of print, but its best performing items were kept for a newer instrument, the Traditional Assessment of Wellness. The TAW measured all eight of the CAS’ pairs of traits, plus a ninth health asset, peace: fear versus faith. The best items of the CAS were used or slightly revised for the TAW. These items were the ones most consistent with the other questions designed to measure the same things. After this test was given online to some of Dr. Schmidt’s clients and friends, the hosting service for the test (LimeSurvey in Germany) was unable to make requested changes in the test. So it was taken back off-line, and independent software programmers (four in three years) were hired to put the test back online in a more secure and user-friendly form.
In September of 2023, the Traditional Assessment of Wellness (TAW) was renamed. The term "Traditional" had been politicized, and came to be associated with socially conservative beliefs and values. Likwise the term "Wellness" had become commercialized by the healthcare industry, and associated with physical health in general, and more precisely, with merely the lack of physical symptoms. To describe its broader scope, the TAW was renamed the Assessment of Personal Well-being. The APW presents questions online, and gives test results back immediately through email. It can be taken through our secure, encrypted portal here at mynewlife.com.
Why does the APW measure these nine particular pairs of wellness traits?
- They are characteristics of personal well-being. The APW doesn’t measure what the healthcare and wealthcare industries measure, or what the health and wealth gospel promotes, namely, the current powers of one’s body or bank account. Nor does it measure the healthiness of the heart, mind, or libido that depend on your bodies, or the marriages or families that depend on the bank account. Rather, the APW measures the healthiness of individual people who are taking care of all these things. To religion, it’s the mortal soul. To psychology, it’s the executive ego. To philosophy, it’s the true self. We all experience this as the part of us that chooses what we pay attention to.
- They make practical, common sense. The general definition of wellness behind the APW is whatever does the most good and the least harm to all people in the long run. It sees people not only as individuals, but as members of families, societies, and “tribes”. It teaches the universal and obvious truth that you reap what you sow. Karma comes back to us. Treating others as you need to be treated takes care of individuals and society, by loving others and loving ourselves. As both sickness and wellness can be “caught” from others, in the long run, we can’t afford to take away their health, or make them sick.
- The nine issues cover common causes for patient noncompliance with medical directives. There is now no widely used or accepted measure for predicting and improving medical compliance. In their 2020 review of the literature on compliance, Kardas et al.5 concluded: “Despite half a century of dedicated studies, medication adherence remains far from perfect, with many patients not taking their medications as prescribed. The magnitude of this problem is rising, jeopardizing the effectiveness of evidence-based therapies.” The same is true for diet, exercise, masking, physical therapy, and other health-related behaviors. The APW should be quite useful for addressing the problem of compliance.
- They contrast attitudes of overflowing fullness with those of insatiable hunger. Nine assets among others can be experienced and expressed in either healthy or unhealthy ways, as a creator or as a creature: truth, peace, respect, love, mercy, sexuality, money, purpose, and bodily health. Healthy people believe they draw their health from wellsprings inside and around them, so helping others live healthier lives just seems to make them stronger. By contrast, unhealthy people have a natural craving for more of these experiences, seeing themselves as taking these foods for the soul from other souls through manipulation. This sets them against other people, and over time they need to take more and more. This competitive approach seems to corrode their imaginary leaking containers for holding onto these nine life resources.
- They have been taught all over the world for over 30 centuries, so they have stood the tests of time and space. 10 centuries before Christ, King Solomon called together in Jerusalem wise men and women from all over the known world, to teach and learn from each other. Solomon taught Jewish people about all these traits. These are recorded in the book of Proverbs in the Bible, and passages from this book are included in the Devotional Studies WELL has written for each of the nine assets. According to Harvard professor Morton Bloomfield,6 all the same traditional ideas had appeared 500 years later, in the writings of Persian poets and wisemen, Egyptian mystics and scholars, and Zoroaster, a mysterious but influential teacher sometimes known as Zarathustra. The battle between good/lively versus bad/deadly traits is the central theme in the widespread ancient story of the Soul Journey, and these traits are among the most commonly included in that story. Bloomfield showed that this story also started 2500-3000 years ago with Judaic, Persian, Babylonian, and Greek influences, and then became prevalent in the western world. 1500 years after Solomon, these pairs of traits had become officially sanctioned by Christianity in Rome. Similar lists of nourishing vs. poisonous foods for the soul were being taught in China and Tibet in Confucian and Taoist traditions.7 All these 18 traits are still widely discussed today, throughout all cultures of the world. Six of the nine issues the APW measures are mentioned in a summary of how health and wellbeing is now being understood in India.8
- These nine pairs of traits are a hybrid of both religious and secular wisdom. The secular philosophy of the common good teaches that what is good for one is good for all, and vice versa. This was first taught in Greece by Aristotle, then in Renaissance Europe by Rousseau and Locke, and later by modern Islamic scholars. More recently, when people do their fourth steps, seven of these nine pairs of traits are required to be inventoried by all members of AA and most other 12-step groups.
