Lesson 4: Scientific Studies of Mental Illness and Creativity

What scientific studies have explored the link between creativity and mental illness?

Some Classic Studies – before 1980

Before 1980 many studies did not show a relationship between eminent creativity and mental illness. For example, Terman (1925) studied1000 intellectually gifted people and found they had lower rates of mental illness than non-gifted individuals. In addition, Drevdahl and Cattell (1958) studied 153 American writers and found they did not have higher incidence of psychopathology. However, changes in operational definitions and separating different domains of creativity led to different conclusions after about 1980.

1980-2000

Four classic studies established a correlation between creativity and mental illness.

1) Nancy Andreason (1987) - One of the first studies directly comparing the creativity/mood disorder link was completed by University of Iowa psychiatrist Nancy C. Andreason. She compared 30 creative writers at the University of Iowa with 30 people holding jobs that were not inherently creative. She found that 80% of the writers said they had experienced either manic-depressive illness or major depression, whereas only 30% of the people in noncreative jobs said they had.

2) Kay Redfield Jamison (1989; 1993) is a prominent researcher in this field (see an article she wrote for The Atlantic Links to an external site.. 

Here are some notes on her classic study

–      Studied 47 painters, sculptors, playwrights and poets, all of who had received high honors in their fields.
–      Jamison found that 38% of the artists had been treated for a mood disorder compared to only about 1% of people in the general population.

3. Ludwig’s Biography Research (published 1995)

Arnold Ludwig spent 10 years by reading 2,200 biographies in order to study eminent artists, authors, musicians, scientists and businessmen and women.  Ludwig thought that biographers were less biased because they were unlikely to believe that a person has a mental illness compared to the psychologists who previously conducted studies in this area. Additionally, biographers draw information about their subjects from multiple sources, not just interviews but letters, newspaper articles, etc. His painstaking research concluded that, "members of the artistic professions or creative arts as a whole suffer from more types of mental difficulties and do so over longer periods of their lives than members of the other professions" (1994, p. 4).

To form this conclusion, Ludwig found that between 29 – 34 percent of future artists suffered from symptoms of mental illness as children (in contrast to only 3 – 9 percent of other professional people like scientists). As adults, 59 – 77 percent of artists, writers and musicians suffered mental illness, while only 18 – 2 percent of the other professionals did. Ludwig's findings seemed to confirm Andreasen and Jamison’s findings regarding the link between mental illness and the artistic temperament. Ludwig went on to identify properties of creative individuals.

Eight Properties Creative Individuals (Ludwig)

1. Display special talents or abilities as children
2. Receive support for developing those qualities from parents
3. Harbor an ingrained contrariness and opposition to established beliefs, which frequently antagonizes other people;
4. Possess a capacity for solitude and self-reliance
5. Face physical trials early in life, often a life-threatening illness or physical disability
6. Emblazon their works and achievements with a personal and distinctive style
7. Exhibit an unyielding drive for dominance and supremacy in their chosen discipline
8. Experience a restless, driven state of psychological unease that finds relief through creative problem solving

4) Felix Post (1994) gathered data on 291 eminent personalities from a wide variety of disciplines including science, politics, academics, literature, and the arts. He scored each on a psychopathology index from no psychopathology to severe on 1-4 scale. Post found that 88% of writers had “marked” or “severe” psychopathology. The scientists scored the lowest in psychopathology.

What are main criticisms of the research?

This era of research generally established a connection between creativity and mental illness. However, skeptics have criticized these studies for many reasons. First, Jamison and Andreasen studied very few people. Studies with few people are more likely than large studies to include a group of people that does not accurately represent the population at large. Whereas those studies included few participants and the Ludwig and Post biographies included more observations, many do not agree with Ludwig’s assumption that biographies necessarily contain less bias. For example, a biographer might be more likely to exaggerate the presence of mental illness to sell books or just for a good story. Any time a retrospective design is used there is a chance of misremembering or distortion – whether it is an interview with the person involved or the use of second-hand accounts. Additionally, these studies have the potential for selection bias, that is, the researchers may be more likely to select biographies of individuals who would support, rather than refute underlying hypotheses about creativity and mental illness. All these researchers had a central role in the data collection and interpretation, so it is possible that the researchers were biased when they interpreted the findings.