- Religious wisdom: Whenever the Bible gives major guidance and laws for how to live, it says clearly that they are given to inspire healthy wellbeing. They instruct people to bless others and themselves, not just now but in the long run. These teachings came from Moses in Deuteronomy 6, Solomon throughout Proverbs, Jesus in the sermon on the mount (Matthew 5: 3-9, 6:25-34, and 7:7-12), and Paul in Colossians 3. An annotated bibliography, shows where teachings of the APW and WELL are found throughout the Bible.
- Science needs a way to measure the sickness and wellness of a person. Michael Bishop in 2015 reviewed over 200 wellness resources. He concluded that both philosophy and psychology have found no widely accepted way to define or measure wellness.20 In a more recent international review of wellness literature (86 references cited in October 2019), Matthew Fisher in Australia came to the same conclusion.21 Both Fisher and Bishop recommended that theory and research develop a network of causally related and behaviorally measurable traits, and that is just what the APW has done.
- A review of coaching literature found no dominant theory or model to guide health and wellness coaches.22 In 2020, an excellent journal review of wellness theory and research compared in detailed charts the features, strengths, and weaknesses of six models, each with its own test.23 The authors concluded that each model and test had its merits and limitations, but they found “no gold standard” (p.6). “Current scales need additional research to support use with varying populations” (p.8). WELL is seeking to extablish separate norms for different ages, genders, nationalities, cultures, and perhaps religious faiths.
- Research with the CAS (the earlier version of the APW) first revealed the causal relationships shown in the WELL model flowchart.11 That test measured healthy and unhealthy ways to use eight of the nine issues the APW examines. Of the 300 intercorrelations between the scales, every single one was in the expected direction: changes in any unhealthy trait came along with similar changes in all the other toxic patterns (mindsets and lifestyles). The same positive correlations were observed between healthy traits (beliefs and habits). And every unhealthy trait was negatively correlated with every healthy trait measured, showing that the healthy mindsets and lifestyles were working actively against the toxic ones, and vice-versa. These relationships were so strong that 294 of the 300 intercorrelations were significant beyond the probability level of .001. That showed there was only 1 chance in 1000 that these qualities weren't working together in tandem toward the same effects common to all their trait definitions: freedom, growth, and life versus bondage, decay, and death. These findings were validated by asking the 600 people who took the test to express before knowing their scores which of the eight issues they believed they were having the most problems with. The same question about them was asked of their counselors. The test scores accurately predicted the issues people thought were their healthiest and most unhealthy issues, and also what their counselors thought their highest and lowest scores would be (both these similarities were beyond the .0001 level of significance). In a 2022 review of over 1500 studies on health and well-being, psychologist Dr. Meetu Khosla described the existing measures of wellness.12 None of the tests he reviewed were noted to be more comprehensive, useful, or popular than the others, and therfore he cited the need for a “broad multidimensional inventory.” At the end of his review of all the research to date on wellness, he concludes: “Health psychologists need to work in collaboration with other disciplines, such as social sciences, medical sciences and economics to develop strategies with a more holistic appeal and significance.” WELL and the APW are following that recommendation. Even more recently in 2023, three authors reviewed over 75 studies over 30 years, and concluded that healthy mindsets such as “life satisfaction, positive affect, purpose/meaning in life, and optimism are each associated with better physical health”.13 Traditionally observed lifestyles such as religious service attendance, spiritual problem-solving habits, religious orientation, and prayer have been associated with better health outcomes. The authors called for more experimental designs proving causation, using a wider variety of beliefs and habits studied over longer periods of time with a wider variety of cultures around the world. Open research using the Creative Commons copyright of the APW is designed to realize these hopes. Also this same year, Edward Shafranske summarized over 11,000 articles published over the past 20 years on the relationship between mental health and the positive mindsets and lifestyles that have traditionally been associated with religion and spirituality.14 These studies found conflicting positive and negative relationships with religion/spirituality and mental health. Shafranske recognized that unhealthy forms religion and spirituality have produced unhealthy mental health outcomes, but he did not identify or discuss unhealthy mindsets, lifestyles, or outcomes. WELL has planned to study all this with data from the APW. Shafranske clarified that “positive psychology reflects a secular approach in which positive emotions . . . and the cultivation of virtues promote well-being to achieve optimal human functioning” [health].15 Religion and spirituality on the other hand “anchor well-being [mindsets] and flourishing [lifestyles] in the search for the sacred”[brackets added]. At the conclusion of his article, Schafranske provided an excellent dynamic “conceptual model of religious/spiritual pathways to well-being and mental health” (Figure 22.1, p. 353). This model meshes nicely with the dynamic flowchart being used by WELL. Both models cover issues the other doesn’t, and the areas of overlap are presented in different but compatible ways. Another 2023 literature review to demonstrate the strong positive relationship between moral character and health found that in decades of studies, strengths of character were reliably found along with better physical fitness, life satisfaction, subjective sense of wellbeing, and generally better physical and mental health.16 The reviewers’ own research with 1200 subjects found that those reporting traditional moral beliefs and lifestyles (helping others, delayed gratification, promoting cooperation) not only reported better life satisfaction over two years, but filed significantly fewer health insurance claims during that time. The most comprehensive review of theory and research on what the APW is measuring is the Handbook of Positive Psychology, Religion, and Spirituality (2023).17 In their concluding 31st chapter, the authors recognize that “religious mechanisms have helped people cultivate virtues and well-being for millennia – through historic religious practices, guided by historic religious texts, and nurtured in historic religious traditions and communities” (p.496). The authors specifically call for research that will be more cross-sectional, cross-cultural, and longitudinal, using better experimental designs that will demonstrate cause and effect. They agree with Linley et al18 that the primary research need is for more studies about “wellsprings”, which might include individual genetics and temperament and contributions of relationships and culture. They mention six domains which have the greatest potential for doing the most good for the most people over time. WELL already has written plans to impact all six: clinical practice, religious ministry, character education, organizational settings, humanitarian and disaster contexts, and public health.
- The wellness mindset grows by believing in a supernaturally loving God who indwells people and groups that seek this indwelling power. Seeing God this way as a creative source for life, health, freedom, and wellness helps people experience life as flowing from inner and outer wellsprings of healthy habits and beliefs. Trusting in a stronger, higher power for healthy life reduces the fear of decay, disease, bondage, and death. By contrast, believing that the greatest supernatural power in the universe is impersonal, distant, uncaring, controlling, hateful, or destructive inspires unhealthy attitudes and habits. Such beliefs and habits have been referred to as illsprings. Peterson and Seligman founded a popular movement of positive psychology.19 They impressively demonstrated which traits throughout history had been most frequently believed to produce mental health, and then began to measure them. They originally studied five key virtues: wisdom (creativity, open-mindedness, love of learning, perspective), courage (bravery, persistence, integrity, vitality), humanity (love, kindness, social intelligence), justice (citizenship, fairness, leadership), and temperance (forgiveness, humility, prudence, self-regulation). But in time they changed their theory to add a sixth “character strength” as they called them, transcendence (gratitude, hope, humor, spirituality, and appreciation of beauty, “strengths that forge connections to the larger universe and provide meaning.”). This demonstrated the healing benefits of believing one has indwelling higher powers, especially a benign, divine being who inspires healthiness without taking away the experience of free choice. WELL’s long-term research project here with the APW will investigate this theoretical assertion, among many others. Positive psychology is a major aspect of personal well-being.
- Peterson and Seligman's excellent study of history and culture reveals hybrid definitions of traits that bridge philosophy, psychology, religion, and science. Our research here with the APW follows that lead, using the same 5-point Likert scale for our items. WELL is building on this excellent work, and going beyond it, in three key ways.
- First, we are also looking at negative psychology. We are investigating toxic beliefs and habits that actively undermine positivity and health. We see and study illness as more than the absence of health/strength. Whereas Backus only studied sickening traits with his Sinful Attitudes Inventory, Peterson and Seligman have mostly studied healthy ones. WELL is doing both.
- Secondly, the APW can filter out the effects of social desirability bias. Whether intentionally or subconsciously, some people try to present themselves as more healthy than they really are. The intentional motive to misrepresent is minimized by the anonymous nature of the test. No one will know respondents’ results unless respondents disclose them. And as the forerunning CAS did, some of the questions have been designed to measure and correct for social desirability. It will take a year or two for this correction formula to accurately adjust all the APW’s 30 scores, but for now, the APW’s Denial scale directly measures people's desires to make themselves look good on this test.
- And thirdly, we describe natural assets that are universally needed, and can be experienced in healthy or unhealthy ways. This gives us a dynamic model that shows cause and effect. It portrays the flow of life and death in people and organizations, based on whether they are creating or consuming these nine natural life-giving resources. When WELL researches sensitive issues such as religious belief and practice, two of our core values should help us shed considerable light on such questions. With “Scientific Integrity, we validate truth and demonstrate its practical applications by careful experimental design and literature review that avoid filter bias in what we learn and what we teach.” Likewise with “Cross-validation,we seek and validate truth through multiple wisdom streams, such as scripture and prayer, historical inquiry, scientific research, objective journalism, life stories, and common sense.” What else does this project study, and what other sensitive subjects? WELL is measuring the effects of 18 demographic variables. Spiritual beliefs and religious loyalties are two among these others: age, gender, relational status, physical health, mental health, financial health, educational level, type of occupation, geographical location, and political philosophies. We look forward to learning how these factors can work in favor of some people’s personal health while they may undermine others, depending on the somewhat chosen mindsets and lifestyles which the APW is measuring.
In responsive agreement with all these summaries and recommendations, the Assessment of Personal Well-being stands on decades of theory and research. Its scale norms will soon be based on a large number of respondents now being gathered from around the world. The traits it measures are causally related to each other, and to demographic variables we are studying. We are seeking an academic research partner, preferably at a nearby university, to conduct the primary research with our growing data base. It will have a seat or two on WELL Inc.’s board of directors, and one faculty member will serve as the director of research and technology. Statistical analyses will be objective and rigorous, designed to be worthy of publication in juried professional journals. Data for the APW pilot study are being gathered now from all over the world, to establish norms that are cross-sectional, cross-cultural, and based on a very large criterion population.