In summary, research on creativity and mental illness before 2000 faced the following problems:

• Unclear operational definitions of creativity and mental illness
• Small sample sizes
• Selection bias
• Researcher bias (researchers interpreting results were not blind to conditions)
• Reliance on biographies might embellish mental illness
• Retrospective reports

Take a minute to take some notes: What are the 4 studies between 1980-1999 that contributed to our understanding of the link between creativity and mental illness? What were the general conclusions? What are the most serious criticisms? 

Recent Research 2000-present.

Recent research has explored this link further and has included some promising explorations from neuroscience.

Schizophrenia

Recent research on the relationship between mild schizophrenia and creativity has shown that there is a relationship between the particular domain of creativity and the type of schizophrenic symptoms. Specifically, those in artistic fields (such as visual artists, fiction writers, and poets) tend to have significantly more positive symptoms of schizotypy whereas those demonstrating high degrees of creativity in the sciences either tend to have no relationship to symptoms or have significantly higher negative symptoms. For example, Carson (2001) found a relationship between creativity in the arts and positive symptoms of schizotypy, whereas creativity in the sciences did not show this pattern. Later, Burch et al. (2006) found that visual art students specifically had more symptoms of positive schizotypy than non art students. Nettle (2006) included 501 participants from universities and in the general community and found that those with artistic creative interests had higher positive schizotypy compared with those in STEM related fields (science, technology, engineering, mathematics) who had higher rates of negative schizotypy symptoms. Rawlings and Locarnini (2008) found that artists again scored higher in positive symptoms of schizotypy and hypomania compared with scientists who scored higher on negative symptoms of schizotypy.

The most frequent explanations tend discuss the attenuated latent inhibition and hyerconnectivity, which are discussed below. Other explanations have been offered. Nelson and Rawlings (2008), for example, suggested that positive schizotypy symptoms may be associated with ‘flow' experiences Links to an external site..

Mood Disorders

Some of the most consistent findings in the literature center around the link between creativity and mood disorders (specifically bipolar and depression). In a highly regarded study, Kyaga et al (2012) studied over 1 million Swedish individuals and found that those in creative professions had higher rates of bipolar disorder. Also, the authors found that writers specifically had higher rates of major depression. Interestingly, the authors also found that first-degree relatives of people with psychiatric illness were more likely to be in creative professions.

In spite of evidence that mental illness and creativity may be associated in some areas, the reasons for this relationship are not completely known. Some researchers have explored the finding that relatives of people with mental illness were more likely to be highly creative. The following theories were derived from that research.

The upside down U-shaped curve and The Shared Vulnerability Model

It has been hypothesized that the relationship between creativity and psychopathology resembles and upside-down “U.” In other words, as you can see from the graphic, creativity initially increases as symptoms of psychopathology increase. However this is only true up to a point, after which the pattern reverses and creativity decreases as symptoms increase. In cases of severe mental illness, creativity is extremely low.

Shelley Carson calls the relationship between creativity and psychopathology “a dose-dependent relationship” (2014, p. 261). According to Carson and her colleagues (Kinney & Richards, 2014; Takeuchi, et al., 2011; Fink, et al., 2014; Carson, 2014) there are some qualities of mental illness that may enhance creativity. These qualities include attenuated latent inhibition, hyperconnectivity, and novelty seeking.

Attenuated latent inhibition is a reduced capacity to suppress irrelevant stimuli. Latent inhibition is a filtering mechanism; as we perform a task, it is important that we tune out irrelevant thoughts. One well-documented aspect of many forms of mental illness is a reduced (or attenuated) ability to do this tuning out (Takeuchi, et al., 2011; Carson, 2014). It has been found that creative individuals also have attenuated latent inhibition (Carson, 2014).

Hyperconnectivity is when the brain makes unusual connections that are not strictly necessary in context. In other words, the brain is able to make unusual associations. Hyperconnectiviy may relate to the unusual associations often made by those with schizophrenia or bipolar disorder (Whitfield-Gabrieli et al., 2009; McCrea, 2008 Links to an external site.). This pattern of hyperconnectivity is also found with highly creative people (Fink & Benedek, 2013; Mednick, 1962)

Preference for novelty is when a person prefers to seek out new ideas, things, and situations. Research in personality theory demonstrates that highly creative and intelligent individuals have a preference for novelty (McCrae, 1993). However, this is also associated with addiction, schizophrenia, and bipolar disorder (pg. 267).

These 3 factors (attenuated latent inhibition, hyperconnectivity, and preference for novelty) are present in both mentally ill and highly creative individuals. According to the shared vulnerability model, those who are highly creative also have protective factors. These protective factors include higher intelligence, cognitive flexibility and working memory (Carson, 2014).

As discussed in the previous lesson, the relationship between intelligence and creativity is often contested, though it is generally believed that a minimum degree if intelligence is necessary for creativity. For those with mental illness, having a high intelligence mitigates the cognitive symptoms. This intelligence may help them process and interpret the immense amount of stimulation that attenuated latent inhibition, hyperconnectivity, and preference for novelty allow into their mental life. 

In fact, according to Carson (2014) “a combination of attenuated latent inhibition and higher IQ accounted for over 30% of the variance in creative achievement scores.”

As discussed in the chapter on creativity, cognitive flexibility is the ability to see the same stimulus in multiple ways simultaneously. This requires some disengagement from one perspective in order to adopt others. Cognitive flexibility may allow someone with psychosis to disengage from attachment to one perception – for example, of persecution and entertain other ideas. This is the opposite of perseveration, or fixating on one idea which is often a facet of schizophrenic thought.

Working memory is the amount of information/stimulation you can hold in consciousness ant any moment. An enhanced working memory capacity means that you can process a larger amount of information in consciousness. This enhanced working memory capacity may allow creative people to process, rather than become confused by, the stimulation offered by attenuated latent inhibition and hyperconnectivity.

Although people with mental illness and people with creativity may share many factors that make them vulnerable, highly creative people have protective factors that enable them to use these facets to enable creativity rather than mental illness.

Image Source: http://darjadubravcic.wixsite.com/darjad/single-post/2014/10/20/Creativity-you-need-to-be-MAD Links to an external site. 

Take a minute to take some notes: What are the 3 factors that make those with mental illness vulnerable that are shared with people who are highly creative? What are the 3 protective factors? How do the vulnerability factors contribute both to creativity and to mental illness? How do the protective factors mitigate these effects?

 

Does the type of Creativity Matter?

When it comes to mental illness the type of creativity does matter. As noted above, more artistic types tend to have more significant positive symptom of schizotypy whereas more scientific types tend to experience more negative symptoms. In many studies, such as the Kyanga et. al. study discussed above, writers admit to more symptoms of mood disorders compared to those in other creative professions. Even within specific domains there are differences. For example, Kaufman (2001) found that poets (female poets in particular) were more likely than any other type of writer, including fiction/nonfiction writers and playwrights, to have a history of suicide attempts and psychiatric hospitalizations (a term he dubbed ‘the Sylvia Plath effect’). Kaufman (2013) also wrote that Big-C Creativity is much more associated with symptoms of mental illness whereas little-c creativity tends to be helpful in mitigating symptoms of stress and depression (which we will discuss in the next chapter).

It should be clear that there are many examples of eminently creative individuals who do not seem to suffer from any form of mental illness. There are certainly correlations but beware of drawing causal conclusions. Biases like the availability heuristic and romantic notions make this connection very appealing. We often get sidetracked by the statistical differences; for example, in a study by Kaufman in 2000, Nobel and Pulitzer prize winners were shown to have significantly higher incidents of mental illness than non-winners. However, the incidence of mental illness itself was always low and never reached 50%. It certainly never reached 100%.

Of course - always beware of causal conclusions! When considering research on mental illness and creativity, consider the following: 

• Are artistic communities are more accepting of mental illness?
• Does the type of Creativity Matter? 

• Potential for selection bias
• Controls that are not blinded
• Reliance on biographies that might play up mental illness
• Retrospective designs
• Unclear operational definitions of creativity and mental illness

Conclusion: Though relationships between mental illness and creativity exist:mental illness is neither necessary nor sufficient for eminent creativity

But enough about linking creativity to maladaptive behaviors. There is also evidence that creativity can enhance life in SO many ways! Let's look at that next. But don't forget to quiz yourself on this material!  

TEST YOUR KNOWLEDGE:  Can Creativity Hurt? Three Minute 

Quiz and Matching Mental Illness Lesson

 

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